Navegando por Palavras-chave "Outcome assessment"
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- ItemAcesso aberto (Open Access)Avaliação da qualidade de estudos clínicos e seu impacto nas metanálises(Faculdade de Saúde Pública da Universidade de São Paulo, 2005-12-01) Silva Filho, Carlos Rodrigues da [UNIFESP]; Saconato, Humberto; Conterno, Lucieni de Oliveira [UNIFESP]; Marques, Iara; Atallah, Álvaro Nagib [UNIFESP]; Faculdade Estadual de Medicina de Marília; Universidade Federal do Rio Grande do Norte; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate whether different quality assessment tools applied to a group of clinical trials could be correlated, and what would be their impact on meta-analysis results. METHODS: Thirty-eight randomized controlled clinical trials were analyzed. These had been selected for a systematic review of the therapeutic efficacy of alpha interferon for treating chronic hepatitis B. The following tools were utilized: Maastricht (M), Delphi (D), Jadad (J) and the Cochrane Collaboration (CC) method (gold standard). The Spearman correlation coefficient was used to compare the results from the three methods. The Kappa test was used to assess the concordance between the reviewers in applying the tools, and the weighted Kappa test was applied to compare the quality ranking determined by the tools. The outcomes assessed in the meta-analyses were clearance of HBV-DNA and HBeAg. RESULTS: The studies presented regular to low quality. The concordance between reviewers varied according to the instrument utilized: D=0.12; J=0.29; M=0.33; and CC=0.53. The correlation was moderate and homogeneous (D/J=0.51; D/M=0.53; and J/M=0.52). Thje meta-analysis result relating to HBV-DNA ranged from RR=0.71 (95% CI: 0.66-0.77) to RR=0.67 (95% CI: 0.58-0.79). For HBeAg, the results ranged from RR=0.85 (95% CI: 0.80-0.90) to RR=0.85 ( 95% CI: 0.77-0.93). These results depended on the quality of the studies included. CONCLUSIONS: The quality assessment tools presented good correlation. In systematic reviews with the same direction of effect, the quality assessment may not significantly change the results. The Cochrane Collaboration method was the most reproducible method and easiest to apply.
- ItemAcesso aberto (Open Access)Brazilian version of the Berg balance scale(Associação Brasileira de Divulgação Científica, 2004-09-01) Miyamoto, Samira Tatiyama [UNIFESP]; Lombardi Júnior, Imperio [UNIFESP]; Berg, Katherine Olga; Ramos, Luiz Roberto [UNIFESP]; Natour, Jamil [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); McGill University Division of Physical and Occupational TherapyThe purpose of the present study was to translate and adapt the Berg balance scale, an instrument for functional balance assessment, to Brazilian-Portuguese and to determine the reliability of scores obtained with the Brazilian adaptation. Two persons proficient in English independently translated the original scale into Brazilian-Portuguese and a consensus version was generated. Two translators performed a back translation. Discrepancies were discussed and solved by a panel. Forty patients older than 65 years and 40 therapists were included in the cultural adaptation phase. If more than 15% of therapists or patients reported difficulty in understanding an item, that item was reformulated and reapplied. The final Brazilian version was then tested on 36 elderly patients (over age 65). The average age was 72 years. Reliability of the measure was assessed twice by one physical therapist (1-week interval between assessments) and once by one independent physical therapist. Descriptive analysis was used to characterize the patients. The intraclass correlation coefficient (ICC) and Pearson's correlation coefficient were computed to assess intra- and interobserver reliability. Six questions were modified during the translation stage and cultural adaptation phase. The ICC for intra- and interobserver reliability was 0.99 (P < 0.001) and 0.98 (P < 0.001), respectively. The Pearson correlation coefficient for intra- and interobserver reliability was 0.98 (P < 0.001) and 0.97 (P < 0.001), respectively. We conclude that the Brazilian version of the Berg balance scale is a reliable instrument to be used in balance assessment of elderly Brazilian patients.
- ItemAcesso aberto (Open Access)Esofagectomia trans-hiatal no tratamento do megaesôfago chagásico avançado(Colégio Brasileiro de Cirurgiões, 2003-06-01) Batista Neto, João [UNIFESP]; Fontan, Alberto Jorge; Nepomuceno, Marcos Da Costa; Lourenço, Laércio Gomes [UNIFESP]; Ribeiro, Laércio Tenório; Ramos, Carmen Pereira; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Alagoas; UFAL; UFAL Hospital Universitário Prof. Alberto Antunes Serviço de Clínica Cirúrgica; UFAL HUPAABACKGROUND: To analize the clinical results, radiologic and endoscopic findings of the transhiatal esophagectomy on Chaga's disease megaesophagus. METHODS: A retrospective study was performed from 1982-2000. Twenty-eight chagasic patients, sixteen female and twelve male, were treated at the General Surgery Service of Hospital da Universidade Federal de Alagoas. The disease was diagnosed by serologic trials and epidemiological or anatomopathological information. Variables studied were: a) pre and postoperative surgery patients complaints as dysphagia, regurgitation, pyrosis, diarrhea, dumping, postprandial fullness, pneumonia and weight status; b) post surgery X Rays series (upper GI) evaluation of the cervical esophagogastric anastomosis and the transposed stomach; c) post surgery endoscopic evaluation to analyze the esophagus stump and the anastomotic suture. The follow-up quantitative variable was expressed by medium and error pattern. The Chi-square test was applied to the dysphagia, regurgitation and pyrosis resolution variables considering p<0,05 values significant. The qualitative variables by percentage and the trusting interval calculated within 95% (IC-95%), with the EpiInfo software. RESULTS: Mean follow-up was 58,2 months (from to 4 - 192). Mean age was 36,5 years (from to 16-67). There was no mortality in this series. There was complete resolution of dysphagia in the majority of the patients (21/28 - 71,4%, p<0,05); 7/28 (25%) needed one or more dilatation sessions. Pyrosis was the most important late follow-up symptom (35,7%) and stump esophagitis the most significant endoscopic finding. The majority of X Rays studies findings were normal. CONCLUSIONS: Transhiatal esophagectomy was efficient to the treatment of chagasic megaesophagus dysphagia however the morbidity was high (78,6%). The mortality in this series was none.
- ItemSomente MetadadadosUse of the BREAST-Q (TM) Survey in the Prospective Evaluation of Reduction Mammaplasty Outcomes(Springer, 2018) Cabral, Isaias Vieira; Garcia, Edgard da Silva; Neponucena Sobrinho, Rebecca; Pinto, Natalia Lana Larcher; Juliano, Yara [UNIFESP]; Veiga-Filho, Joel; Ferreira, Lydia Masako [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]BREAST-Q (TM) is a patient-reported outcomes survey instrument with a specific module that evaluates breast reduction surgery. It allows assessment of patient's satisfaction with received treatment and evaluates the impact of surgery on different aspects of the patient's quality of life. This article aims to assess the satisfaction and quality of life of patients who underwent reduction mammaplasty. Women aged between 18 and 60 years, with a body mass index ranging from 19 to 30 kg/m(2), who were already scheduled for reduction mammaplasty, were included in the study. The Brazilian version of the BREAST-Q (TM) Reduction/Mastopexy Module (preoperative 1.0 and postoperative 1.0 versions) was self-applied preoperatively and 1 and 6 months after the operation. One hundred and seven patients were included in the study and completed the 6-month follow-up. The median age was 33 years, and the median preoperative body mass index was 25 kg/m(2). The superomedial pedicle was used in 96.3% of the cases, and the total median weight of the resected breast was 1115 g. There was a significant improvement in the scores of the scales: Psychosocial well-being, Sexual well-being, Physical well-being, and Satisfaction with the breasts compared to the preoperative assessment (p < 0.0001). The scales Satisfaction with the NAC and Satisfaction with the outcome, available only in the postoperative version, demonstrated high satisfaction rates at the two postoperative periods evaluated. Reduction mammaplasty improved the quality of life and provided high levels of patient satisfaction with outcomes 1 and 6 months postoperatively. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
- ItemSomente MetadadadosValidity and reliability of the Foot Function Index (FFI) questionnaire Brazilian-Portuguese version(Springer International Publishing Ag, 2016) Martinez, Bruna Reclusa [UNIFESP]; Staboli, Isabela Maschk [UNIFESP]; Kamonseki, Danilo Harudy [UNIFESP]; Budiman-Mak, Elly; Yi, Liu Chiao [UNIFESP]Purpose: To evaluate the validity and reliability of the Foot Function Index (FFI) in its Brazilian Portuguese version. Methods: The validity and reliability of the FFI were tested in 50 volunteers, with plantar fasciitis, metatarsalgia and chronic ankle sprain. The FFI validity process used the Short Form-36 (SF-36) and Foot and Ankle Outcome Score (FAOS) questionnaires. The correlation between FFI, SF-36 and FAOS was done using the Pearson's linear coefficient. The inter and intra-evaluator reliability was ascertained by means of the intraclass correlation coefficient (ICC) and the internal consistency by means of Cronbach's alpha coefficient. The scores were used to assess the standard error measurement (SEM), minimal detectable change (MDC) and ceiling floor and effects. Results: The validity process showed that there were correlations between FFI and the "pain" and "social aspects" subscales of SF-36 and all subscales of FAOS, except for "other symptoms". The Brazilian-Portuguese version of FFI showed excellent intra and interevaluator correlations, with an ICC range of 0.99-0.97 and score reliability that was considered highly satisfactory, with Cronbach's alpha range of 0.80-0.61. The SEMs for inter and intra-evaluator reliability were 1.32 and 1.08, respectively. The MDC was 2.42 (90 % confidence interval). No ceiling and floor effect were detected. Conclusions: The Brazilian-Portuguese version of the FFI questionnaire was found to be a valid and reliable instrument for foot function evaluation, and can be used both in scientific settings and in clinical practice.