PATRICIA COELHO DE SOAREZ

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Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina - Líder

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  • article 2 Citação(ões) na Scopus
    Systematic Review of Health Economic Evaluations of Diagnostic Tests in Brazil: How accurate are the results?
    (2017) OLIVEIRA, Maria Regina Fernandes; LEANDRO, Roseli; DECIMONI, Tassia Cristina; ROZMAN, Luciana Martins; NOVAES, Hillegonda Maria Dutilh; SOAREZ, Patricia Coelho De
    The aim of this study is to identify and characterize the health economic evaluations (HEEs) of diagnostic tests conducted in Brazil, in terms of their adherence to international guidelines for reporting economic studies and specific questions in test accuracy reports. We systematically searched multiple databases, selecting partial and full HEEs of diagnostic tests, published between 1980 and 2013. Two independent reviewers screened articles for relevance and extracted the data. We performed a qualitative narrative synthesis. Forty-three articles were reviewed. The most frequently studied diagnostic tests were laboratory tests (37.2%) and imaging tests (32.6%). Most were non-invasive tests (51.2%) and were performed in the adult population (48.8%). The intended purposes of the technologies evaluated were mostly diagnostic (69.8%), but diagnosis and treatment and screening, diagnosis, and treatment accounted for 25.6% and 4.7%, respectively. Of the reviewed studies, 12.5% described the methods used to estimate the quantities of resources, 33.3% reported the discount rate applied, and 29.2% listed the type of sensitivity analysis performed. Among the 12 cost-effectiveness analyses, only two studies (17%) referred to the application of formal methods to check the quality of the accuracy studies that provided support for the economic model. The existing Brazilian literature on the HEEs of diagnostic tests exhibited reasonably good performance. However, the following points still require improvement: 1) the methods used to estimate resource quantities and unit costs, 2) the discount rate, 3) descriptions of sensitivity analysis methods, 4) reporting of conflicts of interest, 5) evaluations of the quality of the accuracy studies considered in the cost-effectiveness models, and 6) the incorporation of accuracy measures into sensitivity analyses.
  • article 3 Citação(ões) na Scopus
    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.
  • article 0 Citação(ões) na Scopus
    The authors reply
    (2017) NOVAES, Hillegonda Maria Dutilh; SOAREZ, Patricia Coelho De
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    Impact of Early Referral for Palliative Care in the Use of Emergency Care for Patients with Advanced Cancer
    (2017) ROZMAN, L. M.; CAMPOLINA, A. G.; V, R. Lopez; CHIBA, T.; SOAREZ, P. C. De
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    HEALTHCARE UTILIZATION AND SURVIVAL ASSOCIATED WITH CLINICAL CARE PATHWAY FOR RECTAL CANCER TREATMENT
    (2017) CAMPOLINA, A. G.; KOBAYASHI, S. T.; SOAREZ, P. C.; DIZ, M. D.
  • article 11 Citação(ões) na Scopus
    Multi-criteria decision analysis for health technology resource allocation and assessment: so far and so near?
    (2017) CAMPOLINA, Alessandro Goncalves; SOAREZ, Patricia Coelho De; AMARAL, Fabio Vieira do; ABE, Jair Minoro
    Multi-criteria decision analysis (MCDA) is an emerging tool that allows the integration of relevant factors for health technology assessment (HTA). This study aims to present a summary of the methodological characteristics of MCDA: definitions, approaches, applications, and implementation stages. A case study was conducted in the Sao Paulo State Cancer Institute (ICESP) in order to understand the perspectives of decision-makers in the process of drafting a recommendation for the incorporation of technology in the Brazilian Unified National Health System (SUS), through a report by the Brazilian National Commission for the Incorporation of Technologies in the SUS (CONITEC). Paraconsistent annotated evidential logic Et was the methodological approach adopted in the study, since it can serve as an underlying logic for constructs capable of synthesizing objective information (from the scientific literature) and subjective information (from experts' values and preferences in the area of knowledge). It also allows the incorporation of conflicting information (contradictions), as well as vague and even incomplete information in the valuation process, resulting from imperfection of the available scientific evidence. The method has the advantages of allowing explicit consideration of the criteria that influenced the decision, facilitating follow-up and visualization of process stages, allowing assessment of the contribution of each criterion separately, and in aggregate, to the decision's outcome, facilitating the discussion of diverging perspectives by different stakeholder groups, and increasing the understanding of the resulting recommendations. The use of an explicit MCDA approach should facilitate conflict mediation and optimize participation by different stakeholder groups.
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    BUDGET IMPACT ANALYSIS OF VACCINES: WHAT ARE THE METHODOLOGICAL ISSUES?
    (2017) SOAREZ, P. C. De; SARTORI, A. M.; LEANDRO, R. F.; SILVA, D. R.; SOAREZ, D. S.; CAMPOLINA, A. G.; NOVAES, H. M.
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    A SISTEMATIC REVIEW OF THE COST-EFFECTIVENESS OF VACCINATING ELDERLY WITH THE 23-VALENT PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPV23)
    (2017) NISHIKAWA, A. M.; MAINARDI, G. M.; NOVAES, H. M.; SARTORI, A. M.; SOAREZ, P. C. De