Browsing by Author "Rada, Gabriel"

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    Alma-Ata: Rebirth and revision 2 - Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews
    (ELSEVIER SCIENCE INC, 2008) Lewin, Simon; Lavis, John N.; Oxman, Andrew D.; Bastias, Gabriel; Chopra, Mickey; Ciapponi, Agustin; Flottorp, Signe; Garcia Marti, Sebastian; Pantoja, Tomas; Rada, Gabriel; Souza, Nathan; Treweek, Shaun; Wiysonge, Charles S.; Haines, Andy
    Strengthening health systems is a key challenge to improving the delivery of cost-effective interventions in primary health care and achieving the vision of the Alma-Ata Declaration. Effective governance, financial and delivery arrangements within health systems, and effective implementation strategies are needed urgently in low-income and middle-income countries. This overview summarises the evidence from systematic reviews of health systems arrangements and implementation strategies, with a particular focus on evidence relevant to primary health care in such settings. Although evidence is sparse, there are several promising health systems arrangements and implementation strategies for strengthening primary health care. However, their introduction must be accompanied by rigorous evaluations. The evidence base needs urgently to be strengthened, synthesised, and taken into account in policy and practice, particularly for the benefit of those who have been excluded from the health care advances of recent decades.
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    American Society of Hematology, ABHH, ACHO, Grupo CAHT, Grupo CLAHT, SAH, SBHH, SHU, SOCHIHEM, SOMETH, Sociedad Panamena de Hematologia, Sociedad Peruana de Hematologia, and SVH 2022 guidelines for prevention of venous thromboembolism in surgical and medical patients and long-distance travelers in Latin America
    (2022) Neumann, Ignacio; Izcovich, Ariel; Aguilar, Ricardo; Leon Basantes, Guillermo; Casais, Patricia; Colorio, Cecilia C.; Guillermo Esposito, Maria Cecilia; Garcia Lazaro, Pedro P.; Pereira, Jaime; Meillon-Garcia, Luis A.; Meireles Rezende, Suely; Carlos Serrano, Juan; Tejerina Valle, Mario L.; Vera, Felipe; Karzulovic, Lorena; Rada, Gabriel; Schunemann, Holger J.
    Background: Venous thromboembolism (VTE) is a common disease in Latin American settings. Implementation of international guidelines in Latin American settings requires additional considerations.
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    ASH, ABHH, ACHO, Grupo CAHT, Grupo CLAHT, SAH, SBHH, SHU, SOCHIHEM, SOMETH, Sociedad Panamena de Hematologia, SPH, and SVH 2021 guidelines for management of venous thromboembolism in Latin America
    (ELSEVIER, 2021) Neumann, Ignacio; Izcovich, Ariel; Aguilar, Ricardo; Leon Basantes, Guillermo; Casais, Patricia; Colorio, Cecilia C.; Guillermo Esposito, Maria Cecilia; Garcia Lazaro, Pedro P.; Meillon Garcia, Luis A.; Pereira, Jaime; Rezende, Suely Meireles; Carlos Serrano, Juan; Tejerina Valle, Mario L.; Vera, Felipe; Karzulovic, Lorena; Rada, Gabriel; Schuenemann, Holger
    Background: Venous thromboembolism (VTE) is a common disease in Latin American settings. Implementing international guidelines in Latin American settings requires additional considerations.
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    COVID-19 Living Overview of Evidence repository is highly comprehensive and can be used as a single source for COVID-19 studies
    (2022) Verdugo-Paiva, Francisca; Vergara, Camilo; Avila, Camila; Castro-Guevara, Javier A.; Cid, Josefina; Contreras, Valeria; Jara, Ivan; Jimenez, Valentina; Lee, Min Ha; Munoz, Magdalena; Rojas-Gomez, Ana Maria; Roson-Rodriguez, Pablo; Serrano-Arevalo, Karen; Silva-Ruz, Ivan; Vasquez-Laval, Juan; Zambrano-Achig, Paula; Zavadzki, Giovanna; Rada, Gabriel
    Background and Objective: The coronavirus disease 2019 Living OVerview of Evidence (COVID-19 L$OVE) is a public repository and classification platformforCOVID-19 articles. The repository containsmore than 430,000 articles as of September 20, 2021 and intends to provide a one-stop shop for COVID-19 evidence. Considering that systematic reviews conduct high-quality searches, this study assesses the comprehensiveness and currency of the repository against the total number of studies in a representative sample of COVID-19 systematic reviews.
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    Critical analysis of an article: antibiotics in acute media otitis, are they necessary? Is there any subgroup that benefits?
    (SOC MEDICA SANTIAGO, 2012) Rojas, Pamela; Rada, Gabriel
    Background: Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA and Australia. Objectives: To assess the effects of antibiotics for children with AOM. Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2008, issue 2) which contains the Acute Respiratory Infections (ART) Group's Specialized Register; MEDLINE (1966 to June week 42008); OLDMEDLINE (1958 to 1965); EMBASE (January 1990 to July 2008); and Current Contents (1966 to July 2008). Selection criteria: Randomised controlled trials comparing 1) antimicrobial drugs with placebo 2) immediate antibiotic treatment with observational treatment approaches ill children with AOM. Data collection and analysis: Three review authors independently assessed trial quality and extracted data. Main results: We found 10 trials (2928 children) from high income countries with low risk of bias. Pain was not reduced by antibiotics at 24 hours, but was at two to seven days, (relative risk (RR) 0.72; 95% confidence interval 0.62 to 0.83). However four trials (1271 children) comparing antibiotics prescribed immediately rather than initial observation found no difference at three to seven days. Antibiotics did not reduce tympanometry, perforation or recurrence. The only case of mastoiditis was in an antibiotic treated child. Vomiting, diarrhoea or rash was higher in children taking antibiotics (RR 1.37; 95% CI 1.09 to 1.76). Individual patient data meta-analysis of a subset of the included trials found antibiotics to be most beneficial in children: aged less than two; with bilateral AOM and with both AOM and otorrhoea. Authors' conclusions: Antibiotics slightly reduce the number of children with acute middle ear infection experiencing pain after a few days. However, most (78%) settle spontaneously in this time, meaning 16 children must be treated to prevent one suffering ear pain. This benefit must be weighed against the possible harms: 1 in 24 children experience symptoms caused by antibiotics. Antibiotics are most useful in children under two years of age, with bilateral AOM, and with both AOM and discharging ears. For most other children with mild disease, an expectant observational approach seems justified. We have no data on populations with higher risks of complications.
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    GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction
    (2016) Alonso-Coello, Pablo; Schunemann, Holger J.; Moberg, Jenny; Brignardello-Petersen, Romina; Akl, Elie A.; Davoli, Marina; Treweek, Shaun; Mustafa, Reem A.; Rada, Gabriel; Rosenbaum, Sarah; Morelli, Angela; Guyatt, Gordon H.; Oxman, Andrew D.
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    Improving Social Justice in COVID-19 Health Research: Interim Guidelines for Reporting Health Equity in Observational Studies
    (2021) Antequera, Alba; Lawson, Daeria O.; Noorduyn, Stephen G.; Dewidar, Omar; Avey, Marc; Bhutta, Zulfiqar A.; Chamberlain, Catherine; Ellingwood, Holly; Francis, Damian; Funnell, Sarah; Ghogomu, Elizabeth; Greer-Smith, Regina; Horsley, Tanya; Juando-Prats, Clara; Jull, Janet; Kristjansson, Elizabeth; Little, Julian; Nicholls, Stuart G.; Nkangu, Miriam; Petticrew, Mark; Rada, Gabriel; Rizvi, Anita; Shamseer, Larissa; Sharp, Melissa K.; Tufte, Janice; Tugwell, Peter; Verdugo-Paiva, Francisca; Wang, Harry; Wang, Xiaoqin; Mbuagbaw, Lawrence; Welch, Vivian
    The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into account contributes to the clinical and epidemiological understanding of the disease, identifying specific needs and supporting decision-making processes. Stakeholders are encouraged to consider using this guidance on observational research to help provide evidence to close the inequitable gaps in health outcomes.
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    Outcomes mapping study for childhood vaccination communication: too few concepts were measured in too many ways
    (2016) Kaufman, Jessica; Ryan, Rebecca; Bosch-Capblanch, Xavier; Cartier, Yuri; Cliff, Julie; Glenton, Claire; Lewin, Simon; Rada, Gabriel; Ames, Heather; Muloliwa, Artur Manuel; Oku, Afiong; Oyo-Ita, Angela; Hill, Sophie
    Objectives: The objectives of this article are to (1) comprehensively catalog outcomes measured in trials of childhood vaccination communication interventions and (2) analyze patterns and trends in outcome selection. To achieve these objectives, we developed a Trial Outcomes Map for vaccination communication.
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    Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses
    (2023) Tugwell, Peter; Welch, Vivian; Magwood, Olivia; Todhunter-Brown, Alex; Akl, Elie A.; Concannon, Thomas W.; Khabsa, Joanne; Morley, Richard; Schunemann, Holger; Lytvyn, Lyubov; Agarwal, Arnav; Antequera, Alba; Avey, Marc T.; Campbell, Pauline; Chang, Christine; Chang, Stephanie; Dans, Leonila; Dewidar, Omar; Ghersi, Davina; Graham, Ian D.; Hazlewood, Glen; Hilgart, Jennifer; Horsley, Tanya; John, Denny; Jull, Janet; Maxwell, Lara J.; McCutcheon, Chris; Munn, Zachary; Nonino, Francesco; Pardo, Jordi Pardo; Parker, Roses; Pottie, Kevin; Rada, Gabriel; Riddle, Alison; Synnot, Anneliese; Ghogomu, Elizabeth Tanjong; Tomlinson, Eve; Toupin-April, Karine; Petkovic, Jennifer
    BackgroundInvolving collaborators and partners in research may increase relevance and uptake, while reducing health and social inequities. Collaborators and partners include people and groups interested in health research: health care providers, patients and caregivers, payers of health research, payers of health services, publishers, policymakers, researchers, product makers, program managers, and the public. Evidence syntheses inform decisions about health care services, treatments, and practice, which ultimately affect health outcomes.Our objectives are to:A. Identify, map, and synthesize qualitative and quantitative findings related to engagement in evidence synthesesB. Explore how engagement in evidence synthesis promotes health equityC. Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement in evidence synthesesMethodsOur diverse, international team will develop guidance for engagement with collaborators and partners throughout multiple sequential steps using an integrated knowledge translation approach:1. Reviews. We will co-produce 1 scoping review, 3 systematic reviews and 1 evidence map focusing on (a) methods, (b) barriers and facilitators, (c) conflict of interest considerations, (d) impacts, and (e) equity considerations of engagement in evidence synthesis.2. Methods study, interviews, and survey. We will contextualise the findings of step 1 by assessing a sample of evidence syntheses reporting on engagement with collaborators and partners and through conducting interviews with collaborators and partners who have been involved in producing evidence syntheses. We will use these findings to develop draft guidance checklists and will assess agreement with each item through an international survey.3. Consensus. The guidance checklists will be co-produced and finalised at a consensus meeting with collaborators and partners.4. Dissemination. We will develop a dissemination plan with our collaborators and partners and work collaboratively to improve adoption of our guidance by key organizations.ConclusionOur international team will develop guidance for collaborator and partner engagement in health care evidence syntheses. Incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.
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    Tratamiento de diacereína y artrosis
    (2018) Irarrázaval Domínguez, Sebastián; Alegría Mejias, Anselmo Ignacio; Bravo Soto, Gonzalo Antonio; Rada, Gabriel