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Article ; Online: Challenges to delivering evidence-based management for long COVID.

Peiris, Sasha / Izcovich, Ariel / Ordunez, Pedro / Luciani, Silvana / Martinez, Carmen / Aldighieri, Sylvain / Reveiz, Ludovic

BMJ evidence-based medicine

2023 Volume 28, Issue 5, Page(s) 295–298

MeSH term(s)	Humans ; COVID-19 ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2
Language	English
Publishing date	2023-07-25
Publishing country	England
Document type	Journal Article
ISSN	2515-4478
ISSN (online)	2515-4478
DOI	10.1136/bmjebm-2023-112311
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A guide and pragmatic considerations for applying GRADE to network meta-analysis.

Izcovich, Ariel / Chu, Derek K / Mustafa, Reem A / Guyatt, Gordon / Brignardello-Petersen, Romina

BMJ (Clinical research ed.)

2023 Volume 381, Page(s) e074495

MeSH term(s)	Humans ; Network Meta-Analysis ; Research Design
Language	English
Publishing date	2023-06-27
Publishing country	England
Document type	Meta-Analysis ; Journal Article
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj-2022-074495
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Plasma Therapy to Prevent Severe Covid-19 in Older Adults.

Ragusa, Martin / Tortosa, Fernando / Izcovich, Ariel

The New England journal of medicine

2021 Volume 384, Issue 25, Page(s) e104

MeSH term(s)	Aged ; COVID-19 ; Humans ; Plasma ; SARS-CoV-2
Language	English
Publishing date	2021-05-12
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc2104747
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Article ; Online: Variabilidad geográfica, inequidades en salud y letalidad por COVID-19 en Bariloche, Río Negro, 2020-2021.

Tortosa, Fernando / Perre, Fernando / Carrasco, Gabriela / De Lusarreta, Gonzalo / Artola, Natalia / Prandi, Dana / Bustamante, Rodrigo / Guaresti, German / Izcovich, Ariel

Medicina

2024 Volume 84, Issue 1, Page(s) 29–46

Abstract: Introduction: The objective of this study was to analyze the geographic variability and the relationship between social determinants of health and COVID-19 lethality in Bariloche.: Methods: A database from the National Epidemiological Surveillance ... ...

Title translation	Geographic variability, health inequities and lethality due to COVID-19 in Bariloche, Río Negro, 2020-2021.
Abstract	Introduction: The objective of this study was to analyze the geographic variability and the relationship between social determinants of health and COVID-19 lethality in Bariloche. Methods: A database from the National Epidemiological Surveillance System was used to analyze COVID-19 positive cases from January 2020 to December 2021. The data were geocoded and incorporated into a geographic information system (GIS). A three-step analytical framework was applied to measure health inequity, using socioeconomic indicators and access to services. A multivariate analysis was conducted to predict fatality. Results: A total of 25 020 COVID-19 cases were diagnosed in Bariloche during the study period. The fatality rate was 2.1%. Significant variability in socioeconomic indicators was observed among different territorial delegations of the city. Discussion: The results showed health inequities and an association between social determinants and COVID-19 lethality in Bariloche. Individuals living in areas with higher socioeconomic vulnerability had a higher risk of mortality. These findings highlight the importance of addressing health inequities in a pandemic response.
MeSH term(s)	Humans ; COVID-19/mortality ; Health Inequities ; Multivariate Analysis ; Socioeconomic Factors ; Argentina/epidemiology
Language	Spanish
Publishing date	2024-01-23
Publishing country	Argentina
Document type	English Abstract ; Journal Article
ZDB-ID	411586-7
ISSN	1669-9106 ; 0025-7680 ; 0325-951X
ISSN (online)	1669-9106
ISSN	0025-7680 ; 0325-951X
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Article ; Online: Síntesis de evidencia para intervenciones en COVID-19: informes de actualización de la Comisión Nacional de Evaluación de Tecnologías de Salud de Argentina.

Tortosa, Fernando / Donato, Manuel / Torales, Santiago / Gonzalez Malla, Carlos / Uribe, Javier / Izcovich, Ariel

Revista panamericana de salud publica = Pan American journal of public health

2023 Volume 47, Page(s) e28

Abstract: This report presents the work done on the design, publication, and impact of updates on evidence-based COVID-19 interventions, in order to support decision-making with updated evidence syntheses based on living systematic reviews of therapeutic ... ...

Title translation	Evidence synthesis for COVID-19 interventions: update reports from Argentina's National Commission for Health Technology AssessmentSíntese de evidências para intervenções em COVID-19: relatórios de atualização da Comissão Nacional de Avaliação de Tecnologias em Saúde da Argentina.
Abstract	This report presents the work done on the design, publication, and impact of updates on evidence-based COVID-19 interventions, in order to support decision-making with updated evidence syntheses based on living systematic reviews of therapeutic interventions. To this end, a specific working group was created within the National Commission for Health Technology Assessment (CONETEC) of the Ministry of Health of Argentina, in collaboration with the Pan American Health Organization (PAHO). A methodology was designed to develop and publish assessment documents aimed at supporting decision-making. These update reports were based on the exploration of three areas: health effects, feasibility of implementation, and evidence-based recommendations. A color-coded system was used to present the conclusions according to the balance between their positive and negative effects in different clinical scenarios, in order to improve their interpretation and implementation. In 2021, 16 evidence synthesis reports were published (13 original reports and three full updates). These were downloaded many times from the CONETEC website and the Regional Database of Health Technology Assessment Reports of the Americas (BRISA), highlighting the need for robust, up-to-date, reliable evidence summaries adapted for implementation in the country's health system. Other challenges include constant updating of information, appropriate dissemination, and sustained rigorous preparation of the reports.
Language	Spanish
Publishing date	2023-02-10
Publishing country	United States
Document type	English Abstract ; Journal Article
ZDB-ID	1376934-0
ISSN	1680-5348 ; 1020-4989
ISSN (online)	1680-5348
ISSN	1020-4989
DOI	10.26633/RPSP.2023.28
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Article ; Online: An opportunity for evidence-based care of individuals with monkeypox.

Donato, Manuel / Izcovich, Ariel / Tortosa, Fernando / Ragusa, Martin Alberto / Saenz, Carla / Reveiz, Ludovic

BMJ evidence-based medicine

2022 Volume 28, Issue 3, Page(s) 141–143

MeSH term(s)	Humans ; Mpox (monkeypox) ; Evidence-Based Medicine
Language	English
Publishing date	2022-12-02
Publishing country	England
Document type	Journal Article
ISSN	2515-4478
ISSN (online)	2515-4478
DOI	10.1136/bmjebm-2022-112086
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Article ; Online: Síntesis de evidencia para intervenciones en COVID-19

Fernando Tortosa / Manuel Donato / Santiago Torales / Carlos Gonzalez Malla / Javier Uribe / Ariel Izcovich

Revista Panamericana de Salud Pública, Vol 47, Iss 28, Pp 1-

informes de actualización de la Comisión Nacional de Evaluación de Tecnologías de Salud de Argentina

2023 Volume 7

Abstract: Este informe tiene por objetivo exponer el trabajo realizado sobre el diseño, la publicación y el impacto de las actualizaciones para intervenciones en COVID-19 basadas en la evidencia, para brindar síntesis de evidencia actualizadas a partir de ... ...

Abstract	Este informe tiene por objetivo exponer el trabajo realizado sobre el diseño, la publicación y el impacto de las actualizaciones para intervenciones en COVID-19 basadas en la evidencia, para brindar síntesis de evidencia actualizadas a partir de revisiones sistemáticas vivas sobre intervenciones terapéuticas para dar soporte en la toma de decisiones. Para ello, se generó un grupo específico de trabajo en el ámbito de la Comisión Nacional de Evaluación de Tecnologías de Salud (CONETEC) en el Ministerio de Salud de Argentina en colaboración con la Organización Panamericana de la Salud (OPS). Se diseñó una metodología para elaborar y publicar documentos de evaluación orientados a dar apoyo en la toma de decisiones. Estos informes de actualización se respaldaron en la exploración de tres dominios: los efectos en la salud, la factibilidad de la implementación y las recomendaciones basadas en evidencia. Las conclusiones se adaptaron en un esquema semaforizado según el balance entre los beneficios y los aspectos negativos para los distintos escenarios clínicos, a fin de mejorar su interpretación y aplicación. Durante el año 2021 se publicaron 16 informes de síntesis de evidencia (13 originales y 3 actualizaciones completas) que recibieron un destacado número consultas desde la página web de CONETEC y la Base Regional de Informes de Evaluación de Tecnologías en Salud de las Américas (BRISA). Así se hizo visible la necesidad de disponer de resúmenes de evidencia robustos, actualizados y confiables con adaptación al contexto de aplicación en el sistema sanitario del país. El desafío se presenta, además, en la actualización constante de la información, la diseminación apropiada y el sostenimiento en la rigurosidad en el desarrollo de los informes.
Keywords	práctica clínica basada en la evidencia ; revisiones sistemáticas como asunto ; covid-19 ; evaluación de la tecnología biomédica ; argentina ; Medicine ; R ; Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-02-01T00:00:00Z
Publisher	Pan American Health Organization
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Efectos del tratamiento con plasma de convaleciente con COVID-19

Fernando Tortosa / Gabriela Carrasco / Martín Ragusa / Pedro Haluska / Ariel Izcovich

Revista Argentina de Salud Pública, Vol 13, Pp 1-

Revisión sistemática y metaanálisis

2021 Volume 8

Abstract: INTRODUCCIÓN: Se ha sugerido que el tratamiento con plasma de convaleciente en la enfermedad por coronavirus (COVID-19) mejora la evolución clínica en los casos moderados a graves. Este estudio fue diseñado para evaluar los efectos de este tratamiento en ...

Abstract	INTRODUCCIÓN: Se ha sugerido que el tratamiento con plasma de convaleciente en la enfermedad por coronavirus (COVID-19) mejora la evolución clínica en los casos moderados a graves. Este estudio fue diseñado para evaluar los efectos de este tratamiento en comparación con el tratamiento estándar o placebo en la mortalidad, el ingreso a asistencia ventilatoria mecánica y otros desenlaces críticos en personas hospitalizados con COVID-19 moderada a grave. MÉTODOS: Se siguieron los lineamientos PRISMA para la realización de una revisión sistemática. Se realizó una búsqueda sistemática en la plataforma L·OVE (Living OVerview of Evidence) de COVID-19 hasta el 15 de enero de 2021. Se incluyeron ensayos clínicos en los cuales se estudiaron personas con COVID-19 moderada, grave o crítica. La certeza de la evidencia se analizó mediante el enfoque de evaluación, desarrollo y evaluación de recomendaciones (GRADE, por su sigla en inglés). RESULTADOS: Se identificaron 10 ensayos controlados aleatorizados que incluyeron 11 854 pacientes, en los que se comparó el tratamiento con plasma de convaleciente y las medidas estándares de cuidado o placebo en pacientes con COVID-19. Estos no mostraron diferencias significativas sobre la mortalidad (riesgo relativo: 1,02; intervalo de confianza del 95%: 0,94-1,12). Podría producir un aumento marginal en el ingreso a ventilación mecánica y de los eventos adversos graves. DISCUSION: La evidencia actual muestra que el uso de plasma de convaleciente no tiene efecto en desenlaces críticos en pacientes con COVID-19 moderada o grave.
Keywords	Medicine (General) ; R5-920 ; Public aspects of medicine ; RA1-1270
Language	Spanish
Publishing date	2021-05-01T00:00:00Z
Publisher	Ministerio de Salud
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Lopinavir-ritonavir for COVID-19: A living systematic review.

Verdugo-Paiva, Francisca / Izcovich, Ariel / Ragusa, Martín / Rada, Gabriel

Medwave

2020 Volume 20, Issue 6, Page(s) e7967

Abstract: Objective: Provide a timely, rigorous, and continuously updated summary of the evidence on the role of lopinavir/ritonavir in the treatment of patients with COVID-19.: Methods: We conducted searches in the special L·OVE (Living OVerview of Evidence) ... ...

Title translation	Lopinavir-ritonavir para COVID-19: una revisión sistemática viva.
Abstract	Objective: Provide a timely, rigorous, and continuously updated summary of the evidence on the role of lopinavir/ritonavir in the treatment of patients with COVID-19. Methods: We conducted searches in the special L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs regular searches in PubMed, Embase, CENTRAL, and other 33 sources. We searched for randomized trials and non-randomized studies evaluating the effect of lopinavir/ritonavir versus placebo or no treatment in patients with COVID-19. Two reviewers independently evaluated potentially eligible studies, according to predefined selection criteria, and extracted data using a predesigned standardized form. We performed meta-analyses using random-effect models and assessed overall certainty in evidence using the GRADE approach. A living, web-based version of this review will be openly available during the COVID-19 pandemic. Results: Our search strategy yielded 862 references. Finally, we identified 12 studies, including two randomized trials, evaluating lopinavir/ritonavir, in addition to standard care versus standard care alone in 250 adult inpatients with COVID-19. The evidence from randomized trials shows lopinavir/ritonavir may reduce mortality (relative risk: 0.77; 95% confidence interval: 0.45 to 1.3; low certainty evidence), but the anticipated magnitude of the absolute reduction in mortality, varies across different risk groups. Lopinavir/ritonavir also had a slight reduction in the risk of requiring invasive mechanical ventilation, developing respiratory failure, or acute respiratory distress syndrome. However, it did not lead to any difference in the duration of hospitalization and may lead to an increase in the number of total adverse effects. The overall certainty of the evidence was low or very low. Conclusions: For severe and critical patients with COVID-19, lopinavir/ritonavir might play a role in improving outcomes, but the available evidence is still limited. A substantial number of ongoing studies should provide valuable evidence to inform researchers and decision-makers soon.
MeSH term(s)	Adult ; Antiviral Agents/administration & dosage ; Antiviral Agents/adverse effects ; COVID-19 ; Coronavirus Infections/drug therapy ; Drug Combinations ; Humans ; Lopinavir/administration & dosage ; Lopinavir/adverse effects ; Pandemics ; Pneumonia, Viral/drug therapy ; Randomized Controlled Trials as Topic ; Ritonavir/administration & dosage ; Ritonavir/adverse effects ; Treatment Outcome
Chemical Substances	Antiviral Agents ; Drug Combinations ; lopinavir-ritonavir drug combination ; Lopinavir (2494G1JF75) ; Ritonavir (O3J8G9O825)
Keywords	covid19
Language	English
Publishing date	2020-07-15
Publishing country	Chile
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2818022-7
ISSN	0717-6384 ; 0717-6384
ISSN (online)	0717-6384
ISSN	0717-6384
DOI	10.5867/medwave.2020.06.7966
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Should prophylactic measures to prevent postpolypectomy bleeding after resection of large colorectal polyps be used?

Gómez, Estanislao J / Izcovich, Ariel

Medwave

2016 Volume 16 Suppl 3, Page(s) e6496

Abstract: Post-polypectomy bleeding after colonoscopy with resection of large colorectal polyps can cause significant morbidity (readmission for monitoring, transfusion, repeat endoscopy and therapy) and a significant cost to hospitals and insurers. Nevertheless ... ...

Title translation	¿Deben realizarse medidas profilácticas para evitar el sangrado postpolipectomía luego de resecar pólipos colorrectales grandes?
Abstract	Post-polypectomy bleeding after colonoscopy with resection of large colorectal polyps can cause significant morbidity (readmission for monitoring, transfusion, repeat endoscopy and therapy) and a significant cost to hospitals and insurers. Nevertheless prophylactic endoscopic measures could reduce risk of post-polypectomy bleeding. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including 10 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded prophylactic endoscopic measures could be effective in reducing post-polypectomy bleeding after resection of large colorectal polyps.
MeSH term(s)	Colonic Polyps/surgery ; Colonoscopy/methods ; Endoscopy/methods ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/prevention & control ; Humans ; Randomized Controlled Trials as Topic
Language	Spanish
Publishing date	2016-08-03
Publishing country	Chile
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	2818022-7
ISSN	0717-6384 ; 0717-6384
ISSN (online)	0717-6384
ISSN	0717-6384
DOI	10.5867/medwave.2016.6496
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