Examinando por Autor "Vergara-Merino, Laura"

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    Intravitreal antivascular endothelial growth factor in diabetic macular oedema: scoping review of clinical practice guidelines recommendations
    (Bmj, 2021) Vargas-Peirano, Manuel; Verdejo, Catalina; Vergara-Merino, Laura; Loézar, Cristóbal; Hoehmann, Martín; Pérez-Bracchiglione, Javier
    Background Diabetic macular oedema (DME) is a, worldwide major cause of low vision and blindness. Intravitreal antivascular endothelial growth factor (anti-VEGF) constitutes an effective treatment. linical practice guidelines (CPGs) are synthesis documents that seek to improve patient care. Objectives To identify CPGs that make anti-VEGF recommendations for DME and to assess their reporting quality and their considerations when making recommendations. Eligibility criteria CPGs published between December 2009 and December 2019 that make explicit anti-VEGF recommendations in DME. Sources of evidence Sensitive search strategy in Embase, Google Scholar and hand-searching on 165 websites. Methods We extracted information from each CPG with a previously piloted sheet. Two independent authors applied theAppraisal of Guidelines, Research and Evaluation tool (AGREE-II) assessment for each CPG. Results The 21 included CPGs recommend anti-VEGF for DME, but there is a wide variation among the clinical aspects included, such as location of DME, visual acuity required, therapeutical alternatives or discontinuation. Most have a poor quality of reporting based on the AGREE-II tool assessment, especially those developed by ophthalmological societies, those that have an exclusive content about DME, and those where most of their authors disclose conflict of interest (COI) with pharmaceutical industry or where their authors did not report COIs. Pharmaceutical-sponsored CPGs did not use systematic reviews (SRs) to support their recommendations. Very few recommendations consider patient values and preferences, equity, acceptability and feasibility of the intervention. Conclusions Most of the CPGs that made recommendations of anti-VEGF for DME have poor quality of reporting, do not use SRs and do not consider patients’ values and preferences.
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    Maternal and perinatal outcomes related to COVID-19 and pregnancy: An overview of systematic reviews
    (Wiley, 2021) Vergara-Merino, Laura; Meza, Nicolás; Couve-Pérez, Constanza; Carrasco, Cynthia; Ortiz-Muñoz, Luis; Madrid, Eva; Bohorquez-Blanco, Sandra; Pérez-Bracchiglione, Javier
    Introduction: Evidence about coronavirus disease 2019 (COVID-19) and pregnancy has rapidly increased since December 2019, making it difficult to make rigorous evidence-based decisions. The objective of this overview of systematic reviews is to conduct a comprehensive analysis of the current evidence on prognosis of COVID-19 in pregnant women. Material and methods: We used the Living OVerview of Evidence (L·OVE) platform for COVID-19, which continually retrieves studies from 46 data sources (including PubMed/MEDLINE, Embase, other electronic databases, clinical trials registries, and preprint repositories, among other sources relevant to COVID-19), mapping them into PICO (population, intervention, control, and outcomes) questions. The search covered the period from the inception date of each database to 13 September 2020. We included systematic reviews assessing outcomes of pregnant women with COVID-19 and/or their newborns. Two authors independently screened the titles and abstracts, assessed full texts to select the studies that met the inclusion criteria, extracted data, and appraised the risk of bias of each included systematic review. We measured the overlap of primary studies included among the selected systematic reviews by building a matrix of evidence, calculating the corrected covered area, and assessing the level of overlap for every pair of systematic reviews. Results: Our search yielded 1132 references. 52 systematic reviews met inclusion criteria and were included in this overview. Only one review had a low risk of bias, three had an unclear risk of bias, and 48 had a high risk of bias. Most of the included reviews were highly overlapped among each other. In the included reviews, rates of maternal death varied from 0% to 11.1%, admission to intensive care from 2.1% to 28.5%, preterm deliveries before 37 weeks from 14.3% to 61.2%, and cesarean delivery from 48.3% to 100%. Regarding neonatal outcomes, neonatal death varied from 0% to 11.7% and the estimated infection status of the newborn varied between 0% and 11.5%. Conclusions: Only one of 52 systematic reviews had a low risk of bias. Results were heterogeneous and the overlap of primary studies was frequently very high between pairs of systematic reviews. High-quality evidence syntheses of comparative studies are needed to guide future clinical decisions.
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    Registered trials address questions already answered with high-certainty evidence: A sample of current redundant research
    (Elsevier, 2021) Vergara-Merino, Laura; Verdejo, Catalina; Ariel Franco, Juan Victor; Escobar Liquitay, Camila; Urrútia, Gerard; Klabundea, Rachel; Pérez, Paulina; Sánchez, Luna; Madrid, Eva
    Objective. To identify clinical trials registered later than 2015, that study the effect of an intervention on a primary outcome whose “Certainty of Evidence” (CoE) has already been rated “high” in a Cochrane SR. Study Design and Setting. We searched the Cochrane Library for all SRs from 2015. We analyzed SRs of interventions and excluded withdrawn reviews or those with no Summary of Findings (SoF) table. We retrieved the GRADE CoE ratings of each SR's primary outcomes in the SoF tables and identified those rated “high.” We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials to identify records of clinical studies that tackled those outcomes and were registered after the date of publication of the respective 2015 SR. Results. We selected 602 SRs. Eighty-one contained a “high” CoE rating on at least one primary outcome, totaling 152 primary outcomes rated “high.” We found 39 clinical trials registered for primary outcomes with evidence already rated as “high” in a 2015 Cochrane SR. Conclusion. This study shows the existence of clinical trials registered to study primary outcomes whose CoE has already been rated “high” in a Cochrane SR.
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    Revisiones rápidas: definiciones y usos
    (2021) Tapia-Benavente, Luis; Vergara-Merino, Laura; Garegnani, Luis Ignacio; Ortiz-Muñoz, Luis; Loézar Hernández, Cristóbal; Vargas-Peirano, Manuel
    Este artículo es el primero de una serie metodológica colaborativa de revisiones narrativas sobre temáticas de bioestadística y epidemiología clínica. El objetivo de esta revisión es presentar las revisiones rápidas, compararlas con las revisiones sistemáticas y mencionar su uso actual. Las revisiones rápidas utilizan una metodología similar a las revisiones sistemáticas, pero mediante atajos utilizados en su desarrollo; permiten alcanzar respuestas en menos de seis meses y con menos recursos, por lo que son utilizadas por tomadores de decisiones tanto en América como Europa. No existe consenso sobre cuáles atajos tienen menor impacto en la confiabilidad de las conclusiones, por lo que las revisiones rápidas son heterogéneas entre sí. Los consumidores deben identificar estos atajos en la metodología y ser precavidos en la interpretación de las conclusiones, aunque generalmente alcanzan respuestas concordantes con las obtenidas mediante una revisión sistemática tradicional. Su principal atractivo es ajustarse a las necesidades de los tomadores de decisiones en salud, cuando el contexto exige respuestas en plazos de tiempo acotados.
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    What you need to know about scoping reviews
    (2021) Verdejo, Catalina; Tapia-Benavente, Luis; Schuller-Martínez, Bastián; Vergara-Merino, Laura; Vargas-Peirano, Manuel; Silva-Dreyer, Ana María
    he increasing amount of evidence has caused an increasing amount of literature reviews. There are different types of reviews —systematic reviews are the best known—, and every type of review has different purposes. The scoping review is a recent model that aims to answer broad questions and identify and expose the available evidence for a broader question, using a rigorous and reproducible method. In the last two decades, researchers have discussed the most appropriate method to carry out scoping reviews, and recently the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ for scoping reviews (PRISMA-ScR) reporting guideline was published. This is the fifth article of a methodological collaborative series of narrative reviews about general topics on biostatistics and clinical epidemiology. This review aims to describe what scoping reviews are, identify their objectives, differentiate them from other types of reviews, and provide considerations on how to carry them out.