Apresentação realizada em Oslo - Noruega, 2015.

1. Mapping
the
Stakeholder’s
Opinion
of
Priori5sa5on
Criteria
for
Early
Awareness
and
Alert
System
in
Brazil
A
NASCIMENTO,
AT
VIDAL,
CC
OTTO,
RT
ALMEIDA
1
Programa
de
Engenharia
Biomédica,
COPPE,
Universidade
Federal
do
Rio
de
Janeiro,
Rio
de
Janeiro.
2
Departamento
de
Gestão
e
Incorporação
de
Tecnologias
em
Saúde,
Secretaria
de
Ciência,
Tecnologia
e
Insumos
Estratégicos,
Ministério
da
Saúde,
Brasília,
Brasil
INTRODUCTION
A
Horizon
Scanning
System
(HSS)
on
new
and
emerging
technologies
may
help
to
foresee
the
most
relevant
technologies
to
be
prioriXsed
for
the
Brazilian
Unified
Health
System
(SUS,
in
Portuguese).
FiltraXon
and
prioriXsaXon
are
two
basics
steps
of
a
HSS.
Therefore,
the
definiXon
of
criteria
for
these
two
steps
should
be
done
with
the
involvement
of
different
stakeholder
to
increase
transparency
and
adherence
for
a
HSS.
This
paper
aimed
to
map
the
preferences
of
the
SUS’s
stakeholders
regarding
the
filtraXon
and
prioriXsaXon
criteria.
RESULTS
Searching
the
literature
and
websites
of
HSS
agencies,
four
filtraXon
and
sixteen
prioriXsaXon
criteria
were
selected.
Those
criteria
were
discussed
by
22
strategic
stakeholders
who
were
divided
into
five
groups
in
a
workshop.
Each
parXcipant
chose
the
10
most
relevant
prioriXsaXon
criteria
followed
by
a
group
discussion
to
reach
the
group
opinion.
The
criteria
that
were
chosen
by
four
of
the
five
groups
were
taken
as
the
final
ones.
Finally,
all
groups
decided
to
combine
three
of
the
criteria,
remaining
only
eight.
The
MulXple
Correspondence
Analysis
(MCA)
method
was
applied
to
map
the
preference
within
and
between
groups.
The
method
displays
the
stakeholder`s
opinion
in
a
two
or
more
dimensions,
which
are
associated
with
the
criteria
that
most
discriminated
their
opinions.
METHODS
Figure
1
shows
the
posiXon
of
the
stakeholders
and
their
groups
on
a
two
dimensional
map
that
explains
70.3
%
of
variability
of
the
opinions.
Despite
divergent
views
among
the
stakeholders,
two
groups
(A
and
D)
showed
more
coherence
and
tend
to
have
more
influence
in
the
choice
of
eight
final
criteria.
Other
groups
did
not
show
a
similar
opinion
between
their
stakeholders.
However,
part
of
the
groups
B
and
E
considered
the
cost
of
the
technology
one
of
the
most
important
criterion.
Legend:
Group
A
–
blue;
Group
B
–
green;
Group
C
–
gray;
Group
D
–
violet;
Group
E
–
orange
Figure
1:
Correspondence
Map
of
Stakeholder's
Opinions.
-0.1 0.0 0.1 0.2
-0.2-0.10.00.1
G1=blue, G2=green, G3=gray, G4=violet, G5=orange
Dim1 (65,94%)
Dim2(20,56%)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16 17
18
19
20
21
22
Dimension
1
(variability
=
46.8%)
Dimension
2
(variability
=
23.5
%)
Figure
2:
ContribuXon
(%)
of
the
16
criteria
to
the
total
variability
of
each
dimension.
Legend:
CP
–
PotenXal
impact
on
costs
for
paXents;
CS
–
PotenXal
impact
on
providers'
cost;
Csoc
–
PotenXal
impact
on
costs
for
society;
DI
–
PotenXal
for
inappropriate
diffusion;
DS
–
PotenXal
impact
on
service
performance;
LES
–
Legal,
ethical
and
social
impact;
MB
–
PotenXal
impact
on
morbidity;
MT
–
PotenXal
impact
on
mortality;
PC
–
Changes
in
clinical
pracXce;
Prio
–
Health
policy
relevance;
QV
–
PotenXal
impact
on
the
quality
of
life;
R
–
Available
evidence.
Rep
–
Epidemiological
relevance;
Rtec
–
Clinical
pracXce
relevance;
SB
–
PotenXal
impact
on
paXent
survival;
SG
–
Safety;
0 5 10 15 20
05101520
Dimension 1 (%)
Dimension2(%)
Rep
Prio
MT
MB
QV
SB
DS
RTec
DI
CP
Csoc
CS
PC
R
SG
LES
Dimension
1
(%)
Dimension
2
(%)

2. EPOSTERBOARDS
TEMPLATE
RESULTS
The
MCA
was
carried
out
with
all
16
prioriXsaXon
criteria
proposed
to
the
stakeholders
in
the
selecXon
process
of
priorisaXon
criteria.
Figure
2
shows
the
contribuXon
of
those
prioriXsaXon
criteria
to
the
total
variability
of
dimension
1
and
2
(axis).
The
criteria
with
the
greatest
contribuXon
for
the
dimension
1
were
R
and
Rtec,
reflecXng
the
importance
of
the
technology
anributes
related
to
scienXfic
evidence
available
and
the
epidemiological
relevance,
respecXvely.
On
the
other
hand,
for
dimension
2
the
criteria
with
the
highest
contribuXon
reflected
anributes
concerning
the
impact
of
technology
on
the
paXent’s
life
(SB,
QV
and
LES).
In
Brazil,
the
HSS
is
in
the
iniXal
stage
and
the
involvement
of
SUS’s
stakeholders
is
strategic
to
design
an
effecXve
system,
as
well
as
reducing
the
stakeholder’s
resistance.
This
approach
allows
the
client
of
the
HSS
to
analyse
the
stakeholder’s
individual
opinions
and
to
increase
the
transparency
of
the
process.
To
CoordinaXon
for
the
Improvement
of
Higher
EducaXon
Personnel
(CAPES)
for
the
first
author
scholarship
and
to
the
grant
from
Agreement
Lener
OPAS-­‐OMS
(SCTIE-­‐MS)/
Fundação
Coppetec
BR/LOA/1200120.001.
Mapping
the
Stakeholder’s
Opinion
of
Priori5sa5on
Criteria
for
Early
Awareness
and
Alert
System
in
Brazil
A
NASCIMENTO,
AT
VIDAL,
CC
OTTO,
RT
ALMEIDA
1
Programa
de
Engenharia
Biomédica,
COPPE,
Universidade
Federal
do
Rio
de
Janeiro,
Rio
de
Janeiro.
2
Departamento
de
Gestão
e
Incorporação
de
Tecnologias
em
Saúde,
Secretaria
de
Ciência,
Tecnologia
e
Insumos
Estratégicos,
Ministério
da
Saúde,
Brasília,
Brasil
CONCLUSIONS
ACKNOWLEDGEMENTS
Two
filtraXon
criteria
selected
aser
the
groups
discussion:
• Time
Horizon
from
phase
II
or
III
of
clinical
trial;
• Innova5on
defined
as
totally
new
therapeuXc
opXon
or
when
compared
to
current
opXon
present
a
great
potenXal
of
efficacy
or
reduce
side
effects.
Eight
prioriXsaXon
criteria
selected
by
the
stakeholders:
• Epidemiological
relevance
(Rep);
• Clinical
pracXce
relevance
(RTec);
• Health
policy
relevance
(Prio);
• PotenXal
impact
on
the
SUS´s
budget
(O);
• PotenXal
impact
on
providers'
cost
(CS);
• PotenXal
impact
on
mortality
(MT);
• Safety
(SG);
• Legal,
ethical
and
social
impact
(LES).