The certainty of the evidence for interventions is the certainty or confidence that the true effect is within a particular range or relative to a threshold. In the new pyramid of evidence, systematic reviews represent the magnifying glass through which this certainty is evaluated. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach arises in response to the existence of multiple evidence classification systems, and it offers a transparent and structured process to develop and present summaries of evidence considering its certainty and, in a second step, the strength of the recommendations that they inform. The GRADE process begins with an explicit question that includes all important and critical outcomes explicitly. The main domains used to assess the certainty of the evidence are risk of bias, inconsistency, indirectness of evidence, imprecision, and publication bias. The factors that can increase the certainty of the evidence are dose-response gradient, large magnitude of an effect, and effect of plausible residual confounding. Finally, the Summary of Findings tables summarize the process in a simplified way and with controlled language. This narrative review’s purpose is to address the GRADE approach’s theoretical and practical underlying concepts in a simplified way and with practical examples.

This article is part of a collaborative methodological series of narrative reviews on biostatistics and clinical epidemiology. This review aims to present basic concepts about the minimal clinically important difference and its use in the field of clinical research and evidence synthesis. The minimal clinically important difference is defined as the smallest difference in score in any domain or outcome of interest that patients can perceive as beneficial. It is a useful concept in several aspects since it links the magnitude of change with treatment decisions in clinical practice and emphasizes the primacy of the patient’s perception, affected by endless variables such as time, place, and current state of health, all of which can cause significant variability in results.

Spanish Ophthalmology journals publish a low number of CCTs, with limited methodological quality. Handsearching was more sensitive than the electronic searching. Abbreviations CCT: Controlled clinical trial.

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The significant increase in scientific evidence production has led to the creation of methods to facilitate evidence review and synthesis. This has turned, this has resulted in the emergence of different designs depending on the review’s objective. Evidence gap maps constitute a novel approach for literature review. They are thematic collections of a broad field of evidence, using a systematic search strategy that identifies gaps in knowledge and engages, early on, the target audience to design a friendly graphic product. Evidence maps are a tool to be considered in the roster of options available for research funders in that they are particularly useful for evidence-based decision-making and evidence-based policy development. The most commonly used formats to display the findings of evidence gap search designs are the bubble plot and the intervention-outcome framework. This article corresponds to the sixth of a series of narrative reviews on general topics of biostatistics and clinical epidemiology. The purpose of this review is to describe the principal features of evidence gap maps, highlighting their main objectives and utility, exploring the most commonly used mapping formats, and comparing this approach with other evidence synthesis designs.

Satisfacción con la atención médica de pacientes hospitalizados en un servicio clínico docente y en uno no docente RESUMEN Introducción: En Chile, una proporción importante de hospitales públicos son docente-asistenciales. El objetivo del presente estudio fue determinar y comparar los niveles de satisfacción con la atención médica entre un centro asistencial docente y uno no docente. Material y método: Estudio de corte transversal. Se aplicó un cuestionario para evaluar satisfacción con la atención médica y grado de aceptación hacia estudiantes de Medicina, a pacientes hospitalizados en servicios de urología del Hospital Dr. Gustavo Fricke (no docente) y Hospital Carlos Van Buren (docente), entre septiembre y noviembre de 2009. Se utilizó razón de validez de contenido (CVR) como criterio de inclusión para los diferentes ítems del cuestionario final, que consideró 14 ítems, además de evaluarse su consistencia interna. Resultados: Fueron encuestados 140 pacientes en total, 70 de cada servicio. No hubo diferencia en la satisfacción por servicio (90% y 88,6%). Respecto a las variables demográficas, hubo diferencia en edad, proporción de pensionados, y nivel educacional, por servicios. La única variable que mostró asociación con satisfacción fue el sexo, apreciándose en un 95% de hombres contra un 81,4% de mujeres (p=0,01). Un 94,3% de los pacientes aceptó la presencia de los estudiantes en el servicio docente. Discusión: En la muestra estudiada, estar internado en uno u otro centro no afectó la satisfacción de los pacientes. La única variable que se asoció a la satisfacción fue el ser hombre, y la presencia del estudiante fue aceptada por la gran mayoría de pacientes.

This article is the first in a collaborative methodological series of narrative reviews on biostatistics and clinical epidemiology. This review aims to present rapid reviews, compare them with systematic reviews, and mention how they can be used. Rapid reviews use a methodology like systematic reviews, but through shortcuts applied, they can attain answers in less than six months and with fewer resources. Decision-makers use them in both America and Europe. There is no consensus on which shortcuts have the least impact on the reliability of conclusions, so rapid reviews are heterogeneous. Users of rapid reviews should identify these shortcuts in the methodology and be cautious when interpreting the conclusions, although they generally reach answers concordant with those obtained through a formal systematic review. The principal value of rapid reviews is to respond to health decision-makers’ needs when the context demands answers in limited time frames.

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