National Institute of Health Dr. Ricardo Jorge
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Burden of Disease and Cost of Illness of Overweight and Obesity in Portugal
No full textIntroduction: The prevalence of overweight and obesity has increased in the last decades, posing significant health and economic impacts globally. These conditions are related to several non-communicable diseases, including cardiovascular disease, type II diabetes, and cancer. This study estimated the disease burden and healthcare costs associated with overweight and obesity in the adult population in mainland Portugal, in 2018.
Method: Burden of disease was measured in disability-adjusted life years (DALYs) following Global Burden of Disease (GBD) methodology. DALYs were calculated as the sum of years of life lost (YLL) and years lived with disability (YLD). The analyses included morbidity, mortality, and related costs directly related to overweight and obesity, as well as the attributable morbidity, mortality, and related costs of 25 selected diseases related to obesity (DrO). A prevalence-based cost analysis was conducted a from the perspective of the public National Health Service, including costs related to inpatient, outpatient care, and pharmacological treatment.
Results: In 2018, total DALY amounted to 260,943, with 75% due to premature death (196,438 YLL) and 25% due to disability (64,505 YLD). The economic burden of overweight and obesity was estimated at approximately EUR 1,148 million. Of these, approximately EUR 13.3 million (1%) were costs related to the treatment of obesity, and the remaining were costs of DrO attributed to overweight and obesity. Outpatient care corresponded to 43% of total costs, pharmacological treatment 38%, and inpatient care 19%. Cardiovascular and cerebrovascular diseases were the largest contributor to total costs (38%), followed by type II diabetes (34%).
Conclusion: Overweight and obesity incur a large disease and economic burden to the public healthcare sector, representing approximately 0.6% of the country's gross domestic product and 5.8% of public health expenditures.This study was funded by Novo Nordisk Portugal, Lda
Re‐evaluation of argon (E 938) and helium (E 939) as food additives
No full textThe Panel on Food Additives and Flavourings (FAF) provides a scientific opinion re-evaluating the safety of the two food additives argon (E 938) and helium (E 939). Argon (Ar) and helium (He) are two noble gases, highly stable single atoms. Their chemical inertness is well known. Their physicochemical properties have served as a basis for their previous evaluations by SCF and JECFA, which have considered the use of these food additives safe even in the absence of a toxicological evaluation. No business operator or other interested party provided information in response to the call for data published by EFSA to support the re-evaluation of these two food additives with respect to their identity and specifications, manufacturing process (including the identification and quantification of potential impurities) and how they are applied to food to exert their technological function. One business operator replied to the call for data issued by EFSA reporting use levels of E 938 as a packaging gas in one food category. Based on their physicochemical properties, both gases are considered by the Panel to be of low toxicological concern when used as food additives. No information was available on the potential presence of impurities of toxicological concern resulting from the manufacturing process(es) applied to the production of the food additives E 938 and E 939. The Panel however noted that a minimum purity of 99.0% is required to comply with existing specifications. The Panel concluded that the use of argon (E 938) and helium (E 939) as food additives does not raise a safety concern. The Panel recommended an amendment of the existing EU specifications to introduce the respective CAS numbers.info:eu-repo/semantics/publishedVersio
Waste management survey: Buccal cells sampling - Partnership for the Assessment of the Risks from Chemicals
No full textLead authors: Henriqueta Louro and Maria João Silva, National Institute of Health Dr. Ricardo Jorge (INSA), Lisbon, Portugal.SOP9 Buccal Cells Sampling - presentation for PARC Training for Waste Management Survey / Partnership for the Assessment of the Risks from Chemicals. Aim of presentation: Provide the general procedure for the collection, storage, and transfer of buccal cell samples for micronucleus analysis in exfoliated buccal cells. The buccal micronucleus assay is a minimally invasive approach for measuring DNA damage, cell proliferation, cell differentiation and cell death in exfoliated buccal cells (Bolognesi et al., 2015). It offers a great opportunity to evaluate in a clear and precise way the appearance of genetic damage whether it is present as a consequence of occupational or environmental risk, being reliable, fast, relatively simple, cheap, and minimally invasive and causes no pain. This Standard Operating Procedure (SOP) for buccal cells sampling is intended to be used in the PARC waste management survey. The SOP provides the general procedure for the collection, storage, and transfer of buccal cell samples
Rare variants at KCNJ2 are associated with LDL-cholesterol levels in a cross-population study
No full textLeveraging whole genome sequencing data of 1751 individuals from the UK and 2587 Qatari subjects, we suggest here an association of rare variants mapping to the sour taste-associated gene KCNJ2 with reduced low-density lipoprotein cholesterol (LDL-C, P = 2.10 × 10-12) and with a 22% decreased dietary trans-fat intake. This study identifies a novel candidate rare locus for LDL-C, adding insights into the genetic architecture of a complex trait implicated in cardiovascular disease.TwinsUK is funded by the Wellcome Trust, Medical Research Council, European Union, Chronic Disease Research Foundation (CDRF), the National Institute for Health Research (NIHR)-funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guy’s and St. Thomas’ NHS Foundation Trust in partnership with King’s College London. QBB study was funded in part by the Qatar National Research Fund’s Path towards Precision Medicine award (PPM1-1229-15002).info:eu-repo/semantics/publishedVersio
Rapid response Task Force: addressing the detection of Aedes albopictus in Lisbon, Portugal
No full textAbstract publicado em: Eur J Public Health. 2024 Oct 28;34(Suppl 3):ckae144.279. doi: 10.1093/eurpub/ckae144.279Issue: The invasive Aedes albopictus mosquitoes are spreading in southern Europe and pose a heightened risk of mosquito-borne diseases, like Dengue and Chikungunya. On September 2023, A. albopictus was first identified in Lisbon through community-based surveillance and a multidisciplinary national Task Force (TF) was convened.
Description of the problem: The TF included experts in epidemiology, entomology, environmental health, laboratory diagnosis, prevention and control and communication. The objectives were to i) confirm A.albopictus presence in Lisbon and adjust the risk assessment, ii) raise awareness and prevent mosquitoes’ spread, iii) revise national guidelines on arboviruses surveillance and control. During September-December 2023, the National Network for Vectors Surveillance (REVIVE) and the Hygiene and Tropical Medicine Institute sampled mosquito-prone habitats within 2km-radius of the detection point using QGIS software. They used snowball sampling to identify any new foci. They placed ovitraps for ongoing surveillance and conducted morphological analysis and xenomonitoring for pathogen DNA and RNA detection at the national reference laboratory.
Results: By November 2023, A.albopictus was detected in two new foci. No mosquitoes tested positive for arboviruses, and no autochthonous cases of mosquito-borne diseases were identified. The TF developed national guidelines for vector prevention and control and awareness for arboviruses and trained municipality workers. To raise awareness, we communicated with experts and the public through existing channels and media. As of April 2024, no new foci have been detected.
Lessons: Community-based surveillance and REVIVE approach were crucial for invasive A.albopictus detection and monitoring in Lisbon. Rapid multidisciplinary TF coordination may have been key for timely vector control.info:eu-repo/semantics/publishedVersio
Re‐evaluation of saccharin and its sodium, potassium and calcium salts (E 954) as food additives
No full textThis opinion deals with the re-evaluation of saccharin and its sodium, potassium and calcium salts (E 954) as food additives. Saccharin is the chemically manufactured compound 1,2-benzisothiazol-3(2H)-one-1,1-dioxide. Along with its sodium (Na), potassium (K) and calcium (Ca) salts, they are authorised as sweeteners (E 954). E 954 can be produced by two manufacturing methods i.e. Remsen-Fahlberg and Maumee. No analytical data on potential impurities were provided for products manufactured with the Maumee process; therefore, the Panel could only evaluate saccharins (E 954) manufactured with the Remsen-Fahlberg process. The Panel concluded that the newly available studies do not raise a concern for genotoxicity of E 954 and the saccharins impurities associated with the Remsen-Fahlberg manufacturing process. For the potential impurities associated with the Maumee process, a concern for genotoxicity was identified. The data set evaluated consisted of animals and human studies. The Panel considered appropriate to set a numerical acceptable daily intake (ADI) and considered the decrease in body weight in animal studies as the relevant endpoint for the derivation of a reference point. An ADI of 9 mg/kg body weight (bw) per day, expressed as free imide, was derived for saccharins (E 954). This ADI replaces the ADI of 5 mg /kg bw per day (expressed as sodium saccharin, corresponding to 3.8 mg /kg bw per day saccharin as free imide) established by the Scientific Committee on Food. The Panel considered the refined brand-loyal exposure assessment scenario the most appropriate exposure scenario for the risk assessment. The Panel noted that the P95 exposure estimates for chronic exposure to saccharins (E 954) were below the ADI. The Panel recommended the European Commission to consider the revision of the EU specifications of saccharin and its sodium, potassium and calcium salts (E 954).info:eu-repo/semantics/publishedVersio
Prediction of Genes Associated With Autism Spectrum Disorder Using Sequence and Graph Embedding Methods
No full textDissertação de mestrado em Bioinformática e Biologia Computacional, apresentada à Faculdade de Ciências da Universidade de Lisboa, 2025Orientadora Astrid Vicente (Departamento de Promoção da Saúde e Prevenção de Doenças Não Transmissíveis, INSA)Neurodevelopmental disorders impose a significant social and economic burden on individuals with these conditions and their families. Given that all neurodevelopmental disorders have a genetic component, identifying the risk genes for these disorders enhances our understanding of their etiology and can aid in the development of future screening methods and targeted therapies. Autism Spectrum Disorder (ASD) is a prototypical complex neurodevelopmental disorder characterized by high heritability and a heterogeneous genetic architecture and phenotypic presentation. This thesis presents a Machine Learning (ML) approach that improves upon state-of-the-art methods for ASD risk gene prediction, this thesis presents a Machine Learning (ML) approach capable of improving state-of-the-art methods for ASD risk gene prediction. To achieve this goal, a novel approach is created using publicly available ASD-associated genes and graph and sequence gene embeddings with supervised ML classifiers. Using a 5-fold nested stratified cross-validation, the pipeline achieved an AUC of 0.90, F1 of 0.82, and MCC of 0.77. Additionally, the top decile of the ranked list of predicted risk genes generated by the model was significantly enriched for ASD phenotypes but not other brain-specific disorders. The proposed pipeline improved state-of-the-art approaches in predicting genes targeted by LOF mutations in the MSSNG and SCC studies. A functional network characterization of the top decile identified four distinct communities significantly enriched for biological pathways associated with ASD. Of the 50 top predicted genes by the pipeline, 37 were already present in ASD risk gene databases, while 13 were not yet linked to ASD. The 13 genes were significantly enriched in the cerebral cortex, and the telencephalon cell migration processes critical for brain development and linked to neurodevelopmental disorders. This thesis provides an accurate comparison of embedding methods for risk gene discovery and improves existing ASD risk gene predictions, taking a step closer to a better understanding of this complex genetic disorder.As perturbações do neurodesenvolvimento colocam um fardo social e económico significativo nos indi víduos afetados tal como nas suas famílias. Embora se tenham registado avanços significativos nas tec nologias de sequenciação de genes, ainda não foram descobertos todos os aspetos da arquitetura genética destas perturbações. Tendo em conta que perturbações do neurodesenvolvimento apresentam uma com ponente genética, é de elevada importância identificar os genes de risco responsáveis. Determinar os genes de risco não só aprofunda o nosso conhecimento sobre a etiologia de cada perturbação, como tam bém contribui para o desenvolvimento de métodos de rastreio e terapias direcionadas. A Perturbação do Espectro do Autismo (PEA) é uma perturbação do neurodesenvolvimento complexa, altamente hered itária e heterogénea. Esta heterogeneidade cria desafios significativos na identificação de todos os genes de risco associados ao PEA. Métodos convencionais para identificar genes de risco do PEA, como o Transmission and De Novo Association (TADA), dependem de dados clínicos de pacientes com PEA, como os obtidos por Whole Exome Sequencing (WES). Embora eficazes, estes estudos são dispendiosos e os dados gerados são restritos devido às leis de proteção de dados, o que limita a partilha de dados e impossibilita a reprodução dos estudos. Dada a complexidade da PEA e as limitações dos métodos mais convencionais para a descoberta de genes de risco, esta tese adota uma abordagem de aprendizagem automática (AA).
O principal objetivo desta tese é melhorar os métodos state-of-the-art para a previsão de genes de risco do PEA. Para alcançar este objetivo, é criada uma abordagem que utiliza genes associados ao PEA disponíveis em bases de dados públicas com embeddings de genes, utilizando classificadores de aprendizagem automática supervisionada. Num problema de aprendizagem automática supervisionada é necessário definir um conjunto de dados de treino positivos e negativos. Neste caso os dados positivos vão ser genes que foram previamente associados com PEA e os dados negativos vão ser genes o mais distantes possível dos genes positivos. Os genes positivos usados nesta tese foram os genes da Simons Foundation Autism Research Initiative (SFARI) gene dataset. Esta base de dados é constituída por um conjunto de genes com evidencia bibliográfica de associação com PEA. Cada gene presente nesta base de dados é classificado de um a três. Os genes que têm a categoria um são os genes para qual existe uma maior evidencia biliografica da associação com PEA. Os de categoria três por sua vez são os que demostram ter menor evidencia. Seguindo a metodologia de abordagens state-of-the-art, nesta tese, os genes negativos usados foram os do artigo de Krishnan et al. de 2016. De modo a conferir que os genes negativos eram relevantes, foi realizada uma verificação utilizando os códigos de ICD10 com uma base de dados proteína-doença. Devido a novos estudos funcionais alguns dos genes negativos do artigo de 2016 estavam agora associados a genes do neurodesenvolvimento e como o objetivo dos genes nega tivos é ser o mais distante possível de genes do PEA esses genes foram removidos. Um dos maiores desafios nesta tese foi em encontrar a melhor maneira de representar genes numa forma compatível com os modelos de AA. Foram utilizadas duas abordagens, grafos e sequencias para criar as representações, ou embeddings. Para a abordagem de grafos foi utilizada a base de dados de interação proteína-proteína STRING, onde cada nó desse grafo corresponde a uma proteína. Foi criado para cada gene Embed dings utilizando os transcritos canónicos e diversos modelos de embeddings. Os transcritos canónicos são os transcritos que são considerados os principais de um gene por serem os mais expressos, serem os mais conservados, melhor caracterizados e por codificarem para a proteína funcional principal. No caso das representações de sequências, tal como as representações de grafos utilizei as sequencias de DNA e de aminoácidos de transcritos canónicos. Os embeddings de sequências de DNA foram gerados com o modelo BERT, DNABERT-2, e os embeddings de sequências de aminoácidos foram criados uti lizando o modelo de aprendizagem profunda PortT5. Para fazer a previsão binária se um gene é ou não um gene de risco da PEA, nesta tese utilizei no total 6 modelos de AA de diferentes tipos. Os modelos utilizados foram modelos lineares como regressão logística, Support Vector Machines (SVM), mode los baseados em vizinhança como K-Nearest Neighbors (KNN), e modelos de ensemble como Random Forest, LightGBM e XGBoost. De modo a garantir previsões mais precisas dos modelos de AA testei diferentes permutações dos datasets de treino. Por exemplo, em vez de utilizar o dataset completo da SFARI como os genes positivos, utilizei apenas os genes da categoria um, os genes das categorias um e dois, entre outras combinações. A ideia é encontrar o melhor equilíbrio entre um dataset com genes mais específicos e um dataset não enviesado. Como o dataset de treino era limitado, nesta tese utilizei uma validação nested stratified cross fold. Métodos de oversampling por vezes são utilizados quando o dataset está enviesado, com mais elementos de uma categoria que a outra, contudo como neste caso como cada gene é altamente específico utilizar métodos de oversampling pode introduzir viés, que põe em causa a relevância das previsões do modelo. Deste modo, utilizar uma validação nested stratified cross fold não só possibilita o uso da totalidade dos dados para treinar e validar como assegura que o mesmo rácio de dados positivos e negativos são utilizados. Os resultados gerados pela pipeline bioinformática proposta demonstram a eficacidade e capacidade de esta pipeline em classificar com sucesso os genes de risco do PEA. Ao utilizar uma validação nested stratified cross fold foi possível de obter um AUC de 0,90, F1 de 0,82 e MCC de 0,77. O modelo que demostrou os melhores resultados foi a regressão logís tica com os embeddings de grafos Deepwalk CBOW. Usando esta combinação de modelo e embedding, a pipeline foi aplicada a todos os genes humanos disponíveis, gerando uma lista com cerca de 18000 genes.
Cada gene tinha uma percentagem associada que representava a confiança do modelo em classificar o gene como de risco para PEA. Esta lista de genes foi ordenada pela percentagem de confiança, do maior para o menor valor, e posteriormente dividida em decis. O primeiro decil da lista ordenada de genes de risco previstos pelo modelo demostrou estar significativamente enriquecido para fenótipos de PEA mas não para outros Transtornos específicos do cérebro, deste modo demostrando a precisão da previsão. A pipeline proposta melhorou as abordagens state-of-the-art na previsão de genes associados a mutações de perda de função (LOF) presentes nos estudos MSSNG e SCC. Ao fazer uma caracterização funcional VI de rede do primeiro decil foi possível identificar quatro comunidades distintas que demostraram estar significativamente enriquecidas para o desenvolvimento do sistema nervoso, organização e remodelação da cromatina, transdução de sinal intercelular e modificação de proteínas, processos diretamente ligados ao PEA. A identificação de comunidades foi feita utilizando o algoritmo de Leiden. Dos 50 genes de topo do primeiro decil da lista gerada pela pipeline, 37 genes já tinham sido previamente associados ao PEA, enquanto 13 genes ainda não tinham sido associados no momento de escrita desta tese. Ao fazer análise de enriquecimento funcional, treze dos genes demostraram estar significativamente enriquecidos para processos de migração no córtex cerebral e no telencéfalo, críticos no desenvolvimento cerebral e ligados a distúrbios do neurodesenvolvimento. Em conclusão, esta tese fornece uma comparação de métodos de embeddings para a previsão de genes de risco e melhora as abordagens existentes de previsão de genes de risco do PEA usando métodos de AA, contribuindo para uma melhor compreensão desta complexa perturbação
Infections by Chlamydia trachomatis and Neisseria gonorrhoeae: results of laboratory diagnosis at INSA, 2017-2022
Get PDFChlamydia trachomatis e Neisseria gonorrhoeae são responsáveis pelas
duas infeções sexualmente transmissíveis (IST) curáveis mais comuns em
todo o mundo. Sendo frequentemente assintomáticas, o rastreio laboratorial
destas IST é fundamental, para que possa ser efetuado o tratamento
adequado que evite o desenvolvimento de sequelas clínicas graves e para
quebrar cadeias de transmissão.
O presente estudo teve por objetivo determinar a frequência das infeções por
C. trachomatis e N. gonorrhoeae no âmbito da prestação de serviços do Laboratório
Nacional de Referência das IST no INSA, no período 2017-2022.
A pesquisa laboratorial de C. trachomatis e N. gonorrhoeae foi efetuada por
uma técnica de PCR em tempo real, tendo sido obtidos resultados válidos para
47 136 amostras biológicas (genitais, anorretais e/ou orofaríngeas) de 21 188
pessoas que, em 22,6% (n=4799) dos casos, revelaram ser positivas para qualquer
uma destas IST. Nas mulheres, a infeção por C. trachomatis foi a mais frequente
(10,5%; 494/4692), enquanto nos homens a infeção por N. gonorrhoeae
foi a mais comum (16,2%; 2669/16 455). C. trachomatis foi mais detetada nas
amostras anorretais (10,1%; 1222/12 057), nas quais 19,3% (236/1222) revelaram
pertencer ao grupo do linfogranuloma venéreo, e N. gonorrhoeae na orofaringe
(11,5%; 1621/14 123). Ambas as infeções foram mais frequentemente
detetadas nos homens (28,4%; 4680/16455) e nas pessoas (independentemente
do sexo) com menos de 25 anos (36,8%; 1389/3777).
Em conclusão, este estudo revelou infeção por C. trachomatis e N.
gonorrhoeae em amostras colhidas de diferentes locais anatómicos, tendo
sido observadas elevadas frequências de infeção por N. gonorrhoeae a nível
orofaríngeo e anorretal, assim como de C. trachomatis neste último local
anatómico, sugerindo que o rastreio destas IST não se deverá restringir
à região genital. O aumento (8,6 pontos percentuais entre 2017 e 2022)
das infeções por N. gonorrhoeae configura motivo de preocupação dada a
potencial emergência de estirpes resistentes aos antibióticos.Chlamydia trachomatis and Neisseria gonorrhoeae constitute the two
most common curable sexually transmitted infections (STI) worldwide.
As they are of ten asymptomatic, laboratory screening of these STI is
essential for establishing adequate treatment that should prevent the
development of serious clinical sequelae, and to break transmission chains.
The present study aimed to determine the frequency of C. trachomatis and N.
gonorrhoeae infections within the scope of the routine laboratory diagnosis
at the National STI Reference Laboratory at INSA, in the period 2017-2022. Laboratory research for C. trachomatis and N. gonorrhoeae was carried out using real-time PCR on 47,136 biological samples (genital, anorectal and/or
oropharyngeal) from 21,188 people. Infection by any of these STI was detected
in 22.6% (n=4799) of the individuals. In women, infection by C. trachomatis
was the most common (10.5%; 494/4692), while infection by N. gonorrhoeae
was the most common in men (16.2%; 2669/16,455). C. trachomatis was
the most frequent in anorectal samples (10.1%; 1222/12057), of which 19.3%
(236/1222) revealed to belong to the lymphogranuloma venereum group, and
N. gonorrhoeae was the most common in the oropharynx (11.5%; 1621/14,123).
Both infections were more frequently detected in men (28.4%; 4680/16,455)
and in people (regardless of gender) under 25 years of age (36.8%; 1389/3777).
In conclusion, laboratory screening for C. trachomatis and N. gonorrhoeae in
samples collected from dif ferent anatomical sites revealed high percentages
of N. gonorrhoeae infections at the oropharynx and anorectum and of C.
trachomatis at the anorectum, suggesting that screening for these STIs
should not be restricted to the genital region. The rise (8.6 percentage points
between 2017 and 2022) of N. gonorrhoeae infections represents a serious
concern, given the potential emergence of strains resistant to antibiotics.info:eu-repo/semantics/publishedVersio
Ornamental lakes as potential reservoirs for microorganisms resistant to antimicrobial agents
Get PDFOs espaços verdes nas grandes cidades têm ganho uma importância crescente
para a qualidade de vida e saúde da população. Os lagos e fontes
ornamentais presentes nestes espaços são muito atrativos, mas podem
esconder alguns perigos.
Neste estudo foi avaliada mensalmente durante um ano a flora bacteriana
(planctónica e organizada em biofilmes) presente num lago ornamental de
um parque urbano situado em Lisboa (Portugal).
Foram identificadas bactérias pertencentes a 14 Géneros diferentes, mas
apenas as Aeromonas spp. foram identificadas em todas as colheitas na
água e/ou biofilmes sendo consideradas residentes. A suscetibilidade aos
antibióticos e à cloragem foram avaliadas para esta população residente.
Os resultados obtidos permitiram identificar um grupo de bactérias
residentes que não são alvo de pesquisa dedicada de acordo com a
legislação em vigor em Portugal. O nível de eficácia da cloragem na
eliminação de biofilmes destes microrganismos sugere a necessidade de
monitorização e/ou uso de métodos de desinfUrban parks and other green spaces in large cities have gained increasing
importance for the quality of life and health of inhabitants. The lakes and
ornamental fountains present in these spaces are very attractive, but can
hide some dangers.
In this study, the bacterial flora (planktonic and organized in biofilms)
present in an ornamental lake in an urban park located in Lisbon (Por tugal)
was evaluated monthly for a year.
Bacteria from 14 different Genus were identified, but only Aeromonas spp.
were identified in all water collections and/or biofilms being considered as
residents. Susceptibility to antibiotics and chlorination were assessed for
this resident population.
The obtained results allowed the identification of a resident bacterial group
that are not target of dedicated research in accordance with the legislation
in force in Portugal. The level of effectiveness of chlorination in eradicating
biofilms of these microorganisms suggests the need for monitoring and/or
use of more effective disinfectioninfo:eu-repo/semantics/publishedVersio
Use of quasi-experimental studies to evaluate causal effects of public health interventions in Portugal: a scoping review
No full textAbstract publicado em: Popul Med. 2023;5 (Suppl. 5):A1862. https://doi.org/10.18332/popmed/163887Background and Objective:
Evaluating causal effects of public health interventions using traditional randomized controlled trials might not be feasible. Quasi-experimental designs are a valid option but still not widely used in Portugal. Knowing their application in real public health problems will support the development of this research area. We thus performed a scoping review aiming at identifying and characterising the use of quasi-experimental studies to evaluate causal effects of public health interventions in Portugal.
Methods:
We included studies that used a quasi-experimental design to assess causal effects of one or more public health intervention in Portugal. PubMed, Scopus, Web of Science and CINHAL were searched from inception, combining free text and controlled vocabulary terms. Grey literature was identified through screening of tables of contents of non-indexed publications and institutional repositories of national Public Health PhD and MSc programmes theses. Studies were selected after title and abstract followed by full-text, double-screening. Searches were supplemented by reference mining and contact with authors of eligible studies. We extracted information on the intervention assessed, study design, statistical analysis approach and reporting guidelines followed using a standardised extraction form.
Results:
This study is ongoing, we present preliminary results from the databases search. After deduplication we identified 500 studies, 38 were included for full-text screening, and 25 were eligible. Studies assessed interventions in various areas, namely healthcare services (40.0%), tobacco and drugs control policy (20.0%), and pharmaceutics policy (16.0%), among others. Study designs were mainly interrupted time series (44.0%), followed by difference-in-differences approaches (40.0%).
Conclusion:
There is a paucity of studies in this area with interrupted time series and difference-in-differences approaches being the most often used study designs. Training in this area might promote the use and dissemination of quasi-experimental studies.info:eu-repo/semantics/publishedVersio