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- Hospital admissions in children with acute respiratory disease in PortugalPublication . Borges, Joana; Rosa, Matilde; Fernandes, Ricardo M.; Nogueira, P. J.; Bandeira, Teresa
- Perceção e atitudes sobre prescrição racional durante a formação médica : resultados de grupos focais com estudantes de medicina e médicos internosPublication . Boaventura, Isabel; Costa, João; Fernandes, Ricardo M.; Ferreira, Joaquim J.Introduction: Clinical pharmacology educational strategies for medicine students seek to foster skills that range from technical knowledge to the development of behaviors that ensure rational prescribing decisions. The authors present the results of a study to evaluate the perceptions, attitudes and behaviors linked with rational prescribing throughout training. Material and Methods: Four focus groups were held with first, third and fifth year medical students and residents from the first years of various specialties, with a total of 29 participants. A semi-structured questionnaire with open-ended questions was used to facilitate interaction between the participants, alongside case-studies to explore the behaviors associated with therapeutic decisions. Results: The analysis of the references showcased an evolution of concepts throughout academic training. References regarding guidelines and effectiveness emerge during the third year; safety and treatment personalization emerge during the fifth year and specialist training. Efficacy studies, systematic reviews, regulatory documents and online platforms were considered the most relevant sources of information. Discussion: The literature review showcases the need to implement strategies dedicated to the development of adequate skills for rational prescribing. The use of focus groups may be a useful methodology to engage students in self-evaluation of their skills and inform faculty of the perceptions and behaviors of students. Conclusion: This analysis illustrates the awareness of students and young physicians to the need to adapt therapeutic approaches to the characteristics of the patient. These concepts should be reinforced so that young doctors feel more prepared for rational prescription in complex clinical situations.
- Systematic reviews and meta-analysis published in indexed Portuguese medical journals: time trends and critical appraisalPublication . Prada, Luísa; Prada, Ana; Marques Antunes, Miguel; Fernandes, Ricardo M.; Costa, João; Ferreira, Joaquim J; Caldeira, DanielIntroduction: Over the last years, the number of systematic reviews published is steadily increasing due to the global interest in this type of evidence synthesis. However, little is known about the characteristics of this research published in Portuguese medical journals. This study aims to evaluate the publication trends and overall quality of these systematic reviews. Material and methods: This was a methodological study. We aimed the most visible Portuguese medical journals indexed in MEDLINE. Systematic reviews were identified through an electronic search (through PUBMED). We included systematic reviews published up to August 2020. Systematic reviews selection and data extraction were done independently by three authors. The overall quality critical appraisal using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) was independently assessed by three authors. Disagreements were solved by consensus. Results: Sixty-six systematic reviews published in 5 Portuguese medical journals were included. Most (n = 53; 80.3%) were systematic reviews without meta-analysis. Up to 2010 there was a steady increase in the number of systematic reviews published, followed by a period of great variability of publication, ranging from 1 to 10 in a given year. According to the systematic reviews' typology, most have been predominantly conducted to assess the effectiveness/efficacy of health interventions (n = 27; 40.9%). General and Internal Medicine (n = 20; 30.3%) was the most addressed field. Most systematic reviews (n = 46; 69.7%) were rated as being of "critically low-quality". Conclusions: There were consistent flaws in the methodological quality report of the systematic reviews included, particularly in establishing a prior protocol and not assessing the potential impact of the risk of bias on the results. Through the years, the number of systematic reviews published increased, yet their quality is suboptimal. There is a need to improve the reporting of systematic reviews in Portuguese medical journals, which can be achieved by better adherence to quality checklists/tools.