Níveis de Evidência, Análise de Decisão e Análise de Sensibilidade

68 Pages·2010·0.71 MB·Portuguese

Níveis de Evidência, Análise de
Decisão e Análise de
Sensibilidade
Moysés Szklo
INTERFACE OF EPIDEMIOLOGY AND CANCER CONTROL POLICY
1. BURDEN OF CANCER
Determine health status

(mortality, incidence,
survival, recurrence
rates)
7. REASSESSMENT
Reassessment of health status
2. ETIOLOGY AND
PROGNOSIS
Identify risk factors and
prognostic factors
6. SURVEILLANCE
Ongoing monitoring of outcomes
(Population-Based and Hospital 3. EFFICACY: assess efficacy of
Registries) preventive and therapeutic strategies
5. COST-EFFECTIVENESS
Determine relationships between 4. EFFECTIVENESS
costs and effectiveness across Assess effectiveness in the target
programs/protocols population/patients
Modified from: Tugwell et al, J Chron Dis 38(4)
INTERFACE OF EPIDEMIOLOGY AND CANCER CONTROL POLICY
1. BURDEN OF CANCER
Determine health status

(mortality, incidence,
survival, recurrence
rates)
7. REASSESSMENT
Reassessment of health status
2. ETIOLOGY AND
PROGNOSIS
Identify risk factors and
prognostic factors
6. SURVEILLANCE
Ongoing monitoring of outcomes
(Population-Based and Hospital 3. EFFICACY: assess efficacy of
Registries) preventive and therapeutic strategies
5. COST-EFFECTIVENESS
Determine relationships between 4. EFFECTIVENESS
costs and effectiveness across Assess effectiveness in the target
programs/protocols population/patients
Modified from: Tugwell et al, J Chron Dis 38(4)
INTERFACE OF EPIDEMIOLOGY AND CANCER CONTROL POLICY
1. BURDEN OF CANCER
Determine health status

(mortality, incidence,
survival, recurrence
rates)
7. REASSESSMENT
Reassessment of health status
2. ETIOLOGY AND
PROGNOSIS
Identify risk factors and
prognostic factors
6. SURVEILLANCE
Ongoing monitoring of outcomes
(Population-Based and Hospital 3. EFFICACY: assess efficacy of
Registries) preventive and therapeutic strategies
5. COST-EFFECTIVENESS
Determine relationships between 4. EFFECTIVENESS
costs and effectiveness across Assess effectiveness in the target
programs/protocols population/patients
Modified from: Tugwell et al, J Chron Dis 38(4)
INTERFACE OF EPIDEMIOLOGY AND CANCER CONTROL POLICY
1. BURDEN OF CANCER
Determine health status

(mortality, incidence,
survival, recurrence
rates)
7. REASSESSMENT
Reassessment of health status
2. ETIOLOGY AND
PROGNOSIS
Identify risk factors and
prognostic factors
6. SURVEILLANCE
Ongoing monitoring of outcomes
(Population-Based and Hospital 3. EFFICACY: assess efficacy of
Registries) preventive and therapeutic strategies
5. COST-EFFECTIVENESS
Determine relationships between 4. EFFECTIVENESS
costs and effectiveness across Assess effectiveness in the target
programs/protocols population/patients
Modified from: Tugwell et al, J Chron Dis 38(4)
INTERFACE OF EPIDEMIOLOGY AND CANCER CONTROL POLICY
1. BURDEN OF CANCER
Determine health status

(mortality, incidence,
survival, recurrence
rates)
7. REASSESSMENT
Reassessment of health status
2. ETIOLOGY AND
PROGNOSIS
Identify risk factors and
prognostic factors
6. SURVEILLANCE
Ongoing monitoring of outcomes
(Population-Based and Hospital 3. EFFICACY: assess efficacy of
Registries) preventive and therapeutic strategies
5. DECISION ANALYSIS /
COST-EFFECTIVENESS 4. EFFECTIVENESS
Determine relationships Assess effectiveness in the target
between costs and population/patients
effectiveness across
programs/protocols
Modified from: Tugwell et al, J Chron Dis 38(4)
INTERFACE OF EPIDEMIOLOGY AND CANCER CONTROL POLICY
1. BURDEN OF CANCER
Determine health status

(mortality, incidence,
survival, recurrence
rates)
7. REASSESSMENT
Reassessment of health status
2. ETIOLOGY AND
PROGNOSIS
Identify risk factors and
prognostic factors
6. SURVEILLANCE
Ongoing monitoring of outcomes
(Population-Based and Hospital 3. EFFICACY: assess efficacy of
Registries) preventive and therapeutic strategies
5. DECISION ANALYSIS /
COST-EFFECTIVENESS 4. EFFECTIVENESS
Determine relationships Assess effectiveness in the target
between costs and population/patients
effectiveness across
programs/protocols
Modified from: Tugwell et al, J Chron Dis 38(4)
INTERFACE OF EPIDEMIOLOGY AND CANCER CONTROL POLICY
1. BURDEN OF CANCER
Determine health status

(mortality, incidence,
survival, recurrence
rates)
7. REASSESSMENT
Reassessment of health status
2. ETIOLOGY AND
PROGNOSIS
Identify risk factors and
prognostic factors
6. SURVEILLANCE
Ongoing monitoring of outcomes
(Population-Based and Hospital 3. EFFICACY: assess efficacy of
Registries) preventive and therapeutic strategies
5. DECISION ANALYSIS /
COST-EFFECTIVENESS 4. EFFECTIVENESS
Determine relationships Assess effectiveness in the target
between costs and population/patients
effectiveness across
programs/protocols
Modified from: Tugwell et al, J Chron Dis 38(4)
INTERFACE OF EPIDEMIOLOGY AND CANCER CONTROL POLICY
1. BURDEN OF CANCER
Determine health status

(mortality, incidence,
survival, recurrence
rates)
7. REASSESSMENT
Reassessment of health status
2. ETIOLOGY AND
PROGNOSIS
Identify risk factors and
prognostic factors
6. SURVEILLANCE
Ongoing monitoring of outcomes
(Population-Based and Hospital 3. EFFICACY: assess efficacy of
Registries) preventive and therapeutic strategies
5. DECISION ANALYSIS /
COST-EFFECTIVENESS 4. EFFECTIVENESS
Determine relationships Assess effectiveness in the target
between costs and population/patients
effectiveness across
programs/protocols
Modified from: Tugwell et al, J Chron Dis 38(4)
INCA/DECIT/MS: Núcleo de Avaliação de Tecnologias em Saúde -- Processo de
Implementação de Politicas de Controle de Câncer Baseadas em Evidências
Políticas baseadas em
evidências
O
Aquisição de evidências Revisões efeCtuivsidtoa-de n cia sbstác
científicas sistemáticas vid ê ulos
• Ensaios • Colaboração E
aleatorizados Cochrane Aplicação da politica:
L
it
e
• Estudos de coorte • Outras fontes r • Evidências
a
L (meta-análises tu • Obstáculos
• Estudos de casos e ite publicadas em ra
r
controles a revistas)
t
u
ra • Avaliação de níveis
• Estudos de séries • Meta-análises de evidência
temporais realizadas no
NATS-INCA • Seleção de opções Análise de
sensibilidade
• Estudos de programáticas
processo e estrutura (Análise de decisão)

• Outros estudos (ex: • Recomendações
sensibilidade/especi-
ficidade, pe squisa
qualitativa)
Es tu do s c on duz id o s
n o IN CA
Tradução de conhecimentos