José Antonio Sacristán | Universidad CEU Cardenal Herrera (original) (raw)
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Papers by José Antonio Sacristán
Hace más de 15 años que en Gaceta Sanitaria se publicó el artículo titulado «¿Qué es una tecnolog... more Hace más de 15 años que en Gaceta Sanitaria se publicó el artículo titulado «¿Qué es una tecnología sanitaria eficiente en España?». El creciente interés por fijar el precio de las nuevas tecnologías en función del valor que estas proporcionan a los sistemas de salud y la experiencia acumulada por los países de nuestro entorno hacen oportuno revisar qué es una intervención sanitaria eficiente en España en el año 2020. El análisis de coste-efectividad sigue siendo el método de referencia para maximizar los resultados en salud de la sociedad con los recursos disponibles. La interpretación de sus resultados requiere establecer unos valores de referencia que sirvan de guía sobre lo que constituye un valor razonable para el sistema sanitario. Los umbrales de eficiencia deben ser flexibles y dinámicos, y actualizarse periódicamente. Su aplicación debe estar basada en la gradualidad y la transparencia, considerando, además, otros factores que reflejen las preferencias sociales. Aunque la f...
Este manual tiene como objetivo principal acercar los resultados de la investigación interdiscipl... more Este manual tiene como objetivo principal acercar los resultados de la investigación interdisciplinar relacionada con la educación científica a los docentes para que se animen a aplicarlos en sus aulas o, en el caso de los muchos y muchas que ya lo hacen, para que se sientan respaldados y reforzados con pruebas obtenidas de decenas de años de investigación en enseñanza de las ciencia
Background: Since Professor Hampton announced the death of clinical freedom in 1983, the increasi... more Background: Since Professor Hampton announced the death of clinical freedom in 1983, the increasing influence of Evidence-based Medicine and Health Technology Assessment has contributed to augment the feeling that clinicians have a secondary role in the therapeutic decision-making process. Discussion: This article constitutes a reflection on how clinicians may use the results of economic evaluations in their daily clinical practice, making decisions about cost-effectiveness on a case by case basis, and addressing both the patient's and society's needs. To that end, some illustrating examples are taken from the literature to show there are factors with great impact on cost-effectiveness results that can be easily identified and modified by clinicians. Summary: The evolution of the discipline and the trend towards a tailored therapy suggest that health economics is not the end of clinical freedom but the start of it. Background Twenty five years ago Professor Hampton announced...
Health Economics & Outcome Research: Open Access, 2017
Health Economics & Outcome Research: Open Access, 2017
Health Economics & Outcome Research: Open Access, 2017
Rheumatology and Therapy, 2019
The Patient - Patient-Centered Outcomes Research, 2019
Health Economics & Outcome Research: Open Access, 2017
JAMA, 2017
In Reply Our systematic review was 1 of 3 systematic reviews commissioned by the UK Food Standard... more In Reply Our systematic review was 1 of 3 systematic reviews commissioned by the UK Food Standards Agency covering a range of early dietary exposures and risk of allergic or autoimmune disease.1 Many of the answers to the queries raised by Drs Nwaru and Virtanen can be found in the full Food Standards Agency report (https://www.food.gov.uk/science /research/allergy-research/fs305005b). For autoimmune conditions, others have reported on associations between cow’s milk exposure in infancy and risk of type 1 diabetes mellitus as well as timing of wheat or gluten exposure in infancy and risk of celiac disease or type 1 diabetes mellitus.2-4 There is less evidence for associations between other allergenic foods and autoimmune disease, but the environmental determinants of these diseases are largely unknown, so to inform national infant feeding guidance, we thought it was important to take a comprehensive and openminded approach. The definition of allergenic foods in our review was that used in the US Congress food allergen labeling law.5 We evaluated timing of introduction of other foods (including roots, fruits, and vegetables) in our third systematic review, currently under peer review. Nwaru and Virtanen highlight their DIPP cohort finding that early egg and fish introduction were associated with reduced risk of allergic sensitization to other allergens. We did include these data in our analyses, within the full Food Standards Agency report (“Allergic Sensitization Observational Data” section). The DIPP data for egg are not supported by some other observational studies such as the LISA cohort. The DIPP data for fish are supported by 2 other prospective cohort studies, and this very low-certainty evidence that early fish introduction is associated with reduced allergic sensitization was reported in the text and summary of findings (Table 4 in the article). In the intervention trials of allergenic food avoidance or early allergenic food introduction, we found no evidence that early introduction of one allergenic food can influence risk of either allergic sensitization or clinical allergy to a different allergenic food. We included wheeze data from the DIPP, SEATON, and Western Australian cohort studies, in addition to 27 other observational studies (eTable 4 in the Supplement to the article). The findings are in the Food Standards Agency report (“Wheeze Observational Data” section) and are summarized in eTable 11 in the Supplement to the article. Opportunities for pooling data were limited, partly because estimates of association reported as hazard ratios were meta-analyzed separately from odds ratios. We did not find consistent associations between timing of allergenic food introduction and wheeze across all the studies, and we found no consistent association in intervention trials. The LISA study did not report analyses of timing of introduction of the allergenic foods specified in our protocol and risk of wheezing. The investigators did report associations with timing of solid food introduction, which we have analyzed as part of our third systematic review. Finally, we did evaluate asthma as part of this systematic review but reported most asthma definitions within the category of recurrent wheeze, unless the definition of asthma was limited to a single episode of wheezing. Despo Ierodiakonou, MD, PhD Vanessa Garcia-Larsen, PhD Robert J. Boyle, MD, PhD
The Journal of Clinical Psychiatry, Oct 1, 2001
Patient Preference and Adherence, 2016
BMC medical research methodology, 2015
Despite their close relationship, clinical research and medical care have become separated by cle... more Despite their close relationship, clinical research and medical care have become separated by clear boundaries. The purpose of clinical research is to generate generalizable knowledge useful for future patients, whereas medical care aims to promote the well-being of individual patients. The evolution towards patient-centered medicine and patient-oriented research, and the gradual standardization of medicine are contributing to closer ties between clinical research and medical practice. But the integration of both activities requires addressing important ethical and methodological challenges. From an ethical perspective, clinical research should evolve from a position of paternalistic beneficence to a situation in which the principle of non-maleficence and patient autonomy predominate. The progressive adoption of "patient-oriented informed consent", "patient equipoise", and "altruism-based research", and the application of risk-based ethical oversight, i...
International Clinical Psychopharmacology, 2000
Clinical Therapeutics, 2004
Hace más de 15 años que en Gaceta Sanitaria se publicó el artículo titulado «¿Qué es una tecnolog... more Hace más de 15 años que en Gaceta Sanitaria se publicó el artículo titulado «¿Qué es una tecnología sanitaria eficiente en España?». El creciente interés por fijar el precio de las nuevas tecnologías en función del valor que estas proporcionan a los sistemas de salud y la experiencia acumulada por los países de nuestro entorno hacen oportuno revisar qué es una intervención sanitaria eficiente en España en el año 2020. El análisis de coste-efectividad sigue siendo el método de referencia para maximizar los resultados en salud de la sociedad con los recursos disponibles. La interpretación de sus resultados requiere establecer unos valores de referencia que sirvan de guía sobre lo que constituye un valor razonable para el sistema sanitario. Los umbrales de eficiencia deben ser flexibles y dinámicos, y actualizarse periódicamente. Su aplicación debe estar basada en la gradualidad y la transparencia, considerando, además, otros factores que reflejen las preferencias sociales. Aunque la f...
Este manual tiene como objetivo principal acercar los resultados de la investigación interdiscipl... more Este manual tiene como objetivo principal acercar los resultados de la investigación interdisciplinar relacionada con la educación científica a los docentes para que se animen a aplicarlos en sus aulas o, en el caso de los muchos y muchas que ya lo hacen, para que se sientan respaldados y reforzados con pruebas obtenidas de decenas de años de investigación en enseñanza de las ciencia
Background: Since Professor Hampton announced the death of clinical freedom in 1983, the increasi... more Background: Since Professor Hampton announced the death of clinical freedom in 1983, the increasing influence of Evidence-based Medicine and Health Technology Assessment has contributed to augment the feeling that clinicians have a secondary role in the therapeutic decision-making process. Discussion: This article constitutes a reflection on how clinicians may use the results of economic evaluations in their daily clinical practice, making decisions about cost-effectiveness on a case by case basis, and addressing both the patient's and society's needs. To that end, some illustrating examples are taken from the literature to show there are factors with great impact on cost-effectiveness results that can be easily identified and modified by clinicians. Summary: The evolution of the discipline and the trend towards a tailored therapy suggest that health economics is not the end of clinical freedom but the start of it. Background Twenty five years ago Professor Hampton announced...
Health Economics & Outcome Research: Open Access, 2017
Health Economics & Outcome Research: Open Access, 2017
Health Economics & Outcome Research: Open Access, 2017
Rheumatology and Therapy, 2019
The Patient - Patient-Centered Outcomes Research, 2019
Health Economics & Outcome Research: Open Access, 2017
JAMA, 2017
In Reply Our systematic review was 1 of 3 systematic reviews commissioned by the UK Food Standard... more In Reply Our systematic review was 1 of 3 systematic reviews commissioned by the UK Food Standards Agency covering a range of early dietary exposures and risk of allergic or autoimmune disease.1 Many of the answers to the queries raised by Drs Nwaru and Virtanen can be found in the full Food Standards Agency report (https://www.food.gov.uk/science /research/allergy-research/fs305005b). For autoimmune conditions, others have reported on associations between cow’s milk exposure in infancy and risk of type 1 diabetes mellitus as well as timing of wheat or gluten exposure in infancy and risk of celiac disease or type 1 diabetes mellitus.2-4 There is less evidence for associations between other allergenic foods and autoimmune disease, but the environmental determinants of these diseases are largely unknown, so to inform national infant feeding guidance, we thought it was important to take a comprehensive and openminded approach. The definition of allergenic foods in our review was that used in the US Congress food allergen labeling law.5 We evaluated timing of introduction of other foods (including roots, fruits, and vegetables) in our third systematic review, currently under peer review. Nwaru and Virtanen highlight their DIPP cohort finding that early egg and fish introduction were associated with reduced risk of allergic sensitization to other allergens. We did include these data in our analyses, within the full Food Standards Agency report (“Allergic Sensitization Observational Data” section). The DIPP data for egg are not supported by some other observational studies such as the LISA cohort. The DIPP data for fish are supported by 2 other prospective cohort studies, and this very low-certainty evidence that early fish introduction is associated with reduced allergic sensitization was reported in the text and summary of findings (Table 4 in the article). In the intervention trials of allergenic food avoidance or early allergenic food introduction, we found no evidence that early introduction of one allergenic food can influence risk of either allergic sensitization or clinical allergy to a different allergenic food. We included wheeze data from the DIPP, SEATON, and Western Australian cohort studies, in addition to 27 other observational studies (eTable 4 in the Supplement to the article). The findings are in the Food Standards Agency report (“Wheeze Observational Data” section) and are summarized in eTable 11 in the Supplement to the article. Opportunities for pooling data were limited, partly because estimates of association reported as hazard ratios were meta-analyzed separately from odds ratios. We did not find consistent associations between timing of allergenic food introduction and wheeze across all the studies, and we found no consistent association in intervention trials. The LISA study did not report analyses of timing of introduction of the allergenic foods specified in our protocol and risk of wheezing. The investigators did report associations with timing of solid food introduction, which we have analyzed as part of our third systematic review. Finally, we did evaluate asthma as part of this systematic review but reported most asthma definitions within the category of recurrent wheeze, unless the definition of asthma was limited to a single episode of wheezing. Despo Ierodiakonou, MD, PhD Vanessa Garcia-Larsen, PhD Robert J. Boyle, MD, PhD
The Journal of Clinical Psychiatry, Oct 1, 2001
Patient Preference and Adherence, 2016
BMC medical research methodology, 2015
Despite their close relationship, clinical research and medical care have become separated by cle... more Despite their close relationship, clinical research and medical care have become separated by clear boundaries. The purpose of clinical research is to generate generalizable knowledge useful for future patients, whereas medical care aims to promote the well-being of individual patients. The evolution towards patient-centered medicine and patient-oriented research, and the gradual standardization of medicine are contributing to closer ties between clinical research and medical practice. But the integration of both activities requires addressing important ethical and methodological challenges. From an ethical perspective, clinical research should evolve from a position of paternalistic beneficence to a situation in which the principle of non-maleficence and patient autonomy predominate. The progressive adoption of "patient-oriented informed consent", "patient equipoise", and "altruism-based research", and the application of risk-based ethical oversight, i...
International Clinical Psychopharmacology, 2000
Clinical Therapeutics, 2004
