Análisis de la evidencia científica en el diagnóstico por la imagen / Analysis of scientific evidence in imaging diagnosis

Se realiza un análisis de la situación de las evidencias científicas en el área del Diagnóstico por la Imagen, se describen los principales tipos de estudios clasificados según su nivel de calidad, con especial atención a los estudios de exactitud diagnóstica, y se proporcionan una serie de herramientas y guías para la lectura crítica en este campo. Se observa que las investigaciones sobre la eficacia y utilidad de estas tecnologías presentan actualmente déficit en cuanto a la calidad y estandarización de los estudios. La aplicación de los principios de la medicina basada en la evidencia al Diagnóstico por la Imagen es un reto que está todavía por desarrollar

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[Searching for evidence. A compilation of useful resources for health technology assessment]. / Búsqueda de evidencias. Una recopilación de recursos útiles en la evaluación de tecnologías sanitarias.

The spectacular growth in the produced volume of published scientific and technical information during the last years makes it difficult to discriminate and localize the information of greater quality. The parallel development of technologies for the fast handling of great volumes of single information has partially solved the problem of the access and use of the most advisable information. Health technology assessment tries to facilitate the decision making on the introduction, diffusion or use of health technologies, being based on the best evidences available. In order to improve the process of searching for evidences, needed in the process of health technology assessment, the Agency of Health Technology Assessment of the Institute of Salud Carlos III (AETS) made a compilation of information resources that can be useful for searching biomedical information in general. This article presents the above mentioned compilation along with the description of the process of elaboration and the criteria of selection applied.

[The incidence and distribution of accidents with biological fluids among health personnel and the general population]. / Incidencia y distribución de accidentes con fluidos biológicos en personal sanitario y población general.

OBJECTIVES: To assess the informative usefulness of the Registry, to calculate the incidence rates of accident with biological fluids among health care workers and in the community, to know about the postaccident rate of seroconversion to HIV and to identify risk groups. METHODS: A descriptive study of the HIV records file of the Registry of Accidental Contacts to Biological Fluids in the Clinic Hospital of Zaragoza was conducted, between January 1987 and September 1993. The registry includes the reports of health care workers and the general population of Health Area III in Aragón (Spain), except for the Calatayud's Hospital. Incidence rates, rate ratios and their 95% confidence intervals were calculated. RESULTS: A total number of 595 accidents were reported, in none of them and HIV infection occurred subsequently. The incidence rate in health care workers was of 1.7 reports per 100 workers per year, while in the community it was of 8.1 per 100,000 people. The housekeeping staff was the group with a higher incidence (rate = 6.7; 95% IC: 3-14.8) and the type of accident more frequently described was needlestick injury. CONCLUSIONS: The incidence of reported accidents has increased in the community and in health care workers, which may be due to the increase in the reporting. In health care workers, the incidence in 1993 was within the range reported from other countries. The perception of risk is universal after accidents with unknown biological fluids. The correct disposal of material with biological contamination should be the more important preventive action.