Una revisión sistemática de ensayos aleatorios de programas de manejo de enfermedades en la insuficiencia cardíaca

CRD COMMENTARY:

This paper was clearly structured and well written, and adequately described the process used for reviewing the topic. However, the inclusion criteria for selecting the studies were not defined clearly, and the definition of disease management programmes was somewhat broad. In addition, the authors acknowledged that their results might have been hampered by the imprecise descriptions of the interventions in the studies. The search terms appear adequate, although those used to search for randomised controlled trials were not specified. The relatively small number of papers in the initial results suggests the possibility that studies were missed.
When describing the results of the review, the authors divided the included studies into two different treatment groups. Whilst this may be justified, it is difficult from the descriptions of the studies given to see where the differences between some of the studies lie. The authors' choice of total mortality as a primary outcome is significant, but only 5 of the 11 studies reported on this. In addition, as the authors stated, the studies have relatively small sample sizes and the treatment effects might have been overestimated.
The results of this review should be treated with caution in view of these comments.