ni ndazion comanRacc tesi Sint rcaRicer

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Master in Evidence Based Nursing

Bologna, Venerdì 16 gennaio 2015

Li id li i h

Linee guida cliniche Dove reperirle p

F N i Chi B i

Francesco Nonino, Chiara Bassi

Area Valutazione del Farmaco

A i S it i S i l R i l RER Agenzia Sanitaria e Sociale Regionale, RER

WHO Collaborating Centre for Evidence Based Research Synthesis

and Guideline Development

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La letteratura: una risorsa o un problema?

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3 PLOS MEDICINE 2010

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FATTORE TEMPO

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Ricerca clinica, sintesi degli studi e raccomandazioni

rca Studi

Primari

Rice r

Primari

tesi

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Revisioni sistematiche

Metanalisi

Sin t n i

Metanalisi

Linee guida

n dazio n

Linee guida

coma n

5 Rac c

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CHI PRODUCE LE LINEE GUIDA

 AGENZIE GOVERNATIVE E/O DI TECHNOLOGY

 AGENZIE GOVERNATIVE E/O DI TECHNOLOGY ASSESSMENT

non pubblicate a stampa (BD Linee Guida, Siti p p ( , Agenzie)

 SOCIETA’ SCIENTIFICHE

spesso pubblicate su riviste scientifiche (Medline, p p ( Embase, …)

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NATIONAL GUIDELINE CLEARINGHOUSE

- Prodotta dall’Agency for Healthcare Research and Quality (già AHCPR) American Medical Association Quality (già AHCPR), American Medical Association, American Association for Health Plans (1998)

- Contiene attualmente 2600 LG (che rispondono ai ( p precisi criteri di inclusione) inviate da Società

Scientifiche, Agenzie governative , …

- Di ciascuna LG viene fornito un Brief Summary, un Complete Summary e, dove è disponibile, il link al full t t

text

- Sistema di comparazione delle LG presenti in banca dati

dati

- Gli aggiornamenti sono settimanali

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NCG - CRITERI DI INCLUSIONE

- The clinical practice guideline contains systematically developed statements that include recommendations, strategies, or information that assists physicians and/or other health care practitioners and patients make decisions about appropriate health other health care practitioners and patients make decisions about appropriate health care for specific clinical circumstances.

- The clinical practice guideline was produced under the auspices of medical specialty associations; relevant professional societies public or private specialty associations; relevant professional societies, public or private organizations, government agencies at the Federal, State, or local level; or health care organizations or plans. A clinical practice guideline developed and issued by an individual not officially sponsored or supported by one of the above types of organizations does not meet the inclusion criteria for NGC.

types of organizations does not meet the inclusion criteria for NGC.

- Corroborating documentation can be produced and verified that a systematic literature search and review of existing scientific evidence published in peer reviewed journals was performed during the guideline development A guideline is reviewed journals was performed during the guideline development. A guideline is not excluded from NGC if corroborating documentation can be produced and verified detailing specific gaps in scientific evidence for some of the guideline's

recommendations.

- The full text guideline is available upon request in print or electronic format (for free or for a fee), in the English language. The guideline is current and the most recent version produced. Documented evidence can be produced or verified that the guideline was developed, reviewed, or revised within the last five years.

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NATIONAL GUIDELINE CLEARINGHOUSE

9 http://www.guideline.gov/

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NATIONAL GUIDELINE CLEARINGHOUSE

10 http://www.guideline.gov/

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NHS EVIDENCE

11 https://www.evidence.nhs.uk/

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NHS – CRITERI DI INCLUSIONE

- The clinical practice guideline was produced under the auspices of an international or national medical specialty association,

l t f i l i t t

relevant professional society or government agency.

- The guideline is produced in the UK, or produced outside the UK by one of the foregoing types of groups and officially

d d b th it ti UK i ti

endorsed by an authoritative UK organization.

- Corroborating documentation can be produced and verified that a systematic literature search and review of existing scientific evidence published in peer reviewed journals was performed during the guideline development.

- The guideline has been developed, reviewed, or revised g p within the last 5 years.

- The guideline is in English.

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SNLG – Sistema Nazionale Linee Guida

13 http://www.snlg-iss.it/

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Agenzie pubbliche

• National Institute for Clinical Excellence (NICE) Agenzia del servizio sanitario nazionale britannico

sanitario nazionale britannico http://www.nice.org.uk/

• Agency for Healthcare Quality and Research (AHRQ)

Agenzia governativa US, al cui interno sono disponibili rapporti sanitari EB e raccomandazioni di US Preventive Service Task Force (USPSTF)

http://www.ahcpr.gov/research/womenix.htm http://www.ahcpr.gov/research/womenix.htm

• Haute Autorité de Santé (HAS) Agenzia governativa francese g g

http://www.anaes.fr/anaes/anaesparametrage.nsf/HomePage?ReadForm

• The Canadian Task Force on Preventive Health Care (CTFPHC) Agenzia governativa canadese

http://www.ctfphc.org

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Agenzie Pubbliche

SIGN

http://www sign ac uk/guidelines/published/index html http://www.sign.ac.uk/guidelines/published/index.html

CMA

http://mdm.ca/cpgsnew/cpgs/index.asp

NEW ZEALAND GUIDELINES GROUP NEW ZEALAND GUIDELINES GROUP

http://www.nzgg.org.nz/gldb_search.cfm

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NICE

16 http://www.nice.org.uk/

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NIHR Health Technology Assessment programme

17 http://www.hta.nhs.uk/

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Canadian Agency for Drugs and Technology in Health (CADTH)

18 http://www.cadth.ca/index.php/en/home

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Società Scientifiche

AACE

http://www.aace.com/

AMERICAN COLLEGE OF CARDIOLOGY http://www acc org/clinical/statements htm http://www.acc.org/clinical/statements.htm ASCO

http://www asco org/ac/1 1003 12 002130 00 asp http://www.asco.org/ac/1,1003,_12-002130,00.asp

Royal College of Obstetricians and Gynaecologists (RCOG)

h // k/

http://www.rcog.org.uk/

Australian medical association

in The Medical Journal of Australia (MJA)

http://www.mja.com.au/public/guides/guides.html

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The 6S model

20 Haynes RB et al., ACP J Club 2009

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MEDLINE MEDLINE

Banca Dati bibliografica prodotta dalla National Library of - Banca Dati bibliografica prodotta dalla National Library of

Medicine

- Copre i settori della medicina, infermieristica, odontoiatria,

di i t i i i i it i

medicina veterinaria, organizzazione sanitaria...

- Contiene riferimenti bibliografici (record) relativi a circa 5.600 riviste biomediche pubblicate negli Stati Uniti e in altri 70

paesi

- Contiene attualmente più di 24 milioni di record dal 1946 ad oggi (con l’inclusione dell’OLDMEDLINE)

- Aggiornamenti quotidiani (In Process Citations) - Gratuita dal 1997

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PUBMED PUBMED

22 http://www.pubmed.gov

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EMBASE

- Banca Dati bibliografica che copre i settori della

medicina con particolare riguardo alla farmacologia e medicina, con particolare riguardo alla farmacologia e alla tossicologia.

- Contiene più di 24 milioni di record dal 1974 indicizzati p da circa 7500 riviste in prevalenza europee (molte delle quali non indicizzate da Medline)

- 80% records ha l’abstract - Aggiornamenti quotidiani

- Prodotta dalla casa editrice Elsevier, - Non esiste una versione gratuita

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EMBASE

24 http://www.embase.com/home

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BANCHE DATI SPECIFICHE

PER IL NURSING:

–Joanna Briggs –Systematic reviews within nursing and midwifery CINAHL: Cumulative Index to Nursing and Allied Health

–CINAHL: Cumulative Index to Nursing and Allied Health MEDICINE COMPLEMENTARI E ALTERNATIVE:

–MANTIS –MANTIS

–Allied and Complementary Medicine (AMED) SALUTE MENTALE:

SALUTE MENTALE:

–PsycINFO

–The PILOTS (Published International Literature on Traumatic Stress) FISIOTERAPIA:

–Physiotherapy Evidence Database (PEDro) ONCOLOGIA:

ASCO American Society of Clinical Oncology

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CINAHL

(Cumulative Index to Nursing & Allied Health Literature)

- La più importante Banca Dati per il nursing La più importante Banca Dati per il nursing

- Contiene più di 700,000 record dal 1982 indicizzati da circa 2800 riviste ( 55% non comprese in Medline) da circa 2800 riviste ( 55% non comprese in Medline) - Il materiale indicizzato include: articoli, libri,

letteratura grigia, audiovisivi, ...

- Dal 1994 sono state inserite nel record anche le referenze bibliografiche dei singoli articoli g g

- Aggiornamenti mensili

- Non esiste una versione gratuita Non esiste una versione gratuita

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CINAHL

Esempi di discipline collaterali:

- Nutrizione e dietetica

Fisioterapia e riabilitazione - Fisioterapia e riabilitazione - Tecnica radiologica