González De Dios J
Departamento de Pediatría, Hospital Universitario San Juan, Facultad de Medicina, Universidad Miguel Hernández, Alicante.
An Esp Pediatr. 2001 Apr;54(4):380-9.
Evidence-based medicine is a new scientific paradigm that aims to use medical literature more effectively in guiding medical practice. The aim of this study was to assess the quality of scientific evidence in Spanish pediatric articles. Original articles published in Anales Españoles de Pediatría during a 6.5year period (n733) were compared with those published in Pediatrics during a 1.5year period (n300). The quality of scientific evidence in Anales was high in only 3% of original articles (randomized clinical trials). It was average in 30.4% (non-randomized clinical trials, cohort studies, case-control studies) and poor in 66.6% (descriptive studies, case reports, etc.). Only 10.2% of articles used appropriate methodological concepts according to evidence-based medicine. These concepts were mainly "soft" (odds ratio, relative risk, confidence interval) and no "hard" concepts (number needed to treat, likelihood ratio, odds pretest) were detected. The pediatric specialty showing the highest quality of scientific evidence, greatest use of appropriate methodological concepts and greatest statistical accessibility was pneumology. The first step in improving the quality of scientific evidence would be to establish collaboration between epidemiologists and/or biostatisticians. The evidence-based bibliometric indicators found in Pediatrics serve as a gold standard for Anales.
循证医学是一种新的科学范式，旨在更有效地利用医学文献来指导医疗实践。本研究的目的是评估西班牙儿科文章中科学证据的质量。将《西班牙儿科学年鉴》在6.5年期间发表的原创文章（n = 733）与《儿科学》在1.5年期间发表的原创文章（n = 300）进行比较。《年鉴》中科学证据的质量在仅3%的原创文章（随机临床试验）中为高质量。在30.4%的文章（非随机临床试验、队列研究、病例对照研究）中为中等质量，在66.6%的文章（描述性研究、病例报告等）中为低质量。只有10.2%的文章根据循证医学使用了适当的方法学概念。这些概念主要是“软性”的（比值比、相对风险、置信区间），未检测到“硬性”概念（治疗所需人数、似然比、验前概率）。科学证据质量最高、适当方法学概念使用最多且统计可及性最大的儿科专业是肺病学。提高科学证据质量的第一步是在流行病学家和/或生物统计学家之间建立合作。《儿科学》中发现的循证文献计量指标可作为《年鉴》的金标准。
