Produção em Conjunto com Discente

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    Efficacy of Carpentier-Edwards pericardial prostheses: a systematic review and meta-analysis
    (International Journal of Technology Assessment in Health Care, 2015) Magliano, Carlos Alberto S.; Saraiva, Roberto M.; Azevedo, Vitor Manuel P.; Innocenzi, Adriana M.; Tura, Bernardo R.; Santos, Marisa
    Objectives: The Carpentier-Edwards pericardial (CEP) prostheses are the type of bioprostheses most used worldwide. Although they were designed to minimize the rate of valve deterioration and reoperation, their clinical superiority over other prostheses models still lacks confirmation. The objective of this study was to evaluate its effectiveness. Methods: We performed a systematic review and meta-analysis in the PubMed, Embase, Cochrane, and Lilacs databases. Operative mortality, overall mortality and reoperation rates after heart valve surgery were compared between the use of CEP and other cardiac prostheses. Two independent reviewers screened studies for inclusion and extracted the data. Disagreements were resolved by consensus. The GRADE criterion was used to assess the evidence quality. Results: A total of twenty-eight studies were selected, including 19,615 individuals. The studies presented a high heterogeneity and low quality of evidence what limited the reliability of the results. The pooled data from the selected studies did not demonstrate significant differences between CEP and porcine, pericardial or stentless prostheses regarding operative mortality, overall mortality and reoperation rates. However, the pooled data from 3 observational trials pointed out a higher risk for reoperation after valve replacement using CEP prostheses against mechanical prostheses (OR 4.92 [95 percent confidence interval 2.43–9.96]). Conclusions: The current data present in the literature still does not support a clinical advantage for the use of CEP prostheses over other bioprostheses. The quality of the studies in the literature is limited and further studies are needed to address if CEP prostheses will have a clinical advantage over other prostheses.
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    Revisão sistemática da eficácia da vacina da dengue
    (Instituto Nacional de Cardiologia, 2016) Silveira, Lúcia Teresa Côrtes da
    Dengue é uma doença infecciosa viral, causada por arbovírus do gênero Flavivirus, do qual são reconhecidos quatro sorotipos circulantes, sendo eles Dengue Vírus (DENV) tipo 1 (DENV-1), tipo 2 (DENV-2), tipo 3 (DENV-3) e tipo 4 (DENV-4). Seus principais vetores no ambiente urbano são os mosquitos do gênero Aedes, o aegypti e o albopictus. O presente estudo realizou uma revisão sistemática, seguida de metanálise da eficácia da vacina da dengue em prevenir dengue sintomática, com o intuito de obter uma estimativa mais precisa dos parâmetros de eficácia da vacina. Foi realizada busca sistemática na base de dados Medline via Pubmed, na Biblioteca Cochrane, no LILACS e no EMBASE, identificando Ensaios Clínicos Randomizados (ECR) publicados entre 2000 e 2016 e avaliados por dois revisores independentes. Na metanálise foram incluídos sete ECR, somando uma população de 36.371, onde 30 não foram randomizados e 24.257 foram randomizados para receber a vacina e 12.114 para receber o placebo ou outra não intervenção. A eficácia da vacina foi de 44%, variando entre 25% e 59%, com uma heterogeneidade de 80,1%. Que não pode ser explicada pela meta-regressão que avaliou o efeito da soropositividade, do vírus e da idade, mas que pode ser devida ao efeito não uniforme da vacina na prevenção de casos sintomáticos de dengue de acordo com o sorotipo, observada na metanálise estratificada que mostrou pequena heterogeneidade (10,3%) para o sorotipo 4 e heterogeneidade significativa (64,5%) para o sorotipo 2. O impacto orçamentário foi calculado para um prevalência de 70% de soropositividade na população entre 9 e 45 anos, os valores foram retirados da Câmara de Regulação do Mercado de Medicamentos (CMED) e do Sistema de Gerenciamento da Tabela de Procedimentos, Medicamentos, Órteses, Próteses e Materiais de Síntese do SUS (SIGTAP). O total calculado foi R$ 16.256.587.187,80, R$ 18.062.874.620,20 e R$ 25.288.024.349,80, vacinando respectivamente 45%, 50% e 70% da população, o que representa aproximadamente 14%, 16% e 22% do orçamento do Ministério da Saúde para 2016. Em conclusão, a eficácia da vacina é baixa em prevenir dengue sintomática. E por outro lado, o impacto orçamentário é muito alto.
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    Guidelines for budget impact analysis: a literature review 2016
    (Value in Health, 2016) Luna, LC; Costa, MG; Tura, BR; Correia, MG; Santos, MS
    This study aims to review official guidance and critical articles on budget impact analysis(BIA) methodology and to conduct a comparative analysis of the most relevant topics.
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    Budget impact of applying appropriateness criteria for myocardial perfusion scintigraphy: The perspective of a developing country
    (Journal of Nuclear Cardiology, 2016) Santos, Mauro Augusto dos; Santos, Marisa Silva; Tura, Bernardo Rangel; Felix, Renata; Brito, Adriana Soares X; De Lorenzo, Andrea
    Myocardial perfusion imaging is widely used for the risk stratification of coronary artery disease. In view of its cost, besides radiation issues, judicious evaluation of the appropriateness of its indications is essential to prevent an unnecessary economic burden on the health system. We evaluated, at a tertiary-care, public Brazilian hospital, the appropriateness of myocardial perfusion scintigraphy indications, and estimated the budget impact of applying appropriateness criteria. An observational, cross-sectional study of 190 patients with suspected or known coronary artery disease referred for myocardial perfusion imaging was conducted. The appropriateness of myocardial perfusion imaging indications was evaluated with the Appropriate Use Criteria for Cardiac Radionuclide Imaging published in 2009. Budget impact analysis was performed with a deterministic model. The prevalence of appropriate requests was 78%; of inappropriate indications, 12%; and of uncertain indications, 10%. Budget impact analysis showed that the use of appropriateness criteria, applied to the population referred to myocardial perfusion scintigraphy within 1 year, could generate savings of $ 64,252.04 dollars. The 12% inappropriate requests for myocardial perfusion scintigraphy at a tertiary-care hospital suggest that a reappraisal of MPI indications is needed. Budget impact analysis estimated resource savings of 18.6% with the establishment of appropriateness criteria for MPI.
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    Alerta de monitoramento do horizonte tecnológico: Ivacaftor (Kalydeco®) para fibrose cística
    (Ministério da Saúde, 2017) Santos, Marisa da Silva; Medeiros, Bruna; Souza, Charlles Zapp de
    O presente alerta destina-se a informar a sociedade (pacientes, operadores do direito, profissionais da saúde e formuladores de políticas, entre outros) quanto aos potenciais impactos de tecnologias emergentes (em estágio de desenvolvimento) e novas (em fase de aprovação ou recém-aprovadas por agências reguladoras) no cuidado aos pacientes, no sistema de saúde e na organização dos serviços. Este documento foi elaborado com base nas melhores evidências científicas disponíveis, mas não se trata de um guia de prática clínica e não representa posicionamento favorável ou desfavorável do Ministério da Saúde quanto à utilização das tecnologias em saúde analisadas.
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    PP061 Direct Cost Of Physiotherapeutic Devices Judicialization In Brazil
    (International Journal of Technology Assessment in Health Care, 2017) Moraes, Dominique; Tarbes, Luciana; Veras, Bruna de; Santos, Marisa
    INTRODUCTION: The “Judicialization of health” is a judicial option, provided by the Brazilian constitution, which aims to guarantee the access of the population to healthcare products or services to which they were denied or that were otherwise unavailable on the Unified Health System (SUS) (1). This highlights deficiencies in public policies (2). Considering the progressive impact of the judicialization on the budget and the lack of real-world evidence on the subject, the objective was to describe the judicialization profile of physiotherapeutic devices in the city of Rio de Janeiro and to estimate the spending on them within the system. METHODS: The profile was traced based on the analysis of the processes (n = 243) submitted to the Technical Advice Unit of the Rio de Janeiro Justice Court between May 2013 and September 2015, which litigated the provision of physiotherapeutic devices. Direct cost information was obtained from both public and private sources. The analysis was carried out using the SUS perspective. RESULTS: About 63 percent of the patients were over 60 years old. The majority of the requests were due to chronic respiratory diseases, the most common being obstructive sleep apnea-syndrome (31 percent), chronic obstructive pulmonary disease (14 percent) and pulmonary fibrosis (11 percent). The most judicialized devices were continuous positive airway pressure (21 percent), oxygen concentrator (17 percent) and portable oxygen cylinder (13 percent). None of these devices are currently covered by SUS. The expenses related to the purchase of the devices pleaded was approximately USD812,500 over 29 months. CONCLUSIONS: The total spend on these devices were considered very high when compared to Rio de Janeiro's health budgetary capacity. This scenario could be worse if this type of demand were not planned, and needed to be accomplished quickly with urgent purchases. The results obtained shows that judicialization phenomenon has a meaningful impact on the economic viability of the Brazilian healthcare system.
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    Contradições e o limiar de custo-efetividade
    (Cadernos de Saúde Pública, 2017) Santos, Marisa da Silva; Pinto, Marcia; Trajman, Anete
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    VP214 Criteria That Influence The Brazilian Public Decision-Making
    (International Journal of Technology Assessment in Health Care, 2017) Souza, Andrea Brigida de; Santos, Marisa
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    Systematic review of statins effectiveness in prevention secondary in elderly
    (Value in Health, 2017) Shoshima, Andre Y; Costa, MG; Tura, BR
    Although several studies have demonstrated the relationship between high serum cholesterol levels and cardiovascular disease incidence, this relationship for the elderly seems to be the opposite. Observational studies have shown that, in the elderly, higher serum cholesterol rates represented reduction in mortality. Statins have already demonstrated their benefits in the treatment of cardiovascular disease in adults. This correspondence is much clearer in secondary prevention of cardiovascular disease . Based on this context, the objective of this study was to evaluate the efficacy of statins in the secondary prevention of cardiovascular events in the elderly.
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    Avaliação da efetividade dos programas de prevenção da obesidade em adolescentes: revisão sistemática e metanálise
    (Comunicação em Ciências da Saúde, 2017) Freitas, Marina Gonçalves de; Souza, Kathiaja Miranda; Elias, Flávia Tavares Silva; Santos, Marisa da Silva
    Objetivos: Identificar, descrever e avaliar a efetividade dos programas de prevenção da obesidade para adolescentes. Métodos: Revisão sistemática, com busca estruturada em nove bases de dados. Foram considerados elegíveis ensaios clínicos randomizados (ECR) e estudos quase‑experimentais que relataram a experiência desses programas quando comparado a um controle, sendo o tempo de acompanhamento de no mínimo um ano. Os desfechos dos estudos deveriam incluir medidas relativas à obesidade, a partir das quais metanálises foram realizadas. Foi realizada descrição dos componentes dos programas. Resultados: Dentre 1.614 estudos identificados, 13 atenderam aos critérios de inclusão. As metanálises realizadas para a diferença de média dos desfechos escore Z do IMC, IMC e prevalência de sobrepeso e obesidade foram ‑0,01, 0,01 e ‑0,01, respectivamente. A descrição dos programas revelou elementos motivacionais, de educação, de incentivo à alimentação saudável e atividade física e de envolvimento da família. A metanálise realizada mostrou redução do percentual de gordura corporal (diferença média: ‑2,18). Conclusões: Observou‑se relevância no desfecho percentual de gordura corporal. A descrição mostrou que os programas avaliados possuem amplo leque de intervenções.Palavras-chave: obesidade; adolescente; avaliação de programas e projetos de saúde
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    VP64 Post-Graduation Selection Using Multi-Criteria Decision Analysis
    (International Journal of Technology Assessment in Health Care, 2017) Baldissara, Jessica ; Santos, Marisa da Silva; Senna, Katia Marie Simões e; Magliano, Carlos
    INTRODUCTION: Selecting candidates for graduate programs is considered to be a complex task, often subject to failures, especially regarding to the appraisal of non-cognitive (1,2) skills (for example, Motivation). Identifying suitable candidates is important for the overall success of the graduate programs, since dropouts and low productivity negatively affect the program classification by the Brazilian Governmental Agency. This study aims to describe the use of Multicriteria Decision Analysis (3) in the selection of candidates for a master degree program in Health Technology Assessment (HTA). METHODS: The Multicriteria Decision Analysis (MCDA) technique was used to measure value in the selection of students applying for a masters degree program, in 2017, using Multi-Attribute Value Theory methods (MAVT) method. The examiners group consisting of full-time professors who selected the criteria, blinded ranked and assigned weight relative to each criterion, using swing weights technique, normalized to 100 percent. During the face to face interview with the students, each evaluator professor filled an individual spreadsheet based on pre-defined questions and curriculum analysis. The results were summarized with a mean. For criterion performance, a value from 0 until 3 was assigned if the candidate didn't meet the criterion, partially meet and fully meet. The performance scores were multiplied by the weight of each criterion, the results were summarized by simple additive model, and the candidates were ranked. RESULTS: An interview was conducted with the examining group evaluating MCDA asking for difficulties, time consumed and if the result was considered fair. Seven criteria were listed: “Comprehension of HTA”, “Motivation”, “Ability to disseminate information”, “Availability to attend the course”, “Scientific production”, “Potential to work in HTA area” and “Scientific writing skills”. The highest weight (24 percent) was attributed to the “Potential to work in HTA area” and “Scientific writing skills” (20 percent). The evaluating group was unanimous in considering the process easy, fast and fair. CONCLUSIONS: The MCDA technique was applied successfully in student selection. Further prospective studies are needed.
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    Análise de Decisão Multicritérios (MCDA): uma revisão rápida sobre os critérios utilizados na Avaliação de Tecnologias em Saúde
    (Jornal Brasileiro de Economia da Saúde, 2018) Souza, Andrea Brigida de; Silva, Marisa da; Cintra, Monica Akissue de Camargo Teixeira
    Objetivo: Identificar os vários critérios utilizados por agências e órgãos governamentais internacionais na Avaliação de Tecnologias em Saúde (ATS). Métodos: Foi realizada uma revisão rápida com busca estruturada na base de dados Medline (via PubMed) e Lilacs complementada por busca na literatura cinzenta, sem restrição de idioma. Incluíram-se estudos da área de saúde que descreviam critérios e que utilizaram o método MCDA (Análise de Decisão Multicritérios) na ATS. Excluíram-se estudos que avaliaram apenas uma tecnologia específica ou contexto restrito. Os critérios foram agregados e sumarizados conforme opinião de especialistas em ATS. Resultados: Foram identificadas 3.746 publicações, sendo 27 selecionadas. Os critérios extraídos foram categorizados e seus respectivos atributos foram listados. Dez categorias foram apresentadas: benefício e risco da intervenção (4 critérios); impacto da doença (4 critérios); impacto econômico (5 critérios); contexto terapêutico da intervenção (4 critérios); qualidade e incerteza da evidência (4 critérios); implementação da intervenção (5 critérios); benefícios para a sociedade (5 critérios); benefícios para o sistema de saúde público (5 critérios); benefícios para a indústria (1 critério); e outros (3 critérios). Os atributos mais prevalentes foram: custo-efetividade; segurança e tolerabilidade; impacto orçamentário para o sistema/plano de saúde; gravidade da doença; equidade; efetividade; custo. Conclusões: Os órgãos decisores utilizam grande variedade de critérios para o MCDA, refletindo visões e valores diferentes entre as culturas. O estudo fornece informação para discussão no contexto brasileiro de uma lista mais ampla e possível padronização de critérios a serem utilizados na tomada de decisão pública ou privada sobre a incorporação de novas tecnologias
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    PMS18 - Budget impact analysis of knee osteoarthritis viscosupplementation treatment in Brazil
    (Value in Health, 2018) Senna, k; Silva, G; Tura, BR
    Knee osteoarthritis is the most common form of joint disease and has been shown to be associated with aging. It affects 3.8% of the population, worldwide, and causes significant disability, impairing patient’s quality of life. Current treatment options are as follows: pharmacological, non-pharmacological and surgical. Viscosupplementation is a treatment with exogenous hyaluronic acid applied to the knees for symptom relief and postponing surgery. This study aims to estimate the budget impact of viscosupplementation treatment for knee osteoarthritis.
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    Patient and physician preferences for attributes of coronary revascularization
    (Patient Preference and Adherence, 2018) Magliano, Carlos Alberto da Silva; Monteiro, Andrea Liborio; Tura, Bernardo Rangel; Oliveira, Claudia Silvia Rocha; Rebelo, Amanda Rebeca de Oliveira; Pereira, Claudia Cristina de Aguiar
    Background: Patients with a diagnosis of coronary artery disease (CAD) may face important decisions regarding treatment options, with the “right choice” depending on the relative weights of risks and benefits. Studies performed as discrete choice experiments are used to estimate these weights, and attribute selection is an essential step in the design of these studies. Attributes not included in the design cannot be analyzed. In this study, we aimed to elicit, rank, and rate attributes that may be considered important to patients and physicians who must choose between angioplasty and surgery for coronary revascularization.Methods: The elicitation process involved performing a systematic review to search for attri-butes cited in declared preference studies in addition to face-to-face interviews with cardiolo-gists and experts. The interviews were audio-recorded in digital format, and the collected data were transcribed and searched to identify new attributes. The criterion used to finish the data collection process was sampling saturation.Results: A systematic review resulted in the selection of the following 14 attributes: atrial fibrillation, heart failure, incision scar, length of stay, long-term survival, myocardial infarction, periprocedural death, postoperative infection, postprocedural angina, pseudoaneurysm, renal failure, repeat coronary artery bypass grafting, repeat percutaneous coronary intervention, and stroke. The interviews added no new attributes. After rating, we identified significant differ-ences in the values that patients and cardiologists placed on renal insufficiency (p,0.001), periprocedural death (p,0.001), and long-term survival (p,0.001).Conclusion: Decisions regarding the best treatment option for patients with CAD should be made based on differences in risk and the patient’s preference regarding the most relevant endpoints. We elicited, ranked, and rated 14 attributes related to CAD treatment options. This list of attributes may help researchers who seek to perform future preference studies of CAD treatment options.Keywords: preference, ranking, rating, coronary, angina
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    Feasibility of visual aids for risk evaluation by hospitalized patients with coronary artery disease: results from face-to-face interviews
    (Dove Press: Patient Preference and Adherence, 2018) Magliano, Carlos Alberto da Silva; Monteiro, Andrea Liborio; Tura, Bernardo Rangel; Oliveira, Claudia Silvia Rocha; Rebelo, Amanda Rebeca de Oliveira; Pereira, Claudia Cristina de Aguiar
    Purpose: Communicating information about risk and probability to patients is considered a difficult task. In this study, we aim to evaluate the use of visual aids representing perioperative mortality and long-term survival in the communication process for patients diagnosed with coronary artery disease at the National Institute of Cardiology, a Brazilian public hospital specializing in cardiology. Patients and methods: One-on-one interviews were conducted between August 1 and November 20, 2017. Patients were asked to imagine that their doctor was seeking their input in the decision regarding which treatment represented the best option for them. Patients were required to choose between alternatives by considering only the different benefits and risks shown in each scenario, described as the proportion of patients who had died during the perioperative period and within 5 years. Each participant evaluated the same eight scenarios. We evaluated their answers in a qualitative and quantitative analysis. Results: The main findings were that all patients verbally expressed concern about perioperative mortality and that 25% did not express concern about long-term mortality. Twelve percent considered the probabilities irrelevant on the grounds that their prognosis would depend on “God’s will.” Ten percent of the patients disregarded the reported likelihood of perioperative mortality, deciding to focus solely on the “chance of being cured.” In the quantitative analysis, the vast majority of respondents chose the “correct” alternatives, meaning that they made consistent and rational choices. Conclusion: The use of visual aids to present risk attributes appeared feasible in our sample. The impact of heuristics and religious beliefs on shared health decision making needs to be explored better in future studies. Keywords: patients’ preferences, coronary revascularization, angina, cardiology, coronary artery bypass grafting, percutaneous coronary intervention
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    PP43 MACBETH In Brazilian Hospital-Based HTA: Thrombosis Prophylaxis
    (International Journal of Technology Assessment in Health Care, 2018) Santos, Marisa; Morais, Quênia Cristina D; Rodrigues, Teresa; Costa, Carlos Bana e
    INTRODUCTION: Instituto Nacional de Traumato-Ortopedia (INTO) administrates the Enoxaparin drug to prevent deep vein thrombosis (DVT) after extensive orthopedic surgeries. Nevertheless, new oral anticoagulants that offer more comfort and efficacy, but present higher risk of bleeding, have been putting in question the use of Enoxaparin. Making use of the MACBETH method, this study develops a Multicriteria Value Measurement model to evaluate such drugs. METHODS: MACBETH was applied in helping INTO to evaluate two drugs (Rivaroxaban and Enoxaparin), taking into account drug benefits and risks, through a series of interviews and decision conferences attended by INTO stakeholders that acted as evaluators in the modelbuilding process, supported by M-MACBETH DSS (www.m-macbeth.com). Following MACBETH preference elicitation process, the evaluators were asked to make qualitative pairwise comparison judgements of difference in value between stimuli for constructing quantitative value and weighting scales. These scales allow measuring the relative value of the drugs on each evaluation criterion, separately and globally. The value measurement process was informed by a literature review and meta-analysis of randomized clinical trials with a critical appraisal of the evidence. RESULTS: We report a model-structure with eight criteria, hereafter presented by decreasing order of their weighting: Death from any cause, Clinically significant bleeding, Proximal DVT, Distal DVT, Existence of antidote, Thrombocytopenia, Costs, and Comfort. From the value model developed and after performing sensitivity and robustness analyses, Rivaroxaban was considered a robust option for thrombosis prophylaxis, under the MACBETH value framework and at the light of a simple additive aggregation of those eight criteria. CONCLUSIONS: This study shows how a value measurement sociotechnical framework, combining MACBETH with scientific evidence within a participatory group evaluation process, can support health technology assessment in a user-friendly and effective way. MACBETH facilitates transparent and robust decisionmaking in the face of complex evaluation problems that the hospital often faces.
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    Efficacy and Safety of PARACHUTE® Device: systematic review
    (Revista da Associação Médica Brasileira, 2018) Teixeira, Roberta da Silva; Veras, Bruna Medeiros Gonçalves de; Senna, Katie Marie Simões e; Caetano, Rosângela
    INTRODUCTION Heart failure due to an acute myocardial infarction is a very frequent event, with a tendency to increase according to improvements in the treatment of acute conditions which have led to larger numbers of infarction survivors. OBJECTIVE The aim of this study is to synthesize the evidence, through a systematic review, on efficacy and safety of the device in patients with this basic condition. METHODS Studies published between January 2002 and October 2016 were analysed, having as reference databases Embase, Medline, Cochrane Library, Lilacs, Web of Science and Scopus. The selection of studies, data extraction and methodological quality assessment of studies were examined by two independent reviewers, with disagreements resolved by consensus. RESULTS Only prospective studies without control group were identified. Six studies were included, with averages of 34 participants and follow-up of 13 months. Clinical, functional, hemodynamic and quality of life outcomes were evaluated. The highest mortality rate was 8.4% with 12-month follow-up for unspecified cardiovascular reasons, and heart failure rehospitalization was 29.4% with 36-month follow-up. Statistically significant improvements were found only in some of the studies which evaluating changes in left ventricular volume indices, the distance measured by the six-minute walk test, New York Heart Association functional classification, and quality of life, in pre and post-procedure analysis. CONCLUSIONS The present review indicates that no available quality evidence can assert efficacy and safety of PARACHUTE® in the treatment of heart failure after apical or anterior wall myocardial infarction.
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    Electronic Version of the EQ-5D Quality-of-Life Questionnaire: Adaptation to a Brazilian Population Sample
    (Value in Health Regional Issues, 2018) Bagattini, Ângela Maria; Camey, Suzi Alves; Miguel, Sandro René; Andrade, Mônica Viegas; Noronha, Valeria Micaela de Souza; Teixeira, Monica Akissue de C.; Lima, Ana Flávia; Santos, Marisa; Polanczyk, Carisi Anne; Cruz, Luciane Nascimento
    Objectives: To assess the measurement equivalence of the original paper version of an adapted tablet version of the EuroQol fivedimensional questionnaire (EQ-5D). Methods: A randomly selected sample of 509 individuals aged 18 to 64 years from the general population responded to the EQ-5D at two time points separated by a minimum interval of 24 hours and were allocated to one of the following groups: test-retest group (tablet-tablet) or crossover group (paper-tablet and tablet-paper). Agreement between methods was determined using the intraclass correlation coefficient (ICC) and the κ coefficient. Results: In the crossover group, the following ICC values were obtained: 0.76 (confidence interval [CI] 0.58–0.89) for EQ-5D scores and 0.77 (CI 0.68–0.84) for visual analogue scale in subjects responding first to the tablet version; 0.83 (CI 0.75–0.89) for EQ-5D scores and 0.75 (CI 0.67–0.85) for visual analogue scale in subjects responding first to the paper version. In the test-retest group, the ICC was 0.85 (CI 0.73–0.91) for EQ-5D scores and 0.79 (CI 0.66–0.87) for visual analogue scale. The κ values were higher than 0.69 in this group. The internal consistencies of the paper and tablet methods were similar. Conclusions: The paper and tablet versions of the EQ5D are equivalent. Test-retest and crossover agreement was high and the acceptability of the methods was similar among individuals. Keywords: cost-utility, electronic data capture, EQ-5D, EuroQol, quality of life.
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    Assessment of quality of life using the EQ- 5D-3L instrument for hospitalized patients with femoral fracture in Brazil
    (Health and Quality of Life Outcomes, 2018) Souza, Ivanise Arouche Gomes de; Pereira, Claudia Cristina de Aguiar; Monteiro, Andrea Liborio
    Background: Quality of life has become a key outcome in assessing the effectiveness of treatments and interventions in health. Methods: Accordingly, this research study aimed to measure quality of life using the EQ-5D-3L instrument for patients from the Jamil Haddad National Institute of Traumatology and Orthopedics (Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad – INTO) with femoral fractures, hospitalized between 11/2015 and 10/2016. Results: A total of 165 orthopedic trauma patients with femoral fractures, aged 18 years or older, who were hospitalized and operated upon in the INTO were assessed. The assessment instruments were applied at admission and in the first and second follow-up visits to the outpatient clinic. Most study subjects were women and older than 60 years. Proximal femoral fracture was the most commonly found fracture. The Visual Analog Scale (VAS) assessments over the study period showed an increasing gain in self-assessed quality of life. Similarly, the EQ-5D-3L showed significant improvements in quality of life assessed in the five dimensions of the instrument:mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Conclusion: This type of assessment may help in decision-making and cost-utility assessments related to orthopedic trauma.
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    PDB91 An MCDA approach in the evaluation of new technologies for familial hypercholesterolemia treatment
    (Value in Health, 2019) Nascimento, A; Morais, QCD; Rey, HCVR; Assad, M; Tura, BR; Santos Jr, B; Santos, MS
    To rank medicines to be prioritizing in the management of familial hypercholesterolemia (FH) using the multicriteria decision analysis (MCDA) method MACBETH. FH is a hereditary rare disease associated with some gene mutation responsible for regulate the lipid metabolism and cause early cardiovascular events