Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.

BACKGROUND: Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015

Evidencia científica y gestión del conocimiento

La generación de conocimiento científico y la difusión de los resultados de investigación son tareas fundamentales aunque no suficientes para alcanzar una atención sanitaria adecuada. Uno de los principales retos a los que se enfrentan los servicios de salud se refiere a las dificultades para aplicar de manera sistemática la mejor evidencia científica disponible. En este contexto, la “transferencia del conocimiento” (en inglés, knowledge translation) sería el proceso dinámico que puede contribuir a la utilización de la evidencia científica en los procesos de toma de decisiones. Sin embargo, existen diversos factores que contribuyen a dificultar que se observen en la práctica los efectos esperados de las intervenciones sanitarias

Principios básicos de Evaluación Económica de Intervenciones Sanitarias

The objective of this article is to present the general concepts associated with economic evaluations of health interventions. These elements are part of the basic information that must be present in any study and, therefore, should be considered when designing or interpreting any evaluation. Likewise, the article focuses on the objective pursued by this type of analyses, which is none other than to provide information, focused on the dimension of efficiency (cost-effectiveness), in the decision-making processes.El objetivo de este artículo es presentar los conceptos generales asociados a los estudios de evaluación económica de intervenciones sanitarias. Dichos elementos forman parte de la información básica que debe estar presente en cualquier estudio y, por tanto, deben ser tenidos en cuenta a la hora del diseño o la interpretación de cualquier evaluación. Asimismo, se incide en el objeto que persiguen este tipo de análisis, que no es otro sino aportar información, centrada en la dimensión de la eficiencia (coste-efectividad), en los procesos de toma de decisiones

Vaccination coverage, beliefs, and attitudes in transplanted children and adolescents: a mixed-methods systematic review

[ES] Objetivo: Las enfermedades infecciosas prevenibles mediante vacunación son una causa de morbilidad y mortalidad en niños trasplantados. El objetivo principal de este estudio fue sintetizar la evidencia disponible de la cobertura vacunal en niños y adolescentes candidatos o receptores de trasplante y analizar las creencias, actitudes y experiencias acerca de la vacunación. Metodos: Se realizó una revisión sistemática de métodos mixtos (registro Open Science Framework: https://osf.io/auqn3/). Se llevaron a cabo búsquedas en PubMed/MEDLINE, EMBASE, IBECS y LILACS (desde enero de 2000 hasta agosto de 2021) y en literatura gris. Los estudios cuantitativos y cualitativos informaron sobre cobertura, creencias, actitudes y/o experiencias con respecto a cualquier vacuna recomendada en niños candidatos o receptores de trasplante de órganos sólidos y/o progenitores hematopoyéticos. Se evaluó la calidad metodológica mediante la herramienta MMAT (Mixed Methods Appraisal Tool). Se llevó a cabo una síntesis narrativa de los estudios. Resultados: Se incluyeron treinta y dos estudios disponibles en treinta y cinco publicaciones. Las intervenciones más estudiadas fueron las vacunas frente a sarampión (n=21; 66%) y hepatitis B (n=20; 62%). Las tasas de inmunización mostraron una alta variabilidad para las vacunas más representadas (concretamente, 2%-100% en sarampión, 0,4%-100% en hepatitis B, difteria-tétanos-tosferina y rubeola), con coberturas inferiores al 90% en al menos el 70% de los estudios. Los valores más bajos se registraron en situación postrasplante y trasplante de progenitores hematopoyéticos. Sólo se identificó un estudio cualitativo que incluyó información sobre creencias y/o actitudes, aunque nueve estudios cuantitativos exploraron aspectos cognitivos. Conclusiones: Esta revisión muestra una elevada variabilidad en la cobertura vacunal de niños candidatos o receptores de trasplante, con cifras generalmente inferiores a las recomendadas. Sería necesario desarrollar más estudios que contribuyan a identificar creencias y actitudes sobre inmunización en este contexto. [EN] Objective: Vaccine-preventable infectious diseases are a cause of morbidity and mortality in transplanted children. The main objective of this study was to synthesize the available evidence of vaccination coverage in children and adolescents who are candidates or transplant recipients and to analyze beliefs, attitudes, and experiences about vaccination. Methods: A mixed-methods systematic review was performed (Open Science Framework registration: https://osf.io/auqn3/). Searches were conducted in PubMed/MEDLINE, EMBASE, IBECS and LILACS (from January 2000 to August 2021) and in gray literature. Quantitative and qualitative studies reported information on coverage, beliefs, attitudes and/or experiences about recommended vaccines in children who are candidates or recipients of solid organ or hematopoietic progenitor transplantation. Quality assessment was undertaken using Mixed Methods Appraisal Tool (MMAT). A narrative synthesis of the studies was carried out. Results: A total of thirty-two studies in thirty-five publications were included. The most studied interventions were vaccines against measles (n=21; 66%) and hepatitis B (n=20; 62%). Vaccination rates showed a high variability for the most represented vaccines (specifically, 2%-100% for measles, 0.4%-100% for hepatitis B, diphtheria-tetanus-pertussis and rubella), with coverages lower than 90% in at least 70% of the studies. The lowest rates were reported in post-transplantation and hematopoietic stem cell transplantation. Only one qualitative study was identified reporting information on beliefs and/or attitudes, although nine quantitative studies explored cognitive aspects. Conclusions: This review shows a high variability in vaccination coverage in children and adolescents who are transplant candidates or recipients, with rates lower than those recommended. Further studies would be needed to identify beliefs and attitudes about immunization in this context.S

Salvando la brecha (“GAPS”) entre el conocimiento y la acción

Con este editorial queremos dar la bienvenida a la Revista de Gobierno, Administración y Políticas de Salud (GAPS), así como formular algunas reflexiones sobre la importancia del espacio existente entre el conocimiento y la acción, y la necesidad de contribuir a tender puentes que permitan mejorar las competencias relevantes para gobernar los sistemas de salud hacia mejoras efectivas de su desempeño

Promotion of public access and share of raw data from scientific research

Editorial.Plan Nacional de I + D + i, 2012, del Ministerio de Economía y Competitividad. Fundación Mapfre, convocatoria 2012.Peer Reviewe

The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: protocol for a systematic review and network meta-analysis of randomized controlled trials

[Background] Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of children and adolescents, with a significant impact on health services and the community in terms of economic and social burdens. The objective of this systematic review will be to evaluate the comparative efficacy and safety of pharmacological and non-pharmacological treatments in children and adolescents with ADHD.[Methods] Searches involving PubMed/MEDLINE and the Cochrane Database of Systematic Reviews will be used to identify related systematic reviews and relevant randomized trials. Search results will be supplemented by reports from the regulatory and health technology agencies, clinical trials registers and by data requested from trialists and/or pharmaceutical companies. We will consider studies evaluating pharmacological interventions (e.g. stimulants, non-stimulants, antidepressants), psychological interventions (e.g. behavioural interventions, cognitive training and neurofeedback) and complementary and alternative medicine interventions (e.g. dietary interventions, supplement with fatty acids, vitamins, minerals, aminoacids, herbal treatment, homeopathy, and mind-body interventions including massage, chiropractic, acupuncture, yoga, meditation, Tai chi). Eligible control conditions will be placebo, waitlist, no treatment and usual care. Randomized controlled trials of a minimum of 3 weeks duration will be included. The primary outcomes of interest will be the proportion of patients who responded to treatment and who dropped out of the allocated treatment, respectively. Secondary outcomes will include treatment discontinuation due to adverse events, as well as the occurrences of serious adverse events and specific adverse events (decreased weight, anorexia, insomnia and sleep disturbances, anxiety, syncope and cardiovascular events). Two reviewers will independently screen references identified by the literature search, as well as potentially relevant full-text articles in duplicate. Data will be abstracted and risk of bias will be appraised by two team members independently. Conflicts at all levels of screening and abstraction will be resolved through discussion. Random-effects pairwise meta-analyses and Bayesian network meta-analyses will be conducted where appropriate. .[Discussion] This systematic review and network meta-analysis will compare the efficacy and safety of treatments used for ADHD in children and adolescents. The findings will assist patients, clinicians and healthcare providers to make evidence-based decisions regarding treatment selection.Specific funding is provided by the Alicia Koplowitz Foundation (2014 to 2016). RT-S is supported by the Spanish Psychiatric Research Network, Spanish Ministry of Science and Innovation (CIBERSAM). ADM is partially funded by grant number R24 AT001293 from the National Center for Complementary and Alternative Medicine (NCCAM) of the US National Institutes of Health. DM is funded by a University of Ottawa Research Chair

Coauthorship and Institutional Collaborations on Cost-Effectiveness Analyses: A Systematic Network Analysis

Background: Cost-Effectiveness Analysis (CEA) has been promoted as an important research methodology for determining the efficiency of healthcare technology and guiding medical decision-making. Our aim was to characterize the collaborative patterns of CEA conducted over the past two decades in Spain. Methods and Findings: A systematic analysis was carried out with the information obtained through an updated comprehensive literature review and from reports of health technology assessment agencies. We identified CEAs with outcomes expressed as a time-based summary measure of population health (e.g. quality-adjusted life-years or disabilityadjusted life-years), conducted in Spain and published between 1989 and 2011. Networks of coauthorship and institutional collaboration were produced using PAJEK software. One-hundred and thirty-one papers were analyzed, in which 526 authors and 230 institutions participated. The overall signatures per paper index was 5.4. Six major groups (one with 14 members, three with 7 members and two with 6 members) were identified. The most prolific authors were generally affiliated with the private-for-profit sector (e.g. consulting firms and the pharmaceutical industry). The private-for-profit sector mantains profuse collaborative networks including public hospitals and academia. Collaboration within the public sector (e.g. healthcare administration and primary care) was weak and fragmented. Conclusions: This empirical analysis reflects critical practices among collaborative networks that contributed substantially to the production of CEA, raises challenges for redesigning future policies and provides a framework for similar analyses in other regions