Article type
Year
Abstract
Background: Evidence-Based Medicine (EBM) is a paradigm for teaching, research and making decisions, involving appropriate methods and statistical analysis, so that the results from good scientific research can be incorporated into clinical practice. Health professionals, policymakers, researchers and consumers may benefit from this, since the information is critically assessed. Since 2005, through a partnership with Ministry of Health, the Brazilian Cochrane Centre (BCC) has developed or up-to-dated systematic reviews (SR), so that Brazilian public health policy can be based on high quality evidence.
Objectives: To improve public health in Brazil and to ensure that evidence forms part of the decision-making process.
Methods: 36 questions were proposed by Ministry of Health: adalimumab for rheumatoid arthritis; efalizumab for psoriasis; acupuncture for carpal syndrome; surgeries for morbid obesity; imatinib for gastrointestinal tumours and chronic myeloid leukaemia; transcranial electrical stimulation and piribidil for Parkinson disease; electrophysiological and haemodynamics catheters; stents with rapamicina/paclitaxel; multi-chamber pacemakers and implanted electrical cardioversor; teriparatide for osteoporosis; skin replacement materials for burns; uterine artery embolization for myomas; nucleoplasty for disc herniation; Ferrara's ring for keratoconus; surgery for epilepsy; drotrecogin alpha activated for sepsis; agalsidase beta for Fabry disease; laronidase for mucopolysaccharidosis; etanercept and infliximab for severe psoriasis; pegvisomant for acromegaly; nucleic acid amplification and detection tests for HIV and hepatitis C virus, traditional suburethral sling operations for urinary incontinence; acupuncture for headache, epicondilitis and low back pain; cages for spine surgeries; surgical staplers reprocessing; photodynamic therapy for macular degeneration.
Results: These evidence reports were used by the Health Technology Assessment Department in their decision-making processes, including economic evaluations. The systematic reviews are being submitted as papers in major health journals.
Conclusion: This work can be considered an example of successful partnership within the technology health assessment improvement movement. This warrants that whole population has access to an effective and safe health system based on the best evidence available. This also supports its feasibility, allowing the government direct resources to interventions that definitely work and redirect health research investment towards unanswered questions. As a result, more than 12 systematic reviews have been requested and the Brazilian Cochrane Centre is currently leading a Masters Degree Course on systematic reviews and EBM for the Ministry of Health's professionals.
Conflict of interest: none
Source of funding: Brazilian Ministry of Health
Acknowledgements: Brazilian Cochrane Centre researchers: Aline Mizusaki, Delcio Matos, Gustavo Almeida, Eduarda Puga, Eleonora Lins, Hernani Lemos, Humberto Saconato, Regina El Dib, Regis Andriolo, Virginia Trevisani, Sabrina Lacroce, Stella Peccin
Objectives: To improve public health in Brazil and to ensure that evidence forms part of the decision-making process.
Methods: 36 questions were proposed by Ministry of Health: adalimumab for rheumatoid arthritis; efalizumab for psoriasis; acupuncture for carpal syndrome; surgeries for morbid obesity; imatinib for gastrointestinal tumours and chronic myeloid leukaemia; transcranial electrical stimulation and piribidil for Parkinson disease; electrophysiological and haemodynamics catheters; stents with rapamicina/paclitaxel; multi-chamber pacemakers and implanted electrical cardioversor; teriparatide for osteoporosis; skin replacement materials for burns; uterine artery embolization for myomas; nucleoplasty for disc herniation; Ferrara's ring for keratoconus; surgery for epilepsy; drotrecogin alpha activated for sepsis; agalsidase beta for Fabry disease; laronidase for mucopolysaccharidosis; etanercept and infliximab for severe psoriasis; pegvisomant for acromegaly; nucleic acid amplification and detection tests for HIV and hepatitis C virus, traditional suburethral sling operations for urinary incontinence; acupuncture for headache, epicondilitis and low back pain; cages for spine surgeries; surgical staplers reprocessing; photodynamic therapy for macular degeneration.
Results: These evidence reports were used by the Health Technology Assessment Department in their decision-making processes, including economic evaluations. The systematic reviews are being submitted as papers in major health journals.
Conclusion: This work can be considered an example of successful partnership within the technology health assessment improvement movement. This warrants that whole population has access to an effective and safe health system based on the best evidence available. This also supports its feasibility, allowing the government direct resources to interventions that definitely work and redirect health research investment towards unanswered questions. As a result, more than 12 systematic reviews have been requested and the Brazilian Cochrane Centre is currently leading a Masters Degree Course on systematic reviews and EBM for the Ministry of Health's professionals.
Conflict of interest: none
Source of funding: Brazilian Ministry of Health
Acknowledgements: Brazilian Cochrane Centre researchers: Aline Mizusaki, Delcio Matos, Gustavo Almeida, Eduarda Puga, Eleonora Lins, Hernani Lemos, Humberto Saconato, Regina El Dib, Regis Andriolo, Virginia Trevisani, Sabrina Lacroce, Stella Peccin