摘要
In certain situations, which occur with particular frequency in the field of surgery and its related disciplines (where what predominates are observational-type studies), the management of randomized controlled clinical trials (RCT) is very difficult and as such, conducting a systematic review (SR) based on RCT and realice a meta-analysis is even more difficult. Therefore, we have generated a methodology for implementing a SR with different types of designs (including observational studies) as an alternative in order to clarify the uncertainty in the field of therapy when there are few RCT and the evidence relies so heavily on descriptive and observational studies. The aim of this study, was to set out a methodology that leads to a SR with various types of designs. Methodologycally, this is based on consideration of the different primary studies through the application of a methodological quality score made up of 3 items (type of study design, size of the population studied and methodology used in the study). Once assigned a point score, a calculation of weighted averages with their respective confidence intervals of 95% is applied to each variable to be studied, which finally enables to apply a meta-analysis and compare groups. A methodological proposal leading to a SR with various types of designs. En ciertas situaciones, en especial frecuentes en el 芍mbito de la cirug赤a y sus disciplinas afines (donde lo que predomina son estudios de tipo observacional), la conducci車n de ensayos cl赤nicos con asignaci車n aleatoria (EC) es muy dif赤cil; por ende, realizar revisiones sistem芍ticas (RS) con base en EC y posteriormente meta-analizar la informaci車n lo es a迆n m芍s. Por esta raz車n hemos generado una metodolog赤a para realizar RS con diferentes tipos de dise os (incluyendo estudios observacionales), como una alternativa para aclarar la incertidumbre en el 芍mbito de la terapia cuando existen pocos EC y la evidencia se apoya fundamentalmente en estudios descriptivos y observacionales. El objetivo de este estudio fue exponer una metodolog赤a para conducir RS con diversos tipos de dise os. La metodolog赤a, se basa en la ponderaci車n de los diferentes estudios primarios a trav谷s de la aplicaci車n de un escore de calidad metodol車gica compuesto por 3 赤tems (tipo de dise o del estudio, tama o de la poblaci車n estudiada y metodolog赤a empleada en el estudio). Una vez asignado un puntaje se aplica un c芍lculo de promedios ponderados con sus respectivos intervalos de confianza del 95% a cada variable que se desee estudiar, lo que permite finalmente realizar un meta-an芍lisis y compa