ABSTRACT
This study evaluated the effectiveness of thermocycler temperature control, considering the influence of other determinant factors for the optimization of PCR. The reduction in the number of repeated PCR tests, applied in the diagnosis and prognosis of chronic myeloid leukemia at the National Cancer Institute in Brazil, was used as a measure of effectiveness. This indicator was evaluated using samples obtained before and after the temperature control in the wells of the thermocyclers. There was a reduction of 18.9% in the number of repeated exams in the second sample. A structured interview with laboratory staff indicated that there was no change in the other determinant factors.
Subject(s)
Polymerase Chain Reaction/methods , Brazil , DNA Primers/chemistry , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis , TemperatureABSTRACT
OBJECTIVES: The aim of this study was to describe the developing health technology assessment (HTA) activities in Brazil, both historically and in the present day. METHODS: This report is a descriptive analysis based on personal experiences of the authors and on selected literature. RESULTS: Interest in HTA in Brazil began in the mid-1980s. Several seminars and consultations were held, often with invited foreign participants. A cadre of people with knowledge and expertise in HTA was gradually developed. In 2003, several policies were developed by the federal government of Brazil to encourage HTA and base clinical, management, and policy decisions on HTA. During the past 5 years, institutional development has been rapid in government, private companies (mainly prepaid health plans), academia, and research institutes. Further policy changes are needed to maximize the impact of these developments. Nevertheless, although the growing network of HTA programs will have a considerable impact on Brazilian health care, further institutional development could stimulate this change. CONCLUSIONS: It would be desirable if the Federal Ministry of Health of Brazil were to proceed to develop a national agency for HTA.
Subject(s)
Program Development , Technology Assessment, Biomedical , Brazil , Health Policy , History, 20th Century , History, 21st CenturyABSTRACT
The response of healthcare services to new information systems depends upon, among other factors, their local organization. This study aimed at comparing the chemotherapy and radiotherapy production registers for the cities Rio de Janeiro and Belo Horizonte, Brazil, in the Ambulatory Information System of the Unified Brazilian Health System (in Portuguese, SUS) between November/1998 and February/2003. Both cities showed a pattern of increase for the chemotherapy production series, while the radiotherapy series showed such increase only for Rio de Janeiro. Comparing Box-Jenkins models for each series, Rio de Janeiro showed a delay of three months in recording production, due to public services. In Belo Horizonte, the delay was shorter than in Rio de Janeiro and there was no difference between public and non-public services. The observed differences between the cities seem to be associated with the fact that Belo Horizonte already had a mechanism to control and evaluate production before the introduction of the system in 1998.
Subject(s)
Ambulatory Care Information Systems/standards , Neoplasms/drug therapy , Neoplasms/radiotherapy , Ambulatory Care Information Systems/statistics & numerical data , Brazil , Female , Humans , MaleABSTRACT
A resposta dos servicos à implantacão de um sistema de informacão depende de uma série de fatores, entre os quais, destaca-se a organizacão local. Este trabalho comparou o padrão de registro dos dados de producão de quimioterapia e radioterapia dos municípios do Rio de Janeiro e Belo Horizonte, Brasil, no Sistema de Informacão Ambulatorial do SUS, no período de novembro de 1998 a fevereiro de 2003. Ambos os municípios mostraram uma tendência de alta na série de producão de quimioterapia, e apenas o Rio de Janeiro, na série de radioterapia. Comparando os modelos de Box-Jenkins de cada série, verificou-se que o Rio de Janeiro apresenta um atraso de três meses no registro de producão, devido às unidades públicas. Em Belo Horizonte, o atraso é menor e não foi observada diferenca no registro da producão entre as unidades públicas e contratadas. A diferenca observada entre os municípios parece estar associada ao fato de Belo Horizonte dispor de um sistema de controle e avaliacão da producão anterior a 1998, ano da implantacão do sistema.
Subject(s)
Ambulatory Care Information Systems , Medical Oncology , Neoplasms/drug therapy , Neoplasms/radiotherapy , Neoplasms/therapyABSTRACT
O Sistema Único de Saúde (SUS) disponibiliza uma série de dados de produção que podem ser utilizados para a monitorização da assistência oncológica prestada à população. Para tal, faz-se necessária à identificação de um caso novo de câncer nessas bases de dados. Neste trabalho são apresentadas duas formas de identificação de um caso novo de câncer no sistema de Autorização de Procedimentos de Alta Complexidade em Oncologia (APAG ONCO/SUS), em um determinado período de tempo. Para isso foram utilizadas a data de competência mais antiga e a data de diagnóstico do caso de câncer. Foram identificados 40.195 casos pelo primeiro critério e 34.789 pelo segundo critério. A análise das séries de dados dos dois critérios mostrou haver estabilidade no número de casos identificados mensalmente no período de observação. Essa análise dos dados mostrou que 85 por cento dos casos têm apenas uma data de diagnósticos registrada no sistema e que há tendência de queda no número de casos com mais de uma data de diagnóstico. Os prós e contras de cada critério são discutidos, assim como as sua aplicações.
Subject(s)
Databases as Topic , Medical Oncology , Neoplasms/epidemiology , Unified Health SystemABSTRACT
A gestão dos serviços públicos de saúde tem a seu dispor um volume cada vez maior de dados de produção oferecidos pelo DATASUS (Departamento de Informática do SUS). Apesar da existência de instrumentos de visualização desses dados, análises mais detalhadas requerem a utilização do dado não agregado. Isto demanda o conhecimento da estrutura interna das bases de dados e de técnicas de manipulação de dados. Este trabalho propõe rotinas computacionais para integrar as tabelas da base de dados do Sistema de Autorização dos Procedimentos de Alta Complexidade em Oncologia do Sistema Único de Saúde (APAC/ONCO/SUS), de forma a ampliar o uso destes dados por um número maior de usuários com pouca experiência computacional. O processo de obtenção e agregação das tabelas é descrito passo a passo para dois ambientes: Microsoft R Access e SAS R. As rotinas visam a otimizar o tempo de processamento das tabelas e minimizar problemas de compatibilização dos campos. O produto final desta proposta é um arquivo único que poderá ser utilizado posteriormente em qualquer pacote estatístico ou planilha de cálculo.
Subject(s)
Computing Methodologies , Databases as Topic , Health Services , Information Systems , Medical Oncology , Unified Health SystemABSTRACT
OBJECTIVES: The objective of this study was to analyse the relation between residence water access (water taps) and hepatitis A virus (HAV) antibodies, associated with socio-economic, environmental and demographic factors. METHODS: A logistic regression model was used for estimating the relation between residential water access (presence of water taps inside the house) and HAV antibodies, related to confounding effects of selected variables. The odds ratios estimated by the model were used as incidence density ratios (IDR) for the analysis of the water access-antibody association. Data were obtained from a cross-sectional study on the seroprevalence of hepatitis A in 3779 volunteers from Duque de Caxias city, greater Rio de Janeiro, Brazil. Participants were selected according to an age-specified random sampling survey. RESULTS: Besides water access (main variable of interest), age, monthly family income, housewife schooling, persons per room, proximity to open sewage channels and consumption water treatment were statistically associated to hepatitis A seroprevalences. An interaction between water access and proximity to open sewage channels was detected. Persons living in residences distant from an open sewage channel had a water access-antibody IDR of 2.5 (95% CI [1.4; 4.3]), in contrast to 1.1 for those living close to such channels. CONCLUSIONS: Although indirectly measured through the proxy variable water access, personal hygiene, in conjunction with the absence of open sewage channels in the proximity of the residence, was an important factor for low HAV seroprevalence study population.
