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- ItemAssessment 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 LiborioBackground: 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.
- ItemElectronic 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 NascimentoObjectives: 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.
- ItemExploring the predictors of health valuations of EQ 5D 3L with a mixed-effects linear model(Expert Review of Pharmacoeconomics & Outcomes Research, 2019) Santos, Marisa da Silva; Monteiro, Andréa Libório; Santos, BraulioBackground: Information about how individual characteristics influence preferences about health states valuation are scare. The purpose of this study is to identify predictors of the EuroQol with five dimensions and 3 levels – EQ 5D-3L time-tradeoff valuation. Research design and methods: We analyzed a dataset with a probabilistic sample of 5774 individuals. Two sets of independent variables for testing were defined: a set of forced variables composed of 10 dummy variables for EuroQol levels 2 and 3 of each health dimension and a set of demographic variables. Results: The strongest predictors of health valuation were the self-reported health state and the ‘belief in God,’ with 0.11 utility units for each VAS unit and 0.11 utility units for ‘yes’ for the ‘belief in God’ parameter.Age had an impact of 0.0190 utility units for each 10-year interval. Having children had a small effect (0.0338 utility units for ‘yes’), and the other characteristics studied had no significant impact. Conclusions: People who believe in God (or the afterlife) and those of greater age seem to be less prone to forgoing life years to avoid health problems. In our sample, older individuals valued health state higher than younger individuals.
- ItemSystematic review of dengue vaccine efficacy(BMC Infectious Diseases, 2019) Silveira, Lucia Teresa Côrtes da; Tura, Bernardo; Santos, MarisaBackground: Dengue is an arbovirus that has rapidly spread worldwide, and the incidence of dengue has greatly increased in recent decades. The actual numbers of dengue cases are underreported, and many cases are not classified correctly. Recent estimates indicate that 390 million dengue infections occur per year (95% CI, 284-528 million), of which 96 million (67-136 million) are symptomatic infections of any severity. One of the goals of the World Health Organization is to reduce dengue mortality by 50% by the year 2020. The use of a vaccine can be an important strategy to achieve this goal. Vaccines for dengue are in various stages of development; in Brazil, only one commercial formulation is available (CYD-TDV), which was developed by Sanofi Pasteur. Methods: To evaluate the efficacy of Dengue vaccine, a systematic review with a meta-analysis was conducted using randomized controlled clinical trials published between 2000 and 2017 that were identified in the MEDLINE databases via PubMed, LILACS, Cochrane Library, and EMBASE. The selection was performed by two reviewers independently, with disagreements resolved by a third reviewer. Results: Seven clinical trials were included, with a total of 36,371 participants (66,511 person-years) between the ages of 2 and 45 years. The meta-analysis using the random-effects model estimated the efficacy of the vaccine at 44%, with a range from 25 to 59% and high heterogeneity (I2 = 80.1%). The serotype-stratified meta-analysis was homogeneous, except for serotype 2, with the heterogeneity of 64.5%. Most of the vaccinated individuals had previous immunity for at least one serotype, which generated safety concerns in individuals without previous immunity. Conclusions: Compared with other commercially available vaccines, the dengue vaccine showed poor efficacy.