ALESSANDRO GONCALVES CAMPOLINA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/24 - Laboratório de Oncologia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
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- Quality of life in a sample of Brazilian adults using the generic SF-12 questionnaire(2018) CAMPOLINA, Alessandro Goncalves; LOPEZ, Rossana Veronica Mendoza; NARDI, Elene Paltrinieri; FERRAZ, Marcos BosiObjective: This study describes the summary scores of the Short Form-12 (SF-12) questionnaire, according to socio-demographic factors obtained in a probabilistic and representative sample of the Brazilian urban population. Method: Five thousand (5,000) individuals, over the age of 15, were assessed in 16 capital cities, in the five regions of the country. The selection of households was random. Face-to-face approach was applied in the household interviews. The SF-12 questionnaire was used to assess quality of life. Demographic and socioeconomic characteristics were also evaluated: gender, age, marital status, skin color, region of the country and use of the public health service. Results: The mean value (SD) of the SF-12 for the entire population was 49.3 (8.7) for the physical component (PCS-12) and 52.7 (9.7) for the mental component (MCS-12). Statistical differences were found for gender (PCS-12 and MCS-12), age (PCS-12) and working status (PCS-12 and MCS-12). Women, elderly, widowed and unemployed individuals, those with lower income and with complaints in the last seven days showed lower mean values (PCS-12 and MCS-12). Conclusion: From this point forward, we can provide the basis for comparisons with future research that use the SF-12 for quality of life assessment in Brazil. The Brazilian population has a lower degree of quality of life related do the physical component, and the SF-12 is a useful and discriminative instrument for assessing quality of life in different socio-demographic groups.
- Coronary atherosclerotic burden assessed by SYNTAX scores and outcomes in surgical, percutaneous or medical strategies: a retrospective cohort study(2022) SCUDELER, Thiago Luis; FARKOUH, Michael E.; HUEB, Whady; REZENDE, Paulo C.; CAMPOLINA, Alessandro G.; MARTINS, Eduardo Bello; GODOY, Lucas C.; SOARES, Paulo Rogerio; RAMIRES, Jose A. F.; FILHO, Roberto KalilIntroduction Coronary atherosclerotic burden and SYNTAX Score (SS) are predictors of cardiovascular events. Objectives To investigate the value of SYNTAX scores (SS, SYNTAX Score II (SSII) and residual SYNTAX Score (rSS)) for predicting cardiovascular events in patients with coronary artery disease (CAD). Design Retrospective cohort study. Setting Single tertiary centre. Participants Medicine, Angioplasty or Surgery Study database patients with stable multivessel CAD and preserved ejection fraction. Interventions Patients with CAD undergoing coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI) or medical treatment (MT) alone from January 2002 to December 2015. Primary and secondary outcomes Primary: 5-year allcause mortality. Secondary: composite of all-cause death, myocardial infarction, stroke and subsequent coronary revascularisation at 5 years. Results A total of 1719 patients underwent PCI (n=573), CABG (n=572) or MT (n=574) alone. The SS was not considered an independent predictor of 5-year mortality in the PCI (low, intermediate and high SS at 6.5%, 6.8% and 4.3%, respectively, p=0.745), CABG (low, intermediate and high SS at 5.7%, 8.0% and 12.1%, respectively, p=0.194) and MT (low, intermediate and high SS at 6.8%, 6.9% and 6.5%, respectively, p=0.993) cohorts. The SSII (low, intermediate and high SSII at 3.6% vs 7.9% vs 10.5%, respectively, p<0.001) was associated with a higher mortality risk in the overall population. Within each treatment strategy, SSII was associated with a significant 5-year mortality rate, especially in CABG patients with higher SSII (low, intermediate and high SSII at 1.8%, 9.7% and 10.0%, respectively, p=0.004) and in MT patients with high SSII (low, intermediate and high SSII at 5.0%, 4.7% and 10.8%, respectively, p=0.031). SSII demonstrated a better predictive accuracy for mortality compared with SS and rSS (c-index=0.62). Conclusions Coronary atherosclerotic burden alone was not associated with significantly increased risk of all-cause mortality. The SSII better discriminates the risk of death.
- Expansion of morbidity: trends in healthy life expectancy of the elderly population(2014) CAMPOLINA, Alessandro Goncalves; ADAMI, Fernando; SANTOS, Jair Licio Ferreira; LEBRAO, Maria LuciaObjective: to analyze the changes in life expectancy (LE) and disability-free life expectancy (DFLE) in Sao Paulo's elderly population to assess the occurrence of compression or expansion of morbidity, between 2000 and 2010. Methods: cross-sectional and population survey, based on official data for the city of Sao Paulo, Brazil, and data obtained from the Health, Well-Being and Aging Survey (SABE). Functional disability was defined as difficulty in performing at least one basic activity of daily living. The Sullivan method was used to calculate LE and DFLE for the years 2000 to 2010. Results: from 2000 to 2010, there was an increase in disabled life expectancy (DLE) in all age groups and both sexes. The proportion of years of life free of disability, at 60 years of age, decreased from 57.94% to 46.23% in women, and from 75.34% to 63.65% in men. At 75 years of age, this ratio decreased from 47.55% to 34.54% in women, and from 61.31% to 56.01% in men. Conclusion: the expansion of morbidity is an ongoing process in the elderly population of the municipality of Sao Paulo, in the period of 2000-2010. These results can contribute to the development of preventive strategies and planning of adequate health services to future generations of seniors.
- Integrated care pathway for rectal cancer treatment: health care resource utilization, costs, and outcomes(2017) KOBAYASHI, Silvia T.; DIZ, Maria D. P. E.; CAMPOLINA, Alessandro G.; SOAREZ, Patricia C. De; RIBEIRO JR., Ulysses; NAHAS, Sergio C.; VASCONCELOS, Karina G. M. C.; CAPARELI, Fernanda; CECCONELLO, Ivan; HOFF, Paulo M.Aim: Managed Flow C20 (MFC20) is an integrated care pathway (ICP) for rectal cancer implemented at a public teaching hospital. This study aims to quantify resource utilization and estimate direct costs and outcomes associated with the use of this ICP. Methods: We evaluated consecutive rectal cancer patients treated with neoadjuvant chemoradiotherapy (nCRT) followed by surgery, comparing the period before the ICP implementation (Pre-MFC20 group) and after (MFC20 group). We assessed times between treatment steps and quantified the resources utilized, as well as their costs. Results: There were 112 patients in the Pre-MFC20 group and 218 in the MFC20 group. The mean treatment intervals were significantly shorter in the MFC20 group-from the first medical consultation to nCRT (48.3 vs. 87.5 days; P< 0.001); and from nCRT to surgery (14.8 vs. 23.0 weeks; P< 0.001) -as was the mean total treatment time (192.0 vs. 290.2 days; P< 0.001). Oncology consultations, computed tomography, MRI, and radiotherapy sessions were utilized more frequently in the Pre-MFC20 group (P< 0.001). The median per-patient cost was US$ 11 180.92 in the Pre-MFC20 group, compared with US$ 10 412.88 in the MFC20 group (P = 0.125). Daily hospital charges and consultations were the major determinants of the total cost of the treatment. There was no statistical difference in overall survival in the time periods examined. Conclusion: : Implementation of a rectal cancer ICP reduced all treatment intervals and promoted rational utilization of oncology consultations and imaging, without increment in per-patient costs or detrimental effects in overall survival.
- Quality of life evaluation of frail elderly in Campinas, Sao Paulo(2015) VARELA, Flavia Regina de Andrade; CICONELLI, Rozana Mesquita; CAMPOLINA, Alessandro Goncalves; SOAREZ, Patricia Coelho deObjective: describe the quality of life of frail elderly assisted by the Centro de Referencia a Saude do Idoso (CRI), Campinas, Sao Paulo, Brazil. Methods: the convenience sample included 122 frail elderly being treated from January 2010 to July 2011, out of a total of 668 frail elderly who were referred to the CRI after application of the brief evaluation form of the elderly, recommended by Ministry of Health, which identifies the elderly with some degree of frailty. Descriptive observational study collected data through sociodemographic questionnaire and quality of life questionnaires: WHOQOL-BREF, WHOQOL-OLD and SF-36. Results: the study included 122 frail elderly. Of these, 74.6% (91) were female, mean age 73 years, 46.7% (57) were married, 51.6% (63) had less than 3 years of schooling and 87.7% (107) reported income of one to four minimum wages. The mean total score of the WHOQOL-BREF was 56.6, the WHOQOL-OLD 57.6 and SF-36 Physical Component Summary 34.5 and Mental Component Summary 43.6. Conclusion: knowledge of the impairment profile of quality of life among frail elderly is, therefore, essential for planning health care to this population.
- Value-based medicine in oncology: the importance of perspective in the emerging value frameworks(2018) CAMPOLINA, Alessandro GonçalvesRecently, professional and healthcare-related entities have launched frameworks designed to assess the value of cancer innovations in multistakeholder decision processes. Among the most visible entities that propose and implement value frameworks in oncology are the European Society of Medical Oncology (ESMO), the American Society of Clinical Oncology (ASCO), the Memorial Sloan Kettering Cancer Center (MSKCC) and the National Comprehensive Cancer Network (NCCN). However, these value frameworks have been criticized for conceptual inconsistencies, inability to include a greater variety of value criteria, and inadequate explanation of the uncertainty approach used in the modeling process. On the other hand, Multi-Criteria Decision Analysis (MCDA) is a set of methods and processes that allow the multiple criteria involved in a decision to be explicitly addressed. This approach allows the identification of relevant decision criteria, gathering of evidence based on scientific literature, attribution of weights to the criteria and scores to the evidence raised, and aggregation of the weighted scores to constitute a global metric of value. The purpose of this article is to review the main features of these value frameworks in oncology and the importance of perspective for framework readiness to support healthcare decision-making based on MCDA methodology.
- Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model framework(2019) KOBAYASHI, Silvia Takanohashi; CAMPOLINA, Alessandro Goncalves; DIZ, Maria del Pilar Estevez; SOAREZ, Patricia Coelho deBACKGROUND: Management of rectal cancer has become more complex with multimodality therapy (neoadjuvant chemoradiotherapy and surgery) and this has led to the need to organize multidisciplinary teams.The aim of this study was to report on the planning, implementation and evaluation of an integrated care pathway for neoadjuvant treatment of middle and lower rectal cancer. DESIGN AND SETTING: This was a cross-sectional post-implementation study that was carried out at a public university cancer center. METHODS:The Framework for Program Evaluation in Public Health of the Centers for Disease Control and Prevention (CDC) was used to identify resources and activities; link results from activities and outcomes with expected goals; and originate indicators and outcome measurements. RESULTS:The logic model identified four activities: stakeholders' engagement, clinical pathway development, information technology improvements and training programs; and three categories of outcomes: access to care, effectiveness and organizational outcomes. The measurements involved 218 patients, among whom 663% had their first consultation within 15 days after admission; 75.2% underwent surgery < 14 weeks after the end of neoadjuvant treatment and 72.7% completed the treatment in < 189 days. There was 100% adherence to the protocol for the regimen of 5-fluorouracil and leucovorin. CONCLUSIONS: The logic model was useful for evaluating the implementation of the integrated care pathways and for identifying measurements to be made in future outcome studies.
- Spiritual needs among hospitalized patients at a public hospital in Brazil: a cross-sectional study(2023) HIDALGO FILHO, Cassio Murilo Trovo; FREITAS, Ana Julia Aguiar de; ABREU, Lucas Salviano de; SANTIAGO, Hendrio Reginaldo; CAMPOLINA, Alessandro GoncalvesBACKGROUND: The relationship between spirituality and health has been the object of growing discus-sion. There is a lack of data on spiritual needs assessments in Brazil.OBJECTIVE: This study aimed to assess the spiritual needs of patients admitted to a public tertiary hospital and perform a comparative analysis between patients with and without indications for palliative care.DESIGN AND SETTING: A cross-sectional observational study included patients hospitalized between August and December 2020 in Hospital do Servidor Publico Municipal, Sao Paulo, Brazil. METHODS: The included patients answered a questionnaire consisting of sociodemographic data, the Duke religiosity scale, and the Spiritual Needs Assessment for Patients (SNAP) tool for a spiritual needs assessment. The World Health Organization Palliative Needs tool (NECPAL) was used to evaluate the indi-cations for palliative care. The level of significance adopted was 5%.RESULTS: A total of 66 patients were included in this study. Most participants (97%) declared themselves as belonging to a religion. The group without indication for palliative care by the NECPAL showed greater spiritual (P = 0.043) and psychosocial needs (P = 0.004). No statistically significant difference was observed in the religious needs domain (P = 0.176). There were no statistically significant differences in the Duke scale scores between the two groups.CONCLUSION: Spiritual, psychosocial, and religious needs are prevalent among hospitalized patients, and multidisciplinary teams must consider these needs in their management approach. In addition, this study suggests that psychosocial and spiritual needs can be even higher in patients who do not receive pallia-tive care.
- Simple but not simpler: a systematic review of Markov models for economic evaluation of cervical cancer screening(2018) VISCONDI, Juliana Yukari Kodaira; FAUSTINO, Christine Grutzmann; CAMPOLINA, Alessandro Goncalves; ITRIA, Alexander; SOAREZ, Patricia Coelho deThe aim of this study was to critically evaluate the quality of the models used in economic evaluations of screening strategies for cervical cancer prevention. We systematically searched multiple databases, selecting model-based full economic evaluations (cost-effectiveness analyses, cost-utility analyses, and cost-benefit analyses) of cervical cancer screening strategies. Two independent reviewers screened articles for relevance and performed data extraction. Methodological assessment of the quality of the models utilized formal checklists, and a qualitative narrative synthesis was performed. Thirty-eight articles were reviewed. The majority of the studies were conducted in high-income countries (82%, n=31). The Pap test was the most used screening strategy investigated, which was present in 86% (n=33) of the studies. Half of the studies (n=19) used a previously published Markov model. The deterministic sensitivity analysis was performed in 92% (n=35) of the studies. The mean number of properly reported checklist items was 9 out of the maximum possible 18. Items that were better reported included the statement of decision problem, the description of the strategies/comparators, the statement of time horizon, and information regarding the disease states. Compliance with some items of the checklist was poor. The Markov models for economic evaluation of screening strategies for cervical cancer varied in quality. The following points require improvement: 1) assessment of methodological, structural, heterogeneity, and parameter uncertainties; 2) model type and cycle length justification; 3) methods to account for heterogeneity; and 4) report of consistency evaluation (through calibration and validation methods).