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DISEASE	INTERVENTION	COMPARISON	RESULTS
J Am Coll Cardiol. 2012 Aug 28;60(9):861-7		Cohorts
IN anticoagulants, vitamin K antagonists, bleeding risk	The Use of Any of 3 most commonly employed scores: HAS-BLED, ATRIA and HEMORR2 HAGES As Prognostic Item	Is better Than no using any risk score	To predict clinically relevant bleeding events, but only with modest performance, being HAS slightly better: c-index: 0.60 HAS-BLED, 0.55 HEMORR(2)AGES, 0.50 ATRIA
N Engl J Med. 2018 Mar 08;378(10):902-910		Randomized Controlled Trial, Multicenter Study
IN asthma, acute exacerbation	The Use of self-management plan including a temporary quadrupling of the dose of inhaled glucocorticoids when asthma control start to deteriorate As Treatment, Acute	Is better Than self-management plan without increase of inhaled corticosteroids	To reduce severe asthma exacerbations at 1 year: 45% with quadrupling VS 52% in the non-quadrupling. More local adverse events with quadrupling.
JAMA. 2013 Jul 17;310(3):270-9		Randomized Controlled Trial, Multicenter Study
IN cardiac arrest, immediate resuscitation, post-resuscitation care	The Use of combined treatment with vasopressin (20 IU) plus epinephrine (1 mg) each 3 minutes for 5 times, plus 40 mg methylprednisolone IV once, plus hydrocortisone (300 mg/d for 7 days) in patients with shock after resuscitation As Treatment, Acute	Is better Than repeated epinephrine (1 mg) alone, without vasopressin nor corticosteroids	To improve survival to hospital discharge with no or little neurological impairment: 14% combined treatment VS 5% epinephrine alone
Am J Cardiol. 2013 Jun 15;111(12):1701-7		Diagnostic
IN coronary disease, acute coronary syndrome, myocardial infarction, older patients	The Use of high-sensitive cardiac troponin, increased cutoff at 40-50 ng/L in older patients and renal failure As Diagnostic Tool	Is better Than standard cutoff at 14 ng/L	To better diagnose acute coronary syndrome: sensitivity 87% and specificity 87% at 50 ng/Lfor older patients
N Engl J Med. 2006 Mar 23;354(12):1231-42		Randomized Controlled Trial, Multicenter Study
IN depression, unipolar, refractory	The Use of bupropion-SR, sertraline, or venlafaxine-XR As Treatment, Chronic	Is equal Than each other	To improve depression after failure of SSRI (no remission or intolerance) : about 25% patients responded with all 3 treatments
Am J Psychiatry. 2007 May;164(5):739-52		Randomized Controlled Trial, Multicenter Study
IN depression, unipolar, refractory	The Use of cognitive therapy As Treatment, Chronic	Is equal Than pharmacologic treatment : sustained-release bupropion, buspirone or associating a second antidepressant	To improve depression after SSRI failure (no response or intolerance) : equal number of responders. Pharmacologic augmentation was more rapidly effective but has more adverse effects
Am J Psychiatry. 2011 Jul;168(7):681-8		Systematic Review
IN depression, unipolar, refractory, older patients	The Use of lithium, extended-release venlafaxine and selegiline As Treatment, Chronic	Is better Than placebo or other therapeutic options	To improve clinical response : overall 52% of aptients responded
Ann Intern Med. 2017 Feb 07;166(3):191-200		Systematic Review
IN diabetes mellitus, type 2, comorbid conditions contraindicating metformin, kidney disease, chronic, liver failure, chronic, heart failure	The Use of oral hypoglycemic agents, metformin As Treatment, Chronic	Is better Than other diabetes treatments no using metformin	To reduce all-cause mortality (chronic kidney disease HR 0.77 ; chronic heart failure HR 0.78), cardiovascular mortality and rehosp because heart failure
Age Ageing. 2013 Mar;42(2):262-5		Descriptive, Cross-Sectional Study
IN elder people, comprehensive geriatric assessment, frailty scores	The Use of PRISMA-7, a short 7-items questionnaire As Diagnostic Tool	Is better Than other frailty measures : clinical judgement ot GP, polypharmacy or the Groningen frailty indicator (GFI)	To better diagnose frailty : sensitivity 85% and specificity 73% VS Fried criteria as glod standard
J Neurol Neurosurg Psychiatry. 2011 Aug;82(8):924-7		Randomized Controlled Trial, Multicenter Study
IN epilepsy, generalized, focal, newly diagnosed (first tonic-clonic seizure)	The Use of no treatment, unless seizure recurrs As Treatment, Chronic	Is equal Than starting treatment immediatly (carbamazepine, phenytoin, phenobarbital, or sodium valproate)	To modify mortality at 20 years: 10% no Tt VS 9% immediate Tt. Only the presence of aetiological factors for epilepsy predicted a higher mortality (HR 3.4). Most patients died from remote, non primarily neurological diseases.
BMJ. 2017 Jun 6;357:j2353. doi: 10.1136/bmj.j2353		Cohorts
IN lifestyle and habits, alcohol	The Use of moderately (14-21 units/week) or high (>30 units/week) alcohol consumtion As Etiologic risk factor	Is worse Than no alcohol consumtion, or light drinking (1 - 7 units/week)	To predict hypoccampal atrophy at 30 years of follow-up (OR 6 high drinkers, OR 3.4 moderate drinkers)
Br J Sports Med. 2015 Jun;49(11):743-8		Cohorts
IN lifestyle and habits, exercise, old patients	The Use of regular exercise, 30 mins of moderate to vigorous physical activity per 6 days a week As Prevention, Primary	Is better Than sedentary, no physical activity	To reduce overall mortality (40% reduction from 73 to 85 years old, with a 5 years increase in lifetime)
Med Educ. 2010 Jan;44(1):94-100		Systematic Review
IN medical thinking, errors, diagnostic	The Use of encouraging both kinds of reasoning, system 1 (non-analytical) and system 2 (analytical) As Methodology procedure	Is better Than only attempting to be systematic and analytical	To improve physicians diagnostic accuracy: it yields small, but consistent, improvements. Errors result from multiple causes. Little evidence associates diagnostic errors with over-reliance on System 1 (non-analytical) reasoning.
Neurology. 2014 Jan 7;82(1):41-8		Randomized Controlled Trial
IN multiple sclerosis, first demyelinating attack	The Use of Bacille Calmette-Guerin (BCG) vaccine As Treatment, Acute	Is better Than placebo	To reduce at 6 months the number of CNS gadolinium-enhancing lesions and reduce at 5 years the probability of clinically definite multiple sclerosis (HR 0.52)
Cochrane Database Syst Rev. 2012;5(0):CD008165		Systematic Review, Cochrane Review
IN older patients, geriatric pharmacology, inappropriate prescription, multiple medications	The Use of multifaceted pharmaceutical care provided in a variety of settings As Treatment, Acute	Is better Than no intervention	To reduce inappropriate drug prescription and possibly (only 3 studies repporting) the number of adverse drug events (RR 0.65). Effect on hospital admissions (four studies) was conflicting.
JAMA Pediatr. 2017 May 01;171(5):426-434		Meta-Analysis
IN pain, abdominal, acute, appendicitis, children	The Use of antibiotic treatment As Treatment, Acute	Is equal Than appendectomy	To obtain clinical success (91% on antibiotics). But appendicitis with appendicolith had a high failure rate: probably surgery better in this case
Cochrane Database Syst Rev. 2018 Apr 10;4(XX):CD007094		Systematic Review, Cochrane Review
IN respiratory infection, upper airways, cough, children	The Use of honey As Treatment, Acute	Is better Than no treatment, placebo or diphenhydramine, and equal than dextromethorphan	To achieve better symptomatic relief of cough (mean extra reduction of 1 to 1.6 points in a 7-points Likert scale)
J Hosp Med. 2013 Sep;8(9):530-40		Meta-Analysis
IN sepsis, any bacterial infection, critically ill patients, respiratory tract infections	The Use of procalcitonin, treating with antibiotics according to serum procalcitonin levels As Diagnostic Tool	Is better Than empirical treatment with antibiotics	To reduced antibiotic duration by 2 days without increasing morbidity or mortality
N Engl J Med. 2017 Jun 08;376(23):2223-2234		Meta-Analysis
IN sepsis, septic shock	The Use of early, goal-directed therapy As Treatment, Acute	Is equal Than usual care	To reduce mortality at 90 days and 1 year
JAMA Intern Med. 2017 Apr 01;177(4):563-570		Cohorts
IN stroke, haemorrhagic, intracerebral hemorrhage, traumatic, patients with atrial fibrillation	The Use of resuming warfarin afterwards As Treatment, Chronic	Is better Than definitively stopping warfarin, no oral anticoagulant treatment	To reduce at 1 year stroke or systemic embolism (HR 0.5 warfarin) but increasing recurrent intracranial HRR (HR 1.3) with a final reduction in overall mortality (HR 0.5 in stroke HRR, HR 0.35 in traumatic HRR with warfarin)
N Engl J Med. 2018 02 22;378(8):708-718		Randomized Controlled Trial, Multicenter Study
IN stroke, ischemic, cerebral infarction, 6 to 16 h of onset, proximal arterial occlusion in the anterior cerebral circulation, volume of ischemic tissue on perfusion imaging to infarct volume of 1.8 or more	The Use of endovascular treatment: thrombectomy, late As Treatment, Acute	Is better Than standard care	To improve at 3 months functional independence (45% thrombectomy VS 17% controls). Mortality was also some improved (14% thrombectomy VS 26% controls, p=0.05)
Heart. 2018 Mar 23. doi: 10.1136/heartjnl-2017-312571. [Epub ahead of print]		Systematic Review
IN therapeutics, adherence to drug treatment, cardiovascular disease	The Use of 3 interventions: short message service, fixed-dose combination pill, community health worker intervention As Treatment, Acute	Is better Than usual care	To improve medication adherence: 44% to 99% in the intervention groups VS 13% to 96% in usual care groups
N Engl J Med. 2006 Jun 15;354(24):2564-75. Epub 2006 May 21		Randomized Controlled Trial, Multicenter Study
IN acute respiratory distress syndrome, acute lung injury, adults	The Use of fluid restriction As Treatment, Acute	Is better Than liberal fluid administration	To improve oxygenation index and shorten the duration of mechanical ventilation (15.9 days restriction VS 13.4 liberal) But not to reduce mortality at 60 days (25.5% restriction VS 28.4% liberal, p .30)
J Intern Med. 2017 May 4. doi: 10.1111/joim.12627. [Epub ahead of print]		Cohorts
IN ageing, maximum lifespan	The Use of length of life of centenarian people As Undefined	Is useful Than no comparison here	To mortality reaches a plateau at particularly old ages: 50% at 103 years old, with no improvement amongst centenarians in the past 30 years. Rise in life expectancy is driven by reductions in mortality below the age of 100.
Cell. 2013 Jun 6;153(6):1194-217		Review (Narrative)
IN aging	The Use of nine tentative hallmarks: genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication As Etiologic risk factor	Is useful Than no comparison here	To help understand and study aging
JAMA. 2008 Jan 2;299(1):39-52		Randomized Controlled Trial
IN aging, hormonal decline	The Use of testosterone supplementation As Treatment, Chronic	Is equal Than placebo	To modify at 6 months functional mobility, muscle strength, cognitive function or bone mineral density. Lean body mass increased and metabolic effects were mixed.
PLoS One. 2015;10(7):e0132909		Cohorts
IN aging, pathological, old people, multimobidity patterns	The Use of four multimorbidity patterns: Cardiovascular, Induced Dependency (around cognitive decline and dementia), Falls and Osteoarticular As Etiologic risk factor	Is useful Than no comparison done	To identify diseases and/or geriatric syndromes that cluster into patterns
N Engl J Med. 2017 06 29;376(26):2513-2522		Cohorts
IN air pollution, overall mortality	The Use of air pollution: fine particulate matter (particles with a mass median aerodynamic diameter of less than 2.5 μm [PM2.5]) and ozone As Etiologic risk factor	Is useful Than no or lower pollution	To predict overall mrotality in populations affected: Increases of 10 μg/m3 in PM2.5 and of 10 ppb in ozone were associated with (relative) increases in all-cause mortality of 7.3% and 1.1% respectively
N Engl J Med. 2007 Jun 7;356(23):2361-71		Cohorts
IN amyloidosis, AA type, associated to chronic inflammatory disorders	The Use of serum amyloid A (SAA) concentration during follow-up As Prognostic Item	Is useful Than -	To predict long term evolution: renal dysfunction - which was the predominant disease manifestation - and mortality if SAA was low-normal (< 4 mg)
N Engl J Med. 2007 Jun 7;356(23):2349-60		Randomized Controlled Trial
IN amyloidosis, AA type, associated to chronic inflammatory disorders	The Use of eprodisate, interfere with interactions between amyloidogenic proteins and glycosaminoglycans As Treatment, Chronic	Is better Than placebo	To reduce at 2 years progression of renal failure: 27% eprodisate VS 40% placebo.
Am J Med. 2008 Apr;121(4):324-331.e6		Systematic Review
IN ankle sprain, lateral	The Use of long-term clinical course As Prognostic Item	Is useful Than no comparison here	To know that 5 to 33% of patients still had pain at 1 year, and 5-25% staill at 3 years. Instability and re-sprain were also frequent: 3-34% of patients.
Chest. 2007 Oct;132(4):1131-9		Meta-Analysis
IN anticoagulants, heparins, low molecular weight heparins, unfractionated heparin	The Use of low molecular weight heparins As Treatment, Acute	Is equal Than unfractionated heparin	To risk of thrombocytopenia: 1.2% with LMWH VS 1.5% with UH. Severe heparin-induced thrombocytopenia with thrombosis was too low to make an adequate comparison.
Eur Heart J. 2013 Jul;34(27):2094-106		Consensus, Guideline
IN anticoagulants, oral direct thrombin inhibitors, dabigatran, oral factor Xa inhibitors, apixaban, rivaroxaban	The Use of guidelines for their use in diverse situations in practice As Dosage Scheme	Is useful Than no comparison here	To optimize their use and avoid bleeding complications
Gastroenterology. 2013 Jul;145(1):105-112.e15		Systematic Review
IN anticoagulants, oral direct thrombin inhibitors, dabigatran, oral factor Xa inhibitors, apixaban, rivaroxaban, edoxaban	The Use of this direct oral anticoagulants As Treatment, Chronic	Is worse Than warfarin	To cause a higher risk of gastrointestinal bleeding: OR 1.58 dabigatran, 1.48 rivaroxaban, 1.23 apixaban (non-significant), 0.31 edoxaban (non-significant for superiority)
N Engl J Med. 2015 Aug 6;373(6):511-20		Cohorts
IN anticoagulants, oral direct thrombin inhibitors, dabigatran, patients who had serious bleeding or required an urgent procedure	The Use of idarucizumab, an dabigatran-specific antibody fragment As Treatment, Acute	Is better Than no comparison done	To normalize hemostasis tests in 88 to 98% of the patients in minutes. One thrombotic event occurred within 72 hours after idarucizumab administration.
N Engl J Med. 2016 Aug 30;():		Clinical Trial (non-controlled, non-randomized)
IN anticoagulants, oral factor Xa inhibitors, apixaban, rivaroxaban, patients with acute major bleeding	The Use of andexanet alfa, a recombinant modified human factor Xa decoy protein, IV bolus and subsequent 2-hour infusion As Treatment, Acute	Is good Than no comparison group	To quickly reduce anti-factor Xa activity after administration (90% reduction) and achieve effective clinical hemostasis at 12h (79% of patients). However, thrombotic events in 18% patients at 30-day follow-up.
Am J Med. 2012 Nov;125(11):1095-102		Cohorts
IN anticoagulants, oral, vitamin K antagonists, novel anticoagulants	The Use of seven different scoring systems As Etiologic risk factor	Is equal Than physician, subjective assessment	To predict the risk of major bleeding at 12 months (6.8% globally) : c-statistics ranged 0.54 to 0.61
Arch Intern Med. 2000 Feb 28;160(4):470-8		Cohorts
IN anticoagulants, vitamin K antagonists	The Use of age > 75 years As Prognostic Item	Is useful Than -	To predict bleeding rate (9.9% elders VS 6.6% youngs)
Arch Intern Med. 2010 Sep 13;170(16):1433-41		Cohorts
IN anticoagulants, vitamin K antagonists, antiplatelet drugs, aspirin, clopidogrel, bleeding risk	The Use of aspirin and/or clopidogrel associated to warfarin As Treatment, Chronic	Is worse Than warfarin alone	To risk of fatal and nonfatal bleeding: 14% per patient-year with warfarin plus clopidogrel, 16% with warfarin plus aspirin plus clopidogrel
Circulation. 2012 Sep 4;126(10):1185-93		Cohorts
IN anticoagulants, vitamin K antagonists, antiplatelet drugs, aspirin, clopidogrel, bleeding risk	The Use of with vitamin K antagonist (VKA) +aspirin +clopidogrel As Treatment, Chronic	Is worse Than vitamin K antagonist +1 antiplatelet, or dual antiplatelet therapy with aspirin +clopidogrel	To cause bleeding events, specially in the first 30-90 days: 23 events per 100 person-years with triple therapy, 20 with VKA +1 antiplatelet, 14 with dual antiplatelet. Triple therapy was not more effective than VKA +1 antiplatelet
Am J Med. 2010 Jul;123(7):638-645.e4		Systematic Review
IN anticoagulants, vitamin K antagonists, atrial fibrillation	The Use of frequency of use of anticoagulants, vitamin K antagonists As Treatment, Chronic	Is worse Than frequency of use recommended by guidelines	To oral anticoagulants are largely underused in patients with AF and previous AIT or stroke (<70% patients anticoagulated in 25/29 studies, range 19-81%)) or CHADS2 > 2 (<70% patients anticoagulated in 7/9 studies, range 39-92%)
N Engl J Med. 2015 Aug 27;373(9):823-33		Randomized Controlled Trial, Multicenter Study
IN anticoagulants, vitamin K antagonists, atrial fibrillation, periprocedure interruption of anticoagulation	The Use of no bridging anticoagulation, just stopping warfarin 5 days before the procedure and resuming it within 24 hours afterwards As Treatment, Acute	Is better Than bridging anticoagulation with full-dose low-molecular-weight heparin (LMWH)	To avoid major bleeding (1.3% just stop Vs 3.2% bridging) while having similar incidence of arterial thromboembolism (0.4% just stop VS 0.3% bridging)
Arch Intern Med. 2004 Oct 11;164(18):2044-50		Cohorts
IN anticoagulants, vitamin K antagonists, bleeding risk, elder patients	The Use of insufficient therapeutic education, polypharmacy, and INR above therapeutic range As Etiologic risk factor	Is useful Than no comparison done	To predict increase risk of bleeding: insufficient education ([OR, 8.83), polypharmacy (OR, 6.14), and INR above range (OR 1.08). Low rate of major bleeding despite frequent comobidities and cognitive impairment: 2.4 events per 1000 patient-months
J Thromb Haemost. 2016 Sep;14(9):1715-24		Cohorts
IN anticoagulants, vitamin K antagonists, bleeding risk, elder patients	The Use of Any of 3 most commonly employed scores: HAS-BLED, ATRIA and HEMORR2 HAGES As Prognostic Item	Is bad Than no comparison here	To predict major bleeding: All three scores were associated with major bleeding in the elderly, but had poor predictive abilities: C-statistics < 0.60 all. Only 2 (anemia and antiplatelet therapy) of the classical risk factors were associated with bleeding
J Am Coll Cardiol. 2011 Jan 11;57(2):173-80		Cohorts
IN anticoagulants, vitamin K antagonists, bleeding risk, elder patients	The Use of HAS-BLED score: Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly (1 point each, 0 = low risk, 1-2 = moderate, >=3 = high risk) As Prognostic Item	Is better Than other available scores	To predict risk of major haemorrhage under chronic warfarin: low risk 0.9% per patient-year, moderate 3.7%, high 6.7%.
J Gen Intern Med. 2005 Nov;20(11):1008-13		Cohorts
IN anticoagulants, vitamin K antagonists, bleeding risk, elder patients	The Use of outpatient bleeding risk index (BRI): 1 point for: age>65, history of stroke, history gastrointestinal bleeding, any of following (diabetes, recent myocardial infartion, anemia, creat>1.5mg/L) As Prognostic Item	Is useful Than intuitive assesment of bleeding risk	To predict risk of major haemorrhage under chronic warfarin: high-risk 10.6% per patient-year, intermediate 2.5%, and low-risk only 0.8% per year.
Ann Intern Med. 2009 Mar 3;150(5):293-300		Randomized Controlled Trial, Multicenter Study
IN anticoagulants, vitamin K antagonists, excessive anticoagulation, without major bleeding	The Use of low dose oral vitamin K (1.25mg) As Treatment, Acute	Is equal Than placebo	To reduce any bleeding (15.8% vit VS 16.3% placebo) or major bleedings (2.5 % vit K VS 1.1% placebo)
Arch Intern Med. 2003 Nov 10;163(20):2469-73		Randomized Controlled Trial
IN anticoagulants, vitamin K antagonists, excessive anticoagulation, without major bleeding	The Use of oral vitamin K1 (2.5mg if INR 6-10, 5mg if INR > 10) As Treatment, Acute	Is equal Than intravenous vitamin K1 (0.5mg if INR 6-10, 1mg if INR > 10)	To correct INR: response to intravenous phytonadione was more rapid at 6 and 12 hours, but at 24 hours INR values were similar for both groups and more patients in the IV group were overcorrected (INR < 2: 8.7% in PO group VS 29% in IV group)
BMJ. 2002 Nov 9;325(7372):1073-5		Descriptive
IN anticoagulants, vitamin K antagonists, monitoring	The Use of INR values in excess As Prognostic Item	Is useful Than No control	To hight INRs are associated with an excess mortality. With an increase of 1 unit of INR above 2.5, the risks of death from cerebral bleeding (149 deaths / 42 451 patients) and from any cause were about doubled
Ann Intern Med. 2003 May 6;138(9):714-9		Randomized Controlled Trial
IN anticoagulants, vitamin K antagonists, warfarin, thromboembolic disease	The Use of higher starting dose: 10 mg/day As Treatment, Acute	Is better Than usual starting dose: 5 mg/day	To reduce time to achieve therapeutic INR at day 5 (83% with 10mg VS 46% with 5mg, overall reduction by 1.5 days). No significant differences in major bleeding, coagulation excess (INR > 5.0), recurrent events and survival.
N Engl J Med. 2006 Jun 8;354(23):2443-51		Cohorts
IN antihypertensive drugs, angiotensin converting enzyme (ACE) inhibitors, adverse effects, congenital malformations	The Use of angiotensin converting enzyme (ACE) inhibitors during pregnancy, first trimester As Treatment, Chronic	Is worse Than other antihypertensive drugs	To increase the risk of major congenital malformations (RR, 2.71; 95 %CI, 1.72 to 4.27) as compared with no exposure to antihypertensive medications.
Arch Intern Med. 2010 Feb 22;170(4):321-31		Systematic Review
IN anxiety symptoms, patients with a chronic illness	The Use of exercise training As Treatment, Chronic	Is better Than no training	To to modestly improve anxiety symptoms: mean effect Delta 0.29
Arch Intern Med. 2006 Jul 10;166(13):1350-6		Systematic Review
IN aortic dissection, thoracic	The Use of transesophageal echocardiography, helical computed tomography (CT), and magnetic resonance imaging (IRM) As Diagnostic Tool	Is equal Than reference gold standard (angiography)	To diagnose this condition: sensitivity (98%-100%) and specificity (95%-98%) were comparable between all 3 imaging techniques. LR+ was some better for IRM (24) than for echography or CT (14) but without major clinical implications.
JAMA. 2007 Apr 4;297(13):1478-88		Systematic Review
IN arthritis, acute, septic	The Use of synovial fluid white blood cell count > 50.000/mcl and polymorphonuclear count > 90% As Diagnostic Tool	Is better Than any clinical sign or smptom	To diagnose septic arthritis: respective LR+ of 7,7 and 3,4
JAMA. 2008 Mar 12;299(10):1166-78		Systematic Review
IN ascitis, portal hypertension, liver failure, spontaneous bacterial peritonitis	The Use of 1) bedside inoculation of ascitic fluid into blood culture bottles and PMN count >250 cells/microL; 2) serum-ascites albumin gradient < 1.1 g/dL As Diagnostic Tool	Is useful Than no comparison	To diagnose: 1) spontaneous bacterial peritonitis (LR+ 9); 2) portal hypertension as ascitis cause (LR- 0.06)
N Engl J Med. 2007 May 17;356(20):2040-52		Randomized Controlled Trial, Multicenter Study
IN asthma	The Use of combination of inhaled corticosteroids and long-acting beta2-agonists (beclomethasone, albuterol) as on-demand reliever Tt As Treatment, Chronic	Is better Than only short-acting b2-agonists on-demand	To reduce at 6 months number of exacerbations (numbers not stated in abstract). But it was NOT better than regular inhaled corticoids plus on-demand or than regular combined treatment
Chest. 2006 Jan;129(1):15-26		Randomized Controlled Trial, Multicenter Study
IN asthma	The Use of inhaled short-acting beta2-agonist (salmeterol) as on-demand reliever Tt, added to usual treatment As Treatment, Chronic	Is worse Than placebo	To reduce, at 28 weeks, respiratory-related deaths (0.2% salbutamol VS 0.1% placebo)
Ann Intern Med. 2015 Sep 22; doi: 10.7326/M15-1059 [Epub ahead of print]		Systematic Review
IN asthma	The Use of leukotriene antagonists As Treatment, Chronic	Is better Than placebo	To reduce the risk of exacerbations (RR 0.60) and increase FEV1. In 4 trials employed as add-on therapy to inhaled corticosteroids, the RR for exacerbation was 0.80 (CI, 0.60 to 1.07)
Am J Respir Crit Care Med. 2005 Jun 1;171(11):1231-6		Randomized Controlled Trial
IN asthma, acute exacerbation	The Use of corticosteroids, inhaled, fluticasone As Treatment, Acute	Is better Than parenteral IV corticosteroids	To improve PEF and FEV1 (30 to 46% more improvement with inhaled VS. IV corticosteroids) and reduce hospital admisions - all at 3 hours (very short term)
JAMA. 1999 Jun 9;281(22):2119-26		Randomized Controlled Trial
IN asthma, acute exacerbation	The Use of corticosteroids, inhaled, high dose, budesonide As Treatment, Acute	Is better Than placebo	To reducing symptoms and relapses, as unscheduled visits to physician, but not overall low rate of hospitalization. Improving quality of life.
BMJ. 1998 Oct 10;317:971-977		Meta-Analysis
IN asthma, acute exacerbation	The Use of inhaled anticholinergics added to inhaled beta-agonists As Treatment, Acute	Is better Than inhaled beta-agonists alone	To reduce the risk of hospital admission by 30% (RR 0.72, NNT 11) in children and adolescents with severe exacerbations
Am J Med. 1999 Oct;107:363-70		Meta-Analysis
IN asthma, acute exacerbation	The Use of inhaled anticholinergics added to inhaled beta-agonists As Treatment, Acute	Is better Than inhaled beta-agonists alone	To reducing hospitalization rate
N Engl J Med. 2012 Sep 2. [Epub ahead of print]		Randomized Controlled Trial, Multicenter Study
IN asthma, persistent despite treatment with inhaled glucocorticoids and long-acting beta-agonists	The Use of inhaled long-acting anticholinergics, tiotropium As Treatment, Chronic	Is better Than placebo	To increase time to the first severe exacerbation (282 days vs. 226 days), and reduce risk of severe exacerbation (HR, 0.79). No deaths. Patients with cardiac disease were excluded: safety of tiotropium there?
N Engl J Med. 2005 Apr 14;352(15):1519-28		Randomized Controlled Trial
IN asthma, persistent, mild	The Use of as-needed corticosteroids, intermittent short-courses of inhaled or oral corticosteroids As Treatment, Chronic	Is equal Than as-needed inhaled corticoisteroids added to either daily inhaled corticosteroids or oral zafirlukast	To improve rate of asthma exacerbations or quality of life, taking much lesser doses of corticosteroids
Cochrane Database Syst Rev. 2013;2:CD009611		Systematic Review, Cochrane Review
IN asthma, persistent, mild	The Use of intermitent, as needed inhaled corticosteroids As Treatment, Chronic	Is equal Than daily inhaled corticosteroids, continuous	To modify the number of exacerbations, adverse effects, hospitalisations, emergency department visits or quality of life. In children, daily corticosteroid were associated with some lesser growth
N Engl J Med. 2011 May 5;364(18):1695-707		Randomized Controlled Trial
IN asthma, persistent, mild	The Use of leukotriene antagonists As Treatment, Chronic	Is equal Than inhaled glucocorticoid for first-line asthma-controller therapy, or a long-acting beta(2)-agonist as add-on therapy	To improve asthma-related quality of life at 2 months (MiniAQLQ score improvement of about 1 point) but not at 2 years (-0.11 points for leukotriene antag).
N Engl J Med. 2007 May 17;356(20):2027-39		Randomized Controlled Trial, Multicenter Study
IN asthma, persistent, mild	The Use of once daily inhaled corticosteroids As Treatment, Chronic	Is better Than leukotriene antagonist, once daily monlelukast	To reduce, at 4 months, treatment failure (20% inhaled corticoids VS 30% montelukast)
N Engl J Med. 2016 Sep;375(9):850-860		Randomized Controlled Trial, Multicenter Study
IN asthma, persistent, moderate to severe	The Use of long-acting beta(2)-agonists, formoterol added to inhaled corticoisteroids, budesonide As Treatment, Chronic	Is better Than inhaled corticoisteroids, budesonide alone	To reduce the number of exacerbations (HR 0.8) while not modifying the number of serious asthma-related events (<1%)
JAMA. 2013 Mar 27;309(12):1278-88		Systematic Review
IN asthma, rhinoconjunctivitis, allergic	The Use of sublingual immunotherapy As Treatment, Chronic	Is better Than placebo	To improves asthma symptoms (8 of 13 studies reported > 40% improvement)
JAMA. 2006 Feb 8;295(6):655-66		Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention	The Use of intensive dietary intervention to reduce fat intake and increased intakes of vegetables, fruits, and grains As Prevention, Primary	Is equal Than providing diet-related education materials	To reduce at 8 years coronary heart disease (0.64% both groups), stroke (0.27%), in spite of mild reductions in fat intake and blood lipids
Cochrane Database Syst Rev. 2012;5:CD002137		Systematic Review, Cochrane Review
IN atherosclerosis, cardiovascular disease, primary prevention	The Use of reduction of dietary saturated fat by partially replacing by unsaturatef fats As Prevention, Primary	Is better Than no modification of diet	To modestly reduce cardiovascular events (RR 0.86) but not to reduce total or cardiovascular mortality
Cochrane Database Syst Rev. 2013;1:CD004816		Systematic Review, Cochrane Review
IN atherosclerosis, cardiovascular disease, primary prevention	The Use of statins As Prevention, Primary	Is better Than placebo	To reduce all cause mortality (OR 0,86), and cardiovascilar death and events (OR 0,73 to 0,78), after at least 1 year of treatment
N Engl J Med. 2013 Apr 4;368(14):1279-90		Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients	The Use of Mediterranean diet supplemented with extra-virgin olive oil, or with mixed nuts As Prevention, Primary	Is better Than simple advice to reduce dietary fat	To reduce cardiovascular events (myocardial infarction, stroke, or cardiovascular death) : HR 0.70
BMJ. 2014;349(iss):g4379		Meta-Analysis
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, high cholesterol	The Use of drug treatments targeted to increase high density lipoprotein: niacin, fibrates, and cholesteryl ester transfer protein (CETP) inhibitors As Prevention, Primary	Is equal Than placebo or no treatment	To modify cardiovascular events (all cause mortality, coronary heart disease mortality, non-fatal myocardial infarction, and stroke)
JAMA. 2014 Sep 17;312(11):1136-44		Systematic Review
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, high cholesterol, older patients	The Use of statins As Prevention, Primary	Is undefined Than no statin treatment	To reduce cardiovascular events. No RCT in patients older than 80 years was found
Lancet. 2002 Nov 23;360(9346):1623-30		Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, high cholesterol, older patients	The Use of statins, pravastatin 40 mg/d As Prevention, Primary	Is better Than placebo	To to reduce at 3 years cardiovascular events: 14% pravastatine VS 16% placebo. Reduction was due to reduction in non-fatal myocardial infaction, no significant difference in stroke and death
J Am Coll Cardiol. 2013 Dec 3;62(22):2090-9		Meta-Analysis
IN atherosclerosis, cardiovascular disease, primary prevention, high risk patients, older patients	The Use of statins As Prevention, Primary	Is better Than placebo	To reduce myocardial infarction (RR 0.60) and stroke (RR 0.76) but it did not reduced mortality (either total or cardiovascular)
N Engl J Med. 2016 May 26;374(21):2021-31		Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, intermediate risk patients, normal or high cholesterol	The Use of statins, rosuvastatin 10 mg/day for > 5 years As Prevention, Primary	Is better Than placebo	To reduce cardiovascular events (cardiovascular death, nonfatal myocardial infarction or stroke) at 5.6 years: 3.7% rosuvastatin VS 4.8% placebo. No difference in mortality: 2.8-2.9% both. Muscle symptoms in 5.8% of patients on rosuvastatin.
JAMA Intern Med. 2017 Jul 01;177(7):955-965		Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, low to moderate risk patients, older patients	The Use of statin, pravastatin, 40 mg/d As Prevention, Primary	Is equal Than usual care	To modify, after 6 years, mortality or coronary disease
N Engl J Med. 2008 Nov 20;359(21):2195-207		Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, cardiovascular disease, primary prevention, normal cholesterol, elevated C-reactive protein	The Use of statins, rosuvastatin As Prevention, Primary	Is better Than placebo	To reduce the incidence of major cardiovascular events at 2 years: 0.77% per year statin VS 1.4% per year placebo.
J Am Coll Cardiol. 2005 Nov 15;46(10):1855-62. Epub 2005 Oct 24		Meta-Analysis
IN atherosclerosis, coronary disease, ischemic stroke, high or normal cholesterol	The Use of statins As Treatment, Chronic	Is equal Than interventions to primarily lower LDL cholesterol, if equal reduction	To The regression lines for non-statin and statin trials were similar and consistent with a one-to-one relationship between LDL-cholesterol lowering and coronary disease and stroke reduction.
Lancet. 2005 Oct 8;366(9493):1267-78. Epub 2005 Sep 27		Meta-Analysis
IN atherosclerosis, coronary disease, ischemic stroke, high or normal cholesterol	The Use of statins As Treatment, Chronic	Is better Than placebo	To reduce coronary and all-cause mortality (RRR 12%), and reduce major vascular events (vascular death, infarction, revascularization or stroke): RRR 21%.
Arch Intern Med. 2007 Jun 11;167(11):1122-9		Cohorts
IN atherosclerosis, coronary disease, ischemic stroke, peripheral arterial disease	The Use of chronic kidney disease measures (anemia, microalbuminuria, and GFR of <60 mL/min) As Etiologic risk factor	Is useful Than added to classical vascular risk factors	To idependently predict the risk of cardiovascular disease: OR about 1.30 for each one of the 3 measures, OR 1.98 for chronic kidney disease.
BMJ. 2002 Jan 12;324(7329):71-86		Meta-Analysis
IN atherosclerosis, coronary disease, ischemic stroke, peripheral arterial disease	The Use of antiplatelet drugs, aspirin, low-dose (75-150 mg/d), adenosine diphosphate (ADP) receptor inhibitors, clopidogrel As Treatment, Chronic	Is better Than placebo	To reduce recurrence of ischemic coronary and cerebral events, with absolute reductions of 3 to 4%, depending on specific conditions
Lancet. 1996 Nov 16;348(9038):1329-39		Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, coronary disease, stroke, ischemic, peripheral arterial disease, or multiple risk factors	The Use of antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (75 mg/d) As Treatment, Chronic	Is better Than antiplatelet drugs, aspirin (325 mg/d)	To marginally reduce ischemic events (stroke, myocardial infarction or vascular death): 5.32% per year clopidogrel VS 5.83% per year aspirin, ARR 0.51% x year. Adverse effects was similar, i.e. intracraneal (0.33-0.47%) & GI bleeding (0.52-0.72%)
N Engl J Med. 2007 Oct 11;357(15):1477-86		Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, hypercholesterolemic adults and NOT coronary disease	The Use of statins, pravastatin As Prevention, Primary	Is better Than placebo	To reduce death from cronory heart disease, at 5 years of treatment and 10 years after: 11.8% for the entire 15 years period with statin VS 15.5% placebo
Lancet. 2002 Jul 6;360(9326):7-22		Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, normo-cholesterol adults with coronary disease, other occlusive arterial disease, or diabetes	The Use of statins, simvastatin, for 5 years As -	Is better Than placebo	To reduce coronary death rate (5.7% intv. / 6.9% cont.) and all-cause mortality (12.9% intv. / 14.7% cont.). Reduce major vascular events after the first year.
Lancet. 2005 Nov 26;366(9500):1849-61		Randomized Controlled Trial, Multicenter Study
IN atherosclerosis, normo-cholesterol adults with type 2 diabetes	The Use of fibrates, fenofibrate 200 mg daily As Treatment, Chronic	Is equal Than placebo	To prevent coronary events (combined myocardial infarction or coronary death: 5.9% with placebo VS 5.2% with fibrates) or to reduce total mortality.
Stroke. 2009 Apr;40(4):1410-6		Meta-Analysis
IN atrial fibrillation, anticoagulants, vitamin K antagonists, bleeding risk, elder patients, stroke, ischemic, cerebral infarction, embolic	The Use of age As Etiologic risk factor	Is useful Than -	To predict an increased risk of stroke (HR per decade 1.45), major bleeding (HR per decade 1.61) and cardiovascular events (HR per decade 1.45). However the relative benefit of warfarin for preventing stroke persisted, while that of aspirin decreased
Lancet. 2007 Aug 11;370(9586):493-503		Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, elder patients, not high haemorrahgic risk, not high stroke risk, anticoagulants, vitamin K antagonists, bleeding risk, elder patients	The Use of warfarin, antivitamin K As Treatment, Chronic	Is better Than aspirin	To reduce all-type strokes: 1.8% warfarin versus 3.8% aspirin. No increase at all in major haemorrhages.
Circulation. 2007 Jun 19;115(24):3050-6		Cohorts
IN atrial fibrillation, lone (no structural heart disease)	The Use of knowing natural history As Prognostic Item	Is useful Than no comparison here	To predict long-term (30 years) evolution : 30% progressed to permanent AF, mortality similar to general population, heart failure and stroke more frequent than general pop. but less than other AF, linked to HTA and comorbidities.
Eur Heart J. 2016 May 21;37(20):1582-90		Cohorts
IN atrial fibrillation, non valvular, stroke, ischemic, cerebral infarction, embolic	The Use of a new stroke risk score: ABC (Age, Biomarkers, Clinical history) combining: age, NT-proBNP, high-sensitivity troponine, prior stroke/transient ischaemic attack As Prognostic Item	Is better Than CHA2DS2-VASc score	To better predict the risk of stroke at a mean 2 years follow-up (c-indice 0.66 ABC vs. 0.58 CHA2DS2-VASc)
J Am Coll Cardiol. 2015 Jun 23;65(24):2614-23		Meta-Analysis
IN atrial fibrillation, non valvular, stroke, ischemic, cerebral infarction, embolic	The Use of percutaneous left atrial appendage closure As Treatment, Chronic	Is equal Than anticoagulants, antivitamine K, warfarin	To lodify all cause stroke or systemic embolism per year: 1.75% closure VS 1.87 warfarine. More ischemic but less hemorrhagic strokes with the device. Device had also less nonprocedural bleedings.
Cochrane Database Syst Rev. 2018 Mar 06;3:CD008980		Systematic Review, Cochrane Review
IN atrial fibrillation, non valvular, stroke, ischemic, cerebral infarction, embolic, all-cause mortality	The Use of direct oral anticoagulants, oral factor Xa inhibitors, apixaban, edoxaban, rivaroxaban, idraparinux As Treatment, Chronic	Is better Than oral anticoagulants, vitamin K antagonists, warfarin	To Results to be defined
Circulation. 2015 Jul 21;132(3):194-204		Systematic Review
IN atrial fibrillation, non valvular, stroke, ischemic, cerebral infarction, embolic, thromboembolic disease, old patients	The Use of anticoagulants, oral direct thrombin inhibitors, dabigatran, oral factor Xa inhibitors, apixaban, rivaroxaban, edoxaban As Treatment, Chronic	Is equal Than anticoagulants, antivitamine K, warfarin	To reduce thrombo-embolic events, but with different bleeding patterns: dabigatran was associated with a higher risk of gastrointestinal bleeding, risk of intracranial bleeding was lower, apixaban and edoxaban associated lower risk of major bleedings
N Engl J Med. 2010 Apr 15;362(15):1363-73		Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, permanent, rate control strategy	The Use of lenient rate control (resting heart rate <110 beats/min) As Treatment, Chronic	Is equal Than strict rate control (resting heart rate <80 beats/min and during moderate exercise <110 beats/min)	To modify at 2 years a composite of cardiovascular events: 12.9% lenient VS 14.9% strict (NS). Symptoms and adverse effects were also similar.
Heart. 2008 Feb;94(2):191-6. Epub 2007 May 4		Cohorts
IN atrial fibrillation, persistent	The Use of digitalis, digoxin As Treatment, Chronic	Is worse Than other rate control drugs	To modify mortality: 6.5% digitalis VS 4.1% non-digitalis, HR 1.53 after adjustement for other risk factors
JAMA. 2005 Feb 9;293(6):690-8		Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, persistent, non valvular, stroke, ischemic, cerebral infarction, embolic	The Use of anticoagulants, direct thrombin inhibitors, ximelagatran As Treatment, Chronic	Is equal Than warfarin	To prevent, at 20 months, stroke (of any type): 1.6% xime. VS 1.2% warf. Elevated liver enzymes (>3N): 6% xime. VS 0.8% warf. Major bleeding similar. Finally dropped due to hepatic toxicity.
Arch Intern Med. 2006 Apr 10;166(7):719-28		Systematic Review
IN atrial fibrillation, rhythm control strategy	The Use of antiarrhythmic drugs, classes IA, IC, III As Treatment, Chronic	Is worse Than placebo or no treatment	To reduce mortality, class IA drugs (quinidine, dysopiramide) increased mortality (NNH 109) and the rest did not modify it. All drugs increased adverse effects and pro-arrhythmia (but amiodarone).
N Engl J Med. 2009 May 14;360(20):2066-78		Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, stroke, ischemic, embolic	The Use of antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (75 mg/day) plus aspirin As Treatment, Chronic	Is better Than aspirin alone	To reduce major cardiovascular events, specially stroke (6.8% clopidogrel+aspirin VS 7.6% aspirin) but increased major haemorrhage (2% clopidogrel+aspirin VS 1.3% aspirin)
Lancet. 2006 Jun 10;367(9526):1903-12		Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, stroke, ischemic, embolic	The Use of antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (75 mg/day) plus aspirin (75-100 mg/day) As Treatment, Chronic	Is worse Than oral anticoagulation (target INR 2.0-3.0)	To prevent embolic events (stroke, non-CNS systemic embolus, myocardial infarction, or vascular death): annual risk 3.93% with warfarin VS 5.60% with aspirin plus clopidogrel
Clin Infect Dis. 2002 Jun 1;34(11):1481-90. Epub 2002 May 13		Randomized Controlled Trial
IN bacterial infection, cocci gram positive, Staphylococcus aureus, methicillin resistant	The Use of oxazolidinones antibiotics, linezolid (600mg/12h) As Treatment, Acute	Is equal Than vancomycine	To achieve a clinical cure: 73.2% linezolid 73.1% vancomycin. Similar rates of adverse events.
Cochrane Database Syst Rev. 2017 Sep 01;9:CD005186		Systematic Review, Cochrane Review
IN bacterial infection, nosocomial, any	The Use of multimodal interventions to improve hand hygiene compliance As Prevention, Primary	Is equal Than simpler interventions to increase hand hygiene compliance	To reduce colonization and infection rates: a few, low quality studies suggest complex interventions could at best slightly reduce infections
Nat Neurosci. 2013 Jan 28;16(2):139-45		Review (Narrative)
IN basic sciences, psychology, neurology, memory	The Use of sleep As Undefined	Is good Than Comparison to be defined	To perform a triage of wich information retain and consolidate this as a memory
Lancet. 2008 Jan 5;371(9606):57-63		Randomized Controlled Trial
IN behaviour problems, aggressive challenging behaviour, intellectual disability, not psychosis, not dementia	The Use of first-generation typical neuroleptics, haloperidol, second-generation atypical neuroleptics, risperidone As Treatment, Acute	Is equal Than placebo	To improve behaviour: aggression decreased substantially with all 3 treatments by 4 weeks, and placebo group showed the greatest change
Proc Natl Acad Sci U S A. 2007 Sep 18;104(38):15011-6		Descriptive
IN behaviour, regular, mate choices, cognitive process	The Use of women's physical attractiveness, men's overall desirability as a mate As Prognostic Item	Is better Than self-perceived, stated preferences in a mate	To predict the actual mate choice in speed dating
CMAJ. 1995 Sep 15;153(6):769-79		Randomized Controlled Trial
IN birth, non complicated, evidence based medicine, bias, physician beliefs influence in patient outcomes	The Use of physicians with favourably views of episiotomy As Treatment, Acute	Is worse Than physicians who viewed episiotomy very unfavorably	To reduce perineal trauma (intact perineum 12% in intv. VS 23% in ctrl.) and provide their patients satisfaction with the birth experience. The first stage of labour was 2.3 to 3.5 hours shorter and they used more frequently techniques to expedite labour.
Pediatrics. 2012 Jun;129(6):e1397-403		Randomized Controlled Trial
IN bronchiolitis, acute, viral, acute wheezing, preschool children	The Use of nebulized hypertonic 5% saline solution, 4 times a day As Treatment, Acute	Is better Than nebulized isotonic 0,9% saline solution	To reduce hospital adlission rates (62% hypertonic VS 92% isotonic) and lenght of stay at hospital (2 days hypertonic VS 3 days isotonic)
N Engl J Med. 2009 May 14;360(20):2079-89		Randomized Controlled Trial, Multicenter Study
IN bronchiolitis, acute, viral, infants	The Use of combination of nebulized epinephrine (3 ml of epinephrine in a 1:1000 solution, x2 days) and oral dexamethasone (1.0 mg/Kg 1st day and 0.6 mg/Kg for 5 days) As Treatment, Acute	Is better Than placebo, or any of both treatment alone	To reduce need for hospital admission: 17% combined Tt VS 26% placebo
Cochrane Database Syst Rev. 2008;(4):CD006458		Systematic Review, Cochrane Review
IN bronchiolitis, acute, viral, infants	The Use of nebulized hypertonic 3% saline solution As Treatment, Acute	Is better Than nebulized isotonic 0,9% saline solution	To reduce mean length of hospital stay (-0.94 days) and improve clinical score.
JAMA Pediatr. 2014 Jul 1;168(7):657-63		Randomized Controlled Trial
IN bronchiolitis, acute, viral, infants	The Use of nebulized hypertonic 3% saline solution (plus albuterol) As Treatment, Acute	Is better Than nebulized 0.9% normal saline solution (plus albuterol)	To reduce admissions to hospital: 29% hypertonic VS 43% normal saline.
BMJ. 2008 Mar 29;336(7646):701-4		Systematic Review
IN brucellosis	The Use of triple drug regimen with doxycycline, rifampicin and an aminoglycoside (gentamicin or streptomycin) As Treatment, Acute	Is better Than 1 or 2 drugs regimen, or using quinolones instead doxycycline	To reduce rate of failure: relative risk 2.50 with doxycycline-strepto VS triple drug regimen
Am J Med. 2012 Jun;125(6):560-7		Systematic Review
IN cancer, all types	The Use of aspirin, 75 mg daily or more, for at least 2.8 years As Prevention, Primary	Is better Than placebo	To reduce cancer deaths (2% aspirin VS 2.6% placebo) and noncardiovascular mortality (2.3% VS 2.6%)
J Gerontol A Biol Sci Med Sci. 2016 Dec;71(12):1653-1660		Cohorts
IN cancer, all types, older patients	The Use of classificating patients in 4 classes: four classes: relatively healthy (LC1), malnourished (LC2), cognitive and mood impaired (LC3), and globally impaired (LC4) As Prognostic Item	Is useful Than no classification	To predict overall 1-year mortality and 6-month unscheduled admissions
Lancet. 2009 May 2;373(9674):1532-42		Meta-Analysis
IN cancer, associated chronic anemia	The Use of erythropoietin analogs, recombinant human erythropoiesis-stimulating agents As Treatment, Chronic	Is worse Than placebo	To mortality (mean follow-up 6-8 months): 12% with erythropoietin VS 11% with placebo
N Engl J Med. 2007 Apr 12;356(15):1527-35		Randomized Controlled Trial, Multicenter Study
IN cancer, brain, glioblastoma	The Use of radiotherapy (focal, fractions of 1.8 Gy 5 days per week, total dose 50 Gy). As Treatment, Acute	Is better Than supportive care only	To improve survival: median 29 weeks radiotherapy VS 17 weeks supportive care
N Engl J Med. 2016 Apr 7;374(14):1344-55		Randomized Controlled Trial, Multicenter Study
IN cancer, brain, glioma (astrocytoma, oligoastrocytoma, or oligodendroglioma), low-grade	The Use of radiation therapy followed by six cycles of combination chemotherapy: procarbazine, lomustine (also called CCNU), and vincristine, all at the time of initial diagnosis As Treatment, Acute	Is better Than radiation therapy alone	To improve median overall survival (13.3 years radiation+chemo VS 7.8 years radiation only). Overall survival at 10 years: 60% combined Tt VS 40% radiation only
Cochrane Database Syst Rev. 2011;1(del):CD001877		Systematic Review, Cochrane Review
IN cancer, breast, screening	The Use of mammography As Diagnostic Tool	Is better Than no screening	To reduce, very modestly, mortality from breast cancer (NNT 2 000 throughout 10 years), at the cost of early overdiagnosis of bresat cancer (NNH 200) and many false positive findings (NNH 10)
BMJ. 2014;348():g366		Randomized Controlled Trial, Diagnostic
IN cancer, breast, women aged 40-59	The Use of mammography screening As Diagnostic Tool	Is equal Than physical breast examinations	To modify death from breast cancer after 15 years of follow-up: rates identical in both groups. More cancers were diagnosed in the mammography group resulting in less mortality rate in patients diagnosed with cancer
J Clin Oncol. 2011 Sep 1;29(25):3457-6		Cohorts
IN cancer, chemotherapy, toxicity, risk estimation, older patients	The Use of a risk stratification schema (range 0 to 19) composed of age, anemia, renal failure, bad hearing, >1 fall last 6 months, needing help for taking medocs, reduced walking, decreased social life, polychemotherapy and using standard chemo dose As Prognostic Item	Is better Than no systematic assessment	To predict grade 3 (severe), grade 4 (life-threatening or disabling), or grade 5 (death) chemotherapy toxicity: low risk, 0 to 5 points = 30% incidence, intermediate 6 to 9 points = 52%, high risk 10 to 19 points = 83%
PLoS One. 2011;6(6):e20456		Meta-Analysis
IN cancer, colorectal	The Use of high red meat and processed meat consumption As Etiologic risk factor	Is useful Than low red meat and processed meat consumption	To predict the risk of colorectal cancer : RR 1.22 for the highest versus the lowest intake, RR 1.14 for every 100 g/day increase in consumption
N Engl J Med. 2005 Dec 22;353(25):2654-66		Descriptive
IN cancer, colorectal	The Use of pathological signs of early metastatic invasion (venous emboli, lymphatic and perineural invasion) As Prognostic Item	Is useful Than no comparison	To predict survival: absence of early metastatic invasion was independently associated with increased survival. Tumours without early metastatic invasion had increased markers of T-cells migration, activation, and differentiation
BMJ. 2006 Jul 8;333(7558):69-70. Epub 2006 Jun 21		Cohorts
IN cancer, colorectal, clinical presentation	The Use of new onset rectal bleeding in patients aged 45 or more As Diagnostic Tool	Is useful Than no comparison here	To investigate bowel: 5.7% of this patients had colorectal cancer, and 4.9% had colonic adenoma.
Am J Gastroenterol. 2008 Jun;103(6):1541-9		Systematic Review, Cochrane Review
IN cancer, colorectal, screening in asymptomatic average risk adults	The Use of fecal occult blood test (hemoccult) As Diagnostic Tool	Is better Than no screening	To slightly reduce death from colorectal cancer at 12-18 years (0.8% using hemoccult VS 1% no screening, NNT 617) while not reducing overall mortality (31%)
Gastroenterology. 2006 Aug;131(2):390-401; quiz 659-60		Systematic Review
IN cancer, gastroesophageal, clinical feautures	The Use of alarm features such as dysphagia, weight loss, or anemia As Diagnostic Tool	Is worse Than endoscopy	To diagnose upper GI malignancy: sensitivity varied from 0% to 83%, specificity 40% to 98%, with considerable heterogeneity between studies.
N Engl J Med. 2006 Jul 6;355(1):11-20		Randomized Controlled Trial, Multicenter Study
IN cancer, gastroesophageal, resectable	The Use of perioperative chemotherapy: 3 preoperative and 3 postoperative cycles of epirubicin and cisplatin plus a continuous intravenous infusion of fluorouracil for 21 days As Treatment, Acute	Is better Than surgery alone	To improve survival at 5 years: 36% perioperative chemotherapy VS 23% surgery alone.
Cochrane Database Syst Rev. 2000;2(2):CD002139		Systematic Review, Cochrane Review
IN cancer, lung, non-small cell	The Use of chemotherapy containing cisplatin As Treatment, Acute	Is better Than only supportive care, only surgery or only radiotherapy	To modestly improve survival: 10% absolute reduction of death at 1 year vs only supportive care
N Engl J Med. 2010 Jun 24;362(25):2380-8		Randomized Controlled Trial, Multicenter Study
IN cancer, lung, non-small-cell, advanced	The Use of gefitinib, EGFR tyrosine kinase inhibitor As Treatment, Acute	Is better Than carboplatin-paclitaxel chimiotherapy	To improve survival: 30 months gefitinib VS 24 carboplatin. Gefitinib had also less severe adverse effects.
N Engl J Med. 2010 Aug 19;363(8):733-42		Randomized Controlled Trial, Multicenter Study
IN cancer, lung, non-small-cell, advanced	The Use of early palliative care, integrated with standard oncologic care As Treatment, Chronic	Is better Than standard oncologic care alone	To improve quality of life and to improve survival (12 months early palliative VS 9 months standard) despite receiving less agressive end-of-life care.
Nat Genet. 2013 Sep 26;45(10):1127-1133		Descriptive
IN cancer, oncogenic signature classes	The Use of oncogenic signature classes: patterns of combined genetic and epigenetic features As Etiologic risk factor	Is useful Than no comparison here	To various defined oncogenic signature classes are characteristics of multiple cross-tissue groups of tumors
N Engl J Med. 2018 Apr 05;378(14):1313-1322		Randomized Controlled Trial
IN cancer, pleural, effusion	The Use of talc administered through an indwelling pleural catheter (4 g of talc slurry) As Treatment, Acute	Is better Than indwelling pleural catheter alone	To induce pleurodesis: 43% talc VS. 23% catheter only. No significant between-group differences in effusion size, inpatient days, mortality, or number of adverse events
J Clin Oncol. 2007 Aug 20;25(24):3582-8		Decision Model
IN cancer, prostate	The Use of a nomogram including age, ethnicity, family history, urinary symptoms, prostatic specific antigen (PSA), free:total PSA ratio, and digital rectal examination As Diagnostic Tool	Is better Than PSA alone	To detect patients with prostate cancer. 24% of patients with PSA < 4 ng/mL had prostate cancer.
J Clin Oncol. 2005 Jul 1;23(19):4322-9. Epub 2005 Mar 21		Decision Model
IN cancer, prostate	The Use of PSA>1.55 ng/mL or >0.165 ng/mL/cc(prostate volume), hypoechoic lesion, age>55y, prostate volume<44cc As Diagnostic Tool	Is better Than increase PSA alone	To select patients for prostatic biopsy in search of prostatic cancer: 31% sensibility and 96,6% specificity for prostatic cancer
N Engl J Med. 2005 May 12;352(19):1977-84		Randomized Controlled Trial, Multicenter Study
IN cancer, prostate, early non-metastatic	The Use of radical prostatectomy As Treatment, Acute	Is better Than watchful waiting	To decrease - at 8 years - metatasis development, local progression, death due to prostate cancer (8.6% with surgery VS 14.4% waiting) and total mortality (24% with surgery VS 30.5% waiting)
Ann Intern Med. 2008 Mar 18;148(6):435-48		Systematic Review
IN cancer, prostate, early non-metastatic	The Use of radical prostatectomy As Treatment, Acute	Is better Than watchful waiting or external-beam radiation	To reduced at 10 years all-cause mortality (24% prostatectomy vs. 30% wacthful) or reduce at 5 years cancer recurrence
N Engl J Med. 2016 Oct 13;375(15):1425-1437		Randomized Controlled Trial, Multicenter Study
IN cancer, prostate, early non-metastatic	The Use of active monitoring As Treatment, Chronic	Is better Than radical prostatectomy, or external-beam radiotherapy	To preserve sexual, urinary and bowel functions: sexual and urinary function declined gradually. Prostatectomy was the worst on sexual function and urinary continence. Radiotherapy reduced sexual and bowel functions but did not impact continency
N Engl J Med. 2016 Oct 13;375(15):1415-1424		Randomized Controlled Trial, Multicenter Study
IN cancer, prostate, early non-metastatic	The Use of active monitoring only As Treatment, Chronic	Is equal Than radical prostatectomy, or external-beam radiotherapy	To change overral mortality and prostate-cancer-specific deaths at 10 years follow-up: 1.5/1000 persons-year active monitoring VS 1/1000 prostatectomy VS 0.7/1000 radiotherapy. More disease progression and metastases in monitoring only
N Engl J Med. 2003 Jul 17;349(3):215-24		Randomized Controlled Trial, Multicenter Study
IN cancer, prostate, primary prevention in healthy men	The Use of finasteride As Prevention, Primary	Is better Than placebo	To prevent development of prostate cancer (2,63%/year in intv VS 3,48%/year), benign prostatic hyperplasia (5,2% VS 8,7%) and have less urinary symptoms. But intv group had more sexual dysfunction and prostatic cancers were high grade more freq(6,4% vs 5,1%)
N Engl J Med. 2009 Mar 26;360(13):1310-9		Randomized Controlled Trial, Multicenter Study
IN cancer, prostate, screening in healthy men	The Use of screeing using annual PSA testing and digital rectal examination for 6 years As Diagnostic Tool	Is equal Than usual care, not routine screening	To modify mortality by prostatic cancer (2/10,000 person-years screening VS 1.7/10,000 controls) despite detecting more prostatic cancers (116/10,000 person-years screening VS 95/10,000 controls)
N Engl J Med. 2007 Oct 18;357(16):1579-88		Diagnostic
IN cancer, uterine, cervical, screening	The Use of testing for DNA of oncogenic human papillomaviruses As Diagnostic Tool	Is better Than Papanicolaou test	To identify high-grade cervical intraepithelial neoplasia: papillomaviruses DNA: sens 95%, spec 94%; Papanicolau sens 55%, spec 97%.
Lancet. 2005 Oct 22-28;366(9495):1435-42		Randomized Controlled Trial, Multicenter Study
IN candida, systemic infection, non-neutropenic patients	The Use of voriconazole As Treatment, Acute	Is equal Than amphotericin B followed by oral fluconazole	To achieve a successful clinical and bacteriological outcome : 65% voriconazole VS 71% amphotericine; 95% CI for difference -10.6% to 10.6%. Dicontinuation by adverse effects equal to amphot.
N Engl J Med. 2002 Feb 21;346(8):549-56		Randomized Controlled Trial, Multicenter Study
IN cardiac arrest, ventricular fibrillation	The Use of hypothermia, mild, immediatly after resuscitation As Treatment, Acute	Is better Than standard treatment with normothermia	To reduce mortality at 6 months (41% with hypothermia VS 55% if not)
N Engl J Med. 2008 Jan 3;358(1):9-17		Cohorts
IN cardiac arrest, ventricular fibrillation, in hospital	The Use of rapid defibrillation in less than 2 minutes As Treatment, Acute	Is better Than delayed defibrillation in more than 2 minutes	To increase survival to hospital discharge: 39% if in < 2 min VS 22% if not)
N Engl J Med. 2000 Jun 15;342(24):1778-85		Cohorts
IN cardiomyopathy, hypertrophic	The Use of magnitude of left ventricle hypertrophy As Prognostic Item	Is useful Than 0	To predict the risk of sudden death
JAMA. 2011 Mar 2;305(9):913-22		Meta-Analysis
IN cardiovascular death, atherosclerosis, patients with a history of cardiovascular disease or diabetes but without hypertension	The Use of antihypertensive drugs, no information at all about which specific antihypertensive drugs were studied As Treatment, Chronic	Is better Than placebo	To reduce stroke (RR 0.77, NNT 129), myocardial infarction (RR 0.80, NNT 75), heart failure (RR 0.85, NNT 23), and all-cause mortality (RR 0.87, NNT 75)
Arch Intern Med. 2006 Dec 11-25;166(22):2446-54		Meta-Analysis
IN cardiovascular death, risk in critically ill patients	The Use of troponin T As Prognostic Item	Is useful Than no comparison here	To identify patients with an increased risk of death (OR, 2.5). Elevated troponin was found in a median of 43% of those patients.
Am J Cardiol. 2008 May 15;101(10):1437-43		Cohorts
IN cardiovascular death, risk in general population, asymptomatic middle-aged men	The Use of exercise test, stop exercise before reaching 85% of maximal heart rate (HR) and Increased HR at rest, attenuated HR increase or delayed HR recovery As Prognostic Item	Is useful Than no comparison	To predict increased risk of sudden death (HR 1.8), cardiac death (HR 1.4) and all-cause mortality (HR 1.3)
Arch Intern Med. 2007 Dec 10;167(22):2490-6		Cohorts
IN cardiovascular death, risk in general population, elderly patients	The Use of addition of: microalbuminuria, and estimated glomerular filtration rate of less than 75 mL/min/1.73 m(2) As Prognostic Item	Is better Than classic cardiovascular risk models not including renal function	To predict higher cardiovascular mortality at 8 years
Circulation. 2005 Nov 15;112(20):3088-96		Meta-Analysis
IN cardiovascular death, risk in kidney disease, chronic, end-stage	The Use of troponin T As Prognostic Item	Is useful Than no comparison here	To identify patients with higher risk of cardiac death and increased all-cause mortality (relative risk, 2.64)
JAMA. 2013 Sep 4;310(9):918-29		Randomized Controlled Trial, Multicenter Study
IN cardiovascular disease	The Use of polypill, fixed-dose combinations of drugs, 75 mg aspirin, 40 mg simvastatin, 10 mg lisinopril, and 50 mg atenolol As Prevention, Primary	Is better Than usual care	To improve medication adherence (86% polypill VS 65% usual) and statistically significant but small improvements in blood pressure and LDL-C
Cochrane Database Syst Rev. 2014;4:CD009868		Systematic Review, Cochrane Review
IN cardiovascular disease, cardiovascular death	The Use of polypill, fixed-dose combinations of drugs As Treatment, Chronic	Is equal Than Comparison to be defined	To cardiovascular mortality and cardiovascular events. Reductions in blood pressure and lipid parameters are generally lower than those previously projected.
N Engl J Med. 2006 Jun 8;354(23):2452-62		Randomized Controlled Trial
IN cholera	The Use of azithromycin (single 1-g dose of two 500-mg tablets) As Treatment, Acute	Is better Than ciprofloxacin (also a single 1-g dose of two 500-mg tablets)	To produce clinical success (stop watery stools within 48 hours after administration): 73% with azytro VS 27% with cipro. The lack of efficacy of ciprofloxacin may result from its diminished activity against strains in Bangladesh.
Fam Pract. 2009 Aug;26(4):260-8		Systematic Review
IN chronic obstructive pulmonary disease	The Use of clinical items: >45 years, dyspnoea, wheezing, current smoking and extensive smoking (>40 pack years), previous consult for wheezing, self-reported history of COPD, auscultatory wheezing, forced expiratory time, laryngeal height, prolonged expiration As Diagnostic Tool	Is useful Than spirometry as gold standard	To diagnose chronic obstructive pulmonary disease
Cochrane Database Syst Rev. 2014;3:CD010844		Systematic Review, Cochrane Review
IN chronic obstructive pulmonary disease	The Use of double inhaled therapy, combining long-acting beta-agonist and inhaled corticosteroids As Treatment, Chronic	Is better Than any single inhaled therapy: long-acting anticholinergic, long-acting beta-agonist or inhaled corticosteroids	To increase, at 1 year, FEV1 (+100 mL combined LABA+ICS) and a respiratory clinical score. LAA and LABA were roughly equivalent, ICS were more effective than placebo but less than the other long-term threatments
Cochrane Database Syst Rev. 2014;3():CD010115		Systematic Review, Cochrane Review
IN chronic obstructive pulmonary disease	The Use of inhaled corticosteroids, fluticasone, budesonide As Treatment, Chronic	Is worse Than Comparison to be defined	To carry an increased risk of severe pneumonia (causing hospitalization or death) : OR 1.8 for fluticasone, 1.6 with budesonide. The risk of any pneumonia event (i.e. less serious cases) was higher with fluticasone than with budesonide (OR 1.86
Canadian Agency for Drugs and Technologies in Health (CADTH). 2010 May;127:1-131		Systematic Review
IN chronic obstructive pulmonary disease	The Use of triple inhaled therapy combining long-acting anticholinergic, long-acting beta-agonist and inhaled corticosteroids As Treatment, Chronic	Is better Than dual combination therapy or monotherapy	To reduce the number of severe exacerbations leading to hospitalization and increase quality of life (compared to monotherapy), with a possible increase in the risk of pneumonia
Chest. 2005 Nov;128(5):3489-99		Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, emphysema	The Use of lung-volume-reduction surgery As Treatment, Chronic	Is worse Than physical training alone	To perioperative and at 1 year mortality risk: 7/53 patients death in the surgery group VS 1/53 patients in control (p non significant). Health status and FEV1 were improved after surgery at 1 year.
N Engl J Med. 2011 Aug 25;365(8):689-98		Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, exacerbations	The Use of long-term antibiotics, azithromycin 250 mg daily for 1 year As Prevention, Secondary	Is better Than placebo	To reduce (but only marginally) nuber of exacerbations (1.5 par year azytro VS 1.8 per year placebo. Hearing impairment was higher: 25% patients azytro VS 20% placebo
BMJ. 2011 Jun 14;342:d3215. doi: 10.1136/bmj.d3215		Systematic Review
IN chronic obstructive pulmonary disease, exacerbations	The Use of inhaled anticholinergics, long acting, tiotropium, using mist inhaler As Treatment, Acute	Is worse Than placebo	To mortality: increased with tiotropium (2.4%) VS placebo (1.7%). NNH = 124
Thorax. 2008 May;63(5):415-22		Meta-Analysis
IN chronic obstructive pulmonary disease, exacerbations	The Use of short-course antibiotic treatment (5 days or less) As Treatment, Acute	Is equal Than longer duration of antibiotic course	To achieve clinical and bacteriological cure (OR 1.0 and 1.05 respectively)
Chest. 2005 Jul;128(1):48-54		Randomized Controlled Trial
IN chronic obstructive pulmonary disease, exacerbations	The Use of smaller doses of short-acting inhaled beta2 agonists (albuterol, 2.5mg/4h) As Treatment, Acute	Is equal Than greater doses of the same drug (albuterol, 5mg/4h)	To increase FEV1 and peak expiratory flow rate, increase recovery rate, reduce hospital stay (trend to lower stay with higher doses: 6 vs 9 days, but not significant) or reduce side effects.
Chest. 2008 Mar;133(3):756-66		Systematic Review
IN chronic obstructive pulmonary disease, exacerbations	The Use of systemic corticosteroids, antibiotics, and noninvasive positive pressure ventilation As Treatment, Acute	Is better Than placebo or no use of that treatment	To reduce in-hospital mortality (antibiotics and ventilation) and reduce treatment failure (all, corticosteroids)
Chest. 2001 Jun;119(6):1840-1849		Descriptive
IN chronic obstructive pulmonary disease, exacerbations, severe, requiring invasive mechanical ventilation	The Use of presence of comorbidities, APACHE, need for ventilation for > 72h or extubation failure As Prognostic Item	Is useful Than -	To predict higher in-hospital mortality
Chest. 2010 Sep 30;epub(epub):epub		Cohorts
IN chronic obstructive pulmonary disease, in non-smokers	The Use of non-smokers, never smokers patients As Etiologic risk factor	Is useful Than no comparison	To though never smokers have much less risk of developing CPOD, they comprise 20-23% of all individuals with COPD. Asthma, age, lower education occupational exposure, childhood respiratory diseases and BMI alterations predicted COPD
Cochrane Database Syst Rev. 2005 Oct 19;(4):CD003566		Systematic Review, Cochrane Review
IN chronic obstructive pulmonary disease, stable	The Use of cardioselective beta-blockers As Treatment, Chronic	Is equal Than placebo	To modify respiratory function: no significant difference, at 3 months, in FEV1 or respiratory symptoms
BMJ. 2011 May 10;342:d2549. doi: 10.1136/bmj.d2549		Cohorts
IN chronic obstructive pulmonary disease, stable	The Use of cardioselective beta-blockers, given in addition to inhaled corticosteroid and long acting β agonist, with or without long acting antimuscarinic As Treatment, Chronic	Is better Than no beta-blockers use	To reduce all-cause mortality (22% relative reduction) and reduce hospital admissions due to respiratory disease.
N Engl J Med. 2000 Dec 28;343(26):1902-1909		Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, stable	The Use of corticosteroids, inhaled As Treatment, Chronic	Is equal Than placebo	To reduce the rate of decline of post-bronchodilator FEV1 at 3 years. It reduced the visits to a physician because of a respiratory illness (1.2% /year in intv. VS 2.1% /year in ctrl.) and reduced symptoms.
J Gen Intern Med. 2006 Oct;21(10):1011-9		Meta-Analysis
IN chronic obstructive pulmonary disease, stable	The Use of inhaled anticholinergics As Treatment, Chronic	Is better Than long acting beta2-agonists	To reduced severe exacerbations (RR 0.67, compared to placebo) and respiratory deaths (RR 0.27, compared to placebo) while beta2-agonists associated increased risk for respiratory deaths
Cochrane Database Syst Rev. 2006 Jul 19;3:CD006101		Systematic Review, Cochrane Review
IN chronic obstructive pulmonary disease, stable	The Use of inhaled anticholinergics, ipratropium bromide As Treatment, Chronic	Is equal Than long acting beta2-agonists	To to improve COPD symptoms and exercise tolerance, although beta2-agonists improved better morning PEF and FEV1. combination therapy was a little better than beta-2 agonists alone for symptoms.
Thorax. 2006 Oct;61(10):854-62. Epub 2006 Jul 14		Meta-Analysis
IN chronic obstructive pulmonary disease, stable	The Use of inhaled anticholinergics, long acting, tiotropium As Treatment, Chronic	Is better Than placebo, ipratropium bromide, or long acting beta2-agonists	To reduce exacerbations (OR 0.73) and related hospitalisation (OR 0.68), but not to reduce mortality, all-cause or specific
Ann Intern Med. 2007 Nov 6;147(9):639-53		Systematic Review
IN chronic obstructive pulmonary disease, stable	The Use of long-acting beta2 agonists plus corticosteroids, inhaled and oxygen ; pulmonary rehabilitation As Treatment, Chronic	Is better Than placebo or inhaled corticosteroids alone and no oxygen	To reduce mortality (8.6% long-acting beta2 plus cortics VS 11% controls) (oxygen in resting hypoxemic patients RR 0.61). All lon-acting bronchodilators (B2 or tiatropium) reduced exacerbations and rehabilitation improved health status.
Lancet. 2008 Jun 14;371(9629):2013-8		Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, stable	The Use of mucolytics, carbocisteine As Treatment, Chronic	Is better Than placebo	To reduce exacerbation rate: 1.01 per patient per year with carbocisteine VS 1.35 placebo.
Lancet. 2005 Apr 30;365(9470):1552-60		Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, stable	The Use of mucolytics, N-acetylcysteine As Treatment, Chronic	Is equal Than placebo	To reduce yearly reduction in pulmonary function (FEV1 reduction 54ml VS 47ml/y) and the number of exacerbations per year (1.5 VS 1.29)
Chest. 2001 Jun;119(6):1661-70		Randomized Controlled Trial
IN chronic obstructive pulmonary disease, stable	The Use of theophylline, added to inhaled beta2-agonists As Treatment, Chronic	Is better Than inhaled beta2-agonists alone	To reduce - at 3 months - symptoms and dyspnea (53% in Theo+B2 VS 40% in B2 alone) and improve FEV1. Number of exacerbations was not significantly different and theophylline increased adverse effects.
N Engl J Med. 2017 Sep 07;377(10):923-935		Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, stable, early stage	The Use of inhaled anticholinergics, long acting, tiotropium As Treatment, Chronic	Is better Than placebo	To slightly improve at 2 years the FEV1 (mean difference 71 to 133 ml after bronchodilator use) and slightly reduce the decline of FEV1 after bronchodilator use (29 ml/year tiotrop VS 51 ml/year placebo)
N Engl J Med. 2011 Mar 24;364(12):1093-103		Randomized Controlled Trial, Multicenter Study
IN chronic obstructive pulmonary disease, stable, moderate to severe	The Use of inhaled anticholinergics, long acting, tiotropium As Treatment, Chronic	Is better Than long acting beta2-agonists, salmeterol	To reduce number of moderate or seve exarcerbations at 1 year: 0.64 tiotropium VS 0.72 salmeterol. the incidence of serious adverse events was similar.
Ann Intern Med. 2012 Dec 18;157(12):878-88		Systematic Review
IN clostridium difficile Infecion, diarrhea, acute, infectious, antibiotic-associated	The Use of probiotics, mainly different types of lactobacillus As Prevention, Primary	Is better Than placebo	To to reduce the incidence of Clostridium difficile-associated diarrhea in patients taking antibiotics: RR 0.34
N Engl J Med. 2011 Feb 3;364(5):422-31		Randomized Controlled Trial, Multicenter Study
IN clostridium difficile infecion, diarrhea, acute, infectious, antibiotic-associated	The Use of fidaxomicin, 200 mg twice daily for 10 days, new class of narrow spectrum non-absorbable macrocyclic antibiotic As Treatment, Acute	Is better Than oral vancomycin, 125 mg four times daily for 10 days	To reduce recurrence rates at 4 weeks (13% fidaxo VS 24% vanco) with non-inferior rates of initial clinical response (88% fidaxo VS 86% vanco)
AHRQ Comparative Effectiveness Reviews. 2016 Mar. Report No.: 16-EHC012-EF		Systematic Review
IN clostridium difficile infecion, diarrhea, acute, infectious, antibiotic-associated	The Use of high strenght: various preventive intervantions, oral vancomycine, fidaxomicin. Low strenght: probiotics, fecal transplantation As Treatment, Acute	Is better Than comparison	To other comparative intervantions in preventing and treating acute symptomatic c. difficile infection
CADTH Technology Report. 2011 Jan 26; No. 136, publication 2775		Systematic Review
IN clostridium difficile Infecion, diarrhea, acute, infectious, antibiotic-associated	The Use of vancomycin, oral As Treatment, Acute	Is better Than metronidazole, oral	To increase cure rate of initial or recurrent episodes of severe C. difficile (relative reduction 27%), while having equal effectiveness in moderate episodes.
Health Technol Assess. 2013 Dec;17(57):1-140		Randomized Controlled Trial, Multicenter Study
IN clostridium difficile infecion, diarrhea, acute, infectious, antibiotic-associated, older people	The Use of probiotics, high-dose preparation of lactobacilli and bifidobacteria As Treatment, Acute	Is equal Than placebo	To modify incidence of antibiotic-associated diarrhea (10% both groups), including C. difficile infections (probiotic 0.8%, placebo 1.2%, p 0.35)
Aliment Pharmacol Ther. 2006 Jul 1;24(1):47-54		Meta-Analysis
IN coeliac disease	The Use of human recombinant tissue transglutaminase antibody As Diagnostic Tool	Is better Than endomysial antibody	To sreen asymptomatic people and for excluding coeliac disease in symptomatic individuals with a low pretest probability (i.e. <25%), if pretest probability >25%, biopsy should be preferred. Sensitivity 93%, specificity 98%.
Aliment Pharmacol Ther. 2008 Jun 1;27(11):1044-52		Systematic Review
IN coeliac disease	The Use of intake of a little amount of gluten (<10 mg/day) As Etiologic risk factor	Is better Than higher intake of gluten	To avoid cause significant histological abnormalities
Neurobiol Aging. 2014 Aug;35(8):1873-82		Descriptive
IN cognitive impairment, age related, older people without cognitive impairment	The Use of higher lifestyle cognitive activity and higher current physical activity As Etiologic risk factor	Is better Than lower lifestyle cognitive and physical activities	To be associated with lower volume of white matter lesion, higher neural integrity and higher global cognitive functioning
Cochrane Database Syst Rev. 2006 Oct 18;(4):CD003575		Systematic Review, Cochrane Review
IN collagenous colitis, diarrhea, chronic	The Use of budesonide, oral, enteral liberation formulation, 9 mg daily (entocort (r)) As Treatment, Chronic	Is better Than placebo, or other therapeutics tested	To improve diarrhea and symptoms: NNT 2
Neurology. 2006 Jul 25;67(2):203-10		Systematic Review
IN coma, post-cardiac arrest, post-resuscitation care	The Use of several predictors: pupillary light response, corneal reflexes, motor responses to pain, myoclonus status epilepticus, serum neuron-specific enolase, and somatosensory evoked potential studies As Diagnostic Tool	Is better Than others clinical, biological and radiological findings	To accurately predict poor outcome in comatose patients after cardiopulmonary resuscitation
Cochrane Database Syst Rev. 2007;(4):CD006829		Systematic Review, Cochrane Review
IN Condition to be defined	The Use of combined long-acting beta2 agonists plus corticosteroids, inhaled As Treatment, Chronic	Is better Than long-acting beta-agonists alone	To reduce exacerbation rate (Rate Ratio 0.82) and improve quality of life. No difference in mortality or hospitalisations. Pneumonia more frequent with combined Tt (OR 1.62)
Chest. 2016 Mar;149(3):756-66		Systematic Review
IN Condition to be defined	The Use of various pharmacologic treatments, including pirfenidone and nintedanib As Treatment, Chronic	Is equal Than placebo	To modify respiratory-specific or all-cause mortality
N Engl J Med. 2009 Mar 26;360(13):1320-8		Study type to be defined
IN Condition to be defined	The Use of Intervention to be defined As Undefined	Is undefined Than Comparison to be defined	To Results to be defined
Am J Med. 2009 Feb;122(2):152-61		Study type to be defined
IN Condition to be defined	The Use of Intervention to be defined As Undefined	Is undefined Than Comparison to be defined	To Results to be defined
BMJ. 2010;341(341):c3584		Study type to be defined
IN Condition to be defined	The Use of Intervention to be defined As Undefined	Is undefined Than Comparison to be defined	To Results to be defined
Cochrane Database Syst Rev. 2012;3(N):CD007176		Study type to be defined
IN Condition to be defined	The Use of Intervention to be defined As Undefined	Is undefined Than Comparison to be defined	To Results to be defined
Eur Heart J. 2007 Oct;28(20):2485-90		Diagnostic
IN coronary disease	The Use of coronary multidetector computed tomography As Diagnostic Tool	Is better Than exercise electrocardiography, with coronary angiography as gold standard	To diagnose significant coronary disease: 91% sensitivity and 83% specificity of scan VS 73% sensitivity and 31% specificity of exercise ECG.
Ann Intern Med. 2000 Jun 6;132(11):862-70.		Cohorts
IN coronary disease	The Use of stress test, treadmill exercise testing, in elderly persons As Diagnostic Tool	Is equal Than treadmill exercise testing, in younger persons	To predict overall survival and cardiac event-free survival. Workload achieved was the main exercise testing variable that was predictive of death.
Circulation. 2012 Jun 12;125(23):2873-91. Epub 2012 May 14		Meta-Analysis
IN coronary disease	The Use of drug-eluting stents, specially using everolimus, sirolimus and zotarolimus, but not those using paclitaxel As Treatment, Acute	Is better Than bare-metal stents	To reduce long-term need for revascularization and reduce myocardial infarction (RR 0.50), with no increase in the risk of any long-term safety outcomes, including stent thrombosis
Am J Med. 2009 Apr;122(4):356-65		Meta-Analysis
IN coronary disease	The Use of calcium channel blockers As Treatment, Chronic	Is better Than placebo, or mixed comparison placebo plus others treatments	To reduce angina and stroke, but not to reduce mortality (either all-cause or cardiovascular) nor to reduce myocardial infarction
N Engl J Med. 2007 Mar 8;356(10):1030-9		Meta-Analysis
IN coronary disease	The Use of drug-eluting stents, sirolimus As Treatment, Chronic	Is equal Than bare-metal stents	To reduce the overall risk of death, myocardial infarction and stent thrombosis.
Lancet. 2007 Sep 15;370(9591):937-48		Meta-Analysis
IN coronary disease	The Use of drug-eluting stents, sirolimus, paclitaxel As Treatment, Chronic	Is equal Than bare-metal stents	To reduce the risk of death and myocardial infarction
N Engl J Med. 2007 Mar 8;356(10):998-1008		Meta-Analysis
IN coronary disease	The Use of drug-eluting stents, sirolimus, paclitaxel As Treatment, Chronic	Is worse Than bare-metal stents	To reduce stent thrombosis at 4 years (1.2 to 1.3% drug-eluting VS 0.6 to 0.9% bare-metal) Rates of death or myocardial infarction did not differ.
Circulation. 2003 Feb 25;107(7):966-72		Randomized Controlled Trial
IN coronary disease, acute coronary syndrome	The Use of adenosine diphosphate (ADP) receptor inhibitors, clopidogrel, added to aspirin, combined anti-platelet therapy As Treatment, Acute	Is better Than aspirin alone	To reduce ischemic events (cardiovascular death, myocardial infarction, or stroke) at 30 days (4.3% in intv. VS 5.4% in ctrl.) and at 12 months (5.2% in intv. VS 6.3% in ctrl.) No significant excess in life-threatening bleeds (but yes for total bleeds)
N Engl J Med. 2007 Nov 15;vol(issue):pag [Epub ahead of print Nov 4]		Randomized Controlled Trial, Multicenter Study
IN coronary disease, acute coronary syndrome	The Use of adenosine diphosphate (ADP) receptor inhibitors, prasugrel, added to aspirin, combined anti-platelet drugs As Treatment, Acute	Is better Than clopidogrel, added to aspirin, combined anti-platelet therapy	To reduce recurrence of myocardial infarction (7.4% for prasugrel VS 9.7% for clopidogrel) and a derived combined end-point of cardiovascular death and major events.
N Engl J Med. 2009 Sep 10;361(11):1045-57		Randomized Controlled Trial, Multicenter Study
IN coronary disease, acute coronary syndrome	The Use of adenosine diphosphate (ADP) receptor inhibitors, ticagrelor, added to aspirin, combined anti-platelet therapy As Treatment, Acute	Is better Than clopidogrel, added to aspirin, combined anti-platelet drugs	To reduce at 12 months cardiovascular events (death from vascular causes, myocardial infarction, or stroke): 10% ticagrelor VS 12% clopidogrel. Ticagrelor increased minor bleedings but not major haemorrhages.
J Am Coll Cardiol. 2010 May 11;55(19):2096-106		Cohorts
IN coronary disease, acute coronary syndrome, myocardial infarction	The Use of copeptin, added to troponin As Diagnostic Tool	Is better Than troponin	To more accurately diagnose an acute coronary syndrome (c-statistics 0.93 copeptin + troponin VS 0.84 troponin alone) and to rule out coronary syndrome in the first 3 hours: 92% negative predictive value with copeptin + troponin
Cochrane Database Syst Rev. 2011;1:CD007038		Systematic Review, Cochrane Review
IN coronary disease, acute coronary syndrome, myocardial infarction	The Use of pentasacharide analogues, fondaparinux As Treatment, Acute	Is better Than low molecular weight heparins (LMWH), enoxaparin	To reduce the risk of all-cause mortality at 90 to 180 days (RR 0.89) while reducing minor bleeding
Eur Heart J. 2011 Jun;32(11):1379-89		Diagnostic
IN coronary disease, acute coronary syndrome, myocardial infarction, older patients	The Use of high-sensitive cardiac troponin assays As Diagnostic Tool	Is better Than standard cardiac troponin assay	To diagnose acute myocardial infarction: AUC 0.95 sensitive troponine VS 0.90 standard troponine. Best cut-offs in elderly patients differed clearly from younguer patients. Mild elevations are commont in non-infarctus elderly (20% patients)
Eur Heart J. 2013 Sep 11. [Epub ahead of print]		Meta-Analysis
IN coronary disease, acute coronary syndrome, myocardial infarction, ST-segment elevation	The Use of intracoronary bone marrow cell therapy As Treatment, Acute	Is better Than placebo or no cell therapy	To improve (at a time not well defined) left ventricle ejection fraction (LVEF) : 2.5% mean increase, 5.3% when LVEF was < 40%
JAMA. 2006 Apr 5;295(13):1519-30. Epub 2006 Mar 14		Randomized Controlled Trial, Multicenter Study
IN coronary disease, acute coronary syndrome, ST-segment elevation	The Use of pentasacharide analogues, fondaparinux (2.5 mg/d) for 8 days As Treatment, Acute	Is better Than unfractionated heparin for 2 days, or placebo	To reduce at 30 days bad outcome (death or reinfarction): 9.7% fondaparinux VS 11.2% controls. No difference in bleeding.
N Engl J Med. 2001 Aug 16;345(7):494-502		Randomized Controlled Trial, Multicenter Study
IN coronary disease, acute coronary syndrome, without ST elevation	The Use of adenosine diphosphate (ADP) receptor inhibitors, clopidogrel, added to aspirin, combined anti-platelet therapy As Treatment, Acute	Is better Than aspirin alone	To reduce, at 1 year, ischemic events (cardiovascular death, myocardial infarction or stroke): 9.3% in intv VS 11.4% in ctrl. Increase major bleeds (3.7% in intv. VS 2.7% in ctrl.)
N Engl J Med. 2006 Apr 6;354(14):1464-76. Epub 2006 Mar 14		Randomized Controlled Trial, Multicenter Study
IN coronary disease, acute coronary syndrome, without ST elevation	The Use of pentasacharide analogues, fondaparinux (2.5 mg/d SC) for 6 days As Treatment, Acute	Is equal Than low molecular weight heparin (LMWH), enoxaparin 1 mg/Kg/12h	To reduce at 30 days bad outcome (death, reinfarction, or refractory ischemia): 8.0% fondaparinux VS 8.6% enoxaparin. Fondaparinux had fewer major haemorrhages: 3.1% VS 5.0% enoxaparin
JAMA. 2007 Jul 18;298(3):299-308		Cohorts
IN coronary disease, atherosclerosis	The Use of nonfasting triglycerides As Etiologic risk factor	Is useful Than no comparison here	To predict risk of developping coronary disease, myocardial infarction and death.
N Engl J Med. 1997 Dec 4;337(23):1648-53		Cohorts
IN coronary disease, chest pain, acute coronary syndrome	The Use of troponin I, troponin T As Diagnostic Tool	Is better Than CPK and ECG alone	To identify early patients at risk to develop myocardial infartion or death from cardiac causes: For the 34 total events (20 deaths, 14 infarctions), troponin I was positive in 32 and negative in 2. Troponin T was positive in 27 and negative in 7.
Lancet. 2012 Feb 4;379(9814):453-60		Diagnostic
IN coronary disease, chest pain, high risk patients	The Use of magnetic resonance imaging (MRI) of the heart, with adenosine stress As Diagnostic Tool	Is better Than single-photon emission computed tomography (SPECT), with adenosine stress, perfusion scintigraphy	To diagnose significant coronary disease (gold standard : coronary angiography) : IRM sensitivity 86%, specificity 83% ; SPECT sensitivity 66%, specificity 82%
J Am Coll Cardiol. 2008 Jan 1;51(1):37-45		Meta-Analysis
IN coronary disease, elderly patients	The Use of statins As Prevention, Secondary	Is better Than placebo	To reduce overall mortlity (15.6% statins VS 18.7% placebo, NNT 28), cardiac mortality, myocardial infarction and stroke
Eur Heart J. 2006 May;27(10):1230-7. Epub 2006 Apr 18		Cohorts
IN coronary disease, heart failure, stroke, cardiovascular death, risk in general population	The Use of brain natriuretic peptide (BNP), plasma N-terminal pro-A-type and pro-B-type natriuretic peptides (BNP) As Prognostic Item	Is useful Than no comparison here	To predict risk of death from cardiovascular causes: adjusted risk was 1.35-fold for each SD increment in multivariate analysis
Heart. 2009 Mar;95(3):198-202		Systematic Review
IN coronary disease, myocardial infarction	The Use of rutine oxygen As Treatment, Acute	Is worse Than room air	To improve mortality or clinical outcomes: the only one study found that high-flow O2 had non-sifnificant increased risk of death and higher enzyme levels
Eur Heart J. 2007 Dec;28(24):3012-9		Meta-Analysis
IN coronary disease, myocardial infarction	The Use of further reduction of resting heart rate using beta blockers (or calcium channel blockers) As Treatment, Chronic	Is better Than less important reduction of resting herat rate	To reduce cardiac mortality: each 10 b.p.m. reduction estimated to reduce the relative risk of cardiac death by 30%
J Am Coll Cardiol. 2014 Nov 18-25;64(20):2071-82		Randomized Controlled Trial, Multicenter Study
IN coronary disease, myocardial infarction	The Use of polypill, fixed-dose combinations of drugs As Treatment, Chronic	Is better Than same drugs given separately	To improve medication adherence : 51% polypill VS 41% drugs separately
JAMA. 2006 Jun 7;295(21):2511-5		Randomized Controlled Trial, Multicenter Study
IN coronary disease, myocardial infarction, cardiogenic shock	The Use of early invasive strategy, early revascularization, angioplasty or surgical As Treatment, Acute	Is better Than conservative strategy: initial medical stabilization and selective late revascularization	To to improve patient long term survival: at 6 years, overall survival rates were 32.8% in early revasc and 19.6% in initial medical Tt
PLoS Med. 2009 Apr 21;6(4):e1000057		Cohorts
IN coronary disease, myocardial infarction, non-Q, unrecognized	The Use of delayed-enhancement cardiac magnetic resonance As Diagnostic Tool	Is better Than ECG and cardiac enzymes	To diagnose recent non-Q myocardial infarction: 27% of patients suspected of ischemic heart disease. Unrecognized non-Q infarction carries a hight mortality: 26% at 2.2 years.
N Engl J Med. 2005 Mar 24;352(12):1179-89		Randomized Controlled Trial, Multicenter Study
IN coronary disease, myocardial infarction, ST-segment elevation	The Use of antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (300-mg loading dose, 75 mg/d after) added to fibrinolysis plus aspirin plus heparin As Treatment, Acute	Is better Than standard antithrombotic Tt with fibrinolysis + aspirin + heparin alone (+ placebo)	To reduce at 30 days vascular events (cardiovascular death, recurrent infarction, revascularization because recurrent ischemia): 11,6% with clopidogrel VS 14,6% standard Tt, Major bleeding and intracranial hemorrhage similar in the two groups.
Lancet. 2005 Nov 5;366(9497):1607-21		Randomized Controlled Trial, Multicenter Study
IN coronary disease, myocardial infarction, ST-segment elevation	The Use of antiplatelet drugs, adenosine diphosphate (ADP) receptor inhibitors, clopidogrel (75 mg/d) added to standard Tt (aspirin 100%, fibrinolysis 50%, anticoagulant 75%) As Treatment, Acute	Is better Than aspirin alone and standard antithrombotic Tt	To To reduce at 30 days vascular events (death, recurrent infarction, stroke): 9,2% with clopidogrel VS 10,1% aspirin alone.
Lancet. 2005 Nov 5;366(9497):1622-32		Randomized Controlled Trial, Multicenter Study
IN coronary disease, myocardial infarction, ST-segment elevation	The Use of early intravenous beta-blockers (metoprolol, up to 15 mg IV then 200 mg oral daily As Treatment, Acute	Is equal Than placebo	To reduce at 30 days death (7.7% VS 7.8%) or death, reinfarction, or cardiac arrest combined (9.4% with metoprolol VS 9.9% with placebo).
Eur Heart J. 2011 Jan;32(1):51-60		Randomized Controlled Trial
IN coronary disease, myocardial infarction, ST-segment elevation, elder patients	The Use of primary percutaneous coronary intervention As Treatment, Acute	Is equal Than fibrinolysis	To significantly reduce cardiovascular events (all-cause mortality, re-infarction, or disabling stroke) at 30 days: 19% pPCI VS. 25% fibrinolysis. A pooled analysis with other 2 trials showed, however, a significant reduction of cardiovascular events
J Am Coll Cardiol. 2007 Jan 30;49(4):422-30		Meta-Analysis
IN coronary disease, myocardial infarction, ST-segment elevation, failed thrombolysis	The Use of rescue emergency angioplasty after failed thrombolytic therapy As Treatment, Acute	Is better Than repeated thrombolysis or conservative treatment	To reduce heart failure (RR 0.73) and reinfarction (RR 0.58), but associated with increased risk of stroke (RR 4.98)
N Engl J Med. 2011 Dec 1;365(22):2078-87. Epub 2011 Nov 15		Clinical Trial (non-controlled, non-randomized)
IN coronary disease, stable	The Use of high dose statins, atorvastatin 80 mg daily, or rosuvastatin 40 mg daily As Treatment, Chronic	Is useful Than no comparison done	To induced regression of atherome plaques (decrease percent atheroma volume (by about 1%) and total atheroma volume) measured by serial intravascular ultrasonography at 4.5 years
Lancet. 1992 Dec 12;340(8833):1421-5		Randomized Controlled Trial, Multicenter Study
IN coronary disease, stable angina	The Use of aspirin, low dose (75 mg/d) As Treatment, Chronic	Is better Than placebo	To reduce major cardiovascular events (34% relative reduction)
JAMA. 1999 May 26;281(20):1927-36		Meta-Analysis
IN coronary disease, stable angina	The Use of beta blockers As Treatment, Chronic	Is better Than calcium channel blockers	To reduce number of angina episodes (OR 0.31). But no significant differences in rates of death or myocardial infarction.
Circulation. 2014 Apr 15;129(15):1577-85		Cohorts
IN coronary disease, stable, atrial fibrillation	The Use of anticoagulation alone, vitamin K antagonists As Treatment, Chronic	Is equal Than bi-therapy combining anticoagulant (vitamin K antagonist) + an antiplatelet	To modify at 3 years the risk of myocardial infarction, cardiac death or thromboembolism, while the risk of bleeding was higher with bi-therapy (HR 1.5)
Lancet. 2003 Sep 6;362(9386):782-8		Randomized Controlled Trial, Multicenter Study
IN coronary disease, stable, normal left ventricular function, most patients previous myocardial infarction and revascularization	The Use of angiotensin converting enzyme (ACE) inhibitors, perindopril 8 mg/d, added to standard treatment As Treatment, Chronic	Is better Than placebo	To reduce cardiac events (cardiovascular death, myocardial infarction, or cardiac arrest): 8% perindopril VS 10% placebo
N Engl J Med. 2004 Nov 11;351(20):2058-68		Randomized Controlled Trial, Multicenter Study
IN coronary disease, stable, normal left ventricular function, most patients previous revascularization	The Use of angiotensin converting enzyme (ACE) inhibitors, trandolapril (4 mg/d), added to standard treatment As Treatment, Chronic	Is equal Than placebo	To reduce cardiac events (death from cardiovascular causes, myocardial infarction, or coronary revascularization): 21.9% in trandolapil VS 22.5% in placebo - at 5 years (so, aprox. 4.4% per year event rate)
Lancet. 2008 Sep 6;372(9641):807-16		Randomized Controlled Trial, Multicenter Study
IN coronary disease, stable, reduced left ventricular function	The Use of ivabradine, added to beta-blockers As Treatment, Chronic	Is equal Than placebo	To reduce a composite outcome (cardiovascular deah, myocardial infarction or worsening heart failure) at 20 months. It improved a secondary endpoint (myocardial infarction) but not main endpoint, in one subgroup analysis (patients with heart rate > 70 bpm)
Arch Intern Med. 2008 May 26;168(10):1034-46		Review (Narrative)
IN corticosteroids, systemic, for infections	The Use of systemic corticosteroids As Treatment, Acute	Is better Than placebo	To improve outcomes or accelerate symptom resolution in a variety of bacterial, tuberculous and viral infections
N Engl J Med. 2009 Mar 26;360(13):1283-97		Randomized Controlled Trial, Multicenter Study
IN critically ill patients	The Use of tight glucose control (target < 6 mmol/L), intensive insulin therapy As Treatment, Acute	Is worse Than conventional glycemic control (target < 10 mmol/L)	To modify overall mortality at 3 months: 27.5% intensive VS 24.9% conventional
N Engl J Med. 2008 Jul 3;359(1):7-20. Epub 2008 May 20		Randomized Controlled Trial, Multicenter Study
IN critically ill patients, acute kidney injury	The Use of intensive renal-replacement therapy: intermittent hemodialysis 6 days/week if hemodynamically stables, 35 ml/Kg continuous venovenous hemodiafiltration if hemodynamically unstable As Treatment, Acute	Is worse Than less-intensive renal-replacement therapy: intermittent hemodialysis 3 days/week if hemodynamically stables, 20 ml/Kg continuous venovenous hemodiafiltration if hemodynamically unstable	To reduce death (53.6% intensive VS 51.5% less-intensive), reduce the duration of renal-replacement therapy or increase the rate of recovery of kidney function or nonrenal organ failure.
J Neurol Neurosurg Psychiatry. 2011 May;82(5):500-4		Cohorts
IN delirium, dementia, hospitalized older patients	The Use of any error in identifying the year, month, day of the month or day of the week; and an error of >1 h in identifying the time of day As Diagnostic Tool	Is useful Than full cognitive assesment as reference	To diagnose dementia or delirium: error identifying the year sensitivity 86% and specificity 94%; error in either year or month sensitivity 95% and specificity 86%
Age Ageing. 2011 Jan;40(1):23-9		Systematic Review
IN delirium, elder patients	The Use of opioids, benzodiazepines, dihydropyridines calcium channel blockers, antihistamines and possibly (uncertain) H(2) antagonists, tricyclic antidepressants, antiparkinson medications, steroids, non-steroidal anti-inflammatory drugs and antimuscarinics As Etiologic risk factor	Is worse Than not taking those drugs	To increase risk of delirium: opioids OR 2.5, benzodiazepines OR 3.0, dihydropyridines OR 2.4, antihistamines OR 1.8.
JAMA. 2010 Aug 18;304(7):779-86		Systematic Review
IN delirium, hospitalized older patients	The Use of several bedsides tools, specially the Confusion Assessment Method (CAM) As Diagnostic Tool	Is good Than DSM-MD diagnoses definition as gold standard	To diagnose delirium. For CAM test: 2 to 5 minutes to be done, positive LR 9.6, negative LR 0.16.
Age Ageing. 2012 May 15. [Epub ahead of print]		Randomized Controlled Trial
IN delirium, hospitalized older patients	The Use of non-pharmacological intervention: providing a clock and calendar, avoiding sensory deprivation (glasses, denture, hearing aids), familiar objects in the room, reorientation by family members, extended visitation times (5 h) As Treatment, Acute	Is better Than standard management	To reduce occurrence of delirium at any time during the hospitalisation: 6% intervention VS 13% controls
Arch Intern Med. 2007 Jan 8;167(1):21-30		Systematic Review
IN dementia, age related cognitive impairment	The Use of folic acid supplementation, alone or combined with vitamin B6, B12 As Treatment, Chronic	Is equal Than placebo	To reduce age related cognitive impairment: only 1 of 3 trials found a benefit but in patients with low baseline serum folate levels. In 1 trial of folic combined vith B vitamins, placebo group did better
Lancet. 2007 Jan 20;369(9557):208-16		Randomized Controlled Trial, Multicenter Study
IN dementia, age related cognitive impairment, adults with raised homocysteine	The Use of folic acid supplementation, 800 mug daily, long term As Treatment, Chronic	Is better Than placebo	To reduce age related cognitive impairment, at 3 years: memory, sensorimotor speed and information processing speed improved slighty in treated patients while decreased slightly in controls
Curr Med Res Opin. 2005 Aug;21(8):1317-27		Randomized Controlled Trial
IN dementia, alzheimer	The Use of cholinesterase inhibitors, rivastigmine As Treatment, Chronic	Is equal Than cholinesterase inhibitors, donepezil	To modify the measures of cognition and behaviour (main endpoint: Severe Impairment Battery, not significant different). Rivastigmine showed significant results in some secondary and subgroup analysis
Arch Neurol. 1998 Nov;55(11):1409-15		Meta-Analysis
IN dementia, alzheimer	The Use of ginkgo biloba As Treatment, Chronic	Is better Than placebo	To improve, marginally (3% in ADAS-cog scale), cognitive function
JAMA. 1997 Oct 22-29;278(16):1327-32		Randomized Controlled Trial
IN dementia, alzheimer	The Use of ginkgo biloba As Treatment, Chronic	Is better Than placebo	To improve at 6 to 12 months ADAS-Cog score (1.4 points better than placebo)
Eur Heart J. 2013 Jun 4. [Epub ahead of print]		Cohorts
IN dementia, alzheimer, coronary disease, acute coronary syndrome, myocardial infarction, older patients	The Use of cholinesterase inhibitors As Treatment, Chronic	Is better Than no cholinesterase inhibitors	To reduce the risk of myocardial infarction (HR 0.62) and death (HR 0.64). Patients taking the highest doses recommended had the lowest risk of MI or death
J Neurol Neurosurg Psychiatry. 2011 Mar;82(3):240-6		Diagnostic
IN dementia, alzheimer, cortical dementias, frontotemporal dementia, semantic dementia	The Use of cerebrospinal fluid biomarkers, beta-amyloid 1-42 (Aβ 42), total tau protein and phosphorylated tau protein As Diagnostic Tool	Is useful Than no comparison done	To distinguish Alzheimer from frontotemporal or semantic dementia: the best marker was Phosphorylated-Tau/Aβ(42) ratio, with sensitivity 92-98% and specificity 84-92%.
Nat Med. 2014 Mar 9. doi: 10.1038/nm.3466. [Epub ahead of print]		Controlled Trial (non-randomized)
IN dementia, alzheimer, early-stage	The Use of a set of 10 specific plasma phospholipids, reflecting cell membrane integrity As Diagnostic Tool	Is useful Than no comparison done	To predict clinical development of either amnestic mild cognitive impairment or Alzheimer,s disease in a 2-3 year
Arch Neurol. 2004 Dec;61(12):1852-6		Randomized Controlled Trial, Multicenter Study
IN dementia, alzheimer, early-stage	The Use of cholinesterase inhibitors, donepezil As Treatment, Chronic	Is better Than placebo	To improve different cognitive scores, at 6 months: ADAS (by 2.3 points), MMS (by 1.4 points) and Computerized Memory Battery Test, having few adverse events
JAMA. 2009 Jul 22;302(4):385-93		Diagnostic
IN dementia, alzheimer, early-stage, mild cognitive impairment	The Use of cerebrospinal fluid biomarkers: beta-amyloid(1-42) (Abeta42), total tau protein (T-tau), and tau phosphorylated-threonine 181 (P-tau) As Diagnostic Tool	Is useful Than final diagnostic after 4 year follow-up as standard	To help diagnose Alzheimer's: sensitivity 83%, specificity 72%, predictive positive value 62%, negative value 88% (for the 3 markers combined)
Arch Neurol. 2010 Aug;67(8):949-56		Diagnostic
IN dementia, alzheimer, early-stage, mild cognitive impairment	The Use of cerebrospinal fluid biomarkers: beta-amyloid(1-42) (Abeta42), total tau protein (T-tau), and tau phosphorylated-threonine 181 (P-tau) As Diagnostic Tool	Is useful Than final diagnostic after follow-up or autopsy as standards	To help diagnosign Alzheimer's disease: typical biomarker signature found in 90%, 72%, and 36% of Alzh, mild cognitive impairment, and cognitively normal groups, respectively. Very high sesitivity (lower spec.) to predict evol to Alzh in MCI patients
J Am Geriatr Soc. 2011 Sep;59(9):1705-10		Diagnostic
IN dementia, alzheimer, mild cognitive impairment	The Use of neuropsychological tests and structural magnetic resonance imaging (MRI) As Diagnostic Tool	Is better Than measurement of amyloid-beta and tau in cerebrospinal fluid (CSF) or [18F]fluorodeoxyglucose positron emission tomography (FDG-PET)	To diagnose alzheimer,s disease: neuropsychological tests and MRI were the most informative techniques, with 84% and 82% correct classifications. FDG-PET and CSF assessments had 76% and 73% correct classifications
N Engl J Med. 2012 Mar 8;366(10):893-903		Randomized Controlled Trial
IN dementia, alzheimer, moderate to severe	The Use of maintaining cholinesterase inhibitors, donepezil As Treatment, Chronic	Is better Than stopping donepezil or changing for memantine	To improve cognitive measures at 1 year: SMMSE score higher by 1.9 points and BADLS score lower (indicating less impairment) by 3.0 points, than stopping donezepil
JAMA. 2015 Sep 22-29;314(12):1242-54		Randomized Controlled Trial, Multicenter Study
IN dementia, associated agitation or delirium	The Use of dextromethorphan-quinidine combination As Treatment, Acute	Is better Than placebo	To reduce the Neuropsychiatric Inventory (NPI) Agitation/Aggression domain score : 3.8 with dextromethorfan VS 5.3 with placebo after treatment
N Engl J Med. 2006 Oct 12;355(15):1525-38		Randomized Controlled Trial, Multicenter Study
IN dementia, associated agitation or delirium	The Use of antipsychotic drugs, neuroleptics, atypical, olanzapine, quetiapine, risperidone As Treatment, Chronic	Is equal Than placebo	To improve the Clinical Global Impression of Change (CGIC) scale at 12 weeks: 32% of patients on olanzapine, 26% quetiapine, 29% risperidone, and 21% placebo (P=0.22). Time to the discontinuation of treatment for any reason was also similar.
Cochrane Database Syst Rev. 2013;3:CD007726		Systematic Review, Cochrane Review
IN dementia, associated agitation or delirium, associated behavioural and psychological symptoms	The Use of withdrawal of chronic antipsychotic drugs As Treatment, Chronic	Is equal Than continuation of chronic antipsychotic drugs	To modify behavioural and psychological symptoms : no difference in 8 of 9 studies. Patients with more severe symptoms of that responded well to antipsychotics may benefit from keeping their treatment
Age Ageing. 2017 Sep 1:1-7. doi: 10.1093/ageing/afx149. [Epub ahead of print]		Diagnostic
IN dementia, delirium, elder patients, emergency department	The Use of 4AT test As Diagnostic Tool	Is useful Than no comparison here	To accurately screen for dementia or delirium: negative predictive value 0.99 for delirium and 0.94 for dementia
BMJ. 2010 Aug 5;341:c3584. doi: 10.1136/bmj.c3584		Cohorts
IN dementia, diagnosed in primary care	The Use of diagnosis of dementia As Prognostic Item	Is worse Than not having dementia	To predict median survival after initial diagnosis: 6.7 years in 60-70 years old, falling to 1.9 years in >90 years old, overall 2.5 to 4 times higher mortality than matched controls. Higher risk of death in the first year after diagnosis.
Ann Neurol. 2012 Jul;72(1):41-52		Randomized Controlled Trial, Multicenter Study
IN dementia, Lewy bodies	The Use of cholinesterase inhibitors, donepezil As Treatment, Chronic	Is better Than placebo	To improve at 3 months MMSE (mean difference: 2-4 points), other cognitive scores and caregiver burden scale
Lancet. 2000 Dec 16;356(9247):2031-6		Randomized Controlled Trial
IN dementia, Lewy bodies	The Use of cholinesterase inhibitors, rivastigmine As Treatment, Chronic	Is equal Than placebo	To modify the main endpoint (NPI, Neuropsychiatric Inventory score) in the intention to treat population. Several secondary and subgroup outcomes were modestly improved. Rivastigmine increased nausea, vomiting and anorexia.
Lancet Neurol. 2010 Oct;9(10):969-77		Randomized Controlled Trial, Multicenter Study
IN dementia, Lewy bodies, Parkinson associated	The Use of N-methyl D-aspartate receptor antagonists, memantine As Treatment, Chronic	Is better Than placebo	To slightly improve ADCS score (-0.6 points) at 6 months in Lewy bodies patients, but not in Parkinson patients.
JAMA. 2007 Jun 6;297(21):2391-404		Systematic Review
IN dementia, screening	The Use of reports that the patient has memory loss, Mini-Mental State Examination (MMSE), Memory Impairment Screen (MIS) and Clock drawings As Diagnostic Tool	Is useful Than -	To diagnose dementia: report of memory loss LR+ 6.5 LR- ? ; MMSE LR+ 6.3 LR- 0.19 ; MIS LR+ 33 LR- 0.08
J Am Geriatr Soc. 2011 Mar;59(3):463-72		Systematic Review
IN dementia, severe, feeding disorder	The Use of high-calorie supplements As Treatment, Chronic	Is equal Than assisted feeding, or modified foods to promote weight gain	To promote weight gain. No summary measures provided in the abstract
Int J Nurs Stud. 2013 Jan 19. doi: 10.1016/j.ijnurstu.2012.12.021. [Epub ahead of print]		Meta-Analysis
IN dementia, severe, feeding disorder	The Use of nutritional supplements, As Treatment, Chronic	Is better Than other interventions: training/education programs, feeding assistance	To increase food intake, body weight and BMI (no quantitative results in the abstract). But the quality of the evidence was moderate
Lancet. 2009 Feb 28;373(9665):746-58		Meta-Analysis
IN depression, major, unipolar	The Use of selective serotonine reuptake inhibitors (SSRI), escitalopram, sertraline and others antidepressants: mirtazapine, venlafaxine, As Treatment, Acute	Is better Than duloxetine, fluoxetine, fluvoxamine, paroxetine, and reboxetine	To improve antidepressant effectiveness (OR 1.27 to 2.03) with fewer discontinuations.
N Engl J Med. 2017 06 29;376(26):2523-2533		Randomized Controlled Trial
IN depression, unipolar	The Use of transcranial direct-current stimulation (tDCS) As Treatment, Acute	Is worse Than escitalopram, selective serotonin reuptake inhibitors (SSRIs) but it was better than placebo	To improve Hamilton Depression Rating Scale (range, 0 to 52, with higher scores indicating more depression) at 10 weeks: tDCS -9 points, escitalopram -11 points and placebo -6 points
Cochrane Database Syst Rev. 2010;(4):CD006117		Systematic Review, Cochrane Review
IN depression, unipolar	The Use of sertraline, selective serotonin reuptake inhibitors (SSRIs) As Treatment, Chronic	Is better Than tricyclics, heterocyclics, other selective serotonin reuptake inhibitors (SSRIs) and newer agents, mirtazapine	To improve efficacy (better than fluoxetine) or tolerability (better than amitriptyline, imipramine, paroxetine and mirtazapine). But less effective than mirtazapine.
Cochrane Database Syst Rev. 2006;(1):CD003491		Systematic Review, Cochrane Review
IN depression, unipolar, older patients	The Use of selective serotonin reuptake inhibitors (SSRIs) As Treatment, Chronic	Is better Than tricyclic and tricyclic-related antidepressants	To reduce the number of patients who withdrawn by adverse effects (RR 1.30 with SSRIs) while being equally effective.
Br J Gen Pract. 2011 Dec;61(593):e808-20		Meta-Analysis
IN depression, unipolar, patients with chronic physical diseases	The Use of two stem questions: low mood and loss of interest As Diagnostic Tool	Is better Than more complex questionnaries, including Geriatric Depression Scale - 15 and 30	To detect depression in patients with chronic physical diseases: sensib 98%, specif 88%, LR+ 6.8 LR- 0.02. Two step questions was as performant or better than others and much easier
Ann Intern Med. 2006 Nov 7;145(9):665-75		Meta-Analysis
IN diabetes mellitus	The Use of inhaled insulin, premeal, plus once/day lente subcutaneous insulin As Treatment, Chronic	Is worse Than conventional multiple times/day subcutaneous insulin	To decrease hemoglobin A1c (weighted mean difference, 0.08%, favouring SC insulin) but same number of patients achieved HgA1c < 7%. Hypoglycemia was equally frequent. Inhaled insulin induces cough and mild decrease in pulmonary function testing.
Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003287		Systematic Review, Cochrane Review
IN diabetes mellitus	The Use of short acting insulin analogues As Treatment, Chronic	Is equal Than standard insulin	To achieve glycemic control or modify HbA1c levels: 0 to -0.1% weighted mean difference. The WMD of the overall mean hypoglycaemic episodes per patient per month was -0.2. No study investigated long term effects on mortality or diabetic complications.
Diabetes Care. 2006 Nov;29(11):2365-70		Randomized Controlled Trial
IN diabetes mellitus, associated peripheral neuropathy	The Use of alpha-lipoic acid (ALA) As Treatment, Chronic	Is better Than placebo	To improve symptoms: significative reduction in specific symptom scores with all doses compared to placebo, specially stabbing and burning pain. Side effects: nausea, vomiting, and vertigo
Diabetes Care. 2006 Jul;29(7):1538-44		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, associated peripheral neuropathy	The Use of epalrestat, an aldose reductase inhibitor As Treatment, Chronic	Is better Than placebo	To improve symptoms (numbness, sensory abnormality, and cramping) and reduce EMG progession, at 3 years.
Pharmacotherapy. 2008 May;28(5):646-55		Review (Narrative)
IN diabetes mellitus, associated peripheral neuropathy	The Use of epalrestat, an aldose reductase inhibitor, 50 mg 3 times/day As Treatment, Chronic	Is better Than placebo	To motor and sensory nerve conduction velocity and subjective neuropathy symptoms
N Engl J Med. 2008 Oct 2;359(14):1464-76		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 1	The Use of continuous glucose monitoring, added to intensive insulin Tt As Diagnostic Tool	Is equal Than usual monitoring with a capilar blood glucose meter	To improve glycemic control at 26 weeks: HbA1C was improved by -0.50% in adults patients but not in younger and children.
N Engl J Med. 2003 Jun 5;348(23):2285-93		Cohorts
IN diabetes mellitus, type 1	The Use of persistent microalbuminuria As Prognostic Item	Is useful Than no comparison	To predict renal impairment, but it does not imply inexorably progressive nephropathy: regression of proteinuria is frequent if: HbAc1 < 1%, well controlled blood pressure and both cholmesterol and triglyc normal
Cochrane Database Syst Rev. 2010;(1):CD005103		Systematic Review, Cochrane Review
IN diabetes mellitus, type 1	The Use of continuous subcutaneous insulin infusion As Treatment, Chronic	Is better Than multiple insulin injections	To to improve glycemic control and HgbA1C (WMD -0.3%) and quality of life, but no reilable data about long-term morbidity and mortality exist
N Engl J Med. 2005 Dec 22;353(25):2643-53		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 1, cardiovascular complications	The Use of Intensive insulin therapy during 6.5 years: 3 or more daily injections or insulin pump, with > 4 daily glucose measurements As Treatment, Chronic	Is better Than conventional therapy: one or two daily injections of insulin	To reduce, after 17 years, cardiovascular events (angor, myocardial infarction, coronary revascularization, stroke or cardiovascular death): 52 patients of 730 in conventional VS 31 of 711 in intensive
N Engl J Med. 2008 Oct 9;359(15):1577-89		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2	The Use of (moderately) intensive glucose control using insulin or oral hypoglycemic agents, sulfonylurea, metformin As Treatment, Chronic	Is better Than conventional treatment starting with diet	To reduce, at 10 years, any diabetes related point: 4.8% per year intensive VS 5.2% per year conventional (NNT 213). Also reduced mortality of any cause: 2.7%/year intensive VS 3.0%/year conventional (NNT 254)
N Engl J Med. 2006 Dec 7;355(23):2427-43		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2	The Use of oral hypoglycemic agents, glitazones (rosiglitazone) As Treatment, Chronic	Is better Than oral hypoglycemic agents, metformin, sulphonylureas (glyburide)	To avoid, at 5 years, monotherapy failure: 15% rosiglitazone, 21% metformin, 34% glyburide. But rosiglitazone had more cardiovascular events (including heart failure) than glyburide (4.3% VS 2.8%) and mortality was the same with all treatments (2.1 to 2.3%)
N Engl J Med. 2007 June 14;356(24):2457-71. Epub 2007 May 21		Meta-Analysis
IN diabetes mellitus, type 2	The Use of oral hypoglycemic agents, glitazones (rosiglitazone) As Treatment, Chronic	Is worse Than placebo or other hypoglycemic agents	To affect the incidence of myocardial infarction (OR 1.44) and cardiovascular death (OR 1.64)
Cochrane Database Syst Rev. 2006 Jan 25;(1):CD002967		Systematic Review, Cochrane Review
IN diabetes mellitus, type 2	The Use of oral hypoglycemic agents, metformin As Treatment, Chronic	Is equal Than oral hypoglycemic agents, sulphonylureas	To the risk of lactic acidosis: 6.3 cases per 100,000 patient-years with metformin VS 7.8 cases per 100,000 patient-years.
Lancet. 1998 Sep 12;352(9131):854-65		Randomized Controlled Trial
IN diabetes mellitus, type 2	The Use of oral hypoglycemic agents, metformin As Treatment, Chronic	Is better Than oral hypoglycemic agents, sulphonylureas (chlorpropamide, glibenclamide), or insulin	To reduce, at 10 years, diabetes related endpoint (7.5 events/1000 patients/year in metformine VS 12.7 others) and all-cause mortality (13.5 events/1000 patients/year in metformine group vs 20.6 others)
BMJ. 2007 Sep 8;335(7618):497		Systematic Review
IN diabetes mellitus, type 2	The Use of oral hypoglycemic agents, metformin As Treatment, Chronic	Is better Than other oral hypoglycemic agents, sulphonylureas, glitazones	To reduce overall mortality and the risk of hospital admission for heart failure
PLoS Med. 2012;9(4):e1001204		Systematic Review
IN diabetes mellitus, type 2	The Use of oral hypoglycemic agents, metformin As Treatment, Chronic	Is equal Than placebo, diet alone or other hypoglycemic agents	To modify all-cause mortality (RR 0.99), cardiovascular mortality (RR=1.05), myocardial infarctions (RR=0.90), all strokes (RR=0.76), peripheral vascular disease (RR=0.90), leg amputations (RR=1.04) or microvascular complications (RR=0.83)
Lancet. 1998 Sep 12;352(9131):837-53		Randomized Controlled Trial
IN diabetes mellitus, type 2	The Use of oral hypoglycemic agents, sulphonylureas (chlorpropamide, glibenclamide) As Treatment, Chronic	Is equal Than insulin	To reduce, at 10 years, diabetes related endpoint and mortality
JAMA. 2009 Apr 15;301(15):1547-55		Randomized Controlled Trial, Diagnostic
IN diabetes mellitus, type 2, asymptomatic for coronary disease	The Use of routine screening for coronary artery disease, adenosine-stress radionuclide myocardial perfusion imaging As Diagnostic Tool	Is equal Than non screening	To reduce cardiac death or nonfatal myocardial infarction at 5 years: 2.7% screened patients VS 3% non-screened.
JAMA. 2008 Apr 9;299(14):1678-89		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, atherosclerosis, normo-cholesterol adults	The Use of aggressive targets of low-density lipoprotein cholesterol (LDL) < 70 mg/dL and systolic blood pressure < 115 mmHg As Treatment, Chronic	Is better Than standard targets of LDL < 100 mg/dL and systolic blood pressure < 130 mmHg	To reduce common carotid artery intimal medial thickness and left ventricular mass index at 1 year. Clinical cardivascular events did not differed
Diabetes Care. 2011 Feb;34(2):308-13		Randomized Controlled Trial
IN diabetes mellitus, type 2, elderly patients, medical informatics, clinical decision support systems (for patients), telemedicine, remote monitoring (glucose)	The Use of remote clinical decision support system to monitore glucose and adapt treatment by messages to mobile phone As Treatment, Chronic	Is better Than usual self-monitored blood glucose or routine care without blood glucose daily monitoring	To improve number of patients with HgbA1C <7% without hypoglycemia at 6 months: 31% u-healthcare, 23% self-monitoring, and 14% routine care
Int J Clin Pract. 2011 Mar;65(3):308-13		Cohorts
IN diabetes mellitus, type 2, elderly patients, previously not known diabetic, newly recognised fasting hyperglycaemia, at hospital admission because acute ilness	The Use of fasting hyperglycaemia As Prognostic Item	Is useful Than no monitoring of fasting glycaemia	To predict risk of in-hospital mortality: 8% when glucose < 126 mg/dl, 18% when glucose 126-180 mg/dl, 32% when glucose > 180 mg/dl
N Engl J Med. 2002 Feb 7;346(6):393-403		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, glucose intolerance	The Use of lifestyle-modification program, oral hypoglycemic agents, metformine As Prevention, Primary	Is better Than placebo	To reduce incidence of diabetes (in per 100 person-years): 11.0% placebo, 7.8% metformin, and 4.8% lifestyle group
N Engl J Med. 2012 Jun 11. [Epub ahead of print]		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, glucose intolerance, high risk for cardiovascular events	The Use of n-3 fatty acids, 1g capsule of ethyl esters of n-3 fatty acids As Treatment, Chronic	Is equal Than placebo	To modify major vascular events (16.3-16.5%) or cardiovascular mortality (9% both)
Lancet. 2006 Nov 11;368(9548):1673-9		Randomized Controlled Trial
IN diabetes mellitus, type 2, glucose intolerance, in overweight people	The Use of lifestyle-modification program: weight loss, reduce intake of fat, and increase physical activity As Prevention, Primary	Is better Than usual generic recommendations	To reduce incidence of diabetes (in per 100 person-years): 4.3 in lifestyle change VS 7.4 in controls.
Am J Cardiol. 2010 Oct 1;106(7):1006-10		Cohorts
IN diabetes mellitus, type 2, heart failure, chronic	The Use of oral hypoglycemic agents, metformin As Treatment, Chronic	Is better Than oral hypoglycemic agents, sulphonylureas	To reduce deaths
Lancet. 2005 Oct 8;366(9493):1279-89		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, macrovascular complications	The Use of oral hypoglycemic agents, glitazones (pioglitazone), in addition to pre-existing glucose-lowering drugs As Treatment, Chronic	Is worse Than placebo, in addition to pre-existing glucose-lowering drugs	To reduce, at 3 years, a composite outcome of vascular events (all-cause mortality, stroke, acute coronary syndrome, coronary or leg revascularization, amputation: HR 0.90) and heart failure increased: 6% glitazone VS 4% ctrl
N Engl J Med. 2008 Feb 7;358(6):580-91		Randomized Controlled Trial
IN diabetes mellitus, type 2, microalbuminuria, cardiovascular disease	The Use of intensified multifactorial intervention: tight glucose control plus use of renin-angiotensin system blockers, aspirin, and lipid-lowering agents (statins) As Treatment, Chronic	Is better Than usual (conventional) therapy	To reduce, at 13 years, all-cause mortality (30% multifactorial Tt VS 50% usual Tt), cardiovascular events (HR 0.54) and advenced reanl disease.
Diabetes Obes Metab. 2010 Mar;12(3):252-61		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, naive patients	The Use of incretin enhancer, dipeptidyl peptidase 4 (DPP4) inhibitors, sitagliptin, 100mg once-daily As Treatment, Chronic	Is worse Than metformin, 1000 mg twice-daily	To reduce HbA1C: -0.43% sitagliptin VS -0.57% metformin. Sitagliptin caused less gastrointestinal symptoms (12%) than metformine (21%), less hypoglycemia (1.7% VS 3.3%) and patients lost less weight (-0.6Kg VS -1.9Kg metformin)
Diabetes Care. 2010 Oct;33(10):2217-24		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, naive patients	The Use of renal sodium-glucose cotransporter inhibitor, dapagliflozin, in monotherapy As Treatment, Chronic	Is better Than placebo	To reduce at 6 months HgA1C levels: -0.23 placebo VS -0.6 to 0.9 dapagliflozin depending on dose. More urinary tract infections and genital infection with dapagliflozin: 10%. No hypoglycaemia.
N Engl J Med. 2009 Oct 29;361(18):1736-47		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, needing insulin	The Use of long acting insulin (detemir), basal, once daily or short acting insulin (aspart), prandial, three times daily, added to oral hypoglycemic agents As Treatment, Chronic	Is better Than short acting insulin (aspart), biphasic, twice daily	To reduce number of patients having Hbg A1C < 6.5% (32% biphasic VS 43% basal VS 45% prandial) However, mean Hgb A1C was not different in all 3 groups (6.8 to 7.1%)
Diabetes Obes Metab. 2009 Jan;11(1):53-9		Meta-Analysis
IN diabetes mellitus, type 2, needing insulin	The Use of short acting insulin analogues (lispro, aspart or glulisine) As Treatment, Chronic	Is better Than regular human insulin	To improve glucemic control: reduced HbA1c by 0.4%. No differences in severe hypoglycaemia.
Diabetes Obes Metab. 2014 Nov;16(11):1165-73		Case-Control
IN diabetes mellitus, type 2, non-diabetic patients, overall mortality	The Use of oral hypoglycemic agents, metformin As Treatment, Chronic	Is better Than oral hypoglycemic agents, sulphonylurea	To reduce overall mortality: 14.4 /1000 metformin VS 15.2 /1000 matched non-diabetics VS 51 /1000 sulphonylurea.
JAMA. 2007 Jul 11;298(2):194-206		Systematic Review
IN diabetes mellitus, type 2, poor control with oral agents	The Use of incretin mimetic (glucagonlike peptide 1 (GLP-1) analogue), incretin enhancer (dipeptidyl peptidase 4 (DPP4) inhibitor) As Treatment, Chronic	Is better Than placebo, and noninferior to other hypoglycemic agents	To lower, at some weeks or months, hemoglobin A1C (weighted mean difference, -0.97%) with a favorable weight-change profile (loss or no increase)
Clin Ther. 2008 Nov;30(11):1976-87		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, poor control with oral agents	The Use of long acting insulin, insulin detemir (Levemir-TM), basal, once or twice daily, added to oral hypoglycemic agents As Treatment, Chronic	Is equal Than long acting insulin, insulin glargine (Lantus-TM), basal, once daily, added to oral hypoglycemic agents	To modify at 1 year HbA1C (about 7% both) or modify number of hypoglycemia. Insulin detemir assodiated a lower weight gain (2.8Kg detemir VS 3.8 kg glargine)
Lancet. 2007 Sep 8;370(9590):829-40		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, with or without arterial hypertension or proteinuria	The Use of fixed combination of perindopril and indapamide As Treatment, Chronic	Is better Than placebo	To reduce combined micro and macrovascular complications (15.5% treated VS 16.8% placebo) and cardiovascular and overall mortality (7.3% treated VS 8.5% placebo)
N Engl J Med. 2011 Mar 10;364(10):907-17		Randomized Controlled Trial, Multicenter Study
IN diabetes mellitus, type 2, without proteinuria	The Use of angiotensin II-receptor blocker, olmesartan 40 mg /24h As Treatment, Chronic	Is better Than placebo	To reduce at 3.2 years the number of patients with microalbuminuria: 8.2% olmesartan VS 9.8% placebo
Pharmacotherapy. 2010 Feb;30(2):119-26		Meta-Analysis
IN diarrhea, acute, infectious, antibiotic-associated	The Use of fermented milk with Lactobacillus As Prevention, Primary	Is better Than placebo	To prevent development of diarrhea in patients on antibiotic treatment: RR 0.35
Can J Gastroenterol. 2007 Nov;21(11):732-6		Randomized Controlled Trial
IN diarrhea, acute, infectious, antibiotic-associated	The Use of fermented milk with Lactobacillus acidophilus and casei, daily As Prevention, Primary	Is better Than placebo	To reduce diarrhea in patients on antibiotic treatment: 16% lactobacillus VS 36% placebo
Clin Infect Dis. 2008 Oct 15;47(8):1007-14		Systematic Review
IN diarrhea, acute, infectious, traveler	The Use of adjunctive loperamide plus antibiotics As Treatment, Acute	Is better Than antibiotics alone	To improve frequency of early clinical cure at 48/72H: OR 2.2
N Engl J Med. 2005 Nov 10;353(19):2001-11		Randomized Controlled Trial
IN Down syndrome, screening in pregnant women	The Use of stepwise sequential screening or fully integrated screening As Diagnostic Tool	Is better Than first-trimester combined screening OR second-trimester quadruple screening alones	To detect fetuses with Down syndrome: first-trimester combined screening 87%, second-trimester quadruple screening 81%, stepwise sequential screening 95%, fully integrated screening (with first-trimester measurements done at 11 weeks) 96%
Gut. 1999 Aug;45(2):186-90		Randomized Controlled Trial
IN dyspepsia, ulcer-like, helicobacter pylori infection	The Use of empirical Helicobacter pylori eradication, without any diagnostic test As -	Is better Than endoscopy and eradication if positive	To improve dyspepsia and quality of life measure
BMJ. 2002 Apr 27;324(7344):999-1002		Randomized Controlled Trial
IN dyspepsia, ulcer-like, helicobacter pylori infection	The Use of non-invasive strategy, urea breath test only and treatment if positive (7 days course of omeprazol, clarithromycin and amoxicillin) As Diagnostic Tool	Is equal Than invasive strategy, endoscopy plus urea breath test	To reduce dyspepsia severity score at one year and detect other diseases than H pylori
Am J Gastroenterol. 2006 Jun;101(6):1200-8		Randomized Controlled Trial
IN dyspepsia, ulcer-like, helicobacter pylori infection	The Use of testing for helicobacter pylori and eradication when positive As Treatment, Chronic	Is better Than initial proton pump inhibitors (PPI) treatment for everybody	To reduce number of endoscopies needed and low costs at 1 year
Cochrane Database Syst Rev. 2011;0(7):CD006211		Systematic Review, Cochrane Review
IN elder patients, comprehensive geriatric assessment	The Use of comprehensive geriatric assessment As Diagnostic Tool	Is better Than general medical care	To increase a patient,s likelihood of being alive and in their own home at 12 months (OR 1.16) and reduce its risk of suffer death or deterioration (OR 0.76). The effect was more marked for wards than for teams
PLoS One. 2012;7(1):e29090		Cohorts
IN elder patients, comprehensive geriatric assessment, overall mortality, frailty scores	The Use of Multidimensional Prognostic Index as frailty index (calculated from scoring 8 domains: ADL, IADL, cognition, comorbidity, nutrition, number of drugs, co-habitation status) low risk if MPI<0.33, high risk if >0.66 As Prognostic Item	Is better Than other tools to measure frailty: the cumulative deficits model, based on a comprehensive geriatric assessment	To predict mortality at 1 month and 1 year: HR = 2 for MPI = 0.33-0.66, HR = 5.7 for MPI >0.66 (MPI <0.33 was the reference HR=1)
Arch Intern Med. 2010 Jul 12;170(13):1142-8		Cohorts
IN elder patients, geriatric pharmacology, drug adverse effects	The Use of a score combining: number of drugs and a history of adverse drug reaction as the strongest predictors, followed by heart failure, liver disease, presence of 4 or more conditions, and renal failure As Etiologic risk factor	Is useful Than no systematized evaluation	To predict the risk of an adverse drug reaction: from 2% if 0-1 points to 25% when all factors present (8 points or more). The number of drugs were the most important single factor: risk doubled when => 5 drugs used, quadrupled when => 8 drugs
N Engl J Med. 2011 Nov 24;365(21):2002-12		Cohorts
IN elder patients, geriatric pharmacology, drug adverse effects	The Use of four common, appropriate, medication classes: warfarin, insulins, oral antiplatelet drugs, and oral hypoglycemic agents As Etiologic risk factor	Is useful Than no comparison here	To be implicated, alone or in combination, in 2/3 of hospitalizations of elder patients because drug adverse events: warfarin (33.3%), insulins (13.9%), oral antiplatelet agents (13.3%), and oral hypoglycemic agents (10.7%)
J Am Geriatr Soc. 2015 Nov;63(11):2227-46		Consensus Conference
IN elder patients, geriatric pharmacology, inappropriate prescription	The Use of the Beers list: medications that should generally be avoided in persons > 65 years As Prevention, Primary	Is useful Than no comparison done	To this list is expected to be useful to reduce drug-related adverse events in older patients
Fam Pract. 2017 Feb 23. doi: 10.1093/fampra/cmx007. [Epub ahead of print]		Randomized Controlled Trial, Multicenter Study
IN elder patients, geriatric pharmacology, inappropriate prescription, multiple medications	The Use of clinical medication reviews As Treatment, Acute	Is equal Than not doing medication reviews	To modify QoL or the presence of self-reported geriatric problems
JAMA. 2010 Oct 13;304(14):1592-601		Review (Narrative)
IN elder patients, geriatric pharmacology, inappropriate prescription, multiple medications	The Use of an structured and systematic approach: review corrent medication use, match drugs to patients conditions and goals, asses drugs to be discontinued, asses potentially beneficial drugs to be introduced, reduce pill and doses burden As Treatment, Chronic	Is good Than -	To improve medication regimens and improve clinical outcomes of patients
Age Ageing. 2011 Mar;40(2):150-62		Systematic Review
IN elder patients, geriatric pharmacology, inappropriate prescription, optimising prescription, care homes	The Use of education including academic detailing, multi-faceted educational approaches As Prevention, Primary	Is better Than no intervention, pharmacist medication reviews, computerised clinical decision support systems (CDSSs)	To reduce the number of inappropriate prescriptions. Lack of studies on patients outcomes.
J Am Geriatr Soc. 2007 May;55(5):658-65		Randomized Controlled Trial
IN elder patients, geriatric pharmacology, inappropriate prescription, optimising prescription, hospital	The Use of pharmaceutical care by a clinical pharmacist As Treatment, Acute	Is better Than usual prescription (only physician)	To improve the appropriateness of prescribing on admission, at discharge, and 3 months after.
Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003235		Systematic Review, Cochrane Review
IN electrolyte disturbances, hyperkalaemia	The Use of IV insulin-and-glucose, inhaled beta-agonists As Treatment, Acute	Is better Than no treatment	To to reduce K blood levels at 4 hours. No data on mortality or arrhythmias available. Results for IV bicarbonate were inconsistent.
N Engl J Med. 2012 Jun 28;366(26):2466-73		Randomized Controlled Trial
IN endocarditis, bacterial, left sided, large vegetations	The Use of early surgery, urgent (<48 h) As Treatment, Acute	Is better Than conventional treatment, including differred surgery if needed (77% of patients finally)	To reduce at 6 weeks in-hospital death or embolic events (3% early surgery VS 23% conventional). No difference in mortality at 6 months (3% early surgery VS 5% conventional)
J Neurol Sci. 1997 Mar 20;147(1):89-92		Clinical Trial (non-controlled, non-randomized)
IN epilepsy	The Use of oral loading dose of phenytoin: 15 mg/Kg single dose As Treatment, Acute	Is useful Than no comparison done	To obtain therapeutic serum concentrations (i.e. >10 mcg/mL) at and average time of 2.6 hours, with pic concentrations at 7.25 hours. Few, non-severe, adverse events.
Acad Emerg Med. 2004 Mar;11(3):244-52		Randomized Controlled Trial
IN epilepsy	The Use of oral loading dose of phenytoin: 20 mg/Kg in divided doses of 400 mg/2 hours As Treatment, Acute	Is equal Than IV loading dose of phenytoin	To obtain therapeutic serum concentrations (i.e. >10 mcg/mL): oral load took more time to reach it (5.5 h VS 0.25 h) but produced less adverse events, with 0 arrhythmia and 0 hypotension in oral loading.
Lancet. 2007 Mar 24;369(9566):1016-26		Randomized Controlled Trial, Multicenter Study
IN epilepsy, generalized onset, or seizures difficult to classify	The Use of valproate As Treatment, Chronic	Is better Than topiramate, lamotrigine (Lamictal(R))	To achieve a better combination of time to treatment failure and time to one-year remission
J Neurol Neurosurg Psychiatry. 2012 Nov;83(11):1093-8		Randomized Controlled Trial, Multicenter Study
IN epilepsy, generalized, focal, newly diagnosed	The Use of levetiracetam (Keppra(R)) 2000 mg/d As Treatment, Chronic	Is equal Than lamotrigine (Lamictal(R)) 200 mg/d	To modify at 6 months the proportion of seizure-free patients (45% levetir. VS 48% lamotrig.) and of patients with adverse effects (74% VS 70%)
Neurology. 1997 Oct;49(4):991-8		Randomized Controlled Trial, Multicenter Study
IN epilepsy, generalized, focal, newly diagnosed (first tonic-clonic seizure)	The Use of no treatment, unless seizure recurrs As Treatment, Chronic	Is equal Than starting treatment immediatly (carbamazepine, phenytoin, phenobarbital, or sodium valproate)	To modify the probability of long-term remission et 2 years (60% no Tt VS 68% immediate Tt). 50% of patients who were not treated never experienced a second seizure.
Cochrane Database Syst Rev. 2005 Oct 19;(4):CD003723		Systematic Review, Cochrane Review
IN epilepsy, generalized, status epilepticus	The Use of lorazepam As Treatment, Acute	Is better Than diazepam or phenytoin alone	To stop seizures and reducing the risk of continuation of status epilepticus requiring a different drug or general anaesthesia (RR 0.63 and 0.64, compared to diacepam and phenytoin)
N Engl J Med. 2001 Aug 30;345(9):631-7		Randomized Controlled Trial
IN epilepsy, generalized, status epilepticus	The Use of lorazepam IV (2 mg, repeated once if needed) As Treatment, Acute	Is better Than diazepam (5 mg), or placebo	To terminate out-of-hospital status epilepticus on arrival at hospital (59% lorazepam, 43% diacepam, 21% placebo) with less cardiorespiratory complications (10% both benzodiacepines, 22% placebo)
Lancet. 2007 Mar 24;369(9566):1000-15		Randomized Controlled Trial, Multicenter Study
IN epilepsy, partial	The Use of lamotrigine (Lamictal(R)) As Treatment, Chronic	Is better Than carbamazepine, gabapentin, oxcarbazepine (Trileptal(R)), or topiramate	To achieve a better time to treatment failure - so better tolerated/effective. But for one-year remission, carbamazepine was the best over all others.
Pediatrics. 2005 Dec;116(6):1299-302		Randomized Controlled Trial
IN errors, prescription	The Use of preprinted order sheets As Treatment, Acute	Is better Than regular blank order sheets	To reduce prescription errors: drug errors were identified in 16.6% orders using the regular form VS 9.8% on the new form.
BMJ. 2000 Jun 24;320(7251):1720-3		Review (Narrative)
IN evidence based medicine, bias, interpretation, diabetes mellitus, type 2	The Use of care with interpretation and dissemination of results As Methodology procedure	Is good Than -	To not introduce bias - intentional or not - in traslating results of research to practice
Brain. 2000 Sep;123(Pt 9):1964-1969		Descriptive
IN evidence based medicine, bias, publication	The Use of reproducibility of peer review of papers submitted for publication As Methodology procedure	Is bad Than -	To "guarantee" quality of published studies: Agreement between reviewers was not good, and was not convincingly better than chance for either journal for acceptance, revision or rejection, or high, medium or low priority
N Engl J Med. 2008 Jan 17;358(3):252-60		Descriptive
IN evidence based medicine, bias, publication	The Use of restricted publication of trials when results are negative As Methodology procedure	Is bad Than ---	To provide an unbiased assessment of the effectiveneness : 31% of FDA registered trials on antidepressants were not published, 94% of published trials but only 51% of FDA-registered trials showed positive results.
JAMA. 1999 Mar 24-31;281(12):1110-1		Descriptive
IN evidence based medicine, bias, reporting results	The Use of abstracts of medical publisehd articles As Methodology procedure	Is bad Than ---	To acurately get the data: 18% to 68% of abstract had data different from or inexistent in full text
Int J Geriatr Psychiatry. 2009 Sep;24(9):990-1001		Meta-Analysis
IN evidence based medicine, clinical trials, older people, depression	The Use of knowing high attrition rates exists As Methodology procedure	Is useful Than no comparison here	To overall 27.3% attrition rate in randomized trials on antidepressants in elderly. Higher rates if : more severe depression, smaller sample size, unbalanced allocation of treatments, longer duration, studies in USA
BMJ. 2004 Oct 30;329(7473):1017		Systematic Review
IN evidence based medicine, effectiveness of	The Use of clinically integrated teaching of evidence based medicine As Methodology procedure	Is better Than standalone (classrooms) teaching of evidence based medicine	To improve not only knowledge but also skills, attitudes and behaviour. But no one study evaluated petient,s health outcomes.
BMC Emerg Med. 2007 Aug 8;7(1):10 [Epub ahead of print]		Clinical Trial (non-controlled, non-randomized)
IN evidence based medicine, effectiveness of, critical care setting	The Use of introducing 4 evidence-based protocols As Treatment, Chronic	Is better Than practice before introduction	To reduce severity-adjusted mortality: 19.3% in the pre-protocol period VS 16.9% in the post-protocol period.
Implement Sci. 2012;7:50		Review (Narrative)
IN evidence based medicine, implementation, knowledge transfer	The Use of systematic reviews and other syntheses as the basic unit of knowledge transfer, identifying key messages for different audiences, assessing likely barriers and facilitators As Methodology procedure	Is useful Than no comparison done	To improve translation into healthcare practice of research findings
N Engl J Med. 2008 May 1;358(18):1929-40		Randomized Controlled Trial, Multicenter Study
IN evidence based medicine, implementation, knowledge transfer, birth, non complicated	The Use of multifaceted educational intervention combining: opinion leaders, interactive workshops, training of manual skills, detailing visits with attendants, reminders, and feedback As Treatment, Chronic	Is better Than no intervantion	To change practice in real setting: use of prophylactic oxytocin increased from 2.1% at baseline to 83.6%, reducing the rate of postpartum hemorrhage, and use of episiotomy decreased from 41.1% to 29.9%.
JAMA. 2006 Apr 19;295(15):1801-8		Descriptive
IN evidence based medicine, keeping up to date	The Use of an organized system (MORE) of second order of clinical peer review for journal articles As Methodology procedure	Is better Than individual reading of multiple journals	To select relevant published journal articles according to the interests of a broad range of clinical disciplines
Ann Intern Med. 2005 Feb 15;142(4):260-73		Systematic Review
IN evidence based medicine, keeping up to date, clinical experience	The Use of longer time in medical practice, longer time after medical graduation, older age As Prognostic Item	Is worse Than shorter time of medical practice after graduation	To provide good-quality care: physicians with more experience may paradoxaxically be at risk for providing lower-quality care. In some studies, patient mortality was greater
BMJ. 2004 Oct 30;329(7473):1013		Descriptive
IN evidence based medicine, keeping up to date, tacit knowledge, knowledge in practice	The Use of knowing how physicians derive healthcare decisions: relying in mindlines obtained trought formal and informal networking in a community of practice As Methodology procedure	Is useful Than not recognizing how actually knowledge is incorporated	To improve ways of conveying evidence to clinicans in their practice
Lancet. 2000 Jun 10;355(9220):2027-31		Diagnostic
IN evidence based medicine, medical thinking, clinical diagnosis diagnostic accuracy	The Use of necropsy, autopsy As Diagnostic Tool	Is better Than no autopsy	To undercover unsuspected diagnostics and assess performance of clinicians for diagnosing : 14% clinical diagnostics are wrong (greatly improved from a 30% in 1970)
PLoS Med. 2009 Jul 21;6(7):e1000097		Consensus Conference
IN evidence based medicine, meta-analysis	The Use of the PRISMA statement: a checklist plus a flow diagram As Methodology procedure	Is useful Than no use of any recommendation	To improve the quality of meta-analysis and their reports
Lancet. 1999 Nov 27;354(9193):1896-900		Consensus Conference
IN evidence based medicine, meta-analysis	The Use of the QUOROM statement: a checklist plus a flow diagram As Methodology procedure	Is useful Than -	To improve the quality of meta-analysis and their reports
Health Technol Assess. 2005 Jul;9(26):1-134, iii-iv		Systematic Review
IN evidence based medicine, meta-analysis, indirect comparisons	The Use of indirect comparisons, using As Methodology procedure	Is worse Than conventional direct comparisons	To estimate the true effect of an intervention. Without direct evidence, indirect comparisons can be useful, adjusting with a random effect model, but more risk of bias
CMAJ. 2009 Oct 13;181(8):488-93		Review (Narrative)
IN evidence based medicine, meta-analysis, indirect comparisons, treatment networks, multiple meta-analyses	The Use of treatment networks, multiple meta-analyses As Methodology procedure	Is better Than conventional single comparison direct meta-analysis	To provide a broader view of the therapeutic possibilities of a disease and the relative effectiveness of multiple treatments
BMC Med Res Methodol. 2007;7(7):40		Descriptive
IN evidence based medicine, meta-analysis, software employed	The Use of six dedicated programs: Comprehensive Meta-analysis (CMA), MetAnalysis, MetaWin, MIX (free), RevMan (free), and WEasyMA As Undefined	Is useful Than -	To perform meta-analysis, the choice of program depending of the needs and characteristics of the authors.
JAMA. 2003 May 21;289(19):2554-9		Descriptive
IN evidence based medicine, methodology, outcomes, composite outcomes	The Use of Intervention to be defined As Methodology procedure	Is bad Than -	To correctly interpret results. Reporting of composite outcomes is generally inadequate, implying that the results apply to all the individual components.
Cochrane Database Syst Rev. 2011;3:CD006776		Systematic Review, Cochrane Review
IN evidence based medicine, methodology, presenting information about risk, knowledge transfert	The Use of natural frequencies, absolute frequencies, absolute risk reduction (ARR) As Methodology procedure	Is better Than probabilities, relative risk, relative risk reduction (RRR), number needed to treat (NNT)	To better understand information about risks. Relative risk reduction, compared with absolute risk reduction and number needed to treat, may be perceived to be larger and is more likely to be persuasive.
Control Clin Trials. 1996 Feb;17(1):1-12		Meta-Analysis
IN evidence based medicine, methodology, quality scores	The Use of score (Jadad) to assess the quality of reports of randomized clinical trials As -	Is good Than -	To scoring consistently trials by all the raters
JAMA. 1999 Sep 15;282(11):1054-60		Descriptive
IN evidence based medicine, methodology, quality scores	The Use of scores of the quality of clinical trials As -	Is worse Than assessing individually relevant methodological aspects	To to identify trials of high quality for meta-analysis
BMJ. 2005 May 21;330(7501):1179		Diagnostic
IN evidence based medicine, methodology, searching strategy	The Use of specific combinations of terms, search strategy for randomized controlled trials As Methodology procedure	Is better Than other search strategies	To maximize either sensibility or specificity when searching PubMed for good quality RCTs.
Am J Public Health. 2004 Mar;94(3):361-6		Consensus Conference
IN evidence based medicine, non-randomized trials	The Use of TREND statement, a checklist for reporting As Methodology procedure	Is useful Than no comparison here	To improve quality of reporting of non-randomized trials using health interventions
Lancet. 2002 Feb 9;359(9305):515-9		Review (Narrative)
IN evidence based medicine, randomization	The Use of proper randomization method As Methodology procedure	Is better Than no randomization, or inadequate randomization	To achieve scientific accuracy and credibility
Cochrane Database Syst Rev. 2011;(4):MR000012		Systematic Review, Cochrane Review
IN evidence based medicine, randomization	The Use of randomized controlled trials, and concealed allocation As Methodology procedure	Is worse Than observational studies, or uncocealed allocation	To get an accurate estimation of real effects: randomised and non-randomised studies sometimes differed in both ways: either random. or non-random. yielded larger estimates of effet. Trials with inadequate allocation concealment yielded larger estimates
BMJ. 2010 Mar 23;340:c332. doi: 10.1136/bmj.c332.		Consensus Conference
IN evidence based medicine, randomized controlled trials	The Use of CONSORT statement: : a checklist plus a flow diagram As Methodology procedure	Is better Than no use of any recommendation	To improve the quality of randomizes controlled trials and their reports
Cochrane Database Syst Rev. 2008;(3):MR000009		Systematic Review, Cochrane Review
IN evidence based medicine, randomized controlled trials, participating in	The Use of participating in a randomized controlled trials As Treatment, Chronic	Is equal Than receiving the same treatment outside a RCT	To modify patients clinical outcomes: they are similar
Lancet. 2002 May 11;359(9318):1686-9		Review (Narrative)
IN evidence based medicine, statistics, survival analysis	The Use of adequate display and interpretation of survival plots, Kaplan-Meier As Methodology procedure	Is good Than -	To avoid false interpretation of the results of an study
J Fam Pract. 2004 Feb;53(2):111-20		Randomized Controlled Trial
IN evidence based medicine, strength of recommendations	The Use of an scale (SORT) to grade strength of recommendations, as based in available evidence As -	Is useful Than -	To try to unify scales to grade strength of recommendations
BMJ. 2008 May 10;336(7652):1049-51		Consensus, Guideline
IN evidence based medicine, strength of recommendations	The Use of GRADE system, rating strength of recommendations and quality of evidence, simple ways As Methodology procedure	Is useful Than no comparison here	To guide the reader of guidelines, increasing its usefullness
Chest. 2006 Jan;129(1):174-81		Consensus Conference
IN evidence based medicine, strength of recommendations	The Use of GRADE system, rating strength of recommendations and quality of evidence, simple ways As Methodology procedure	Is useful Than no formal assesing of the stength of recommandation	To guide the reader of guidelines, increasing its usefullness
JAMA. 1999 May 26;281(20):1900-5		Descriptive
IN evidence based medicine, validity of publications, guidelines	The Use of guidelines, methodological standards for evaluate its quality As Methodology procedure	Is good Than 0	To know validity of guidelines: those published in the peer-reviewed medical literature during the past decade do not adhere well to established methodological standards, specially in the identification, evaluation, and synthesis of the scientific evidence.
JAMA. 1992 Jul 8;268 (2):240-248		Meta-Analysis
IN evidence based medicine, validity of publications, narrative review	The Use of experts recommendations given in narrative review articles As Methodology procedure	Is worse Than objective meta-analysis	To accurately follow cumulative scientific evidence: review articles often failed to mention important advances or exhibited delays, treatments that have no effect on mortality or are potentially harmful continued to be recommended.
Cochrane Database Syst Rev. 2012 Sep 12;(9):CD007146		Systematic Review, Cochrane Review
IN falls, older people	The Use of group and home-based exercise programmes, home safety interventions, Tai Chi, multifactorial assessment and intervention programmes As Treatment, Chronic	Is better Than no or others interventions	To reduce risk of falling and/or rate of falls (RR 0.70 to 0.85 depending on the intervention)
Health Technol Assess. 2009 May;13(27):iii-iv, ix-x, 1-163		Randomized Controlled Trial
IN fever, any origin, children	The Use of ibuprofen As Treatment, Acute	Is better Than paracetamol	To reduce fever faster (23 minutes feaster) and increase time without fever (55 more minutes without)
Pain. 2010 Nov;151(2):530-9		Randomized Controlled Trial
IN fibromyalgia	The Use of non-pharmacological treatment, alternative therapies, yoga of awareness As Treatment, Chronic	Is better Than wait-listed standard care	To improve at 8 weeks symptoms and functioning: pain, fatigue, mood, acceptance and coping strategies.
Ann Emerg Med. 2008 Jul;52(1):22-29.e6		Randomized Controlled Trial
IN gastritis, gastroenteritis, acute, with vomiting, failed oral rehydration therapy	The Use of oral ondansetron As Treatment, Acute	Is better Than placebo	To allow retake of oral rehydration and reduce need of IV hydration (22% ondansetron VS 54% placebo) and avoid hospital admission (6% ondansetron VS 13% placebo)
Gastroenterology. 2007 Mar;132(3):855-62; quiz 1164-5		Randomized Controlled Trial, Diagnostic
IN gastrointestinal bleeding, obscure origin	The Use of intestinal capsule endoscopy As Diagnostic Tool	Is better Than push enteroscopy, upper and lower	To identify a bleeding source, as first-line exploration: 50% capsule VS 26% enteroscopy
Arch Intern Med. 2007 Jun 25;167(12):1291-6		Cohorts
IN gastrointestinal bleeding, upper	The Use of APACHE II score of 11 or greater, esophageal varices, stigmata of recent hemorrhage and unstable comorbidity on admission As Prognostic Item	Is useful Than -	To predict poor oucome (rebleeding, need for surgery, new or worsening comorbidity or death): if none of these factors only 6.2% had poor outcome
Am J Gastroenterol. 2008 Oct;103(10):2625-32		Systematic Review
IN gastrointestinal bleeding, upper	The Use of hemodynamic instability, comorbid illness, active bleeding at endoscopy, posterior duodenal or lesser gastric curvature ulcer As Prognostic Item	Is useful Than no comparison here	To predict the risk of rebleeding after endoscopy: OR 1.9 to 2.7
Lancet. 2009 Jan 3;373(9657):42-7		Cohorts
IN gastrointestinal bleeding, upper, low risk patients	The Use of GBS score = 0 (normal urea, normal Hgb, PAS>120, pulse<100, no melena, no syncope, no liver disease, no heart failure) As Prognostic Item	Is better Than no score	To identify patients no needing admission to hospital: 12.4% of all bleeding patients
Cochrane Database Syst Rev. 2008;(3):CD000193		Systematic Review, Cochrane Review
IN gastrointestinal bleeding, upper, oesophageal varices	The Use of somatostatin analogues As Treatment, Acute	Is equal Than placebo	To reduce rebleeding 5 (RR 0.84) or mortality (RR 0.97). Need for transfusion was reduced in 0.7 units par patient.
Gastroenterology. 2015 Sep;149(3):660-668.e1		Randomized Controlled Trial, Multicenter Study
IN gastrointestinal bleeding, upper, oesophageal varices, liver failure, liver cirrhosis, Child-Pugh class A or B	The Use of small-diameter covered stent, transjugular intrahepatic portosystemic shunt (TIPS) As Treatment, Acute	Is equal Than medical reduction of portal pressure (propranolol and isosorbide-5-mononitra)	To improve results at 2 years : TIPS reduced variceal rebleeding (7% TIPS VS 27% medical) but increased encephalopathy (18% TIPS vs 8% medical) and had no effect in survival and quality of life.
World J Surg. 1990 Mar-Apr;14(2):262-9		Descriptive
IN gastrointestinal bleeding, upper, peptic disease	The Use of age over 60 years, previous medical illness, shock on admission, large ulcer size, and endoscopic stigmata of hemorrhage As Prognostic Item	Is useful Than -	To predict an increased risk of rebleeding and mortality
N Engl J Med. 1981 Oct 15;305(16):915-6		Cohorts
IN gastrointestinal bleeding, upper, peptic disease	The Use of endoscopic stignmata of recent hemorrhage, specially ulcers with visible vessels As Prognostic Item	Is useful Than -	To predict an increased risk of rebleeding
N Engl J Med. 2007 Nov 1;357(18):1821-8		Diagnostic
IN general population, asymptomatic	The Use of magnetic resonance imaging (MRI) of the brain As Diagnostic Tool	Is good Than no comparison here	To detect incidental findings: asymptomatic brain infarcts in 7.2%; cerebral aneurysms in 1.8%; meningiomas in 1.6%.
Cochrane Database Syst Rev. 2012 Oct 17;10():CD009009		Systematic Review, Cochrane Review
IN general population, asymptomatic, overall mortality	The Use of general health checks As Diagnostic Tool	Is equal Than no doing general heatlh checks	To modify total mortality (RR 0.99), cardiovascular mortality (RR 1.03) or cancer mortality (RR 1.01)
Cochrane Database Syst Rev. 2012;7:CD002063		Systematic Review, Cochrane Review
IN Guillain-Barré syndrome	The Use of intravenous immunoglobulin, administered in the first two weeks after onset As Treatment, Acute	Is equal Than plasma exchange (no adequate studies comparing with placebo)	To improve disability scales
J Eval Clin Pract. 2009 Feb;15(1):55-61		Diagnostic
IN heart failure	The Use of clinical criteria, Framingham criteria As Diagnostic Tool	Is useful Than no comparison done	To diagnose heart failure: more sensitive (92%) than specific (79%), best at ruling out heart failure (LR- 0.1), worse to confirm heart failure (LR+ 4.3)
N Engl J Med. 2011 Mar 3;364(9):797-805		Randomized Controlled Trial, Multicenter Study
IN heart failure, acute	The Use of loops diuretics, furosemide, intravenously, at low dose, in bolus every 12h As Treatment, Acute	Is equal Than loops diuretics, furosemide, intravenously, at high dose, or in continuous infusion	To improve symptoms of heart failure or avoid adverse renal events. High-dose strategy associated greater diuresis and better secondary outcomes but also transient worsening of renal function
Am J Cardiol. 1988 Mar 25;61(9):22E-27E		Randomized Controlled Trial
IN heart failure, acute, cardiogenic pulmonary edema	The Use of nitrates, IV isosorbide-5-mononitrate As Treatment, Acute	Is useful Than not controlled	To survive, improve dyspnea, avoid mechanical ventilation
N Engl J Med. 2008 Jul 10;359(2):142-51		Randomized Controlled Trial, Multicenter Study
IN heart failure, acute, cardiogenic pulmonary edema	The Use of noninvasive ventilation, either continuous positive airway pressure (CPAP), or noninvasive intermittent positive-pressure ventilation (NIPPV) As Treatment, Acute	Is equal Than simple oxygen supplementation	To modify mortality or need for intubation at 7 days. Noninvasive ventilation improved dyspnea in more patients at 1 hour.
Lancet. 1998 Feb 7;351(9100):389-93		Randomized Controlled Trial
IN heart failure, acute, cardiogenic pulmonary edema	The Use of vasodilators IV, high-dose nitrates IV + low-dose furosemide As Treatment, Acute	Is better Than diuretics only, high-dose furosemide + low-dose nitrate	To reduce need for mechanical ventilation (13% patients in high-nitrites VS 40% in high-furosemide) and reduce myocardial infarction (17% VS 37%)
J Am Coll Cardiol. 2005 Aug 2;46(3):425-31		Randomized Controlled Trial, Multicenter Study
IN heart failure, acute, coronary disease, myocardial infarction	The Use of aldosterone blockers, eplerone, 25 mg/day initiated 3 to 14 days after AMI As Treatment, Chronic	Is better Than placebo	To reduce at 30 days all-cause mortality (3.2% with eplerone VS 4.6% with placebo), reduce cardiovascular mortality and reduce hospitalizations.
Acad Emerg Med. 2016 Mar;23(3):223-42		Systematic Review
IN heart failure, acute, dyspnea diagnosis	The Use of auscultation of S3 on physical examination, lung ultrasound, bedside echocardiography, and brain natriuretic peptide (BNP) As Diagnostic Tool	Is good Than no comparison done	To diagnose acute heart failure as a cause of dyspnea in adult patients in the emergency deparment. LR+ and - varied (see text)
N Engl J Med. 2002 Jul 18;347(3):161-7		Diagnostic
IN heart failure, acute, dyspnea diagnosis	The Use of brain natriuretic peptide (BNP) As Diagnostic Tool	Is useful Than gold standard: clinical diagnosis of heart failure, made by a cardiologist	To diagnose heart failure in patients who came to the emergency department with acute dyspnea: at a cutoff of 100 pg/ml sensitivity 90%, specificity 76%; at a cutoff of 50 pg/ml sensitivity 97%
N Engl J Med. 2004 Feb 12;350(7):647-54		Randomized Controlled Trial, Diagnostic
IN heart failure, acute, dyspnea diagnosis	The Use of brain natriuretic peptide (BNP), added to standard diagnostic strategy As Diagnostic Tool	Is better Than standard diagnostic strategy	To diagnose heart failure in patients who came to the emergency department with acute dyspnea, so reducing the need for hospitalization (75% in intv. VS 65% in ctrl.) and reducing median time to discharge (8 days in intv. VS 11 days in ctrl)
JAMA. 2005 Oct 19;294(15):1944-56		Systematic Review
IN heart failure, acute, dyspnea diagnosis	The Use of several clinical signs (history of heart failure, paroxysmal nocturnal dyspnea, 3rd heart sound), chest radiography and ECG As Diagnostic Tool	Is useful Than no comparison	To differentiate heart failure from other causes of dyspnea in the emergency department (LR+ 3.8 to 5.8). B-type natriuretic petide was the best to exclude heart failure (LR- 0.11) but not to affirm it.
Eur Heart J. 2009 Sep;30(18):2186-92		Randomized Controlled Trial
IN heart failure, acute, systolic	The Use of maintaining previous Tt with beta blockers As Treatment, Acute	Is equal Than stoping it during the acute phase of decompensation	To improve dyspnoea and symptoms at 3 days (92.8% maintain VS 92.3% stop), at 8 days and death at 3 months. More patients continuing beta-blockers received it 3 months after (90% VS 76% when stoped)
Circulation. 2006 Mar 21;113(11):1424-33		Cohorts
IN heart failure, chronic	The Use of knowing long-term mortality, a mathematical multivariate model (Seattle Heart Failure Model) including 14 continuous variables and 10 categorical values As Prognostic Item	Is useful Than simple clinical judgement	To to make individual estimations of 1, 2 and 3 years mortality. Overall ROC area under the curve was 0.73
Arch Cardiovasc Dis. 2014 Mar;107(3):158-68		Cohorts
IN heart failure, chronic	The Use of knowing long-term mortality, stratified by ages, in France As Prognostic Item	Is useful Than no comparison here	To be aware of the poor prognosis of patients hospitalised by decompensated HF: 29% mortality at 1 year, 40% at 2 years. Incrased age carried increased mortality
Cochrane Database Syst Rev. 2012;9:CD002752		Systematic Review, Cochrane Review
IN heart failure, chronic	The Use of follow-up after discharge, case management with telephone calls and visits led by a heart failure specialist nurse As Treatment, Chronic	Is better Than multidisciplinary, clinic-based interventions	To reduce all cause mortality (OR 0.66) and readmissions (OR 0.47) at 12 months. Clinic-based follow-up reduced only readmissions and not mortality
J Am Coll Cardiol. 2012 Oct 2;60(14):1239-48		Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic	The Use of follow-up after discharge, home-based multidiscipinary intervention, lead by a trained nurse As Treatment, Chronic	Is equal Than a specialized heart failure clinic-based follow up after hospital discharge	To modify, at 12-18 months, re-hospitalizations (67-69% both) or death (22-28%). But home-based interventions cumulated less days at hospital and lower costs
BMJ. 2000 Jul 22;321(7255):215-8		Randomized Controlled Trial
IN heart failure, chronic, diastolic (preserved ejection fraction)	The Use of seeking alternative diagnoses As Diagnostic Tool	Is useful Than -	To many patients with a diagnosis of heart failure but preserved left ventricular systolic function have an alternative explanation for their symptoms: obesity, lung disease, and myocardial ischaemia mostly
Heart. 2017 Aug 5. doi: 10.1136/heartjnl-2017-311652. [Epub ahead of prin		Systematic Review
IN heart failure, chronic, diastolic (preserved ejection fraction)	The Use of various medical treatments: angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta blockers, others As Treatment, Chronic	Is equal Than placebo ou usual care without those treatments	To modify mortality, with the exception of beta-blockers (RR 0.78). Trend to improve, but non consistent results, exercise capacity and quality of life
Eur J Heart Fail. 2010 Sep;12(9):936-42		Systematic Review
IN heart failure, chronic, mild anemia	The Use of erythropoiesis-stimulating agents, erythropoietin As Treatment, Chronic	Is equal Than placebo	To to modify overall mortality (RR 1.03) or worsening heart failure (RR 0.95)
Cochrane Database Syst Rev. 2010;1(1):CD007613		Systematic Review, Cochrane Review
IN heart failure, chronic, mild anemia	The Use of erythropoiesis-stimulating agents, supplemented by iron therapy As Treatment, Chronic	Is better Than placebo	To improve 6-minute walk distance (WMD 69 metres) and exercise capacity. Mean increase in Hgb was 1.98 g/dL. Also, lower rate of heart failure decompensations and a possible benefit in mortality.
Arch Intern Med. 2000 Mar 27;160(6):777-784		Case-Control
IN heart failure, chronic, systolic	The Use of nonsteroidal anti-inflammatory drugs (NSAIDs) As Etiologic risk factor	Is worse Than not using NSAIDs	To decompensate congestive heart failure requiring hospitalisation: OR 2.1
Arch Intern Med. 2002 Feb 11;162(3):265-70		Case-Control
IN heart failure, chronic, systolic	The Use of nonsteroidal anti-inflammatory drugs (NSAIDs) As Etiologic risk factor	Is worse Than not using NSAIDs	To decompensate previously existing heart failure (RR 3.8) but not to develop a first heart failure (RR 1.1)
J Am Coll Cardiol. 2007 Mar 6;49(9):963-71		Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, systolic	The Use of beta blockers, carvedilol As Treatment, Acute	Is better Than beta blockers, metoprolol	To reduce myocardial infarction (HR 0.71), unstable angina (HR 0.71) and fatal infarction or stroke (HR 0.46)
Lancet. 2000 May 6;355(9215):1575-1581		Meta-Analysis
IN heart failure, chronic, systolic	The Use of angiotensin converting enzyme inhibitors (ACEIs) As Treatment, Chronic	Is better Than placebo	To reduce at 3 years death (23% ACEI VS 27% placebo), reinfarction or rehospitalisation
Lancet. 1997 Feb 8;349(9049):375-80		Randomized Controlled Trial
IN heart failure, chronic, systolic	The Use of beta blockers, carvedilol As Treatment, Chronic	Is better Than placebo	To reduce death or hospitalization
N Engl J Med. 1996 May 23;334(21):1349-55		Randomized Controlled Trial
IN heart failure, chronic, systolic	The Use of beta blockers, carvedilol As Treatment, Chronic	Is better Than placebo	To reduces the risk or death and of hospitalization
JAMA. 2000 Mar 8;283(10):1295-302		Randomized Controlled Trial
IN heart failure, chronic, systolic	The Use of beta blockers, metoprolol As Treatment, Chronic	Is better Than placebo	To reduce all-cause death or hospital admission: metoprolol 32% vs. placebo 38%
N Engl J Med. 1996 Oct 10;335(15):1107-14		Randomized Controlled Trial
IN heart failure, chronic, systolic	The Use of calcium channel blockers, amlodipino As Treatment, Chronic	Is equal Than placebo	To modify mortality
Arch Intern Med. 2007 Oct 8;167(18):1930-6		Meta-Analysis
IN heart failure, chronic, systolic	The Use of combined Tt with angiotensin II receptor blocker (ARB) and angiotensin converting enzyme (ACE) inhibitors As Treatment, Chronic	Is worse Than ACE inhibitor alone	To frequency of side effects: it increased worsening renal function (4.7% combined VS 3.0% alone), hyperkalemia (3.4% combined VS 0.9% alone) and symptomatic hypotension (2.4% VS 1.6% in heart failure and 18% VS 12% in coronary disease)
Circulation. 1999 Mar 9;99:1173-82		Randomized Controlled Trial
IN heart failure, chronic, systolic	The Use of exercise training, 2-3 times/week, 1 hour sessions, combining stretching and indoor cycling As Treatment, Chronic	Is better Than no training	To reduce mortality, cardiac events, hospitalizations and improve quality of life
BMJ. 2013 Jan 28;346:f360. doi: 10.1136/bmj.f360.		Meta-Analysis
IN heart failure, chronic, systolic, kidney disease, chronic, diabetic and non diabetic	The Use of combined Tt with angiotensin II receptor blocker (ARB) and angiotensin converting enzyme (ACE) inhibitors As Treatment, Chronic	Is worse Than monotherapy with either angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blocker (ARB) alone	To increase adverse events (hyperkalaemia, hypotension, renal failure, RR 1.27 to 1.55) while not modifying mortality. Dual therapy reduced admissions to hospital for heart failure (RR 0.82)
N Engl J Med. 2011 Jan 6;364(1):11-21		Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, systolic, mild	The Use of diuretics, aldosterone blockers, eplerenone, added to recommended therapy As Treatment, Chronic	Is better Than placebo	To reduce at 2 years deaths (12.5% eplerenone VS 15.5% placebo) and hospitalizations for heart failure and for any cause. Hyperkaliemia in 12% epleren VS 7% placebo.
N Engl J Med. 1997 Feb 20;336(8):525-33		Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, systolic, patients in sinus rhyhtm	The Use of digoxin As Treatment, Chronic	Is better Than placebo	To reduce hospitalizations for worsening heart failure or by any cause, but mortality remained inchanged.
N Engl J Med. 1999 Sept 2;341(10):709-17		Randomized Controlled Trial
IN heart failure, chronic, systolic, severe	The Use of aldosterone blockers, spironolactone, added to loop diuretics and ACEI As Treatment, Chronic	Is better Than placebo	To reduce overall mortality, at 2 years: 35% in intv. VS 46% in ctrl. Reduce cardiac hospitalizations and significantly improve NYHA class
Lancet. 2010 Sep 11;376(9744):875-85		Randomized Controlled Trial, Multicenter Study
IN heart failure, chronic, systolic, sinus rhythm and heart rate > 70 bpm	The Use of ivabradine, eventually on top of beta-blockers As Treatment, Chronic	Is better Than placebo	To reduce hospitalisations for heart failure at 2 years (16% ivabradine VS 21% placebo) and possibly deaths due to heart failure (3% ivabradine VS 5% placebo) but not cardiovascular mortality.
N Engl J Med. 2005 Mar 3;352(9):875-83		Cohorts
IN heart valve disease, mitral regurgitation, asymptomatic	The Use of effective regurgitant orifice, echographically measured As Diagnostic Tool	Is good Than -	To estimate mortality risk: 40% mortality at 5 years if orifice > 40 mm2. Other, less powerful, risk factors for mortality: cardiac surgery (idependently reduces deaths), age, presence of diabetes
N Engl J Med. 2011 Apr 4. [Epub ahead of print]		Randomized Controlled Trial, Multicenter Study
IN heart valve disease, mitral regurgitation, moderately severe or severe (grade 3+ or 4)	The Use of percutaneous repair, percutaneous implantation of a clip that approximates the mitral leaflets As Treatment, Acute	Is equal Than surgery, surgical repair	To modify at 1 year mortality (6% both), NYHA class or quality of life measures. Percutaneous repair have less major adverse effets (15% VS 48% surgery) but needed more often re-surgery for valve disfunction (20% VS 2% surgery)
Am J Med. 2010 Oct;123(10):913-921.e1		Descriptive, Cross-Sectional Study
IN heart valve disease, systolic murmurs	The Use of distribution on the chest wall with respect to the 3rd left parasternal space As Diagnostic Tool	Is better Than other clinical examination points	To diagnose aetiology of systolic murmurs. However, classic physical findings could not distinguist severe from non-severe valve stenosis ans were absent in many patients with significant cardiac lesions
Cochrane Database Syst Rev. 2018 Mar 15;3:CD012080		Systematic Review, Cochrane Review
IN helicobacter pylori infection	The Use of non-invasive test, (13C) or (14C)-urea breath test As Diagnostic Tool	Is better Than other non-invasive tests, serology, or stool antigen test	To correctly diagnose H.pylori infection: DOR: 150 breath, 47 serology, 45 stool Ag ; Sensitivity at a 90% specificity: 93% breath, 84% serology, 83% stool Ag.
Am J Gastroenterol. 2006 Apr 3;101(4):848-863. Epub 2006 Feb 22		Systematic Review
IN helicobacter pylori infection, bleeding peptic ulcer	The Use of (13)C-urea breath test As Diagnostic Tool	Is better Than all other diagnostic test	To diagnose H. pylori infection in bleeding patients: the better combination of LR+ (9.5) and LR- (0.11). Methods based in biopsy (urease test, histology, or culture) have better specificity but less sensitivity. Serology and stool antigen test are worse.
Aliment Pharmacol Ther. 2006 Jan 1;23(1):35-44		Systematic Review
IN helicobacter pylori infection, resistance	The Use of eradication using levofloxacin plus amoxicillin plus proton pump inhibitors for 10 days As Treatment, Acute	Is better Than quadruple therapy regimens	To eradicate H. pylori: 81% levofloxacin VS 70% quadruple therapy. And few adverse effects: 19% vs. 44%
N Engl J Med. 2008 Jan 17;358(3):221-30		Cohorts
IN hemochromatosis, hereditary, C282Y mutation	The Use of C282Y homozygocity As Prognostic Item	Is useful Than no comprison here	To predict the risk of developing disease related to iron overload: 28.4% of men and only 1.2% of women C282Y homozygotes.
Cochrane Database Syst Rev. 2009 Oct 7;(4):CD007339		Systematic Review, Cochrane Review
IN hepatitis, acute, alcoholic, severe	The Use of pentoxifylline 400 mg/8h PO for 4 weeks As Treatment, Acute	Is better Than placebo	To possibly (high risk of bias in several of the trials) reduce at 1-3 months all-cause mortality (RR 0.64) and mortality due to hepatorenal syndrome (RR 0.40)
World J Gastroenterol. 2009 Apr 7;15(13):1613-9		Randomized Controlled Trial
IN hepatitis, acute, alcoholic, severe	The Use of pentoxifylline for 4 weeks As Treatment, Acute	Is better Than corticosteroids, prednisolone	To reduce at 3 months all-cause death (15% pentoxi VS 35% cortics) specially because of fewer hepato-renal syndromes
N Engl J Med. 2010 May 6;362(18):1675-85		Randomized Controlled Trial
IN hepatitis, nonalcoholic steatohepatitis, chronic, non diabetic patients	The Use of vitamin E, 800 IU daily As Treatment, Chronic	Is better Than placebo	To increase number of patients improving a composite histologic score at 2 years: 43% vitE VS 19% placebo). Pioglitazone did not improve this outcome.
Gastroenterology. 2010 Oct;139(4):1218-29		Meta-Analysis
IN hepatitis, virus, B, chronic	The Use of oral nucleoside analogues, entecavir, tenofovir As Treatment, Chronic	Is better Than other antivirals, lamivudine, pegylated interferon	To induce at 1 year undetectable levels of HBV DNA: 88% tenofovir, 61% entecavir
N Engl J Med. 2006 Mar 9;354(10):1011-20		Randomized Controlled Trial, Multicenter Study
IN hepatitis, virus, B, chronic, HBeAg-negative	The Use of nucleoside analogues, entecavir 0.5 mg/d As Treatment, Chronic	Is better Than nucleoside analogues, lamivudine (3TC)	To obtain histological improvement at 1 year (70% entecavir VS 61% 3TC), undetectable serum HBV DNA (90% entecavir VS 72% 3TC) or normalize ASAT
N Engl J Med. 2006 Mar 9;354(10):1001-10		Randomized Controlled Trial, Multicenter Study
IN hepatitis, virus, B, chronic, HBeAg-positive	The Use of nucleoside analogues, entecavir 0.5 mg/d As Treatment, Chronic	Is better Than nucleoside analogues, lamivudine (3TC)	To obtain histological improvement at 1 year (72% entecavir VS 62% 3TC), undetectable serum HBV DNA (67% entecavir VS 36% 3TC) or normalize ASAT
JAMA. 2006 Jan 4;295(1):65-73		Cohorts
IN hepatitis, virus, B, chronic, hepatocellular carcinoma	The Use of serum hepatitis B virus (HBV) DNA level As Etiologic risk factor	Is useful Than no comparison	To predit the risk of developping hepatocellular carcinoma, at study entry, in a dose-response relationship: cumulative incidence at 12 years: HBV DNA indetectable 1.3% VS DNA > 1 million copies/mL 14.9%
Health Technol Assess. 2006 Jul;10(21):1-113, iii		Randomized Controlled Trial, Multicenter Study
IN hepatitis, virus, C, all genotypes, chronic, mild	The Use of interferon-alpha and ribavirin for 48 weeks As Treatment, Chronic	Is better Than no treatment	To obtain sustained virological response (overall about 33%) and improve quality of life, except forpatients with genotype 1 aged > 65 years.
N Engl J Med. 2014 Jan 16;370(3):211-21		Clinical Trial (non-controlled, non-randomized)
IN hepatitis, virus, C, all genotypes, chronic, previously untreated or after treatment failure	The Use of daclatasvir 60 mg/day (HCV NS5A replication complex inhibitor) plus sofosbuvir 400 mg/day (nucleotide analogue HCV NS5B polymerase inhibitor) As Treatment, Chronic	Is useful Than thera are no valid control in this trial	To obtain sustained virologic response at 3 months: > 90% of patients in all genotypes and categories responded. The most common adverse events were fatigue, headache, and nausea
N Engl J Med. 2014 Apr 17;370(16):1483-93		Randomized Controlled Trial, Multicenter Study
IN hepatitis, virus, C, genotype 1, chronic, after treatment failure	The Use of ledipasvir (HCV NS5A replication complex inhibitor) plus sofosbuvir (nucleotide analogue HCV NS5B polymerase inhibitor) for 12 weeks As Treatment, Acute	Is equal Than ledipasvir + sofosbuvir + ribavirine for 12 weeks, or ledipasvir + sofosbuvir for 24 weeks	To obtain sustained virologic response at 3 months: 94% to 99% of patients
N Engl J Med. 2014 May 15;370(20):1889-98		Randomized Controlled Trial, Multicenter Study
IN hepatitis, virus, C, genotype 1, chronic, previously untreated	The Use of ledipasvir (HCV NS5A replication complex inhibitor) plus sofosbuvir (nucleotide analogue HCV NS5B polymerase inhibitor) for 12 weeks As Treatment, Acute	Is equal Than ledipasvir + sofosbuvir + ribavirine for 12 weeks, or ledipasvir + sofosbuvir for 24 weeks	To obtain a sustained virologic response at 3 months: 97% to 99% of patients
N Engl J Med. 2012 Sep 27;367(13):1237-44		Review (Narrative)
IN hepatitis, virus, E	The Use of knowing the existence of hepatitis E and characteristics As -	Is useful Than 0	To diagnose and manage adequatelly this disease
N Engl J Med. 2006 Nov 30;355(22):2283-96		Randomized Controlled Trial, Multicenter Study
IN HIV infection	The Use of episodic antiretroviral therapy guided by CD4 count: stop when >350 until <250 As Treatment, Chronic	Is worse Than continuous antiretroviral therapy	To reduce, at 16 months, opportunistic diseases (3.3 /100 person-years with episodic Tt VS 1.3 with continuous Tt, HR 2.6) or to reduce death (HR 1.8)
Lancet Infect Dis. 2010 Apr;10(4):251-61		Systematic Review
IN HIV infection, immune reconstitution inflammatory syndrome	The Use of CD4 cell count, type of oportunistic associated infection As Etiologic risk factor	Is useful Than no comparison here	To predict the risk of IRIS: 16% of all patients starting a HAART developed it, more frequent the fewer CD4 and in citomegalovirus, cryptoccocus and tuberculosis infections.
N Engl J Med. 2008 May 15;358(20):2095-106		Randomized Controlled Trial, Multicenter Study
IN HIV infection, initial therapy	The Use of highly active antiretroviral therapy (HAAR), 3 drugs, efavirenz (Sustiva(R)) + 2 nucleoside reverse-transcriptase inhibitors (NRTIs) (ex. Combivir(R) or Kivexa(R)) As Treatment, Chronic	Is better Than lopinavir-ritonavir + two NRTIs OR efavirenz + lopinavir-ritonavir	To achieve undetectable HIV viral load at 2 years (89% efavirenz+2NRTIs VS 77% lopinavir+2NRTIs VS 83% efavirenz+lopinavir) and avoid resistance mutations
N Engl J Med. 2003 Dec 11;349(24):2293-303		Randomized Controlled Trial, Multicenter Study
IN HIV infection, initial therapy	The Use of highly active antiretroviral therapy (HAAR), 3 drugs, zidovudine + lamivudine + efavirenz (Combivir(R) + Sustiva(R)) As Treatment, Chronic	Is better Than zidovudine + lamivudine + nelfinavir, didanosine + stavudine + either efavirenz or nelfinavir	To reducing or delaying virologic failures at 2,3 years
N Engl J Med. 2003 Dec 11;349(24):2304-15		Randomized Controlled Trial, Multicenter Study
IN HIV infection, initial therapy	The Use of highly active antiretroviral therapy (HAAR), 4 drugs, zidovudine + lamivudine + efavirenz + nelfinavir, OR didanosine + stavudine + efavirenz + nelfinavir As Treatment, Chronic	Is equal Than two consecutive 3 drug regimens, specially zidovudine + lamivudine + efavirenz	To reducing the occurrence of regimen failures or prolonging the time to failure, at 2,3 years
Lancet. 2006 Aug 5;368(9534):466-75		Randomized Controlled Trial, Multicenter Study
IN HIV infection, multidrug-resistant	The Use of non-peptidic protease inhibitors, tipranavir, boosted by ritonavir, plus optimised background regimen As Treatment, Chronic	Is better Than other selected protease inhibitors, also ritonavir-boosted, also plus optimised regimen	To achieve and maintain a reduction in viral load of 1 log(10) copies per mL or greater, at 48 weeks: 33.6% with tipranavir VS 15.3% other protease inhibitors
Ann Intern Med. 2000 Sep 19;133(6):401-410		Cohorts
IN HIV infection, natural history	The Use of absence of immunologic response (increase of CD4+ count) after 6 months of HAART As Prognostic Item	Is better Than no response or only virologic response (decrease in HIV viral load)	To predict death or progression to AIDS 18 months after: RR 3.4 in conresponders, RR 2 if only virologic response.
Lancet. 2000 Apr 1;355(9210):1131-37		Cohorts
IN HIV infection, natural history	The Use of natural history, without highly-active antiretroviral therapy As Prognostic Item	Is useful Than no comparison	To Median survival varied from 12.5 years for those aged 15-24 years at seroconversion to 7.9 years for those aged 45-54 years at seroconversion. For development of AIDS the corresponding values were 11.0 years and 7.7 years
N Engl J Med. 1999 Apr 1;340(13):977-87		Randomized Controlled Trial
IN HIV infection, pregnant women and perinatal transmission	The Use of elective cesarean section and antiretroviral therapy during the prenatal, intrapartum, and neonatal periods As Treatment, Acute	Is better Than other modes of delivery, and the absence of antiretroviral therapy	To reduce perinatal transmission of HIV to child: decreased by 50% by elective cesarean, by 87% when cesarean and antiretroviral therapy combined.
JAMA. 2000 Apr 19; 283(15):1967-75		Randomized Controlled Trial, Multicenter Study
IN hypertension, primary	The Use of alpha-blockers, doxazosin As Treatment, Chronic	Is worse Than diuretics (chlortalidone)	To stroke, combined cardivascular events and heart failure
Eur Heart J. 2012 Aug;33(16):2088-97		Meta-Analysis
IN hypertension, primary	The Use of angiotensin converting enzyme inhibitors (ACEI) As Treatment, Chronic	Is better Than placebo, and probably better than angiotensin II receptor blockers (ARBs)	To reduce all-cause mortality (20.4 deaths per 1000 patient-years with ACEIs VS 24.2 placebo). No significant mortality reduction appeared with ARB treatment
Lancet. 2015 Sep 18; doi: 10.1016/S0140-6736(15)00257-3 [Epub ahead of print]		Cross-Over
IN hypertension, primary	The Use of spironolactone, 25-50 mg/d As Treatment, Chronic	Is better Than bisoprolol (5-10 mg/d) or doxazosin modified release (4-8 mg/d)	To reduce averaged home systolic blood pressure at 12 weeks : - 9 mmHg reduction VS placebo, - 4 mmHg reduction VS bisoprolol
Ann Intern Med. 2004 Oct 19;141(8):614-27		Systematic Review
IN hypertension, primary, black patients	The Use of some drugs: calcium-channel blockers, diuretics, angiotensin II receptor blockers, central sympatholytics, alpha-blockers As Treatment, Chronic	Is better Than placebo	To reduce blood pressure. Effect in cardiovascular outcomes less clear. Beta-blockers and angiotensin-converting enzyme inhibitors (ACEI) were not better then placebo.
Cochrane Database Syst Rev. 2009;(4):CD000028		Systematic Review, Cochrane Review
IN hypertension, primary, elder patients	The Use of several drugs, specially thiazide diuretics As Treatment, Chronic	Is better Than placebo	To reduce total cardiovascular morbidity and mortality (RR 0.72 to 0.75). Total mortality was reduced in patients 60-80 years but not in patients > 80 years.
Lancet. 2002 Dec 14;360(9349):1903-13		Meta-Analysis
IN hypertension, primary, elder people, epidemiology	The Use of blood pressure (BP) As Prognostic Item	Is useful Than no comparison	To predict, at all ages, risk of cardiovascular event and death (both cardiovascular and overall): going up from BP 115/75 mmHg, there is a continuous (non-linear) correlation between BP and cardiovascular risk, at all ages.
Cochrane Database Syst Rev. 2011 Jul 6;(7):CD009217		Systematic Review, Cochrane Review
IN hypertension, primary, heart failure, healthy people	The Use of reduced dietary salt As Treatment, Chronic	Is equal Than maintaining same dietary salt	To reduce all cause mortality in both normotensive (RR 0.67, 95%CI: 0.40 to 1.12) and hypertensive patients (RR 0.97, 95%CI: 0.83 to 1.13)
Cochrane Database Syst Rev. 2012;8:CD006742		Systematic Review, Cochrane Review
IN hypertension, primary, mild (TAS 140-159, TAD 90-99), no previous cardiovascular event (primary prevention)	The Use of any antihypertensive drug therapy As Treatment, Chronic	Is worse Than placebo	To it do not significantly modify mortality, coronary syndrome, stroke or total cardiovascular events but it increased withdrawals due to adverse effects (9% more patients on active Tt)
Ann Intern Med. 2004 Nov 2;141(9):674-82		Randomized Controlled Trial
IN hypertension, secondary, renal artery stenosis	The Use of computed tomographic angiography, or magnetic resonance angiography As Diagnostic Tool	Is worse Than digital subtraction angiography	To diagnosis renal artery stenosis: both had a good specificity (CT 92%, MRI 84%) but a less good sensibility (CT 64%, MRI 62%), so they can not accurately rule out a significant stenosis.
Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003420		Systematic Review, Cochrane Review
IN hyperthyroidism, Graves disease	The Use of antithyroid drugs, low-dose 12 month regimen As Treatment, Chronic	Is better Than antithyroid drugs, high dose 6 months regimen	To was eqaul to control hyperthyroidism and reduce recurrence after stopping (30 to 55% in fdifferent studies) but produced less adverse events (9% withdrawals with low dose VS 16% high dose)
Am J Kidney Dis. 2010 Aug;56(2):325-37		Systematic Review
IN hyponatremia, euvolemic and hypervolemic patients, syndrome of inappropriate antidiuretic hormone secretion (SIADH)	The Use of vasopressin receptor antagonists, tolvaptan, with or without fluid restriction As Treatment, Acute	Is better Than placebo or no treatment, with or without fluid restriction	To improve normalization of natremia, both early and late (RR 3.15). However, no clinical outcomes (hospital stay, quality of life) were assessed
Am J Kidney Dis. 2013 Jul;62(1):67-72		Cohorts
IN hyponatremia, hypovolemic, diuretics	The Use of diuretics, thiazides As Treatment, Chronic	Is worse Than no exposure to thiazides	To carry a higher risk of hyponatremia : overall HR = 5.0. Lower age and lower body mass index increased the risk
Cochrane Database Syst Rev. 2007;(3):CD003419		Systematic Review, Cochrane Review
IN hypothyroidism, subclinical	The Use of levothyroxine, L-thyroxine As Treatment, Chronic	Is equal Than placebo or no treatment	To improve symptoms, mood or quality of life. No study assessed mortality. 1 study showed a significant improvement in cognitive function.
N Engl J Med. 2017 06 29;376(26):2534-2544		Randomized Controlled Trial, Multicenter Study
IN hypothyroidism, subclinical, older patients	The Use of levothyroxine, L-thyroxine As Treatment, Chronic	Is equal Than placebo	To improve the Hypothyroid Symptoms score and Tiredness score (range0 to 100, with higher scores indicating more symptoms) at 1 year: mean change +0.2 points both, L-thyroxine and placebo
BMJ. 2009 Sep 7;339:b3354. doi: 10.1136/bmj.b3354		Meta-Analysis
IN idiopathic facial paralysis, Bell,s palsy	The Use of antivirals, aded to corticosteroids As Treatment, Acute	Is equal Than corticosteroids alone	To improve numbers of at least partial facial muscle recovery: OR 1.5
Cochrane Database Syst Rev. 2010 Mar 17;(3):CD001942. doi: 10.1002/14651858.CD001942.pub4.		Systematic Review, Cochrane Review
IN idiopathic facial paralysis, Bell,s palsy	The Use of corticosteroid As Treatment, Acute	Is better Than placebo or no corticosteroids	To reduce number of patients with incomplete recovery: 23% corticosteriods VS 33% placebo
JAMA. 2009 Sep 2;302(9):985-93		Meta-Analysis
IN idiopathic facial paralysis, Bell,s palsy	The Use of corticosteroids As Treatment, Acute	Is better Than placebo, or antiviral agents alone	To reduce at long term (>4 months) unsatisfactory facial recovery (RR 0.69, NNT 11) Association of corticosteroids with antiviral may produce additinal benefit.
Am J Med. 2013 Apr;126(4):336-41		Randomized Controlled Trial
IN idiopathic facial paralysis, Bell,s palsy, severe	The Use of combined corticosteroid and antiviral treatment (prednisolone for 10 days starting 60 mg/d + famciclovir 750 mg/d for 7 days) As Treatment, Acute	Is better Than steroids alone	To improve chances of good recovery (complete or near complete): 83% combined treatment VS 66% steroids alone
N Engl J Med. 2016 Mar 17;374(11):1053-64		Randomized Controlled Trial
IN inappropriate prescription, optimising prescription, primary care	The Use of a complex intervention combining professional education, informatics, and financial incentives to review patients and charts As Treatment, Chronic	Is better Than usual practice	To reduced the rate of high-risk prescribing of antiplatelet medications and NSAIDs (3.7% intervention VS 2.2% control) and reduce the rate of hospitalizations for gastrointestinal bleeding and heart failure.
Proc Biol Sci. 2010 Jun 30. [Epub ahead of print]		Descriptive
IN infectious diseases intensity, average national cognitive ability, average national intelligence	The Use of infectious disease burden, measure in disability-adjusted life years caused by 28 common infectious diseases As Etiologic risk factor	Is useful Than no comparison	To predict average national intelligence and cognitive ability scores: r = 0.76 to 0.82 positive correlation.
N Engl J Med. 2015 Mar 19;372(12):1104-13		Randomized Controlled Trial, Multicenter Study
IN inflammatory bowel disease, crohn	The Use of SMAD7 (an inhibitor of TGF-β1 signaling) antisense oligonucleotide, mongersen As Treatment, Chronic	Is better Than placebo	To reach clinical remission at day 15: 55% with 40-mg/d morgensen, 65% with 160-mg/d mongersen, 12% with 10-mg/d and 10% placebo.
Cochrane Database Syst Rev. 2006 Apr 19;(2):CD000544		Systematic Review, Cochrane Review
IN inflammatory bowel disease, ulcerative colitis	The Use of 5-aminosalicylic acid (5-ASA) As Treatment, Chronic	Is worse Than sulfasalazine	To to maintain clinical or endoscopic remission: OR 1.29 (95%CI, 1.05 to 1.57), NNT negative (-19) for the comparison 5-ASA versus salazopirine
N Engl J Med. 1994 Jun 30;330(26):1841-5		Randomized Controlled Trial
IN inflammatory bowel disease, ulcerative colitis, severe, refractory to 7 days corticosteroid therapy	The Use of cyclosporine (4 mg/Kg.day), added to standard treatment As Treatment, Acute	Is better Than placebo	To increase responses (symptomatic improvement, oral medication and hospital discharge): 9 of 11 patients with cyclosporine, 0 of 9 patient with placebo
Chest. 2017 May;151(5):1069-1080		Randomized Controlled Trial
IN influenza A/H3N2, adults, old patients	The Use of a 2-day combination of clarithromycin 500 mg, naproxen 200 mg, and oseltamivir 75 mg twice daily, followed by 3 days of oseltamivir As Treatment, Acute	Is better Than oseltamivir 75 mg twice daily without placebo for 5 days	To reduce mortality at 30 (0.9% combination VS 8.2% oseltamivir alone) and 90 days (1.9% combination VS 10% oseltamivir alone)
JAMA. 2009 Nov 4;302(17):1872-9		Descriptive
IN influenza A/H1N1, critically ill patients	The Use of some clinical characteristics: being young (30% children), rapid evolution (4 days from beguining) As Prognostic Item	Is useful Than no comparison here	To be associated with critical ilness (severe hypoxemia, multisystem organ failure) and mortality despite prolonged mechanical ventilation, and use of rescue therapies: 17.3% at 3 months.
PLoS One. 2017;12(1):e0163586		Systematic Review
IN influenza, adults, older patients living in institutions	The Use of influenza vaccination of healthcare workers As Prevention, Primary	Is equal Than no vaccination or spontaneous vaccination	To realistically reduce the risk of influenza complications in patients cared for
Cochrane Database Syst Rev. 2016 Jun 2;(6):CD005187		Systematic Review, Cochrane Review
IN influenza, adults, older patients living in institutions	The Use of influenza vaccination of healthcare workers As Prevention, Primary	Is equal Than no vaccination or spontaneous vaccination	To reduce laboratory-proven influenza or the number of residents admitted to hospital for respiratory illness. Probable reduction in lower respiratory tract infection in residents of 4-6%. Mortality not pooled because high risk of bias & high heterogeneity
BMJ. 2010 Jun 9;340:c2843. doi: 10.1136/bmj.c2843.		Review (Narrative)
IN interstitial lung disease	The Use of detailed clinical history, chest x-ray, pulmonary function tests, high resolution computed tomography and for some patients bronchoscopy and/or pulmonary biopsy As Diagnostic Tool	Is useful Than no comparison	To accurately diagnose an evolving interstitial lung disease.
Crit Care Med. 2011 Mar;39(3):554-9		Meta-Analysis
IN intracranial elevated pressure	The Use of hypertonic saline, 3% to 7.5% sodium, dose: 2 to 5 mosm/Kg or about 250 mosm As Treatment, Acute	Is better Than mannitol 20%, equivalent dose in mosm	To modestly improve control of intracranial elevated pressure: RR 1.2 (1.0-1.33) or a mean additional intracranial pressure reduction of 2.0 mm Hg
N Engl J Med. 2011 Jan 6;364(1):22-32		Randomized Controlled Trial
IN irritable bowel syndrome, without constipation	The Use of oral non-absorbable antibiotics, rifaximin, for 2 weeks As Treatment, Acute	Is better Than placebo	To reduce symptoms at 4 weeks after treatment. And longer after ?
Am J Cardiol. 2014 Jun 6. [Epub ahead of print]		Meta-Analysis
IN kidney disease, chronic	The Use of statins As Treatment, Chronic	Is better Than placebo	To reduce progression of renal failure and reduce proteinuria
Eur Heart J. 2013 Jun;34(24):1807-17. Epub 2013 Mar 6.		Meta-Analysis
IN kidney disease, chronic	The Use of statins As Treatment, Chronic	Is better Than placebo	To reduce major cardiovascular events (RR 0.77) and all-cause death (RR 0.91)
Ann Intern Med. 2010 Jul 6;153(1):23-33		Systematic Review
IN kidney disease, chronic, associated anemia, erythropoiesis-stimulating agents	The Use of erythropoiesis-stimulating agents, erythropoietin, targeting higher hemoglobin levels As Treatment, Chronic	Is worse Than targeting lower hemoglobin levels	To increase risks for stroke (RR 1.5), hypertension (RR 1.7), and vascular access thrombosis (RR 1.3) and probably increases risks for death (RR 1.09, p NS)
Lancet. 2008 Aug 16;372(9638):547-53		Randomized Controlled Trial, Multicenter Study
IN kidney disease, chronic, diabetic, atherosclerose	The Use of combination of angiotensin converting enzyme inhibitor (ACEI, ramipril) plus angiotensin II receptor blockers (ARB, telmisartan) As Prevention, Primary	Is worse Than either angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor blockers (ARB) alone	To reduce the development of new renal failure or death in these high-risk patients: 14.5% combined ACEI+ARB versus 13.5% either ACEI or ARB alone
N Engl J Med. 2013 Sep 5;369(10):932-43		Meta-Analysis
IN kidney disease, chronic, glomerular filtration estimation	The Use of cystatin C, alone or added to creatinine, to estimate glomerular filtration rate As Diagnostic Tool	Is better Than creatinine alone	To better predict risk of death or end-stage renal disease. More patients had an estimated GFR < 60 ml/min using cystatine than using creatinine (13.7% vs. 9.7%)
Arch Intern Med. 2011 Mar 14;171(5):396-403		Cohorts
IN kidney disease, chronic, very severe, fit patients	The Use of early start of hemodialysis, with estimated glomerular filtration rate > 10 mL/min/1.73 m(2) As Treatment, Chronic	Is worse Than later start of hemodialysis, with estimated glomerular filtration rate < 10 mL/min/1.73 m(2)	To modify death at 1 year: HR for death was 1.5 to 2.2 in patients with GFR > 10 mL/min
Ann Intern Med. 2008 Jan 1;148(1):30-48		Meta-Analysis
IN kidney disease, chronic, with proteinuria, diabetic and non diabetic	The Use of combination of an angiotensin converting-enzyme (ACE) inhibitor AND an angiotensin II-receptor blocker (ARB) As Treatment, Chronic	Is better Than either ACE inhibitor or ARBs alone	To further reduced proteinuria at 6 to 12 months: ratio of means for combination therapy 0.76. When compared, ARBs and ACE inhibitors reduced proteinuria to a similar degree.
J Am Soc Nephrol. 2007 Jun;18(6):1889-1898. Epub 2007 May 9		Randomized Controlled Trial
IN kidney disease, chronic, with proteinuria, non diabetic	The Use of uptitration to maximal doses of angiotensin converting enzyme inhibitors (ACEI, benazepril ) or angiotensin II receptor blockers (ARB, losartan) As Treatment, Chronic	Is better Than usual doses of both drugs	To reduce, at 3.7 years, doubling creatinine or end-stage renal failure.
Ann Emerg Med. 2001 Jan;37(1):75-87		Review (Narrative)
IN knowledge transfer, graphics use	The Use of depiction of by-subject data, signification of pairing when present, symbols to identify relevant subgroups and small multiples (an array of similar graphics each depicting one group) As Methodology procedure	Is useful Than not using them	To provide the reader with optimum access to the relevant aspects of the data when presenting experimental data.
JAMA. 2008 Sep 10;300(10):1181-96		Meta-Analysis
IN knowledge transfer, internet use	The Use of internet based learning As Undefined	Is equal Than traditional learning methods	To improve or increase knowledge, skills and behaviours. Non-significant effect or small effect compared to traditional non-internet methods, but large effect size compared with no intervention.
Proc Natl Acad Sci U S A. 2014 Jun 10;111(23):8410-5		Meta-Analysis
IN learning, teaching, padagogy	The Use of active learning techniques: group problem-solving, worksheets or tutorials completed during class, use of personal response systems with or without peer instruction, and studio or workshop course designs As Treatment, Acute	Is better Than lecturing, pasive learning	To increase student performance on examinations (by 0.5 SD in avarage) and reduce failure rates (RR 1.5 for failing in exam with lecturing)
N Engl J Med. 2015 Dec 17;373(25):2425-37		Randomized Controlled Trial, Multicenter Study
IN leukemia, chronic lymphocytic leukemia	The Use of ibrutinib, Bruton tyrosine kinase (BTK) inhibitor As Treatment, Chronic	Is better Than chlorambucil	To improve progression-free survival (median, not reached with ibrutinib vs. 18.9 months chlorambucil) and improve survival at 2 years (98% ibrutinib VS 85% chlorambucil)
N Engl J Med. 2006 Dec 7;355(23):2408-17		Randomized Controlled Trial
IN leukemia, chronic myeloid leukemia	The Use of imatinib, BCR-ABL tyrosine kinase inhibitor As Treatment, Chronic	Is better Than interferon alfa plus cytarabine	To improve survival at 5 years: 89% with imatinib VS ? with interferon plus cytarabine.
Arch Intern Med. 2000 Jun 12;160(11):1621-1628		Cohorts