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Health technology assessment

Andrew McDowell, Neeraj Raizada, Sunil D Khaparde, Raghuram Rao, Sanjay Sarin, Aakshi Kalra, Virender Singh Salhotra, Sreenivas Achuthan Nair, Catharina Boehme, Claudia M Denkinger
BACKGROUND: Diagnosing tuberculosis (TB) in children presents considerable challenges. Upfront testing on Xpert® MTB/RIF ('Xpert')-a rapid molecular assay with high sensitivity and specificity-for pediatric presumptive TB patients, as recommended by India's Revised National Tuberculosis Control Program (RNTCP), can pave the way for early TB diagnosis. As part of an ongoing project implemented by Foundation for Innovative New Diagnostics (FIND) dedicated to providing upfront free-of-cost (FOC) Xpert testing to children seeking care in the public and private sectors, a qualitative assessment was designed to understand how national guidelines on TB diagnosis and Xpert technology have been integrated into the pediatric TB care practices of different health providers...
2018: PloS One
Sherry Hamby, Zach Blount, Alli Smith, Lisa Jones, Kimberly Mitchell, Elizabeth Taylor
Many forms of victimization, including bullying and property crime, are increasingly moving online, but most studies of poly-victimization still primarily focus on in-person crime and violence. Few studies have examined the importance of incorporating technology-based victimizations for assessing the true burden of violence. The purpose of this study is to explore whether digital poly-victimization contributes to post-traumatic stress and anxiety/dysphoria symptoms after controlling for in-person poly-victimization...
May 2018: Journal of Trauma & Dissociation
Lesley Uttley, Iñigo Bermejo, Shijie Ren, Marrissa Martyn-St James, Ruth Wong, David L Scott, Adam Young, Matt Stevenson
As part of its Single Technology Appraisal process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer (Pfizer) of tofacitinib (TOF; Xeljanz® ) to submit evidence of the drug's clinical and cost-effectiveness in the treatment of rheumatoid arthritis (RA) after the failure of conventional disease-modifying antirheumatic drugs (cDMARDs). The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG)...
March 15, 2018: PharmacoEconomics
Florian Ferreri, Alexis Bourla, Stephane Mouchabac, Laurent Karila
Background: New technologies can profoundly change the way we understand psychiatric pathologies and addictive disorders. New concepts are emerging with the development of more accurate means of collecting live data, computerized questionnaires, and the use of passive data. Digital phenotyping , a paradigmatic example, refers to the use of computerized measurement tools to capture the characteristics of different psychiatric disorders. Similarly, machine learning-a form of artificial intelligence-can improve the classification of patients based on patterns that clinicians have not always considered in the past...
2018: Frontiers in Psychiatry
Lawrence Mj Best, Yemisi Takwoingi, Sulman Siddique, Abiram Selladurai, Akash Gandhi, Benjamin Low, Mohammad Yaghoobi, Kurinchi Selvan Gurusamy
BACKGROUND: Helicobacter pylori (H pylori) infection has been implicated in a number of malignancies and non-malignant conditions including peptic ulcers, non-ulcer dyspepsia, recurrent peptic ulcer bleeding, unexplained iron deficiency anaemia, idiopathic thrombocytopaenia purpura, and colorectal adenomas. The confirmatory diagnosis of H pylori is by endoscopic biopsy, followed by histopathological examination using haemotoxylin and eosin (H & E) stain or special stains such as Giemsa stain and Warthin-Starry stain...
March 15, 2018: Cochrane Database of Systematic Reviews
David A Kalmbach, Yu Fang, J Todd Arnedt, Amy L Cochran, Patricia J Deldin, Adam I Kaplin, Srijan Sen
BACKGROUND: Although short sleep, shift work, and physical inactivity are endemic to residency, a lack of objective, real-time information has limited our understanding of how these problems impact physician mental health. OBJECTIVE: To understand how the residency experience affects sleep, physical activity, and mood, and to understand the directional relationships among these variables. DESIGN: A prospective longitudinal study. SUBJECTS: Thirty-three first-year residents (interns) provided data from 2 months pre-internship through the first 6 months of internship...
March 14, 2018: Journal of General Internal Medicine
Tassia Cristina Decimoni, Roseli Leandro, Luciana Martins Rozman, Dawn Craig, Cynthia P Iglesias, Hillegonda Maria Dutilh Novaes, Patrícia Coelho de Soárez
Background: Brazil has sought to use economic evaluation to support healthcare decision-making processes. While a number of health economic evaluations (HEEs) have been conducted, no study has systematically reviewed the quality of Brazilian HEE. The objective of this systematic review was to provide an overview regarding the state of HEE research and to evaluate the number, characteristics, and quality of reporting of published HEE studies conducted in a Brazilian setting. Methods: We systematically searched electronic databases (MEDLINE, EMBASE, Latin American, and Caribbean Literature on Health Sciences Database, Scientific Electronic Library Online, NHS Economic Evaluation Database, health technology assessment Database, Bireme, and Biblioteca Virtual em Saúde Economia da Saúde ); citation indexes (SCOPUS, Web of Science), and Sistema de Informação da Rede Brasileira de Avaliação de Tecnologia em Saúde ...
2018: Frontiers in Public Health
Galateia J Kazakia, Julio Carballido-Gamio, Andrew Lai, Lorenzo Nardo, Luca Facchetti, Courtney Pasco, Chiyuan A Zhang, Misung Han, Amanda Hutton Parrott, Phyllis Tien, Roland Krug
Background: There is evidence that human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are independent risk factors for osteoporosis and fracture which is not solely explained by changes in bone mineral density. Thus, we hypothesized that the assessment of trabecular microstructure might play an important role for bone quality in this population and might explain the increased fracture risk. In this study, we have assessed bone microstructure in the proximal femur using high-resolution magnetic resonance imaging (MRI) as well as in the extremities using high resolution peripheral quantitative computed tomography (HR-pQCT) in HIV-infected men and healthy controls and compared these findings to those based on areal bone mineral density (aBMD) derived from dual X-ray absorptiometry (DXA) which is the standard clinical parameter for the diagnosis of osteoporosis...
February 2018: Quantitative Imaging in Medicine and Surgery
(no author information available yet)
Background: Type 1 diabetes is a condition in which the pancreas produces little or no insulin. People with type 1 diabetes must manage their blood glucose levels by monitoring the amount of glucose in their blood and administering appropriate amounts of insulin via injection or an insulin pump. Continuous glucose monitoring may be beneficial compared to self-monitoring of blood glucose using a blood glucose meter. It provides insight into a person's blood glucose levels on a continuous basis, and can identify whether blood glucose levels are trending up or down...
2018: Ontario Health Technology Assessment Series
Pratima Murthy
While guidelines for psychosocial interventions in addictive disorders in India were earlier rooted in clinical experience and global empirical evidence, recently there have been efforts to develop guidelines for intervention based on the local needs assessments of specific populations and more appreciably, a testing of the effectiveness of the interventions. This supplement on psychosocial interventions for addictive disorders covers some of the important aspects of psychosocial interventions in five sections...
February 2018: Indian Journal of Psychiatry
Dror Ben-Zeev
Although underdeveloped in mental health care, the sub-Saharan country of Ghana is advanced in telecommunications. In this context, innovative mobile health (mHealth) approaches may help to overcome limited infrastructure (lack of clinics, trained professionals, and landlines) and to address significant unmet public mental health needs. The Technology in Mental Health editor reports on travels to Ghana to assess the viability of mHealth for mental health initiatives in the region. He found that stakeholders from all sectors (patients, providers, government officials, and traditional and faith healers) were open to exploring whether mHealth approaches could promote more humane care, reduce human rights violations, and improve the clinical outcomes of those in need...
March 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Sana B Ali, Juana Romero, Kevin Morrison, Baria Hafeez, Jessica S Ancker
OBJECTIVES:  Although electronic patient portals are offered by most health care organizations, poor usability and poor fit to patient needs may pose barriers to adoption. We collaborated with an academic hospital to conduct iterative user evaluation of a newly deployed portal designed to deliver inpatient data upon hospital discharge. METHODS:  Three evaluators applied heuristic usability evaluation and conducted 23 individual user testing sessions with patients with chronic disease or managing the care of family members with chronic disease...
January 2018: Applied Clinical Informatics
Sahar Dalahmeh, Sana Tirgani, Allan John Komakech, Charles B Niwagaba, Lutz Ahrens
Occurrence and concentrations of 26 per- and polyfluoroalkyl substances (PFASs) were evaluated in wastewater, surface water, soil and crop plants (yam (Dioscorea spp.), maize (Zea mays) and sugarcane (Saccharum officinarum)) in Nakivubo wetland and Lake Victoria at Kampala, Uganda. ∑PFAS concentrations in effluent from Bugolobi wastewater treatment plant (WWTP) were higher (5.6-9.1ngL-1 ) than in the corresponding influent (3.4-5.1ngL-1 ), indicating poor removal of PFASs within the WWTP. ∑PFAS concentrations decreased by a factor of approximately five between Nakivubo channel (8...
March 11, 2018: Science of the Total Environment
F L Chan, R House, I Kudla, J C Lipszyc, N Rajaram, S M Tarlo
Background: 3D printers emit potentially hazardous ultrafine particles and volatile organic compounds. Workers using 3D printing technologies may be at risk of respiratory illness from occupational exposure. Aims: To assess whether 3D printing is associated with health effects in occupational users. Methods: This was a preliminary survey. Workers in 17 companies using 3D printing, including commercial prototyping businesses, educational institutions and public libraries, in the Greater Toronto Area, Canada, were asked to complete survey questionnaires concerning demographic, occupational and health information...
March 10, 2018: Occupational Medicine
Maria Lucia Specchia, Giuseppe La Torre, Giovanna Elisa Calabrò, Paolo Villari, Roberto Grilli, Antonio Federici, Walter Ricciardi, Chiara de Waure
Background: The current economic context calls for rationalizing health resources that can be pursued through disinvestment from low value health technologies to invest in the best performing ones, ensuring high healthcare quality. Oncology is a field where, because of high costs of health technologies and rapid innovation, disinvestment is crucial. Methods: On this basis, the research team investigated through a survey, based on a questionnaire, opinions and views of representatives of European countries about disinvestment, in terms of fields of application, potential advocates and barriers, specifically focusing on cancer care...
March 12, 2018: European Journal of Public Health
Dolly A Parasrampuria, Leslie Z Benet, Amarnath Sharma
New drug development is both resource and time intensive, where later clinical stages result in significant costs. We analyze recent late-stage failures to identify drugs where failures result from inadequate scientific advances as well as drugs where we believe pitfalls could have been avoided. These can be broadly classified into two categories: 1) where science is mature and the failures can be avoided through rigorous and prospectively determined decision-making criteria, scientific curiosity, and discipline to follow up on emerging findings; and 2) where problems encountered in Phase 3 failures cannot be explained at this time, as the science is not sufficiently advanced and companies/investigators need to recognize the possibility of deficiency of our knowledge...
March 13, 2018: AAPS Journal
Yi-Jing Tsai, Yu-Yun Hsu, Ting-Wei Hou, Chiung-Hsin Chang
INTRODUCTION: Women may experience significant stress during pregnancy, and antenatal care and education provide a means to address this. E-health, the use of computer and information technology for health care, has been incorporated into antenatal care and education, but e-health has not been evaluated for its usefulness in addressing stress. The objective of this study was to investigate the effectiveness of a web-based antenatal care and education system on pregnancy-related stress, general self-efficacy, and satisfaction with antenatal care...
March 13, 2018: Journal of Midwifery & Women's Health
Meixun Zheng, Daniel Bender
Computer-based testing (CBT) has made progress in health sciences education. In 2015, the authors led implementation of a CBT system (ExamSoft) at a dental school in the U.S. Guided by the Technology Acceptance Model (TAM), the purposes of this study were to (a) examine dental students' acceptance of ExamSoft; (b) understand factors impacting acceptance; and (c) evaluate the impact of ExamSoft on students' learning and exam performance. Survey and focus group data revealed that ExamSoft was well accepted by students as a testing tool and acknowledged by most for its potential to support learning...
March 13, 2018: Medical Teacher
David J Cottrell, Alex Wright-Hughes, Michelle Collinson, Paula Boston, Ivan Eisler, Sarah Fortune, Elizabeth H Graham, Jonathan Green, Allan O House, Michael Kerfoot, David W Owens, Eirini-Christina Saloniki, Mima Simic, Sandy Tubeuf, Amanda J Farrin
BACKGROUND: Self-harm in adolescents is common and repetition rates high. There is limited evidence of the effectiveness of interventions to reduce self-harm. OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of family therapy (FT) compared with treatment as usual (TAU). DESIGN: A pragmatic, multicentre, individually randomised controlled trial of FT compared with TAU. Participants and therapists were aware of treatment allocation; researchers were blind to allocation...
March 2018: Health Technology Assessment: HTA
Xianghong Zhang, Sanyi Tang, Qiyong Liu, Robert A Cheke, Huaiping Zhu
The introduction of endosymbiont Wolbachia into laboratory-reared mosquito populations, which are then released to mix with natural populations to prevent the mosquito vectors from reproducing and thus break the transmission cycle of dengue disease, is an innovative new technology. Field trials of Wolbachia-carrying mosquitoes have now been implemented in many countries where there have been the outbreaks of dengue disease. A mathematical model is proposed to investigate the effects of non-identical sex ratio releases of Wolbachia-carrying mosquitoes on the control of dengue transmission...
March 9, 2018: Mathematical Biosciences
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