Carlos Alfredo Loureiro

Propriedades psicométricas de indicador subjetivo aplicado em crianças

OBJECTIVE To evaluate the psychometric properties of the Oral Heath Impact Profile (OHIP-14) to measure oral health in children. METHODS The OHIP-14 questionnaire was applied to 312 schoolchildren aged 12 years residing in Sabará, Brazil, in 2001. OHIP-14s reliability was evaluated using Cronbachs alpha and correlation intraclass coefficient. For examining content validity, Pearsons correlation and logistic regression analysis were applied. For construct validity, Students t-test and Tukey-Kramer test were used. RESULTS Tooth loss among the subjects was low in this study (between 85% and 100%). Caries prevalence was very low and not detectable in 59.0% of the sample. The logistic regression model showed high predictive values for reporting treatment need and intermediate values for dental caries perception. The comparison between different OHIP average scores, according to the DMF-S indexs three categories of decayed, missing, filled surfaces, indicated significant difference only for the categories social disability and deficit. CONCLUSIONS The study results indicated that the adolescents did not report high prevalence of oral conditions. The OHIP was associated with perceived treatment need, reporting of dental caries and increased DMF-S index. These results suggest that the OHIP has good psychometric properties when applied to children and could be a promising instrument for screening priority care groups.

Custos para implantação e operação de serviço de saúde bucal na perspectiva do serviço e da sociedade

The aim of this study was to assess the costs of setting up and maintaining dental care in the public sector. Costs were updated or depreciated according to the services lifespan and were analyzed from the perspective of the service itself and society. According to the findings, for the service the total cost of setting up a dental care unit with seven rooms was BRL

Assessing the risk of bias in randomized controlled trials in the field of dentistry indexed in the Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) database

860.643.67 in the first year, plus BRL

Validity of Qualis database as a predictor of evidence hierarchy and risk of bias in randomized controlled trials: a case study in dentistry

545,419.23 for maintenance, and clinical dental care was the most expensive specialty. For society, the total cost was BRL

Pesquisa de avaliação da utilização de um método sistemático de mudança em um serviço de saúde bucal - BEPREM, MG

990,065.06 (implementation) and BRL

Revisões sistemáticas da literatura

668,369.55 (maintenance), and the most expensive specialty was prevention (US

Um estudo transcultural de valores de saúde bucal utilizando o instrumento OHIP-14 (Oral Health Impact Profile) na forma simplificada: parte I - adaptação cultural e linguística

1.00 = BRL

Oral appliances to prevent occupational accidents involving obstructive sleep apnea syndrome patients – a systematic review and meta-analysis

1.62). Capital costs represented a small percentage of total costs for a dental care unit, but they need to be considered, since they can modify the results. Due to the high costs, preventive and promotional interventions should not be performed in the clinical setting, but should be replaced by broader and less expansive population-based interventions, since considerable sums need to be spent by the low-income population to participate in free public programs.

Razão de custo-efetividade em saúde bucal na área pública sob a perspectiva do serviço e da sociedade

CONTEXT AND OBJECTIVE Well-conducted randomized controlled trials (RCTs) represent the highest level of evidence when the research question relates to the effect of therapeutic or preventive interventions. However, the degree of control over bias between RCTs presents great variability between studies. For this reason, with the increasing interest in and production of systematic reviews and meta-analyses, it has been necessary to develop methodology supported by empirical evidence, so as to encourage and enhance the production of valid RCTs with low risk of bias. The aim here was to conduct a methodological analysis within the field of dentistry, regarding the risk of bias in open-access RCTs available in the Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde) database. DESIGN AND SETTING This was a methodology study conducted at Universidade Federal de São Paulo (Unifesp) that assessed the risk of bias in RCTs, using the following dimensions: allocation sequence generation, allocation concealment, blinding, and data on incomplete outcomes. RESULTS Out of the 4,503 articles classified, only 10 studies (0.22%) were considered to be true RCTs and, of these, only a single study was classified as presenting low risk of bias. The items that the authors of these RCTs most frequently controlled for were blinding and data on incomplete outcomes. CONCLUSION The effective presence of bias seriously weakened the reliability of the results from the dental studies evaluated, such that they would be of little use for clinicians and administrators as support for decision-making processes.

Cost-effectiveness ratio of public oral care in the perspective of service and society

OBJECTIVE To evaluate the validity of the Qualis database in identifying the levels of scientific evidence and the quality of randomized controlled trials indexed in the Lilacs database. METHODS We selected 40 open-access journals and performed a page-by-page hand search, to identify published articles according to the type of study during a period of six years. Classification of studies was performed by independent reviewers assessed for their reliability. Randomized controlled trials were identified for separate evaluation of risk of bias using four dimensions: generation of allocation sequence, allocation concealment, blinding, and incomplete outcome data. The Qualis classification was considered to be the outcome variable. The statistical tests used included Kappa, Spearmans correlation, Kendall-tau and ordinal regressions. RESULTS Studies with low levels of scientific evidence received similar Qualis classifications when compared to studies with high levels of evidence. In addition, randomized controlled trials with a high risk of bias for the generation of allocation sequences and allocation concealment were more likely to be published in journals with higher Qualis levels. DISCUSSION The hierarchy level of the scientific evidence as classified by type of research design, as well as by the validity of studies according to the bias control level, was not correlated or associated with Qualis stratification. CONCLUSION Qualis classifications for journals are not an approximate or indirect predictor of the validity of randomized controlled trials published in these journals and are therefore not a legitimate or appropriate indicator of the validity of randomized controlled trials.