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"Health technology assessment"

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
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
(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
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
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
Marta O Soares, Simon Walker, Stephen J Palmer, Mark J Sculpher
In recent years, Health Technology Assessment (HTA) processes specific to diagnostics and prognostic tests have been created in response to the increased pressure on health systems to decide not only which tests should be used in practice but also the best way to proceed, clinically, from the information they provide. These technologies differ in the way value is accrued to the population of users, depending critically on the value of downstream health care choices. This paper defines an analytical framework for establishing the value of diagnostic and prognostic tests for HTA in a way that is consistent with methods used for the evaluation of other health care technologies...
March 1, 2018: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Kadri Mägi, Marika Lepaste, Monika Szkultecka-Dębek
The aim of this article was to present a general overview of the health care system as well as pricing and reimbursement environment in Estonia. In Estonia the main stakeholders in the pharmaceutical sector are the Ministry of Social Affairs, the State Agency of Medicine, and the Estonian Health Insurance Fund. The national health insurance scheme is public, and approximately 95% of the population is covered by it. It is a social insurance, and universal and equal access to health care based on national health insurance is granted...
March 9, 2018: Value in Health Regional Issues
Tien Le, Christopher Giede
OBJECTIVES: To optimize the management of adnexal masses and to assist primary care physicians and gynaecologists determine which patients presenting with an ovarian mass with a significant risk of malignancy should be considered for gynaecologic oncology referral and management. OPTIONS: Laparoscopic evaluation, comprehensive surgical staging for early ovarian cancer, or tumour debulking for advanced stage ovarian cancer. OUTCOMES: To optimize conservative versus operative management of women with possible ovarian malignancy and to optimize the involvement of gynaecologic oncologists in planning and delivery of treatment...
March 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Giovanni Improta, Mario Alessandro Russo, Maria Triassi, Giuseppe Converso, Teresa Murino, Liberatina Carmela Santillo
Health technology assessments (HTAs) are often difficult to conduct because of the decisive procedures of the HTA algorithm, which are often complex and not easy to apply. Thus, their use is not always convenient or possible for the assessment of technical requests requiring a multidisciplinary approach. This paper aims to address this issue through a multi-criteria analysis focusing on the analytic hierarchy process (AHP). This methodology allows the decision maker to analyse and evaluate different alternatives and monitor their impact on different actors during the decision-making process...
March 5, 2018: Mathematical Biosciences
Matthew Cox, Catherine O'Connor, Katie Biggs, Daniel Hind, Oscar Bortolami, Matthew Franklin, Barbara Collins, Stephen Walters, Allan Wailoo, Julie Channell, Paul Albert, Ursula Freeman, Stephen Bourke, Michael Steiner, Jon Miles, Tom O'Brien, David McWilliams, Terry Schofield, John O'Reilly, Rodney Hughes
BACKGROUND: Chronic obstructive pulmonary disease (COPD) affects > 3 million people in the UK. Acute exacerbations of COPD (AECOPD) are the second most common reason for emergency hospital admission in the UK. Pulmonary rehabilitation is usual care for stable COPD but there is little evidence for early pulmonary rehabilitation (EPR) following AECOPD, either in hospital or immediately post discharge. OBJECTIVE: To assess the feasibility of recruiting patients, collecting data and delivering EPR to patients with AECOPD to evaluate EPR compared with usual care...
March 2018: Health Technology Assessment: HTA
Florian Dams, Javier Leonardo Gonzalez Rodriguez, Kei Long Cheung, Ben F M Wijnen, Mickaël Hiligsmann
OBJECTIVES: Several studies, mostly from developed countries, have identified barriers and facilitators with regard to the uptake of health technology assessment (HTA). This study elicited, using best-worst scaling (BWS), what HTA experts in Colombia consider to be the most important barriers and facilitators in the use of HTA, and makes a comparison to results from the Netherlands. METHODS: Two object case surveys (one for barriers, one for facilitators) were conducted among 18 experts (policy makers, health professionals, PhD students, senior HTA-researchers) from Colombia...
March 7, 2018: Journal of Medical Economics
Geoffrey David Debelle, Sabine Maguire, Patrick Watts, Rosa Nieto Hernandez, Alison Mary Kemp
The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) has recently published what they purported to be a systematic review of the literature on 'isolated traumatic shaking' in infants, concluding that 'there is limited evidence that the so-called triad (encephalopathy, subdural haemorrhage, retinal haemorrhage) and therefore its components can be associated with traumatic shaking'. This flawed report, from a national body, demands a robust response. The conclusions of the original report have the potential to undermine medico-legal practice...
March 6, 2018: Archives of Disease in Childhood
Tricia McKeever, Kevin Mortimer, Andrew Wilson, Samantha Walker, Christopher Brightling, Andrew Skeggs, Ian Pavord, David Price, Lelia Duley, Mike Thomas, Lucy Bradshaw, Bernard Higgins, Rebecca Haydock, Eleanor Mitchell, Graham Devereux, Timothy Harrison
Background Asthma exacerbations are frightening for patients and are occasionally fatal. We tested the concept that a plan for patients to manage their asthma (self-management plan), which included a temporary quadrupling of the dose of inhaled glucocorticoids when asthma control started to deteriorate, would reduce the incidence of severe asthma exacerbations among adults and adolescents with asthma. Methods We conducted a pragmatic, unblinded, randomized trial involving adults and adolescents with asthma who were receiving inhaled glucocorticoids, with or without add-on therapy, and who had had at least one exacerbation in the previous 12 months...
March 3, 2018: New England Journal of Medicine
Alison F Smith, Mike Messenger, Peter Hall, Claire Hulme
INTRODUCTION: Numerous factors contribute to uncertainty in test measurement procedures, and this uncertainty can have a significant impact on the downstream clinical utility and cost-effectiveness of testing strategies. Currently, however, there is no clear guidance concerning if or how such factors should be considered within Health Technology Assessments (HTAs) of tests. OBJECTIVE: The aim was to provide an introduction to key concepts in measurement uncertainty for the HTA community and to explore, via systematic review, current methods utilised within HTAs...
March 3, 2018: PharmacoEconomics
G E Calabrò, G La Torre, C de Waure, P Villari, A Federici, W Ricciardi, M L Specchia
BACKGROUND: In an era of a growing economic pressure for all health systems, the interest for "disinvestment" in healthcare increased. In this context, evidence based approaches such as Health Technology Assessment (HTA) are needed both to invest and to disinvest in health technologies. In order to investigate the extent of application of HTA in this field, methodological projects/frameworks, case studies, dissemination initiatives on disinvestment released by HTA agencies and organizations located in Europe were searched...
March 1, 2018: BMC Health Services Research
(no author information available yet)
Background: Hospital-acquired infections (HAIs) are infections that patients contract while in the hospital that were neither present nor developing at the time of admission. In Canada an estimated 10% of adults with short-term hospitalization have HAIs. According to 2003 Canadian data, between 4% and 6% of these patients die from these infections. The most common HAIs in Ontario are caused by Clostridium difficile . The standard method of reducing and preventing these infections is decontamination of patient rooms through manual cleaning and disinfection...
2018: Ontario Health Technology Assessment Series
Joan M Quigley, Juliette C Thompson, Nicholas J Halfpenny, David A Scott
RATIONALE, AIMS, AND OBJECTIVES: When randomized controlled trial data are limited or unavailable, or to supplement randomized controlled trial evidence, health technology assessment (HTA) agencies may rely on systematic reviews of nonrandomized studies (NRSs) for evidence of the effectiveness of health care interventions. NRS designs may introduce considerable bias into systematic reviews, and several methodologies by which to evaluate this risk of bias are available. This study aimed to identify tools commonly used to assess bias in NRS and determine those recommended by HTA bodies...
February 27, 2018: Journal of Evaluation in Clinical Practice
Thomas G Poder, Christian A Bellemare
OBJECTIVES: Contextual data and local expertise are important sources of data that cannot be ignored in hospital-based health technology assessment (HTA) processes. Despite a lack of or unconvincing evidence in the scientific literature, technology can be recommended in a given context. We illustrate this using a case study regarding biplane angiography for vascular neurointervention. METHODS: A systematic literature review was conducted, along with an analysis of the context in our setting...
February 27, 2018: International Journal of Technology Assessment in Health Care
Marie-France Mamzer, Sophie Dubois, Christian Saout, Nicolas Albin, Jehan-Michel Béhier, Anne Buisson, Vincent Diebolt, Olivier Delaitre, Christophe Duguet, Jean-Yves Fagon, Ségolène Gaillard, Claire Le Jeunne, René Mazars, Joëlle Micallef, Hervé Nabarette, Laurent Piazza, Catherine Raynaud, Nathalie Varoqueaux
The constant development of health technologies, combined with the increase in the cost of treatment, means that States must continually make choices about the introduction of new technologies into their healthcare system and how they are to be funded. In France, the systematic participation of patients in these processes is one of the targets to be met in terms of healthcare democracy. Although, on an international level, patient involvement in these assessments is constantly growing, it is difficult to define due to the presence of unstabilised elements in terms of both terminology and assessment methods...
December 21, 2017: Thérapie
Charles E Phelps, Darius N Lakdawalla, Anirban Basu, Michael F Drummond, Adrian Towse, Patricia M Danzon
The fifth section of our Special Task Force report identifies and discusses two aggregation issues: 1) aggregation of cost and benefit information across individuals to a population level for benefit plan decision making and 2) combining multiple elements of value into a single value metric for individuals. First, we argue that additional elements could be included in measures of value, but such elements have not generally been included in measures of quality-adjusted life-years. For example, we describe a recently developed extended cost-effectiveness analysis (ECEA) that provides a good example of how to use a broader concept of utility...
February 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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