OBJETIVO: realizar uma revisão narrativa sobre revisão sistemática. FONTE DOS DADOS: foi realizada busca no Cochrane Methodology Register, na Medline, na LILACS, no Google Scholar e na Cochrane Library, no período de 2000 a janeiro de 2007. Foram utilizados a busca manual das listas de referências e os contatos pessoais. SELEÇÃO DOS ESTUDOS: a estratégia de busca empregou, na Medline, as seguintes combinações dos termos MeSH: "Meta-Analysis" [Publication Type] AND "Evidence-Based Medicine"[MeSH] Limits: Publication Date from 2000 to 2007, Humans, Systematic Reviews. Na LILACS: (metanalise) or "metanalise" [Descritor de assunto] and [ medicina baseada em evidências] or "medicina baseada em evidências" [Descritor de assunto]. No Cochrane Methodology Register e no Google Scholar: "revisão sistemática e metanálise" e "medicina baseada em evidências". Após uma revisão independente por dois revisores, dez artigos que se referiam ao objetivo proposto foram selecionados. SÍNTESE DOS DADOS: os temas mencionados nos estudos foram agrupados em duas categorias: aqueles que se reportavam à história da revisão sistemática e aqueles que definiam Medicina Baseada em Evidência, revisão sistemática e metanálise. CONCLUSÃO: os autores concluem com a necessidade de mais discussões sobre revisão sistemática entre os cirurgiões.
SummaryObjective. To make a narrative review of the accuracy of induced sputum for diagnosis of pulmonary disease in HIV-infected patients. Data sources: The MEDLINE, LILACS, EMBASE and the Cochrane Library were searched. reference lists, abstracts of conference proceedings and scientific meetings were hand searched. MethOds. Study selection: Fifteen articles that specifically addressed the stated purpose were selected. Data extraction: Yield of sputum induction and fiberoptic bronchoscopy with bronchoalveolar lavage were analyzed using explicit methodologic to evaluate the quality of clinical trials. Results. Sputum induction demonstrated 55.5% sensitivity and 98.6% specificity to Pneumocystis pneumonia. Sensitivity of sputum induction was significantly higher with immunofluorescence than with cytochemical staining (67.1 versus 43.1%). Sputum induction for diagnosis of bacterial pneumonia demonstrated 60% sensitivity, 40% specificity, 80% positive predictive value, 20% negative predictive value and 56% accuracy. In relation to tuberculosis, sputum induction demonstrated 36% sensitivity, 100% specificity, 100% positive predictive value and 54.2% negative predictive value. cOnclusiOn. Sputum induction seems to be effective and safe for diagnosis of pulmonary diseases in HIV-infected patients.
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