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Carlos Alberto da Silva Magliano,1 Andrea Libório Monteiro,2 Amanda Rebeca de Oliveira Rebelo,1 Claudia Cristina de Aguiar Pereira31Instituto Nacional de Cardiologia, INC, Rio de Janeiro, Brazil; 2Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Illinois, USA; 3Escola Nacional de Saúde Pública, ENSP, FIOCRUZ, Rio de Janeiro, BrazilAims: Guidelines current recommendations regarding the best treatment option for coronary revascularization are usually based on composite outcomes that were not selected or weighed with patients thence they may fail in representing patients’ preferences adequately. This systematic review aimed to appraise existing literature surrounding stated preference (SP) regarding coronary revascularization.Methods and results: Studies related to SP regarding coronary revascularization were searched on Medline, Embase and Lilacs databases. Two reviewers screened all titles independently, and consensus resolved any disagreements. Of 735 total citations, six studies were included and qualitatively synthesized. Notably, the attributes most often cited in these studies coincided with those already used in clinical trials (death, myocardial infarction, stroke and redo revascularization). Half of the studies analyzed the use of composite endpoints and showed the necessity to review this practice since the attributes are weighed differently, and there is a disagreement between patients and physicians. Also, a large variety of methods were used to elicitate and value the attributes such as rating, ranking, standard gamble, willingness to pay, and discrete choice experiments.Conclusion: Despite a large number of studies comparing revascularization treatment efficacy, there are just a few focusing on patients’ preferences. The selection of outcomes to be considered in the trade-off between treatment options and how to weigh them properly, taking into consideration patients’ preferences, need to be explored in future trials.Keywords: review, systematic, preference, patient, angioplasty, transluminal, percutaneous coronary, bypass surgery, coronary revascularization

Carlos Alberto da Silva Magliano,1 Andrea Liborio Monteiro,2 Bernardo Rangel Tura,1 Claudia Silvia Rocha Oliveira,1 Amanda Rebeca de Oliveira Rebelo,1 Claudia Cristina de Aguiar Pereira3 1HTA Department, National Institute of Cardiology, Rio de Janeiro, Brazil; 2Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA; 3The National School of Public Health Sergio Arouca ENSP/Fiocruz, Rio de Janeiro, Brazil Background: Patients with a diagnosis of coronary artery disease (CAD) may face important decisions regarding treatment options, with the “right choice” depending on the relative weights of risks and benefits. Studies performed as discrete choice experiments are used to estimate these weights, and attribute selection is an essential step in the design of these studies. Attributes not included in the design cannot be analyzed. In this study, we aimed to elicit, rank, and rate attributes that may be considered important to patients and physicians who must choose between angioplasty and surgery for coronary revascularization. Methods: The elicitation process involved performing a systematic review to search for attributes cited in declared preference studies in addition to face-to-face interviews with cardiologists and experts. The interviews were audio-recorded in digital format, and the collected data were transcribed and searched to identify new attributes. The criterion used to finish the data collection process was sampling saturation. Results: A systematic review resulted in the selection of the following 14 attributes: atrial fibrillation, heart failure, incision scar, length of stay, long-term survival, myocardial infarction, periprocedural death, postoperative infection, postprocedural angina, pseudoaneurysm, renal failure, repeat coronary artery bypass grafting, repeat percutaneous coronary intervention, and stroke. The interviews added no new attributes. After rating, we identified significant differences in the values that patients and cardiologists placed on renal insufficiency (p

Para avaliar a qualidade da água em um sistema de cultivo integrado entre agricultura irrigada e piscicultura foram monitorados parâmetros físicos, químicos e biológicos da água de canais de irrigação com cultivo de tilápia nilótica (Oreochromis niloticus) nas densidades de 10; 20 e 30 peixes/m3. O experimento foi conduzido em canais de irrigação do DITALPI/DNOCS, seccionado com tela, onde foram estocados peixes com peso médio de 30±3 g. Já a água foi monitorada aos 8; 14; 21; 28; 35; 43; 50; 58 e 78 dias após a colocação dos peixes no canal. As variações registradas foram para temperatura: 29 a 30,9 ºC; transparência: 41 a 78 cm; alcalinidade total: 19,5 a 28,7 mg L-1; pH: 6,6 a 7,9; dureza: 26 a 66 mg L-1; oxigênio dissolvido: 4,3 a 6,9 mg L-1; condutividade elétrica: 0,059 a 0,150 mS cm-1; gás carbônico: 3,4 a 5,3 mg L-1; nitrito: 1,93 a 3,36 mg L-1; ortofosfato: 0,00 a 0,07 mg L-1 e clorofila a: 0,00 a 3,36 ?g L-1. Os dados indicam que a criação de tilápia nilótica, em qualquer das densidades testadas, não alterou de forma negativa a qualidade da água do canal, sendo esse fato favorecido pelo manejo de bombeamento e vazão da água para a irrigação. Há, assim, possibilidade de integrar a piscicultura com a agricultura irrigada, maximizando o uso dos recursos hídricos continentais. Made available in DSpace on 2015-02-04T09:04:38Z (GMT). No. of bitstreams: 1 RCAv39n4p531.pdf: 1279933 bytes, checksum: ac4fdac877d5554fc6d586ffe713707b (MD5) Previous issue date: 2009-06-19