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Aplicação ao doente individual dos resultados dos ensaios clínicos : regras práticas

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Resumo:Randomized controlled trials (RCTs) constitute the methodological gold standard to generate therapeutic or preventive evidence. Diagnostic or prognostic evidence is given by studies with different designs, rather than RCTs. Given the structural design that a RCT must present to be valid--discussed in previous issues of the Journal--one major question is the applicability of trial results to populations or individual patients that are different from those analyzed in that trial. In other words, how does the cardiologist know whether to apply a specific treatment--whose efficacy and risk profile have been defined in a good quality RCT, i.e. one with valid and important results--to his/her individual patient? The simplest solution would be found in the answer to the question: "Could my patient have been enrolled in the study by satisfying its inclusion and exclusion criteria?" If the answer is "yes", then it would be sound to apply the study results to the patient, so long as it is done carefully. If the answer is "no" (because the patient presents different demographic features or serious comorbidities not found in the trial subjects, for example), then transfer of the therapeutic results from the trial would be seriously compromised. The evaluation of these questions is complex and, due to its importance, deserves a systematic approach. In this article we will present some practical guidelines on whether to reject the applicability of RCT results to patients who are different from those included in the trial.
Autores principais:Carneiro, António Vaz
Assunto:Randomized controlled trials External validity Applicability of trial results Evidence-based cardiology
Ano:2003
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Universidade de Lisboa
Idioma:português
Origem:Repositório da Universidade de Lisboa
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author Carneiro, António Vaz
author_facet Carneiro, António Vaz
author_role author
contributor_name_str_mv Repositório Científico de Acesso Aberto da ULisboa
country_str PT
creators_json_txt [{\"Person.name\":\"Carneiro, António Vaz\",\"Person.identifier.orcid\":\"0000-0002-2783-0544\"}]
datacite.contributors.contributor.contributorName.fl_str_mv Repositório Científico de Acesso Aberto da ULisboa
datacite.creators.creator.creatorName.fl_str_mv Carneiro, António Vaz
datacite.date.Accepted.fl_str_mv 2003-02-01T00:00:00Z
datacite.date.available.fl_str_mv 2018-04-19T15:56:31Z
datacite.date.embargoed.fl_str_mv 2018-04-19T15:56:31Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Randomized controlled trials
External validity
Applicability of trial results
Evidence-based cardiology
datacite.titles.title.fl_str_mv Aplicação ao doente individual dos resultados dos ensaios clínicos : regras práticas
Applicability of clinical trial results to the individual patient : practice guidelines
dc.contributor.none.fl_str_mv Repositório Científico de Acesso Aberto da ULisboa
dc.creator.none.fl_str_mv Carneiro, António Vaz
dc.date.Accepted.fl_str_mv 2003-02-01T00:00:00Z
dc.date.available.fl_str_mv 2018-04-19T15:56:31Z
dc.date.embargoed.fl_str_mv 2018-04-19T15:56:31Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://hdl.handle.net/10451/32911
dc.language.none.fl_str_mv por
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Cardiologia
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.subject.none.fl_str_mv Randomized controlled trials
External validity
Applicability of trial results
Evidence-based cardiology
dc.title.fl_str_mv Aplicação ao doente individual dos resultados dos ensaios clínicos : regras práticas
Applicability of clinical trial results to the individual patient : practice guidelines
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Randomized controlled trials (RCTs) constitute the methodological gold standard to generate therapeutic or preventive evidence. Diagnostic or prognostic evidence is given by studies with different designs, rather than RCTs. Given the structural design that a RCT must present to be valid--discussed in previous issues of the Journal--one major question is the applicability of trial results to populations or individual patients that are different from those analyzed in that trial. In other words, how does the cardiologist know whether to apply a specific treatment--whose efficacy and risk profile have been defined in a good quality RCT, i.e. one with valid and important results--to his/her individual patient? The simplest solution would be found in the answer to the question: "Could my patient have been enrolled in the study by satisfying its inclusion and exclusion criteria?" If the answer is "yes", then it would be sound to apply the study results to the patient, so long as it is done carefully. If the answer is "no" (because the patient presents different demographic features or serious comorbidities not found in the trial subjects, for example), then transfer of the therapeutic results from the trial would be seriously compromised. The evaluation of these questions is complex and, due to its importance, deserves a systematic approach. In this article we will present some practical guidelines on whether to reject the applicability of RCT results to patients who are different from those included in the trial.
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person_str_mv Carneiro, António Vaz
Carneiro, António Vaz
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0000-0002-2783-0544
publishDate 2003
publisher.none.fl_str_mv Sociedade Portuguesa de Cardiologia
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spelling porSociedade Portuguesa de Cardiologiapt_PTRandomized controlled trials (RCTs) constitute the methodological gold standard to generate therapeutic or preventive evidence. Diagnostic or prognostic evidence is given by studies with different designs, rather than RCTs. Given the structural design that a RCT must present to be valid--discussed in previous issues of the Journal--one major question is the applicability of trial results to populations or individual patients that are different from those analyzed in that trial. In other words, how does the cardiologist know whether to apply a specific treatment--whose efficacy and risk profile have been defined in a good quality RCT, i.e. one with valid and important results--to his/her individual patient? The simplest solution would be found in the answer to the question: "Could my patient have been enrolled in the study by satisfying its inclusion and exclusion criteria?" If the answer is "yes", then it would be sound to apply the study results to the patient, so long as it is done carefully. If the answer is "no" (because the patient presents different demographic features or serious comorbidities not found in the trial subjects, for example), then transfer of the therapeutic results from the trial would be seriously compromised. The evaluation of these questions is complex and, due to its importance, deserves a systematic approach. In this article we will present some practical guidelines on whether to reject the applicability of RCT results to patients who are different from those included in the trial.application/pdfpt_PTAplicação ao doente individual dos resultados dos ensaios clínicos : regras práticasAlternativeTitlept_PTApplicability of clinical trial results to the individual patient : practice guidelinesPersonalCarneiro, António VazDSpacehttp://dspace.org/items/376d157f-1127-4663-9d99-038dac28f37dDSpacehttp://dspace.org/items/376d157f-1127-4663-9d99-038dac28f37dVaz CarneiroAntónioORCIDhttp://orcid.org0000-0002-2783-0544Researcher IDhttps://www.researcherid.comL-8026-2013Scopus Author IDhttps://www.scopus.com7006837792HostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptISSNIsPartOf0870-25512018-04-19T15:56:31Z2003-022003-02-01T00:00:00ZHandlehttp://hdl.handle.net/10451/32911http://purl.org/coar/access_right/c_abf2open accessRandomized controlled trialsExternal validityApplicability of trial resultsEvidence-based cardiology52924 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/df7a4340-4aea-402b-ac3f-431c9c2b47c6/downloadRevista Portuguesa de Cardiología222259268
spellingShingle Aplicação ao doente individual dos resultados dos ensaios clínicos : regras práticas
Carneiro, António Vaz
Randomized controlled trials
External validity
Applicability of trial results
Evidence-based cardiology
status SINGLETON
subject.fl_str_mv Randomized controlled trials
External validity
Applicability of trial results
Evidence-based cardiology
title Aplicação ao doente individual dos resultados dos ensaios clínicos : regras práticas
title_full Aplicação ao doente individual dos resultados dos ensaios clínicos : regras práticas
title_fullStr Aplicação ao doente individual dos resultados dos ensaios clínicos : regras práticas
title_full_unstemmed Aplicação ao doente individual dos resultados dos ensaios clínicos : regras práticas
title_short Aplicação ao doente individual dos resultados dos ensaios clínicos : regras práticas
title_sort Aplicação ao doente individual dos resultados dos ensaios clínicos : regras práticas
topic Randomized controlled trials
External validity
Applicability of trial results
Evidence-based cardiology
topic_facet Randomized controlled trials
External validity
Applicability of trial results
Evidence-based cardiology
url http://hdl.handle.net/10451/32911
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