The purpose of this study was to evaluate the quality of the medical evidence available to the clinician in the practice of hematology/oncology.
We selected 14 neoplastic hematologic disorders and identified 154 clinically important patient management decision/interventions, ranging from initial treatment decisions to those made for the treatment of recurrent or refractory disease.
We also performed a search of the scientific literature for the years 1966 through 1996 to identify all randomized controlled trials in hematology/oncology.
We identified 783 randomized controlled trials (level 1 evidence) pertaining to 37 (24%) of the decisionlinterventions.
An additional 32 (21%) of the decision/interventions were supported by evidence from single arm prospective studies (level 2 evidence).
However, only retrospective or anecdotal evidence (level 3 evidence) was available to support 55% of the identified decision/interventions.
In a retrospective review of the decision/interventions made in the management of 255 consecutive patients, 78% of the initial decision/interventions in the management of newly diagnosed hematologic/oncologic disorders could have been based on level 1 evidence.
However, more than half (52%) of all the decision/interventions made in the management of these 255 patients were supported only by level 2 or 3 evidence. (...)
Mots-clés Pascal : Hématologie, Carcinogenèse, Essai thérapeutique contrôlé, Arbre décision, Facteur qualité, Randomisation, Revue bibliographique, Homme, Etats Unis, Amérique du Nord, Amérique, Diagnostic, Hémopathie
Mots-clés Pascal anglais : Hematology, Carcinogenesis, Controlled therapeutic trial, Decision tree, Q factor, Randomization, Bibliographic review, Human, United States, North America, America, Diagnosis, Hemopathy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0168757
Code Inist : 002B19D. Création : 16/11/1999.