Navegando por Palavras-chave "Evidências"
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- ItemSomente MetadadadosPolítica Baseada Em Evidências(Universidade Federal de São Paulo (UNIFESP), 2017-05-23) Simoyama, Felipe De Oliveira [UNIFESP]; Bueno, Ricardo Luiz Pereira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)A large number of studies have been published on the so-called evidence-based policy (EBP), however, some significant gaps remain open in the area, such as: who should be responsible for research integrity, how to assess the quality of evidence, and how should decisions be made. Moreover, in spite of the large number of recommendations for EBP implementation, it lacks empirical evidence to validate these arguments, i.e. a demonstration that policies, as currently formulated, do not work. Also, despite such recommendations, it is not known whether, in fact, evidences are not used by policymakers. This research presents three essays on EBP with the main objective of filling some of the gaps noticed in literature, and also contributing to the advancement of EBP by setting forth its importance in different aspects of public policy. The first essay is a systematic literature review based on the PRISMA protocol, it focuses on conceptual studies and includes the most used methods and the main barriers faced by EBP. The second essay presents an analysis of a set of systematic reviews of public policies carried out by Campbell Collaboration over a period of five years, with the main objective of verifying the effectiveness of public policies in several areas. Results indicate that less than half of public policies work, and it demonstrates the importance of the use of evidence in public policies, especially in the formulation and evaluation stages. The third essay is an analysis of public policies of Brazilian municipal capitals, amounting to 180 documents. Its main objective was to verify the rate of use of evidence in public policies in these cities. Results indicate that evidences do not play an important role in the process of policy formulation in the main Brazilian cities, not even those considered of less scientific value. Essentially, this study presents several opportunities for the advancement of EBP both practically and theoretically, by pointing out its importance for the improvement of public policy process, especially when confronted with the failures noted in the method currently used by policy formulators.
- ItemAcesso aberto (Open Access)Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática(Universidade Federal de São Paulo (UNIFESP), 2009-04-29) Oliveira, Márcio Moysés de [UNIFESP]; Prado, Gilmar Fernandes do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Restless legs syndrome (RLS) is common and often misdiagnosed entity in the general population and it may be more common in dialysis patients, with an estimated prevalence of 6.6% to 21.5%. Objective: The treatment for uremic RLS has been controversial and therefore a systematic synthesis of the evidence is needed in order to evaluate the effectiveness and safety of treatments for uremic RLS. Method: This was a systematic review of randomized or quasirandomized double-blind trials on treatments for uremic RLS. The outcomes considered were relief of RLS symptoms marked on a validated scale, subjective sleep quality, sleep quality measured using night polysomnography and actigraphy, quality of life measured subjectively and adverse events associated with these treatments. Results: Six eligible clinical trials were included. The results from subjective analyses in these studies were divergent, although objective analyses in one trial showed that there was a statistically significant improvement in periodic leg movement (PLM) during time asleep (PLM) in the treatment group. No combined analysis (meta-analysis) was performed. The most common adverse event seen was gastrointestinal symptoms. Conclusion: Only a few therapeutic trials on uremic patients with RLS have been published, and there is not enough to give scientific evidence favoring any specific therapeutic regimen for uremic-associated RLS. Therapy with levodopa, dopaminergics agonists, anticonvulsants, and clonidine tend to be effective, but more studies are need. Key words: systematic review, restless legs syndrome, uremic, end-stage renal disease.
- ItemAcesso aberto (Open Access)Tratamento Miofuncional para os Transtornos Respiratórios do Sono Baseado em Evidências(Universidade Federal de São Paulo (UNIFESP), 2010-08-25) Valbuza, Juliana Spelta [UNIFESP]; Prado, Gilmar Fernandes do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introdução: O Ronco é o ruído causado pela vibração da úvula, palato e paredes faríngeas durante a inspiração, cujas causas envolvem diversos fatores. Objetivo: O tratamento do ronco pelos métodos para aumento do tônus muscular da via aérea superior tem sido controverso e pouco relatado, portanto uma revisão sistemática em busca de evidências é necessária para avaliar a efetividade destes métodos. Método: Revisão sistemática de ensaios clínicos randomizados ou quasi-randomizados, duplo-cegos para o tratamento do ronco, com métodos que visam o aumento do tônus da via aérea superior, tais como fonoterapia e fisioterapia. Desfechos: diminuição ou cura do ronco, qualidade do sono, qualidade de vida e efeitos adversos. Resultados: Três estudos elegíveis foram potencialmente analisados, porém nenhum deles foi capaz de prover evidência científica suficiente para favorecer a intervenção. As análises objetivas de um estudo demonstraram melhora do ronco, entretanto as subanálises objetivas e as análises subjetivas demonstraram resultados controversos. Os efeitos adversos não foram relatados. Conclusão: Não existe evidência científica suficiente para sustentar a recomendação de métodos para aumentar o tônus muscular da via aérea superior no tratamento do ronco. Ensaios clínicos randomizados bem elaborados são necessários para avaliarmos a efetividade de tais métodos e uma padronização com métodos mundialmente aceitos de intervenção para o ronco seriam necessários para pesquisas futuras. Palavras-chave: Ronco, distúrbios do sono, tratamento, revisão.