Talavera JO, Wacher-Rodarte NH, Rivas-Ruiz R

Language: Spanish
References: 7
Page: 289-294
PDF size: 56.73 Kb.

ABSTRACT

The need to solve a clinical problem leads us to establish a starting point to address (risk, prognosis or treatment studies), all these cases seek to attribute causality. Clinical reasoning described in the book Clinical Epidemiology. The architecture of clinical research, offers a simple guide to understanding this phenomenon. And proposes three basic components: baseline, maneuver and outcome. In this model, different systematic errors (bias) are described, which may be favored by omitting characteristics of the three basic components. Thus, omissions in the baseline characteristics cause an improper assembly of the population and susceptibility bias, omissions in the application or evaluation of the maneuver provoke performance bias, and omissions in the assessment of out-come cause detection bias and transfer bias. Importantly, if this way of thinking facilitates understanding of the causal phenomenon, the appropriateness of the variables to be selected in the studies to which attribute or not causality, require additional arguments for evaluate clinical relevance.

REFERENCES

1. Charlson ME, Frederic LS. The therapeutic efficacy of critical care units from two perspectives; a traditional cohort approach vs. a new case control methodology. J Chron Dis 1987;40:31-39.

2. Feinstein AR. Clinical epidemiology. The architecture of clinical research. Philadelphia: WB Saunders; 1985.

3. Feinstein AR. Directionality and scientific Inference. J Clin Epidemiol 1989;42:829-833.

4. Fletcher R, Fletcher S, Wagner E. Clinical epidemiolgy: the essentials. 2nd. ed. Baltimore: Williams & Wilkins; 1988.

5. Rothman KJ, Greenland S, Lash TL. Modern epidemiology. Third edition. Baltimore: Williams & Wilkins; 2008.

6. Sackett D, Haynes R, Tugwell P. Epidemiología clínica una ciencia básica para la medicina clínica. Madrid: Ediciones Diaz de Santos; 1989.

7. Talavera JO. Pronóstico. En: Ramiro M, Lifshitz A, Halabe J, Frati A, editores. El internista. Medicina interna para internistas. 3a. ed. México: Nieto Editores; 2008. p. 1893-1898.