Moja - Le incertezze in medicina
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Revisioni e metanalisi: strumenti per arginare l'incertezza?
![Lorenzo Moja, MD, MSc, Dr PubHealth Centro Cochrane Italiano, Vice-Direttore Mario Negri Institute for Pharmacological Research, Milan Open University, London, UK (DPhil Candidate) [email_address] Revisioni e meta-analisi: strumenti per arginare l ’ incertezza? Milano – 14 Aprile 2009](https://image.slidesharecdn.com/moja-091215090140-phpapp01/85/moja-le-incertezze-in-medicina-1-320.jpg)
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Moja - Le incertezze in medicina
- 1. Lorenzo Moja, MD, MSc, Dr PubHealth Centro Cochrane Italiano, Vice-Direttore Mario Negri Institute for Pharmacological Research, Milan Open University, London, UK (DPhil Candidate) [email_address] Revisioni e meta-analisi: strumenti per arginare l ’ incertezza? Milano – 14 Aprile 2009
- 8. Revisioni Sistematiche e meta-analisi: definizioni
- 11. Screening colorectal cancer Exposed Control Weight Association measure Study ID Year n[e](E=1)/n[e] n[c](E=1)/n[c] (%) with 95% CI Goteborg 1994 121/32154 138/32154 14,24% 0,8768 (0,6872 to 1,1187) Minnesota 1993 199/31157 121/15394 16,71% 0,8126 (0,6488 to 1,0177) Funen 1996 205/30967 249/30966 25,69% 0,8233 (0,6848 to 0,9897) Nottingham 1996 360/76466 420/76384 43,36% 0,8562 (0,7441 to 0,9853) META-ANALYSIS: 885/170744 928/154898 0,1 1 10 RR (log scale) Studies 100% 0,8434 (0,7689 to 0,9252)
- 20. Diffusione
- 21. Cochrane Reviews are now the “gold standard” for systematic reviews in such key publications as The Lancet , New England Journal of Medicine , British Medical Journal , and the Journal of the American Medical Association and routinely appear there as well as in specialised medical journals for various specialty areas. Alla base delle decisioni
- 22. Informazioni al letto del paziente The ‘‘5S’’ levels of organisation of evidence from healthcare research (adapted from Haynes model)
- 25. CHE COSA E’ LA COCHRANE LIBRARY? FONTE DI INFORMAZIONI EBM AFFIDABILI RILEVANTI PER PRENDERE DECISIONI SULLA PROPRIA SALUTE
- 26. Il caso dello screening mammografico
- 29. I nostri amici hanno cominciato a chiedersi…
- 34. O Olsen, PC Gøtzsche. Screening for breast cancer with mammography. The Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD001877. Authors' conclusions The currently available reliable evidence does not show a survival benefit of mass screening for breast cancer (and the evidence is inconclusive for breast cancer mortality). Women, clinicians and policy makers should consider these findings carefully when they decide whether or not to attend or support screening programs.
- 36. 2001 - 2009
- 37. 17 nov 2009
- 38. 17 nov 2009
- 41. “… men are generally ready to believe what they want to believe” Julius Caesar De Bello Gallica (ca BC 55)
- 42. Cosa succede a 2000 donne che fanno lo screening mammografico ogni due anni per 10 anni non hanno nessun vantaggio dallo screening 1789 subiscono un intervento chirurgico demolitivo senza avere un cancro mortale 10 è guarita dal cancro grazie allo screening 1 hanno uno stress psicologico senza avere il cancro 200
- 43. Cosa succede a 2000 donne che non fanno lo screening mammografico ogni due anni per 10 anni non hanno nessun s/vantaggio dal non partecipare screening 1999 è morta per cancro perché non ha partecipato allo screening 1
- 46. www.cochrane.it
Hinweis der Redaktion
- The Cochrane Library is a collection of databases that contain high-quality, independent evidence to inform healthcare decision-making. It is considered the “gold-standard” as a resource for healthcare professionals worldwide
- At a time when we are reflecting, and most of the time bickering, about the future of the health system, which will be fixed for a generation, there are perhaps too many avenues to explore. Which is the right one?