Supporting evidence-based judicial decisions in Brazil: a case study
Ana Luiza Martimbianco, Hospital Sírio-libanês / Unimes
Rachel Riera, Hospital Sírio-Libanês / Universidade Federal de São Paulo / Cochrane Affiliate Rio de Janeiro
Background: Judicial demands related to healthcare increased by 130% in Brazil between 2008 and 2017 . In 2016, the 10 most burdening drugs that were demanded comprised 91% of the resources guaranteed for the acquisition of technologies by the Brazilian Government. From 2018 to 2020, the Health Technology Center of the Hospital Sírio-Libanês conducted an innovative project that capacitated over 400 researchers working in the judiciary system, published 80 research syntheses, and hosted other educational initiatives . Despite the advances in introducing core concepts of evidence-based medicine in judiciary decisions, further work is needed to continue the much-needed improvement in this area.
Objectives: To report the implementation and expected results of the project “Supporting Health Related Judicial Decision in Brasil” an initiative from Hospital Sírio-Libanês, conducted from 2022 to 2023, funded by the Brazilian Ministry of Health initiative (PROADI-SUS) and in partnership with the Brazilian National Justice Council.
Methods: A case study conducted at Health Technology Center, Hospital Sírio-Libanês, São Paulo, Brazil.
Results: From 2022 to 2023, the following activities and main products are expected to be completed: two courses in critical appraisal of primary and secondary studies, 11 regional workshops and chat-based tutoring for health professionals who provide technical support to the judiciary, 10 research syntheses of widely demanded technologies, one nationwide event to promote the topic, and a weekly blog with three informative posts per week. Another innovative product of the project is to develop a digital platform that will offer updated evidence-based information and tutoring to judges across Brazil.
Conclusions: The project was designed to increase the efficiency of judicial decisions in health-related demands. The activities and products will act in the short- and long-term in the system already structured to help judges while deciding on a judicial demand. By adopting evidence-based medicine and research synthesis core concepts in its objectives, the project supports not only a better decision-making process in the judiciary system but also a better healthcare system in Brazil. Patient, public, and/or healthcare consumer involvement: The actions developed in this project are structured to contribute to the efficiency of the Brazilian health system.