Статья
Является ли метаанализ "вершиной пирамиды доказательств" в кардиологии?
Автор высказывает свое мнение о значимости и месте метаанализов в современной доказательной медицине, в первую очередь, в кардиологии. Кратко описывается история появления метаанализов. Рассматриваются основные ограничения метаанализов. Приводятся примеры, когда метаанализы, посвященные одной и той же проблеме, давали прямо противоположные результаты. Обсуждается значение метаанализов в выявлении побочных действий лекарственных препаратов. Демонстрируется возможность манипулирования результатами метаанализов. Значимость метаанализов в настоящее время оценивается на примере пандемии коронавирусной инфекции, когда разные метаанализы по-разному оценивали эффективность и безопасность одних и тех же лекарственных препаратов.Автор приходит к выводу, что метаанализы следует исключить из уровня доказательства I и отвести им более скромную роль в иерархии доказательств.
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