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- Health Intervention’s Evaluation – from concept to practicePublication . Gómez, VerónicaLecture invited by the IHMT, within the scope of the VAX-TRUST project - Workshop for evaluators in the session Health Intervention’s Evaluation – from concept to practice Background: The InfAct (Information for Action) is a Joint Action of the European Commission’s 3rd Health Programme with the main goal to build a health information system infrastructure for a stronger European Union and to strengthen its core elements. The InfAct Joint Action was developed along 36 months and structured in 10 work packages. Portugal co-led the Work Package 6 (WP6) of this project, which included the development of the proposal of a flagship capacity building programme - the European Health Information Training Programme - and its evaluation. The evaluation objectives included: to evaluate the adequacy of the training programme to the health information needs in the European Member States; to identify possible changes regarding the participants selection process, the training activities and the pedagogical project; and to contribute to the understanding of the potential of the programme to add to available offers in learning on the topics of Public Health information, on the capacity building and behavioural changes in Public Health activities which can be attributed to the course, and of the potential of the programme to contribute to the alignment of health information criteria and procedures between the European Member States. Methods: The evaluation process was developed using an observational descriptive study design using a mixed methodological approach with both document analysis and primary data collected by questionnaires and interviews analysis. Mixed quantitative and qualitative data collection methods and analysis were used. Results: The proposal of the European Health Intervention’s Training Programme seemed adequate to the formative needs and capacities in line with the work performed by the InfAct project. In what concerns about its main thematic areas, it was also aligned with the areas identified in the previous formative needs and capacities mapping. The participants selection process proposed seemed, in general, adequate. The potential of the European Health Information Training Programme proposal to learning, capacity building and behavioral changes at work attributable to the course was considered positive, as well as the potential to the alignment of health information criteria and procedures between European Union Member States. Discussion: In general, we found high consistency between the results obtained from data collected by the techniques used. However, different suggestions for improvement were outlined by the evaluation study population.
- Envelhecimento e saúdePublication . Santos, Ana João Carvalho da Silva; Braz, Paula; Gómez, Verónica; Folha, Teresa; Alves, Tatiana; Matias Dias, CarlosO relatório “Envelhecimento e saúde” tem como objetivo contribuir para o conhecimento da realidade da população idosa portuguesa através da integração e síntese de informação sobre saúde. Os dados foram obtidos através de fontes estatais nacionais, fontes europeias, inquéritos de saúde nacionais e estudos de temas específicos. Apresentam-se os dados mais recentes, publicados e disponíveis à data de dezembro de 2019, podendo o período dos diferentes indicadores variar, de acordo com a temática apresentada. Tendo em conta que são múltiplos os determinantes (individuais, biológicos, genéticos e psicológicos) que contribuem para a forma como envelhecemos, o relatório inclui cinco capítulos com informação sobre aspetos demográficos e sociais, relacionada com o bem-estar e qualidade de vida, referente às condições e ao estado de saúde e à utilização dos serviços de saúde. Partindo-se da definição multidimensional de saúde avançada pela OMS, em 1946, o relatório, para além da caracterização do estado de saúde, apresenta indicadores de várias áreas, que influenciam a saúde e a qualidade de vida desta população, nomeadamente ao nível económico, social e individual. Os indicadores apresentados caracterizam as especificidades relevantes do contexto nacional, e sempre que possível, os aspetos de continuidade do contexto europeu, onde Portugal se insere.
- Vaccine effectiveness against COVID-19 hospitalisation in adults (≥ 20 years) during Alpha- and Delta-dominant circulation: I-MOVE-COVID-19 and VEBIS SARI VE networks, Europe, 2021Publication . Rose, Angela M.C.; Nicolay, Nathalie; Sandonis Martín, Virginia; Mazagatos, Clara; Petrović, Goranka; Niessen, F Annabel; Machado, Ausenda; Launay, Odile; Denayer, Sarah; Seyler, Lucie; Baruch, Joaquin; Burgui, Cristina; Loghin, Isabela I.; Domegan, Lisa; Vaikutytė, Roberta; Husa, Petr; Panagiotakopoulos, George; Aouali, Nassera; Dürrwald, Ralf; Howard, Jennifer; Pozo, Francisco; Sastre-Palou, Bartolomé; Nonković, Diana; Knol, Mirjam J.; Kislaya, Irina; Luong Nguyen, Liem binh; Bossuyt, Nathalie; Demuyser, Thomas; Džiugytė, Aušra; Martínez-Baz, Iván; Popescu, Corneliu; Duffy, Róisín; Kuliešė, Monika; Součková, Lenka; Michelaki, Stella; Simon, Marc; Reiche, Janine; Otero-Barrós, María Teresa; Lovrić Makarić, Zvjezdana; Bruijning-Verhagen, Patricia C.J.L.; Gómez, Verónica; Lesieur, Zineb; Barbezange, Cyril; Van Nedervelde, Els; Borg, Maria-Louise; Castilla, Jesús; Lazar, Mihaela; O’Donnell, Joan; Jonikaitė, Indrė; Demlová, Regina; Amerali, Marina; Wirtz, Gil; Tolksdorf, Kristin; Valenciano, Marta; Bacci, Sabrina; Kissling, Esther; I-MOVE-COVID-19 Hospital Study Team; VEBIS Hospital Study TeamIntroduction: Two large multicentre European hospital networks have estimated vaccine effectiveness (VE) against COVID-19 since 2021. Aim: We aimed to measure VE against PCR-confirmed SARS-CoV-2 in hospitalised severe acute respiratory illness (SARI) patients ≥ 20 years, combining data from these networks during Alpha (March–June)- and Delta (June–December)-dominant periods, 2021. Methods: Forty-six participating hospitals across 14 countries follow a similar generic protocol using the test-negative case–control design. We defined complete primary series vaccination (PSV) as two doses of a two-dose or one of a single-dose vaccine ≥ 14 days before onset. Results: We included 1,087 cases (538 controls) and 1,669 cases (1,442 controls) in the Alpha- and Delta-dominant periods, respectively. During the Alpha period, VE against hospitalisation with SARS-CoV2 for complete Comirnaty PSV was 85% (95% CI: 69–92) overall and 75% (95% CI: 42–90) in those aged ≥ 80 years. During the Delta period, among SARI patients ≥ 20 years with symptom onset ≥ 150 days from last PSV dose, VE for complete Comirnaty PSV was 54% (95% CI: 18–74). Among those receiving Comirnaty PSV and mRNA booster (any product) ≥ 150 days after last PSV dose, VE was 91% (95% CI: 57–98). In time-since-vaccination analysis, complete all-product PSV VE was > 90% in those with their last dose < 90 days before onset; ≥ 70% in those 90–179 days before onset. Conclusions: Our results from this EU multi-country hospital setting showed that VE for complete PSV alone was higher in the Alpha- than the Delta-dominant period, and addition of a first booster dose during the latter period increased VE to over 90%.
- Envelhecimento e Saúde: caracterização da saúde da população idosa em PortugalPublication . Santos, Ana João; Braz, Paula; Gomez, Verónica; Folha, Teresa; Alves, Tatiana; Matias Dias, CarlosO presente documento apresenta uma integração e síntese de dados sobre a saúde da população idosa portuguesa, obtidos através de fontes estatais nacionais, fontes europeias, inquéritos de saúde nacionais e estudos de temas específicos. Apresentam-se os dados atualizados até 2021, variando o período temporal dos diferentes indicadores, de acordo com as publicações disponíveis até dezembro de 2021, para cada uma das temáticas apresentadas. Partindo-se da definição multidimensional de saúde proposta pela Organização Mundial da Saúde em 1946, o relatório apresenta, para além da caracterização do estado de saúde, indicadores de várias áreas que influenciam a saúde e a qualidade de vida desta população, nomeadamente ao nível económico, social e individual. Está dividido em cinco capítulos: 1. Demografia e sociologia do envelhecimento; 2. Desafios do envelhecimento; 3. Processos de envelhecimento e saúde: condições associadas; 4. Estado de saúde e 5. Serviços e cuidados de saúde.
- Métodos epidemiológicos e estatísticos numa emergência de Saúde PúblicaPublication . Nunes, Baltazar; Caetano, Constantino; Antunes, Liliana; Torres, Ana Rita; Silva, Susana; Rodrigues, Ana Paula; Kislaya, Irina; Machado, Ausenda; Garcia, Ana Cristina; Gómez, Verónica; Namorado, Sónia; Patrício, Paula; Ribeiro, Maria Luísa; Pereira, João; Matias Dias, CarlosSobre o papel dos método estatístico e epidemiológico na resposta à emergência COVID-19: Vigilância epidemiológica; Estudos epidemiológicos especiais; Modelação matemática.
- Evaluability Assesment Report WP6 Task 6.3 InfAct JAPublication . Garcia, Ana Cristina; Sousa Uva, Mafalda; Gómez, VerónicaInfAct (Information for Action!), the Joint Action on Health Information (https://www.inf-act.eu/) is a project funded by the European Commission. It builds on the BRIDGE Health project and other initiatives in health information. The project was launched in March 2018. Through country collaboration, InfAct streamlines health information activities across Europe. It builds towards a sustainable and solid infrastructure on EU health information and strengthens its core elements based on capacity building, health information tools and political support. Portugal, together with Finland, leads the project's Work Package 6 (WP6), through a team of professionals from the Directorate General of Health (who coordinates), the Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon and the National Institute of Health Doctor Ricardo Jorge. WP6 includes, among other tasks, the development of a Sustainable Capacity Building Programme (flagship Programme) and its evaluation. The preparation of the first proposal of the referred Programme is ongoing and will be evaluated when completed. The evaluation team conducted an evaluability assessment (pre-evaluation) based on the principles and methods of the theory of change, with the agreement of the national team. The aims of the evaluability assessment were to describe the target programme of the evaluation through a logical model built with the participation of key stakeholders, and to define the focus of the evaluation. The logical model was built based on the results of a literature review by the evaluation team and the contributions of a workshop meeting, which took place on October 30, 2019, and was attended by 14 stakeholders, selected as representatives of each part interested in the evaluation.
- Effectiveness of complete primary vaccination against COVID-19 at primary care and community level during predominant Delta circulation in Europe: multicentre analysis, I-MOVE-COVID-19 and ECDC networks, July to August 2021Publication . Kissling, Esther; Hooiveld, Mariëtte; Martínez-Baz, Iván; Mazagatos, Clara; William, Naoma; Vilcu, Ana-Maria; Kooijman, Marjolein N.; Ilić, Maja; Domegan, Lisa; Machado, Ausenda; de Lusignan, Simon; Lazar, Mihaela; Meijer, Adam; Brytting, Mia; Casado, Itziar; Larrauri, Amparo; Murray, Josephine-L.K.; Behillil, Sylvie; de Gier, Brechje; Mlinarić, Ivan; O’Donnell, Joan; Rodrigues, Ana Paula; Tsang, Ruby; Timnea, Olivia; de Lange, Marit; Riess, Maximilian; Castilla, Jesús; Pozo, Francisco; Hamilton, Mark; Falchi, Alessandra; Knol, Mirjam J.; Kurečić Filipović, Sanja; Dunford, Linda; Guiomar, Raquel; Cogdale, Jade; Cherciu, Carmen; Jansen, Tessa; Enkirch, Theresa; Basile, Luca; Connell, Jeff; Gómez, Verónica; Sandonis Martín, Virginia; Bacci, Sabrina; Rose, Angela M.C.; Pastore Celentano, Lucia; Valenciano, Marta; I-MOVE-COVID-19 and ECDC primary care study teamsIntroduction: In July and August 2021, the SARS-CoV-2 Delta variant dominated in Europe. Aim: Using a multicentre test-negative study, we measured COVID-19 vaccine effectiveness (VE) against symptomatic infection. Methods: Individuals with COVID-19 or acute respiratory symptoms at primary care/community level in 10 European countries were tested for SARS-CoV-2. We measured complete primary course overall VE by vaccine brand and by time since vaccination. Results: Overall VE was 74% (95% CI: 69–79), 76% (95% CI: 71–80), 63% (95% CI: 48–75) and 63% (95% CI: 16–83) among those aged 30–44, 45–59, 60–74 and ≥ 75 years, respectively. VE among those aged 30–59 years was 78% (95% CI: 75–81), 66% (95% CI: 58–73), 91% (95% CI: 87–94) and 52% (95% CI: 40–61), for Comirnaty, Vaxzevria, Spikevax and COVID-19 Vaccine Janssen, respectively. VE among people 60 years and older was 67% (95% CI: 52–77), 65% (95% CI: 48–76) and 83% (95% CI: 64–92) for Comirnaty, Vaxzevria and Spikevax, respectively. Comirnaty VE among those aged 30–59 years was 87% (95% CI: 83–89) at 14–29 days and 65% (95% CI: 56–71%) at ≥ 90 days between vaccination and onset of symptoms. Conclusions: VE against symptomatic infection with the SARS-CoV-2 Delta variant varied among brands, ranging from 52% to 91%. While some waning of the vaccine effect may be present (sample size limited this analysis to only Comirnaty), protection was 65% at 90 days or more between vaccination and onset.
- Influenza vaccine effectiveness estimates using the test-negative design with different control groups: a seven-season overviewPublication . Gómez, Verónica; Kislaya, Irina; Machado, Ausenda; Pechirra, Pedro; Costa, Inês; Cristóvão, Paula; Conde, Patrícia; Guiomar, Raquel; Nunes, BaltazarBackground: The test-negative design (TND) has been used to monitor influenza vaccine effectiveness (IVE). Negative controls are those that tested negative for any influenza virus - however, there are issues related to the selection of the negative controls; As it is hypothesized a potential bias introduced by virus interference in TND, some authors suggest to use other respiratory virus as control group. Hence, the objective of this study is to compare IVE estimates using the classic TND and alternative controls.
- Interim 2019/20 influenza vaccine effectiveness: six European studies, September 2019 to January 2020Publication . Rose, Angela; Kissling, Esther; Emborg, Hanne-Dorthe; Larrauri, Amparo; McMenamin, Jim; Pozo, Francisco; Trebbien, Ramona; Mazagatos, Clara; Whitaker, Heather; Machado, Ausenda; Gómez, Verónica; Nunes, Baltazar; Kislaya, Irina; Pechirra, Pedro; Conde, Patrícia; Rodrigues, Ana Paula; Cristóvão, Paula; Costa, Inês; Guiomar, Raquel; European IVE GroupBackground: Influenza A(H1N1)pdm09, A(H3N2) and B viruses were co-circulating in Europe between September 2019 and January 2020. Aim: To provide interim 2019/20 influenza vaccine effectiveness (VE) estimates from six European studies, covering 10 countries and both primary care and hospital settings. Methods: All studies used the test-negative design, although there were some differences in other study characteristics, e.g. patient selection, data sources, case definitions and included age groups. Overall and influenza (sub)type-specific VE was estimated for each study using logistic regression adjusted for potential confounders. Results: There were 31,537 patients recruited across the six studies, of which 5,300 (17%) were cases with 5,310 infections. Most of these (4,466; 84%) were influenza A. The VE point estimates for all ages were 29% to 61% against any influenza in the primary care setting and 35% to 60% in hospitalised older adults (aged 65 years and over). The VE point estimates against A(H1N1)pdm09 (all ages, both settings) was 48% to 75%, and against A(H3N2) ranged from −58% to 57% (primary care) and −16% to 60% (hospital). Against influenza B, VE for all ages was 62% to 83% (primary care only). Conclusions: Influenza vaccination is of continued benefit during the ongoing 2019/20 influenza season. Robust end-of-season VE estimates and genetic virus characterisation results may help understand the variability in influenza (sub) type-specific results across studies.
- Evaluating a training programe: European Health Information Training Programme - EHITPPublication . Gómez, Verónica; Sousa Uva, Mafalda; Roquette, Rita; Garcia, Ana Cristina; Matias Dias, CarlosBackground: The InfAct (Information for Action) is a Joint Action of the European Commission’s 3rd Health Programme with the main goal to build an infrastructure of a health information system for a stronger European Union and to strengthen its core elements. The InfAct Joint Action was developed along 36 months and structured in 10 work packages. Portugal co-led the Work Package 6 (WP6) of this project, which included the development of the proposal of a flagship capacity building programme - the European Health Information Training Programme - and its evaluation. The evaluation objectives included: to evaluate the adequacy of the training programme to the health information needs in the European Member States; to identify possible changes regarding the participants selection process, the training activities and the pedagogical project; and to contribute to the understanding of the potential of the programme to add to available offers in learning on the topics of Public Health information, on the capacity building and behavioural changes in Public Health activities which can be attributed to the course, and of the potential of the programme to contribute to the alignment of health information criteria and procedures between the European Member States. Methods: The evaluation process was developed using an observational descriptive study design using a mixed methodological approach with both document analysis and primary data collected by questionnaires and interviews analysis. Mixed quantitative and qualitative data collection methods and analysis were used. Results The proposal of the European Health Information Training Programme seemed adequate to the formative needs and capacities in line with the work performed by the InfAct project. In what concerns about its main thematic areas, it was also aligned with the areas identified in the previous formative needs and capacities mapping. The participants selection process proposed seemed, in general, adequate. The potential of the European Health Information Training Programme proposal to learning, capacity building and behavioral changes at work attributable to the course was considered positive, as well as the potential to the alignment of health information criteria and procedures between European Union Member States. Discussion In general, we found high consistency between the results obtained from data collected by the techniques used. However, different suggestions for improvement were outlined by the evaluation study population.