CM. The importance of evidence assessment: Reanalyzing a Meta-analysis on the effect of Prophylactic Amiodarone, on Mortality after Acute Myocardial Infarction and Congestive Heart Failure.

https://doi.org/10.47449/CM.2020.1.1.26

This article could also be named, The high risks of administering amiodarone to patients with acute myocardial infarction and congestive heart failure. The authors completed a commission of three parts series to explain with successive examples of known clinical importance, how our readers could find help to interpret the wealth of clinical studies that are characteristic of the current pandemic. The first article dealt with, A brief note on Systematic Reviews and Meta-analysis, which introduced the nonspecialist with the tools of the trade to assess a mass of research data. The second part, last month, started our new section of Questions & Answers and responds to a simple and related matter, What is Evidence-based medicine. With this new piece, an extensive and detailed Critical Review, Marti-Carvajal and Martí-Amarista offer a lesson or two on how to be cautious to 26 well regarded Trial Metanalyses on the clinical benefits and harms of amiodarone, one of the most prescribed drugs in the U.S. The conclusions of the article are crystal clear, «The scope of this publication was not to conduct a new systematic review to answer the clinical question but to perform a re-analysis of a highly cited meta-analysis and, in the words of Sir Karl Popper, generate a critical discussion to expand knowledge. As already discussed, we found no benefit of amiodarone in MI and CHF patients, as well as increased risk of adverse events and low quality of evidence.»

Rafael Rangel-Aldao, Editor