Conoscere EBM
- Definizione
- Acronimi
- Cronologia
- Ambiti
- Know-how e strumenti
- EBM in 4 step
- Limiti e ostacoli

EB Practice
- Formulazione quesito
- Ricerca evidenze
- Valutazione evidenze
- Applicazione evidenze

EBHC Library
- Risorse in italiano

SSN Hot Topics
- Appropriatezza
- Conflitti di interesse
- ECM
- Farmaci
- Governo Clinico
- LEA

InfoSanità

GIMBE^®

Workshop
Evidence based Medicine
Le opportunità per un linguaggio comune
Seconda edizione

Como, 21-22 maggio 2004

in collaborazione con

Società
Nazionale di
Aggiornamento
Medico
InterDisciplinare

Sezione di Como

Alcuni degli  articoli non disponibili in full text possono essere richiesti a: info@gimbe.org
Per visualizzare le diapositive è necesssario Acrobat Reader

Introduzione

• Slides

Sindrome metabolica e rischio cardiovascolare: perchè la strada non passa sempre per il diabete?
Conduttore: Antonino Cartabellotta.
Discussant: Alessandro Di Pasquale, Mario Parenti, Pierluigi Perseghin

• Slides

• Evidence appraised

  • Linee guida

    • American Heart Association; National Heart, Lung, and Blood Institute. Definition of metabolic syndrome. Circulation. 2004;109:433-8

    • National Heart, Blood and Lung Institute.Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

    • American Association of Clinical Endocrinologist. AACE Position: Insulin Resistance Syndrome

  • Revisioni narrative, editoriali

    • Shaw JE, Chisholm DJ.  Epidemiology and prevention of type 2 diabetes and the metabolic syndrome. Med J Aust. 2003 Oct 6;179(7):379-83.

    • Kereiakes DJ, Willerson JT. Metabolic syndrome epidemic. Circulation 2003;108:1552-3

    • Reilly MP, Rader DJ. The metabolic syndrome: more than the sum of its parts? Circulation 2003;108:1546-51

    • Haffner S, Taegtmeyer H. Epidemic obesity and the metabolic syndrome. Circulation 2003;108:1541-5.

    • Wilson PW, Grundy SM. The Metabolic Syndrome: Practical Guide to Origins and Treatment: Part I.  Circulation 2003;108:1422-1424

    • Wilson PW, Grundy SM. The Metabolic Syndrome: A Practical Guide to Origins and Treatment: Part II. Circulation 2003;108:1537-1540

    • Scott CL.  Diagnosis, prevention, and intervention for the metabolic syndrome. Am J Cardiol 2003;92(1A):35i-42i.

    • Meigs JB.  The metabolic syndrome. BMJ 2003;327:61-2

    • Ginsberg HN. Treatment for patients with the metabolic syndrome. Am J Cardiol. 2003 Apr 3;91(7A):29E-39E. [abstract]

    • Hill JO, Bessesen D. What to do about the metabolic syndrome? Arch Intern Med 2003;163:395-7

    • Reaven G. Metabolic syndrome: pathophysiology and implications for management of cardiovascular disease. Circulation 2002;106:286-8

    • Bloomgarden ZT. Obesity, hypertension, and insulin resistance. Diabetes Care. 2002 Nov;25(11):2088-97.

  • Ricerca primaria

    • Studi osservazionali

      • C. Lorenzo, M. Okoloise, K. Williams, et al. The Metabolic Syndrome as Predictor of Type 2 Diabetes: The San Antonio Heart Study. Diabetes Care 2003;26:3153-3159.

      • Meigs JB, Wilson PW, Nathan DM, et al. Prevalence and characteristics of the metabolic syndrome in the San Antonio Heart and Framingham Offspring Studies. Diabetes. 2003 Aug;52(8):2160-7.

      • Park YW, Zhu S, Palaniappan L, et al. The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med. 2003 Feb 24;163(4):427-36.

      • Alexander CM, Landsman PB, Teutsch SM, et al. NCEP-defined metabolic syndrome, diabetes mellitus, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003;52:1210-214

      • Lakka HM, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002;288:2709-16 

      • Laaksonen DE, Lakka HM, Niskanen LK, et al. Metabolic syndrome and development of diabetes mellitus Application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol. 2002;156:1070-1077.

      • Janssen I, Katzmarzyk PT, Ross R. Body mass index, waist circumference, and health risk: evidence in support of current National Institutes of Health guidelines. Arch Intern Med. 2002 Oct 14;162(18):2074-9.

      • Deedwania PC. Clinical significance of cardiovascular dysmetabolic syndrome. Curr Control Trials Cardiovasc Med 2002;3:2

      • Isomaa B, Almgren P, Tuomi T, et al Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24:683-689

    • Trial clinici

      • Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393-403.

      • Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343-1350

Tavola rotonda. The non-disease: le implicazioni sanitarie, etiche, sociali, medico-legali ed economiche dell’eccesso di medicalizzazione
Conduce: Antonino Cartabellotta.
Partecipano: Marco Cambielli, Maurizio Mancuso, Valeria Valioni

• Slides

La gestione del paziente con emicrania in medicina generale: verso l’integrazione ottimale con con i servizi specialistici
Conduttore: Antonino Cartabellotta.
Discussant: Daniela Canini, Primiano Iannone, Roberto Sterzi

• Slides

• Evidence appraised

  • Linee guida

    • Snow V, Weiss K, Wall EM, Mottur-Pilson C. Pharmacologic management of acute attacks of migraine and prevention of migraine headache. Ann Intern Med 2002;137:840-52.

    • Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology.  American Academy of Neurology 2000 Sep

    • Migraine headache.  Institute for Clinical Systems Improvement - Private Nonprofit Organization.  1998 Nov (revised 2003 Jul)

    • Prodigy Guidance. April 2002

  • Evidence summaries

    • Clinical Evidence

    • Bandolier

  • Revisioni sistematiche

    • Cochrane

      • Oldman AD, Smith LA, McQuay HJ, Moore RA. Rizatriptan for acute migraine (Cochrane Review). In: The Cochrane Library, Issue 2, 2004. Chichester, UK: John Wiley & Sons, Ltd.

      •  Smith LA, Oldman AD, McQuay HJ, Moore RA. Eletriptan for acute migraine (Cochrane Review). In: The Cochrane Library, Issue 2, 2004. Chichester, UK: John Wiley & Sons, Ltd.

      • McCrory DC, Gray RN. Oral sumatriptan for acute migraine (Cochrane Review). In: The Cochrane Library, Issue 2, 2004. Chichester, UK: John Wiley & Sons, Ltd.

      • Linde K, Rossnagel K. Propranolol for migraine prophylaxis (Cochrane Review). In: The Cochrane Library, Issue 2, 2004. Chichester, UK: John Wiley & Sons, Ltd.

    • Non-Cochrane

      • Ferrari MD, Roon KI, Lipton RB, Goadsby PJ. Oral triptans (serotonin 5-HT(1B/1D) agonists) in acute migraine treatment: a meta-analysis of 53 trials. Lancet 2001;358:1668-75.

  • Revisioni non sistematiche

    • Silberstein SD. Migraine. Lancet  2004;363:381-91

    • Aukerman G, Knutson D, Miser WF. Management of the acute migraine headache. Am Fam Physician 2002;66:2123-30.

    • Goadsby PJ, Lipton RB, Ferrari MD. Migraine--current understanding and treatment. N Engl J Med 2002;346:257-70.

    • Ryan RE Jr. Patient treatment preferences and the 5-HT1B/1D agonists. Arch Intern Med 2001;161:2545-53.

Workshop Metodologico. Valutare prove di efficacia e i rischi dei trattamenti: le regole dell’EBM

Conduttore: Antonino Cartabellotta

• Slides

Strategie diagnostiche nel LES: quando le tecnologie non possono sostituire storia ed esame clinico
Conduttore: Antonino Cartabellotta.
Discussant: Matteo Longhi, Daniele Luraschi

• Slides

• Evidence appraised

• Linee guida

  • American College of Rheumatology

    • Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum 1999;42:1785-96

    • Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725

    • The 1982 Revised Criteria of the Classification of Systemic Lupus Erythematosus. Arthritis Rheum 1982;25:1271-7

  • College of American of Pathology. Guidelines for clinical use of the antinuclear antibody test and tests for specific autoantibodies to nuclear antigens. Arch Pathol Lab Med 2000;124:71-81

• Evidence summaries

  • Mazanec DJ, Kantor SM. Systemic Lupus Erythematosus. In: Diagnostic Strategies for Common Medical Problems. 1999:419-428.

• Revisioni non sistematiche

  • Gill JM, et al. Diagnosis of systemic lupus erythematosus. Am Fam Physician 2003;68:2179-86

  • Ruiz-Irastorza G, et al . Systemic lupus erythematosus. Lancet 2001;357:1027-32

Il trattamento della depressione in medicina generale: efficacia e tollerabilità di vecchi e nuovi farmaci
Conduttore: Antonino Cartabellotta.
Discussant: Sergio Bettinelli, Gabriella Cilli

• Slides

• Evidence appraised

• Linee guida

  • Prodigy.Depression. April, 2003

  • American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder. April, 2002

  • British Association for Psychopharmacology. Evidence-based guidelines for treating depressive disorders with anti-depressants. March, 2000

• Evidence summaries

  • Improving the recognition and management of depression in primary care. Effective Health Care Bulletin, 2002 

• Revisioni sistematiche

  • Cochrane

    • Guaiana G, Barbui C, Hotopf M. Amitriptyline versus other types of pharmacotherapy for depression. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

    • Barbui C, Hotopf M, Freemantle N, et al. Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic antidepressants (TCAs) In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

    • Furukawa TA, Streiner DL, Young LT. Antidepressant and benzodiazepine for major depression. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

    • Geddes JR, Freemantle N, Mason J, Eccles MP, Boynton J. Selective serotonin reuptake inhibitors (SSRIs) versus other antidepressants for depression. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

    • Furukawa T, McGuire H, Barbui C. Low dosage tricyclic antidepressants for depression. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

  • Non-Cochrane

    • van Weel-Baumgarten EM, Schers HJ, van den Bosch WJ, van den Hoogen HJ, Zitman FG. Long-term follow-up of depression among patients in the community and in family practice settings. A systematic review. J Fam Pract 2000;49:1113-20

• Revisioni non sistematiche

  • Remick RA. Diagnosis and management of depression in primary care: a clinical update and review. CMAJ 2002;167:1253-60