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EBM distance learning course to support judicial decisions on healthcare: a case study
  1. Carisi Anne Polanczyk1,2,
  2. Amanda Maciel de Quadros1,
  3. Andreia Turmina Fontanella1,
  4. Angélica Dutra Zanotto1,
  5. Fernanda d Athayde Rodrigues1,3,
  6. Denizar Araujo Vianna1,4,
  7. Cristiana Maria Toscano1,5,
  8. Rachel Riera6,7,
  9. Luiz Fernando Lima Reis8
  1. 1 Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre, Brazil
  2. 2 Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
  3. 3 Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
  4. 4 Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
  5. 5 Universidade Federal de Goias, Goiania, Brazil
  6. 6 Discipline of Evidence-based Medicine, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
  7. 7 Center of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil
  8. 8 Hospital Sirio-Libanes, Sao Paulo, Brazil
  1. Correspondence to Dr Fernanda d Athayde Rodrigues, Instituto de Avaliação de Tecnologia em Saúde, Porto Alegre 97017660, Brazil; fe.athayde{at}gmail.com

http://dx.doi.org/10.1136/bmjebm-2020-111551

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    Between 2008 and 2017, health-related legal demands have increased 130% in Brazil.1 In 2016, the 10 most expensive drugs that were legally required comprised 91% of the resources guaranteed for the acquisition of technologies by the Brazilian government.1 These drugs were intended for 1213 users of Brazilian Public Health System (SUS), which covers 140 million Brazilians. In this scenario, it has been necessary to adopt strategies to enhance the judicial process, ensuring evidence-informed judicial decisions.

    Through a broad project of the Brazilian Ministry of Health, formally named PROADI-SUS, a collaborative agreement has been established between Hospital Sírio-Libanês and the National Council of Justice since 2016. The collaboration was consolidated with the implementation of a set of initiatives for supporting the judicial process in healthcare, including a free EBM distance course for health and law professionals, who provide scientific and technical support on health issues for the judiciary departments (table 1).

    View this table:
    Table 1

    Characteristics and details of the EBM distance course for health and law professionals in Brazil

    The first edition of the course was launched in May 2018 and its content was conceived along with the Instituto Nacional de Ciência e Tecnologia/Instituto de Avaliação de Tecnologias em Saúde, and counted with pedagogical support from specialists in distance teaching/learning methods. The content and support materials remained available for consultation and download. The chats and web conferences were recorded and uploaded on the learning online platform for access on demand.

    Table 2 presents the preliminary data from the participants of the three editions carried out to date. Detailed analyses of approval and withdraw rates, test results as well as information on participant satisfaction are underway.

    View this table:
    Table 2

    Preliminary data from participants of the EBM distance course

    It is important to point out that the fundamental aim of the set of initiatives that includes this EBM course is to optimise the judicial decision-making process and not directly reduce the number of judicial proceedings. Indeed, the set of initiatives in itself already represents a process of awareness raising on the relevance of evidence-based decision-making in the judicial area as well. contributing to a decision that provides technologies that clearly work and are safe to the detriment of those that are ineffective, harmful or have uncertain efficacy/safety.

    By reporting this study case, we have presented a teaching strategy to disseminate EBM concepts among legal professionals reinforcing that EBM may assume a pivotal role in promoting the sustainability of a public health system. Similar strategies can be adopted by other countries that also have a burden of legal proceedings in healthcare.

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    Reference

    1. ↵
      1. Conselho Nacional de Justiça - CNJ
      . [Judicialização da Saúde no Brasil: Perfil das demandas, causas e propostas de solução], 2019. Available: https://static.poder360.com.br/2019/03/relatorio-judicializacao-saude-Insper-CNJ.pdf [Accessed 16 Aug 20200].

    Footnotes

    • CAP, DAV, RR and LFLR are joint senior authors.

    • Twitter @RieraRachel

    • Contributors Conception and design: CAP, CMT, DAV, LFLR. Data collection: AMdQ, ATF, ADZ, FdAR. Manuscript draft: CAP, FdAR, AMdQ, ADZ. Content revisor: CAP, DAV, CMT, RR, LFLR. Final approval: all authors.

    • Funding This study was supported by the Brazilian Ministry of Health through the Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS Program), led by Hospital Sírio- Libanês, São Paulo, Brazil.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.