Validation of a computerized decision support system to review pharmacotherapy treatment: scheduling guidelines.

BACKGROUND: The review of pharmacotherapy can be conceptualized as a service in which the drugs used by the patient are reviewed to control the risks as well as to improve the results of the drug therapy, detecting, solving, and preventing issues associated with the drug, readjusting the doses and times (schedule) so that the treatment is not incompatible or in duplicity. METHODS: The aim of the study was to validate an intelligent information system, which was developed to assist the scheduling activity in the pharmacotherapy review. The system used the concept of Genetic Algorithms. To validate the system, hypothetical cases were elaborated considering various aspects of pharmacotherapy such as underdose, overdose, drug interactions and contraindications. These cases were tested in the system and were also analyzed by pharmaceutical experts with clinical and research experience in the pharmacotherapy review process. The degree of agreement between the assessments of the appointments carried out by the pharmaceutical specialists and by the system were measured using the Kappa index with a 95% confidence interval. RESULTS: In detecting errors and make propositions, the system was able to identify 80% of errors, with pharmaceutical experts identifying between 20 and 70% of errors. In relation the results of kappa between the cases, the system had 87,3% of concordance, whereas the best pharmaceutical expert had 75,5% of concordance, considering the correct answer. CONCLUSION: It can be concluded that with the methodology used, the investigation met the objectives and confirmed the system is effective for pharmaceutical review process. There are indications that the system can help in the Pharmacotherapy review process, being able to find prescription errors as well as to establish times for the use of medications according to the patient's routine.

Internal construct validity of the Brazilian version of a tool for assessing the population's knowledge of human papillomavirus.

OBJECTIVE: To verify the internal construct validity of the Brazilian Portuguese version of a tool for measuring the general population's knowledge of human papillomavirus (HPV). MATERIALS AND METHODS: A cross-culturally adapted Brazilian Portuguese version of a measurement tool originally designed for English speaking populations was administered to 330 adults in Tubarão, Santa Catarina, Southern Brazil. After examining the overall suitability of the method, we performed investigations based on the item response theory and exploratory factor analysis. RESULTS: Ten of the 29 items presented a low contribution to the construct and were excluded from subsequent analysis. The factor analysis yielded three factors, which explained approximately 51% of the variance variability. A different arrangement from the original measurement tool was found: general HPV knowledge, with six items; HPV vaccination knowledge, with five items; HPV transmission and testing knowledge, with eight items. CONCLUSION: The Brazilian Portuguese version under study presented a different behavior from the original measurement tool, but proved to be a reliable and valid instrument in assessing the Brazilian population's knowledge about HPV.

Internal construct validity of the Brazilian version of a tool for assessing the population's knowledge of human papillomavirus / Validade interna do construto da versão brasileira de um instrumento para aferição do conhecimento sobre o papilomavírus humano

ABSTRACT: Objective: To verify the internal construct validity of the Brazilian Portuguese version of a tool for measuring the general population's knowledge of human papillomavirus (HPV). Materials and methods: A cross-culturally adapted Brazilian Portuguese version of a measurement tool originally designed for English speaking populations was administered to 330 adults in Tubarão, Santa Catarina, Southern Brazil. After examining the overall suitability of the method, we performed investigations based on the item response theory and exploratory factor analysis. Results: Ten of the 29 items presented a low contribution to the construct and were excluded from subsequent analysis. The factor analysis yielded three factors, which explained approximately 51% of the variance variability. A different arrangement from the original measurement tool was found: general HPV knowledge, with six items; HPV vaccination knowledge, with five items; HPV transmission and testing knowledge, with eight items. Conclusion: The Brazilian Portuguese version under study presented a different behavior from the original measurement tool, but proved to be a reliable and valid instrument in assessing the Brazilian population's knowledge about HPV.

RESUMO: Objetivo: Verificar a validade interna do construto da versão em português de uma ferramenta para aferir o conhecimento da população sobre o papilomavírus humano (HPV). Materiais e métodos: Uma versão brasileira transculturalmente adaptada de uma ferramenta de aferição de conhecimento sobre HPV originalmente projetada para ser utilizada em populações de língua inglesa foi aplicada a 330 adultos em Tubarão/SC, Brasil. Após examinar a adequação geral do método, foram realizadas análises baseadas na Teoria de Resposta ao Item e na Análise Fatorial Exploratória. Resultados: Dez dos 29 itens apresentaram baixa contribuição para o construto e foram excluídos das análises subsequentes. Três fatores foram gerados pela análise fatorial e explicaram aproximadamente 51% da variabilidade da variância. Um arranjo diferente em relação ao instrumento de medida original foi encontrado, baseado em: conhecimento geral do HPV, com seis perguntas; conhecimento sobre vacinação contra o HPV, com cinco perguntas; e conhecimento sobre transmissão e teste de HPV com oito perguntas. Conclusão: A versão brasileira em estudo apresentou um comportamento diferente da ferramenta de aferição original, mas demonstrou ser um instrumento confiável e válido para acessar o conhecimento da população brasileira sobre o HPV.

Preliminary stages of a cross-cultural Brazilian Portuguese adaptation of a measurement tool for assessing public understanding of human papillomavirus.

The objective of this study was to conduct the initial stages of the cross-cultural adaptation to Brazilian Portuguese of a scale to measure the level of knowledge about HPV. The stages included: translation from English into the Portuguese spoken in Brazil; synthesis of the translated version; back-translation; analysis by an expert committee; and reliability analysis based on internal consistency and reproducibility. Cronbach's α coefficient for the instrument was 0.985. Subset analysis produced only minor variations. The correlation coefficients between the individual items and the overall result showed strong positive correlations, except for three items. Reproducibility analysis showed kappa values with substantial or moderate agreement for the majority of the items. A preliminary Brazilian version was obtained with satisfactory results, but other stages are necessary in the process of validation of the Brazilian version.

Preliminary stages of a cross-cultural Brazilian Portuguese adaptation of a measurement tool for assessing public understanding of human papillomavirus / Etapas preliminares da adaptação transcultural para o Português de um intrumento de aferição do conhecimento sobre o papilomavírus humano / Etapas preliminares de una adaptación cultural al portugués de una herramienta de medición para evaluar la comprensión pública de virus del papiloma humano

Abstract: The objective of this study was to conduct the initial stages of the cross-cultural adaptation to Brazilian Portuguese of a scale to measure the level of knowledge about HPV. The stages included: translation from English into the Portuguese spoken in Brazil; synthesis of the translated version; back-translation; analysis by an expert committee; and reliability analysis based on internal consistency and reproducibility. Cronbach's α coefficient for the instrument was 0.985. Subset analysis produced only minor variations. The correlation coefficients between the individual items and the overall result showed strong positive correlations, except for three items. Reproducibility analysis showed kappa values with substantial or moderate agreement for the majority of the items. A preliminary Brazilian version was obtained with satisfactory results, but other stages are necessary in the process of validation of the Brazilian version.

Resumo: O objetivo deste artigo foi proceder às primeiras etapas de adaptação transcultural de um instrumento que mede o conhecimento sobre HPV para a língua portuguesa falada no Brasil. Foram realizadas a tradução inicial para o português brasileiro; síntese das versões traduzidas; retrotradução; análise por comitê de especialistas e análise de confiabilidade por intermédio da análise de consistência interna e de reprodutibilidade. O coeficiente α-Cronbach do instrumento foi estimado em 0,985. A análise por blocos implicou em pequenas variações. Os coeficientes de correlação entre cada questão e o resultado geral do instrumento mostraram correlações positivas fortes, com exceção de três questões. A análise de reprodutibilidade mostrou valores de kappa que evidenciaram concordâncias substanciais ou moderadas para a maioria das questões. Foi obtida uma primeira versão brasileira com resultados satisfatórios, mas outras etapas são necessárias ao processo de validação.

Resumen: El objetivo de este trabajo fue realizar las primeras etapas de la adaptación cultural un instrumento que mide los conocimientos sobre el VPH para el idioma portugués hablado en Brasil. Se realizó la traducción inicial para el portugués brasileño; síntesis de las versiones traducidas; retrotraducción; análisis por un Comité de Expertos y análisis de confiabilidad a través de la consistencia interna y reproducibilidad. El coeficiente α-Cronbach del instrumento se estimó en 0,985. El análisis por bloques resultó en variaciones menores. Los coeficientes de correlación entre cada ítem y el resultado general del instrumento mostraron fuertes correlaciones positivas, a excepción de tres ítems. El análisis de la reproducibilidad mostró valores del kappa con concordancias sustanciales o moderadas para la mayoría de los ítems. Fue obtenida una primera versión brasileña con resultados satisfactorios, pero otros pasos son necesarios para el proceso de validación.