Virtual assistant: a tool for health co-production in coping with covid-19 / Asistente virtual: una herramienta para co-producción en salud con el fin de hacer frente al covid-19 / Assistente virtual: ferramenta para coprodução em saúde no enfrentamento à covid-19

ABSTRACT Objective: to describe the development of a virtual assistant as a potential tool for health co-production in coping with COVID-19. Method: this is an applied technological production research study developed in March and April 2020 in five stages: 1) literature review, 2) content definition, 3) elaboration of the dialog, 4) test of the prototype, and 5) integration with the social media page. Results: the literature review gathered diverse scientific evidence about the disease based on the Brazilian Ministry of Health publications and by consulting scientific articles. The content was built from the questions most asked by the population, in March 2020, evidenced by Google Trends, in which the following topics emerged: concept of the disease, prevention means, transmission of the disease, main symptoms, treatment modalities, and doubts. Elaboration of the dialog was based on Natural Language Processing, intentions, entities and dialog structure. The prototype was tested in a laboratory with a small number of user computers on a local network to verify the functionality of the set of apps, technical and visual errors in the dialog, and whether the answers provided were in accordance with the user's question, answering the questions correctly and integrated into Facebook. Conclusion: the virtual assistant proved to be a health education tool with potential to combat "Fake News". It also represents a patient-centered form of health communication that favors the strengthening of the bond and interaction between health professionals and patients, promoting co-production in health.

RESUMEN Objetivo: describir el desarrollo de un asistente virtual como posible herramienta para la co-producción en salud a fin de hacer frente al COVID-19. Método: trabajo de investigación aplicado de producción tecnológica, desarrollado en marzo y abril de 2020 en cinco etapas: 1) revisión de la literatura, 2) definición del contenido, 3) elaboración del diálogo, 4) prueba del prototipo y 5) integración con la página web del medio social. Resultados: en la revisión de la literatura se reunieron evidencias científicas sobre la enfermedad a partir de las publicaciones del Ministerio de Salud de Brasil, al igual que sobre la base de consultas en artículos científicos. El contenido se elaboró a partir de las preguntas más frecuentes de la población, en marzo de 2020, puestas en evidencia por medio de Google Trends, donde surgieron los siguientes temas: concepto de la enfermedad, formas de prevención, transmisión de la enfermedad, principales síntomas, modalidades de tratamiento y dudas. La elaboración del diálogo se basó en el Procesamiento de Lenguaje Natural, en intenciones, en entidades y en la estructura del diálogo. El prototipo se puso a prueba en un laboratorio con una cantidad reducida de computadoras usuario en una red local para verificar la funcionalidad del conjunto de aplicaciones, errores técnicos y visuales acerca del diálogo, y si las respuestas proporcionadas estaban de acuerdo con la pregunta del usuario, respondiendo correctamente los interrogantes e integrado a Facebook. Conclusión: el asistente virtual demostró ser una herramienta de educación en salud con potencial para combatir Fake News. También representa una forma de comunicación en salud centrada en el paciente que favorece el fortalecimiento del vínculo y la interacción entre profesionales de la salud y pacientes, promoviendo así la coproducción en salud.

RESUMO Objetivo: descrever o desenvolvimento de um assistente virtual como ferramenta potencial para a coprodução em saúde no enfrentamento à COVID-19. Método: trata-se de uma pesquisa aplicada de produção tecnológica, desenvolvida nos meses de março e abril de 2020 em cinco etapas: 1) revisão de literatura, 2) definição de conteúdo, 3) construção do diálogo, 4) teste do protótipo e 5) integração com página de mídia social. Resultados: a revisão de literatura reuniu evidências científicas sobre a doença a partir das publicações do Ministério da Saúde, no Brasil, e de consultas em artigos científicos. O conteúdo foi construído a partir das perguntas mais realizadas pela população, em março de 2020, evidenciadas por meio do Google Trends, em que emergiram os seguintes temas: conceito da doença, formas de prevenção, transmissão da doença, principais sintomas, formas de tratamento e dúvidas. A construção do diálogo foi baseada em Processamento de Linguagem Natural, intenções, entidades e estrutura de diálogo. O protótipo foi testado em laboratório com um número reduzido de computadores usuários em uma rede local para verificar a funcionalidade do conjunto de aplicações, erros técnicos e visuais acerca do diálogo e se as respostas fornecidas estavam de acordo com a pergunta do usuário, respondendo de forma correta os questionamentos e integrado ao Facebook. Conclusão: o assistente virtual mostrou-se uma ferramenta de educação em saúde e com potencial para combater fake news. Também representa uma forma de comunicação em saúde centrada no paciente, que favorece o fortalecimento de vínculo e interação entre profissionais de saúde e pacientes, promovendo a coprodução em saúde.

Comparison of Survival and Clinical Profile of Adults with COVID-19 Hospitalized in Two Clinics in Medellín, Colombia.

Purpose of Review: This study compares the survival and clinical profile of hospitalized adults with COVID-19 in two clinics in the city of Medellín, Colombia, with a prospective study with 198 patients in clinic A and 201 in clinic B. Comparisons were made with chi-square and Mann-Whitney U, factors associated with survival were identified with a Cox regression. Recent Findings: The proportion of deaths was 7.1% in clinic A with a mean survival of 51.9 days (95% CI = 45-59); in clinic B 13.9% of patients died with mean survival of 37.8 days (95% CI = 32-43). The most prevalent comorbidities were hypertension (41.6%), diabetes (23.8%), obesity (15.0%), hypothyroidism (13.0%), dyslipidemia (11.0%), and chronic lung disease (10.8%) with similar proportions in both clinics. There were also differences by the clinic in the most prevalent complications: bacterial pneumonia (18.8%), acute renal failure (14.3%), and encephalopathy (9.5%). There were no differences in the days of hospitalization, mechanical ventilation (clinic A 23.7% and clinic B 29.4%) and admission to the ICU (25.3% in A and 32.3% in B). Summary: We evidence the heterogeneity of the survival and the clinical profile of the patients who are cared for by two institutions of the same city. These findings demonstrate the need to conduct unique studies for each institution, which poses a significant challenge for hospital epidemiology programs due to the impossibility of extrapolating evidence from other healthcare institutions and the need to implement personalized medicine programs given the clinical diversity of patients hospitalized for COVID-19.

Producción científica sobre la COVID-19 en revistas médicas cubanas a 90 días del inicio de la pandemia / Scientific production on COVID-19 in Cuban medical journals during the first 90 days after the start of the pandemic

RESUMEN Introducción: Desde la aparición del primer caso contagiado por el SARS-Cov-2, la pandemia ha experimentado un ascenso en el número de casos casi incontrolable. La producción científica juega un papel clave en la lucha por este necesario control y erradicación. El número de artículos que se produce diariamente desde los inicios sobrepasan los miles a nivel internacional y las editoriales y bases de datos han puesto su mayor esfuerzo para que estas contribuciones tengan la debida prioridad y visibilidad. Cuba no ha hecho menos en este esfuerzo. Objetivo: caracterizar la producción científica publicada en revistas médicas cubanas en los primeros noventa días de inicio de la pandemia en Cuba. Material y Métodos: se realizó un estudio descriptivo transversal donde se analizaron el 100 por ciento de las revistas médicas certificadas como científicas. Se definieron variables como tipología documental, afiliaciones institucionales y colaboración, temática, país y tiempo de publicación entre otros. Resultados: El 58 por ciento de los artículos publicados correspondió a revistas de universidades médicas. El 31,1 por ciento fue aportado por la revista Medisur de la Universidad de Ciencias Médicas de Cienfuegos. El 77,8 por ciento de los artículos son cubanos. El 22,6 por ciento fueron cartas al editor, seguidas de 20,8 por ciento correspondiente a artículos originales. Conclusiones: la producción científica nacional en revistas médicas cubanas en el período estudiado es baja, si tomamos en consideración que las cartas al editor no son artículos de investigación propiamente dichos. Hay áreas de las ciencias médicas como la medicina familiar que pudiendo haber aportado sus experiencias en el trabajo investigativo en la comunidad, aún no lo han hecho en este período de tiempo(AU)

ABSTRACT Introduction: Since the first case of SARS-CoV-2 was confirmed, the pandemic has experienced an almost uncontrollable increase in the number of cases. The scientific production plays a key role in the fight against the necessary control and eradication of the pandemic. From the very beginning, thousands of articles per day are produced at international level; furthermore, editorials and databases have made a great effort to give due priority and visibility to these contributions. Cuba has made significant efforts in this respect. Objective: To characterize the scientific production on COVID-19 in Cuban medical journals during the first ninety days after the start of the pandemic in Cuba. Material and Methods: A cross-sectional descriptive study aimed at analyzing 100 percent of the scientific medical journals was conducted. Variables such as documental typology, institutional and collaborative affiliations, subject matter, country and time of publication, among others were identified. Results: In total, 58 percent of the articles were published in medical journals and 31,1 percent was a contribution by Medisur Journal, University of Medical Sciences in Cienfuegos. In addition, 77,8 percent of the articles were written by Cuban health researchers, 22,6 percent of the articles were Letters to the Editor and 20,8 percent were original articles. Conclusions: Over the period studied, the national scientific production in Cuban medical journals is low taking into account that the Letters to the Editor are not actual research articles. Some subject areas in Medical Sciences such as Family Medicine, which could have contributed with their experiences in research work within the community, have not produced any scientific article during this period of time(AU)

Caracterización de la población VIH-SIDA del Hospital Universitario de Caracas / Characterization of the HIV-AIDS population of the Hospital Universitario de Caracas

Objetivo: Caracterizar los pacientes con infección por VIH-SIDA atendidos en la consulta externa y hospitalización de los Servicios de Medicina Interna e Infectología del Hospital Universitario de Caracas. Métodos: Se recolectó información de los pacientes a través de una historia médica dirigida que incluyó información sociodemográfica, médica, de hábitos sexuales y respecto a la infección por VIH, así como conocimiento del paciente sobre su enfermedad. Resultados: la muestra constó de 100 pacientes, con una media de edad de 39 años; el 75% de los pacientes fue de sexo masculino y se observó que la mayoría de ellos tenía una depresión ausente o mínima (64). El grado de adherencia al tratamiento se midió con de la escala CEAT, observándose una media del índice de adhesión total de 73,16. La mayoría se agrupaba en la máxima puntuación para nuestra escala de evaluación de conocimiento de su enfermedad (33%), equivalente a un conocimiento aceptable. Conclusión: La población afectada son en su mayoría hombres en edad productiva. El estado de ánimo de los pacientes es un factor fundamental. El 13% requirió derivación al servicio de psiquiatría. Al correlacionar la adherencia con el grado de depresión, se obtuvo que dicha asociación era estadísticamente significativa con una p = 0,039. El conocimiento de la enfermedad en general fue aceptable, sin embargo independientemente del grado de información general que la población posea acerca de la enfermedad, no se modificaron las conductas de riesgo(AU)

Objective: To characterize the patients with HIV-AIDS infection treated in the ambulatory setting and hospitalization of the Internal Medicine and Infectology wards of the Hospital Universitario de Caracas, Venezuela. Methods: Patient information was collected through a medical history that included sociodemographic and medical information, sexual habits and HIV infection, as well as the patient´s knowledge about their disease. Results: The sample consisted of 100 patients, with a mean age of 39 years; 75% of them were male. Most of the patients had non or minimal depression (64%). The degree of adhesion to the treatment was measured applying the CEAT scale, with a mean index of total adhesion in 73. Most of them people had highest score for our scale to assess disease knowledge (33%), equivalent to an acceptable knowledge. Conclusions: The majority of the population affected was in a productive age. The patients' mood was a fundamental factor and 13% were referred to a psychiatric consultation(AU)

Is There Evidence of Cost Benefits of Electronic Medical Records, Standards, or Interoperability in Hospital Information Systems? Overview of Systematic Reviews.

BACKGROUND: Electronic health (eHealth) interventions may improve the quality of care by providing timely, accessible information about one patient or an entire population. Electronic patient care information forms the nucleus of computerized health information systems. However, interoperability among systems depends on the adoption of information standards. Additionally, investing in technology systems requires cost-effectiveness studies to ensure the sustainability of processes for stakeholders. OBJECTIVE: The objective of this study was to assess cost-effectiveness of the use of electronically available inpatient data systems, health information exchange, or standards to support interoperability among systems. METHODS: An overview of systematic reviews was conducted, assessing the MEDLINE, Cochrane Library, LILACS, and IEEE Library databases to identify relevant studies published through February 2016. The search was supplemented by citations from the selected papers. The primary outcome sought the cost-effectiveness, and the secondary outcome was the impact on quality of care. Independent reviewers selected studies, and disagreement was resolved by consensus. The quality of the included studies was evaluated using a measurement tool to assess systematic reviews (AMSTAR). RESULTS: The primary search identified 286 papers, and two papers were manually included. A total of 211 were systematic reviews. From the 20 studies that were selected after screening the title and abstract, 14 were deemed ineligible, and six met the inclusion criteria. The interventions did not show a measurable effect on cost-effectiveness. Despite the limited number of studies, the heterogeneity of electronic systems reported, and the types of intervention in hospital routines, it was possible to identify some preliminary benefits in quality of care. Hospital information systems, along with information sharing, had the potential to improve clinical practice by reducing staff errors or incidents, improving automated harm detection, monitoring infections more effectively, and enhancing the continuity of care during physician handoffs. CONCLUSIONS: This review identified some benefits in the quality of care but did not provide evidence that the implementation of eHealth interventions had a measurable impact on cost-effectiveness in hospital settings. However, further evidence is needed to infer the impact of standards adoption or interoperability in cost benefits of health care; this in turn requires further research.

Portfólio Reflexivo Eletrônico: Resultados de um Projeto Piloto / Reflective e-Portfolio: Results of a Pilot Project

RESUMO Este estudo investigou a implantação de um Portfólio Reflexivo Eletrônico (PRE) nas atividades de Prática Profissional (PP), que ocorrem em ambientes internos e externos ao campus. Para avaliação, um protótipo foi instalado em netbooks e usado durante cinco meses por um grupo de estudantes e um facilitador do primeiro ciclo da Unidade Educacional de Prática Profissional (Uepp) do curso de Medicina da Universidade Federal de São Carlos (UFSCar). O estudo percorreu as seguintes etapas: levantamento dos requisitos, design e implementação do protótipo e avaliação do protótipo. Na avaliação foi feito um inquérito com aplicação de dois questionários e a realização de observações locais durante esse período. Os resultados demonstraram que a maioria dos estudantes prefere usar o PRE nas atividades internas e em grupo, mas prefere usar papel durante o atendimento aos pacientes, e que características de hardware e software do dispositivo de acesso e os diferentes ambientes de uso influenciam essa preferência.

ABSTRACT This study investigated the deployment of a Reflective e-Portfolio (REP) for Professional Practice (PP) activities, which activities occur on and off the campus. For the prototype evaluation, the e-Portfolio was installed on netbooks and used for five months by a group of students and a facilitator of the first cycle of the Educational Unit of Professional Practice (EUPP) of the UFSCar Medicine Course. The study involved the following steps: survey to establish the requirements, design and implementation of the prototype, and evaluation of the prototype. The evaluation consisted of an investigation with the application of two questionnaires and local observations conducted during that period. The results showed that most students prefer to use the REP in the internal and group activities, but prefer to use paper for patient care, and that hardware and software characteristics of the access device as well as the different environments of use influence this preference.

How reliable is online diffusion of medical information targeting patients and families?

AIM: To determine whether online diffusion of the "Ten Warning Signs of Primary Immunodeficiency Diseases (PID)'' adheres to accepted scientific standards. METHODS: We analyzed how reproducible is online diffusion of a unique instrument, the "Ten Warning Signs of PID", created by the Jeffrey Modell Foundation (JMF), by Google-assisted searches among highly visited sites from professional, academic and scientific organizations; governmental agencies; and patient support/advocacy organizations. We examined the diffusion, consistency of use and adequate referencing of this instrument. Where applicable, variant versions of the instrument were examined for changes in factual content that would have practical impact on physicians or on patients and their families. RESULTS: Among the first 100 sites identified by Google search, 85 faithfully reproduced the JMF model, and correctly referenced to its source. By contrast, the other 15 also referenced the JMF source but presented one or more changes in content relative to their purported model and therefore represent uncontrolled variants, of unknown origin. Discrepancies identified in the latter included changes in factual content of the original JMF list (C), as well as removal (R) and introduction (I) of novel signs (Table 2), all made without reference to any scientific publications that might account for the drastic changes in factual content. Factual changes include changes in the number of infectious episodes considered necessary to raise suspicion of PID, as well as the inclusion of various medical conditions not mentioned in the original. Together, these changes will affect the way physicians use the instrument to consult or to inform patients, and the way patients and families think about the need for specialist consultation in view of a possible PID diagnosis. CONCLUSION: The retrieved adaptations and variants, which significantly depart from the original instrument, raise concerns about standards for scientific information provided online to physicians, patients and families.

El discreto encanto de los medicamentos / The discreet charm of drugs

El presente artículo es un resumen de un grupo de conferencias sobre la industria farmacéutica mundial ofrecidas entre 2010 y 2013 en diferentes foros nacionales e internacionales. El comportamiento de la producción y consumo de medicamentos en el mundo, teniendo en cuenta que se trata de un bien social que se utiliza para prevenir enfermedades y restablecer la salud del ser humano, ofrece un panorama extraño en relación con las reales necesidades de la población. Se analiza cuáles son los elementos implicados en ese comportamiento. Comienza con una caracterización de la industria farmacéutica mundial contemporánea y analiza tres aspectos que considera están relacionadas con estos resultados: la investigación médico-farmacéutica, la promoción e información médica y el funcionamiento de las agencias reguladoras nacionales de medicamentos. La industria farmacéutica mundial ha aportado enormes ventajas al tratamiento de las enfermedades. Es un hecho irrefutable, pero la Gran Pharma no es una industria cualquiera y requiere ser rentable. La globalización y el neoliberalismo han creado patrones de motivación y conducta basados fundamentalmente en los intereses del mercado. Debemos estar alertas en el futuro. Este nuevo siglo introduce nuevos retos a los pueblos, sus gobiernos y a la Gran Pharma en relación con la salud y la enfermedad y su enfrentamiento(AU)

This article summarized a group of lectures on the world drug industry delivered from 2010 to 2013 in a number of national and international fora. Taking into account that a pharmaceutical is a social asset used to prevent diseases and recover human health, the behavior of the drug production and consumption worldwide shows a awkward overview in terms of the real needs of the population. An analysis was made on the elements involved in such behavior, beginning with a characterization of the world current drug industry and analyzing three aspects related to the results: medical-drug research, medical promotion and information and operation of the national drug regulatory agencies. The world drug industry has provided huge benefits for the treatment of diseases and this is an undeniable fact; however, the Big Pharma needs to be profitable. Globalization and neoliberalism have created patterns of incentives and behaviors mainly based on the market interests. We should be aware of that in the future. This new century poses new challenges for the peoples, their governments and for the Big Pharma in terms of health, disease and how to face it(AU)

El discreto encanto de los medicamentos / The discreet charm of drugs

El presente artículo es un resumen de un grupo de conferencias sobre la industria farmacéutica mundial ofrecidas entre 2010 y 2013 en diferentes foros nacionales e internacionales. El comportamiento de la producción y consumo de medicamentos en el mundo, teniendo en cuenta que se trata de un bien social que se utiliza para prevenir enfermedades y restablecer la salud del ser humano, ofrece un panorama extraño en relación con las reales necesidades de la población. Se analiza cuáles son los elementos implicados en ese comportamiento. Comienza con una caracterización de la industria farmacéutica mundial contemporánea y analiza tres aspectos que considera están relacionadas con estos resultados: la investigación médico-farmacéutica, la promoción e información médica y el funcionamiento de las agencias reguladoras nacionales de medicamentos. La industria farmacéutica mundial ha aportado enormes ventajas al tratamiento de las enfermedades. Es un hecho irrefutable, pero la Gran Pharma no es una industria cualquiera y requiere ser rentable. La globalización y el neoliberalismo han creado patrones de motivación y conducta basados fundamentalmente en los intereses del mercado. Debemos estar alertas en el futuro. Este nuevo siglo introduce nuevos retos a los pueblos, sus gobiernos y a la Gran Pharma en relación con la salud y la enfermedad y su enfrentamiento(AU)

This article summarized a group of lectures on the world drug industry delivered from 2010 to 2013 in a number of national and international fora. Taking into account that a pharmaceutical is a social asset used to prevent diseases and recover human health, the behavior of the drug production and consumption worldwide shows a awkward overview in terms of the real needs of the population. An analysis was made on the elements involved in such behavior, beginning with a characterization of the world current drug industry and analyzing three aspects related to the results: medical-drug research, medical promotion and information and operation of the national drug regulatory agencies. The world drug industry has provided huge benefits for the treatment of diseases and this is an undeniable fact; however, the Big Pharma needs to be profitable. Globalization and neoliberalism have created patterns of incentives and behaviors mainly based on the market interests. We should be aware of that in the future. This new century poses new challenges for the peoples, their governments and for the Big Pharma in terms of health, disease and how to face it(AU)

Analysis of the doctor-patient communication if breast cancer is diagnosed / Análisis de la comunicación médico-paciente en el diagnóstico de cáncer de mama / Análise da comunicação médico-paciente em caso de diagnóstico de câncer de mama

The aim of the paper is the recognition and evaluation of demand for medical information among patients suffering from breast cancer. The research was conducted among 120 women with diagnosed breast cancer in the Oncological Surgery Clinic of the Independent Public Research Hospital Nº 1 in Lublin, the Oncological Clinic of the Independent Public Research Hospital Nº 1 in Lublin and the Rehabilitation Centre with the Rehabilitation Clinic at the Lublin Oncology Centre. The research included women from the Club of Women after Mastectomy “Amazons”, the Club “Amazons” at the Complex of Specialist Clinics in Ostrowiec Swietokrzyski and the Club “Amazons” in Radom. Research showed that the demand for medical information among women with diagnosed breast cancer is very high. Respondents want to know all the information concerning the diagnosis, treatment and prognosis (93 percent). They also expect that the doctor will give them medical information concerning further consequences of cancer and its influence on future health and life (78 percent). Most of the respondents expect to receive information concerning medicaments which should be taken (77 percent) and the essence of the conducted treatment (93 percent). The research analysis showed that women with diagnosed breast cancer expect that the doctor will give them reliable and real medical information. Patients want the doctor to present them the probable course of the cancer (85 percent) and all the possible side effects connected with it (89 percent).

El objetivo de este trabajo es el reconocimiento y la evaluación de la demanda de información médica en pacientes con cáncer de mama. Se realizó la investigación con 120 mujeres diagnosticadas con cáncer de mama en la Clínica de Cirugía Oncológica y la Clínica Oncológica del Hospital de Investigación Público Independiente Nº 1 en Lublin, y el Centro de Rehabilitación con la Clínica de Rehabilitación del Centro Oncológico de Lublin. La investigación incluyó mujeres del Club “Amazons” de Mujeres que han sufrido Mastectomía, el Club “Amazons” del Complejo de Clínicas Especializadas en Ostrowiec Swietokrzyski y el Club “Amazons” en Radom. La investigación mostró que la demanda de información médica de mujeres con diagnóstico de cáncer de mama es muy alta. Aquellas que respondieron quieren saber todo acerca del diagnóstico, tratamiento y pronóstico (93 por ciento). También esperan que el médico les dé información médica respecto de posteriores consecuencias del cáncer y su influencia en su salud futura y su vida (78 por ciento). La mayoría de las que respondieron esperan recibir información sobre medicamentos que deberían tomar (77 por ciento) y lo esencial sobre el tratamiento realizado (93 por ciento). El análisis de la investigación muestra que las mujeres diagnosticadas con cáncer de mama esperan que el médico les dé información médica confiable y verdadera, les presente el curso probable del cáncer (85 por ciento) y todos los posibles efectos secundarios conectados (89 por ciento).

O objetivo deste artigo é o reconhecimento e a avaliação da demanda por informação médica entre pacientes que sofrem de câncer de mama. A investigação foi conduzida entre 120 mulheres diagnosticadas com câncer de mama na Oncological Surgery Clinic of the Independent Public Research Hospital Nº 1 de Lublin, a Oncological Clinic of the Independent Public Research Hospital Nº 1 de Lublin e a Rehabilitation Centre with the Rehabilitation Clinic do Lublin Oncology Centre. A pesquisa incluiu mulheres do Club of Women after Mastectomy “Amazons”, o Club “Amazons” do Complex of Specialist Clinic sem Ostrowiec Swietokrzyskie o Club “Amazons”em Radom. Pesquisa revelou que a demanda por informação médica entre mulheres com diagnóstico de câncer mamário é muito alta. As respondentes queriam saber todas as informações concernentes ao diagnóstico, tratamento e prognóstico (93 por cento). Elas também esperavam que o médico pudesse dar-lhes informação sobre consequências tardias do câncer e a influência sobre a sua saúde e vida futuras (78 por cento). A maioria dos respondentes tinham a expectativa de receber informação sobre medicamentos que deveriam tomar(77 por cento) e a essência do tratamento realizado(93 por cento). A análise da pesquisa demonstrou que as mulheres com diagnóstico de câncer de mama esperavam que o médico pudesse fornecer-lhes informação confiável e honesta. Pacientes queriam que o médico lhes apresentasse o provável curso do câncer (85 por cento) e todos os possíveis efeitos relacionados a ele (89 por cento).

Qualidade da informação da internet disponível para pacientes em páginas em português / Quality of internet information available to patients on websites in Portuguese

OBJETIVO: Pacientes e seus familiares frequentemente procuram na internet informações a respeito de suas doenças. Diabetes mellitus (DM), hipertensão arterial sistêmica (HAS) e infarto agudo do miocárdio (IAM) são muito prevalentes no Brasil, e informações sobre estas patologias são bastante procuradas na internet. Por isso, buscamos avaliar a qualidade da informação relacionada com estas doenças disponível em português na internet. MÉTODOS: Foram selecionadas as primeiras 20 páginas em português de cada uma das doenças escolhidas, através do algoritmo de busca do Google®. Como ferramentas para avaliar a qualidade da informação foram utilizados o Discern Questionnarie (DQ) e o Health on Net (HON). Para saber se as informações eram adequadas, foram utilizadas as diretrizes (guidelines) brasileiras e internacionais para as diferentes comorbidades. RESULTADOS: Ao avaliar o conteúdo das informações disponíveis, 45%, 95%, 85% das páginas continham, respectivamente, a definição de DM, HAS e IAM. Com relação ao diagnóstico e ao tratamento, somente 25% das páginas das três comorbidades apresentavam especificamente esta informação. Somente 15%, 20% e 10% das páginas tinham a certificação pelo HON, respectivamente. Em função do DQ, as páginas obtiveram notas maiores que 50% em 70% das páginas de DM, 65% nas de HAS e 55% nas de IAM. CONCLUSÃO: A informação disponível em português na internet sobre as três patologias escolhidas (DM, HAS e IAM) é frequentemente inadequada e insuficiente.

OBJECTIVE: Patients and their relatives often look for information about their diseases on the internet. Diabetes mellitus (DM), systemic arterial hypertension (SAH), and acute myocardial infarction (AMI) are the most prevalent in Brazil, thus, information on these pathologies is extremely searched for on the internet. For this reason, this study attempted to evaluate the quality of information available in Portuguese on the web regarding these disorders. METHODS: The first 20 websites in Portuguese for each disease through the Google® search algorithm were selected. The Discern Questionnaire (DQ) and Health on the Net (HON) were used as tools in order to evaluate the quality of information. To assess adequacy, international and Brazilian guidelines for different co-morbidities were used. RESULTS: When evaluating the information content available, 45%, 95%, and 85% of pages had the definition of DM, SAH, and AMI, respectively. Only 25% of the websites regarding the three co-morbidities had specific information on diagnosis and treatment. Only 15%, 20%, and 10% of the websites had HON certification, respectively. Using the DQ approach, scores higher than 50% were obtained in 70% of the DM websites, in 65% of SAH websites, and in 55% of the AMI websites. CONCLUSION: The available information in Portuguese on the internet regarding the three pathologies selected (DM, SAH, and AMI) is quite often inadequate and insufficient.

Informática Médica y Policlínico Universitario, vinculados al Análisis de la Situación de Salud en la carrera de Medicina / The Medical Information Technology and the University Polyclinic linked to the Health Situation Analysis in the Medicine career

La confección del Análisis de Situación de Salud, a nivel comunitario, es elemento común en los planes de estudio de las carreras de Ciencias de la Salud. La Informática Médica, disciplina estructurada también en todas las carreras sanitarias, puede y debe apoyar más eficazmente la realización de este instrumento científico metodológico. Por esta razón, se realizó el presente estudio de corte cualitativo, para determinar las potencialidades en información generada en los nuevos escenarios de formación, para la vinculación de la Informática Médica con el Análisis de Situación de Salud, e identificar contenidos presentes en esta disciplina que deben apoyar su realización. El estudio se enmarcó en el Instituto de Ciencias Básicas y Preclínicas, Victoria de Girón, curso académico 2009-2010. Los procedimientos utilizados fueron la revisión bibliográfica y el análisis documental, entrevistas a profundidad dirigidas a informantes clave, y la alternativa de triangulación metodológica. El estudio culmina con la identificación de las bondades en información, generada en los nuevos escenarios (Policlínico Universitario), para el aprendizaje de la Informática Médica y su vinculación con el tema Análisis de Situación de Salud, así como la identificación de los principales contenidos de la disciplina que tributan al desarrollo de este instrumento. Se recomendó valorar, por las autoridades competentes, la utilización de los resultados de este estudio en el perfeccionamiento de la enseñanza de la Informática Médica y continuar en la profundización de esta temática, con énfasis en el enfoque multidisciplinario e interdisciplinario del contenido Análisis de Situación de Salud

The drawing up of Health Situation Analysis at community level is a common element in study plans of Health Sciences careers. The Medical Information Technology is a structured discipline also in all health careers may and must to support effectively the carrying out of this methodological scientific tool. Thus, a qualitative study was conducted to determine the potentials in the information generated in the new training scenarios, the linking of Medical Information with the Health Situation Analysis and to identify the contents present in this discipline supporting its carrying out. The study was framed in the Victoria de Girón Basic and Preclinical Sciences Institute in the academic course 2009-2010. The procedures used were the bibliographic review and the documentary analysis, deep interviews aimed to the key informers and the methodological triangulation alternative. Present paper concludes with the identification of information goodness generated in the new scenarios (University Polyclinic) for the learning of Medical Information Technology and its link with the Analysis of Health Situation as a subject, as well as the identification of the main contents of this discipline leading to the development of this tool. Authors recommended that the competent authorities must to assess the use of results from present study in the improvement of Medical Information Technologies education and to continue in the deepening of this subject matter emphasizing the multidisciplinary and interdisciplinary approach of the Analysis of Health Situation content

Uso de mineração de texto como ferramenta de avaliação da qualidade informacional em laudos eletrônicos de mamografia / Text mining as a tool for assessment of informational quality of electronic mammographic reports

OBJETIVO: Investigação do uso da técnica de mineração de texto como forma de avaliar a qualidade informacional de laudos eletrônicos de mamografia, tendo como parâmetro de qualidade a adesão ao léxico BI-RADS®. MATERIAIS E MÉTODOS: Foram extraídos 22.247 laudos de mamografia do banco de dados do sistema de informação em radiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, no período de janeiro de 2000 até junho de 2006. Foram realizados dois experimentos, um buscando-se verificar a utilização mais correta dos termos do léxico - experimento 1 (especificidade do método de mineração), e outro buscando-se verificar toda e qualquer tentativa de uso ou alusão ao léxico - experimento 2 (sensibilidade do método de mineração). RESULTADOS: Experimento 1: variação entre 11 por cento e 61 por cento de laudos contendo termos do léxico em sua conclusão, distribuída de forma aleatória ao longo do tempo, a partir do ano de 2001. Experimento 2: variação entre 44 por cento e 100 por cento de laudos que se referem de alguma forma ao léxico em sua conclusão. CONCLUSÃO: Os resultados indicam um bom potencial da aplicação da ferramenta de mineração de texto para a avaliação da qualidade das informações contidas em laudos eletrônicos de mamografia.

OBJECTIVE: To investigate the utilization of text mining technique for evaluating the informational quality of electronic mammographic reports considering adherence to the BI-RADS® lexicon as a quality parameter. MATERIALS AND METHODS: A total of 22,247 mammography reports of the period between January, 2000 and June, 2006 were collected from the radiology information database of Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, SP, Brazil. Two experiments were undertaken - experiment 1 to evaluate the accuracy in the adoption of the lexicon terms (text mining method specificity), and experiment 2 to identify all and any attempt to utilize or refer to the lexicon (text mining method sensitivity). RESULTS: Experiment 1: variation between 11 percent and 61 percent in reports including lexicon terms in their conclusion, randomly distributed over time since 2001. Experiment 2: variation between 44 percent and 100 percent in reports that somehow refer to the lexicon in their conclusion. CONCLUSION: Results indicate a good potential for text mining tool application for assessing the quality of information included in electronic mammography reports.

Sistema de informação em saúde e atuação do profissional médico / Health information system and medical professional performance

Objetivos: avaliar e analisar criticamente a qualidade da informação em saúde e o papel de instituições e profissionais sobre este tema. Metodologia: estudo ecológico exploratório a partir de dados secundários do SIM e SINASC. A análise frequentista foi realizada por meio dos programas R e TabWin. Resultados: ao analisar o índice de preenchimento de campos obrigatórios das declarações de óbito, detectou-se que em campos a serem obrigatoriamente preenchidos, em caso de óbitos infantis, faltavam 30% ou mais de informações. O manuseio dos documentos originais permitiu constatar mais de um tipo de caneta e letra. O índice médio de falta de preenchimento de declarações de nascidos vivos foi de 1% em Alfenas e 0,28% na Regional de Saúde. Conclusão: a mortalidade perinatal é importante indicador de saúde, que reflete diretamente a qualidade da assistência ao parto e pós-parto. Embora desde 1976 se tenha instituído um modelo único de declaração de óbito, seu preenchimento continua apresentando inúmeros problemas, entre eles a falta de registro em campos obrigatórios, o que inviabiliza correto diagnóstico situacional. A má qualidade da informação gerada por documentos exclusivamente de responsabilidade médica indica que o atestado de óbito é visto apenas como uma burocracia a mais e não como fonte geradora de dados fundamentais para o planejamento e avaliação de políticas públicas de saúde. Por isso, é necessário e urgente rediscutir a atuação do profissional médico, instituições formadoras e entidades de classe.

Objectives: to evaluate and critically analyze the information quality on health and the institutions and professionals? role on the matter. Methodology: exploratory ecological study of secondary data from SIM and SINASC. The frequency analysis was carried out through the R and TabWin programs. Results: when analyzing the contents? rate of mandatory s in death declarations, It was found that in case of infants death 30% or more of the information was missing. The original documents handling allowed to find more than one kind of pen and writing type. The average rate of missing information in the live births declaration was 1% in Alfenas and 0,28% in the Regional Health Care. Conclusion: perinatal mortality is a significant health factor, which reflects directly the delivery and pos-delivery health care quality. Although a unique model for death declaration has been established since 1976, its correct fulfillment still presents a number of problems, such as missing information in the mandatory s, which prevents the correct situation diagnosis. Information poor quality generated by documents of exclusively medical responsibility indicates that the death declaration is seen as only one more bureaucracy request rather than a source of basic data for planning and evaluation of public health policies. Therefore, it is necessary and urgent to revisit the performance of the medical professional, formation institutions and class entities.