Economic evaluations conducted by Canadian health technology assessment agencies: Where do we stand?

2008 ◽  
Vol 24 (04) ◽  
pp. 437-444 ◽  
Author(s):  
Jean-Eric Tarride ◽  
Catherine Elizabeth McCarron ◽  
Morgan Lim ◽  
James M. Bowen ◽  
Gord Blackhouse ◽  
...  
Keyword(s):  
Web Sites ◽  
Impact Analysis ◽  
Evidence Synthesis ◽  
Clinical Information ◽  
Health Technology ◽  
Sensitivity Analyses ◽  
Economic Evaluations ◽  
Policy Recommendations ◽  
Design Retrieval ◽  
Selection Of

Objectives:To examine the production of Health Technology Assessments (HTAs) with economic evaluations (EEs) conducted by Canadian HTA agencies.Methods:This research used a three-step approach: (i) the Web sites of five Canadian organizations promoting HTA were searched to identify HTA reports with EEs; (ii) HTA agencies were surveyed to verify that our information was complete with respect to HTA activities and to describe the factors that influence the HTA process in Canada (i.e., selection of HTA topics, execution, dissemination of results and future trends); (iii) HTAs with EEs were appraised in terms of study design, retrieval of clinical and economic evidence, resource utilization and costing, effectiveness measures, treatment of uncertainty as well as presence of a budget impact analysis (BIA), and policy recommendations.Results:Two hundred forty-nine HTA reports were identified of which 19 percent included EEs (n= 48). Decision analytic techniques were used in approximately 75 percent of the forty-eight EEs and probabilistic sensitivity analyses were commonly used by all agencies to deal with parameter uncertainty. BIAs or policy recommendations were given in 50 percent of the evaluations. Differences between agencies were observed in terms of selection of topics, focus of assessment and production of HTA (e.g., in-house activities). Major barriers to the conduct of HTAs with EEs were capacity, a lack of interest by decision makers and a lack of robust clinical information.Conclusions:The results of this research point to the need for increased HTA training, collaboration, evidence synthesis, and use of pragmatic “real world” evaluations.

Medical Privacy and the Internet

2009 ◽  
pp. 17-29
Author(s):  
D. John Doyle
Keyword(s):  
Web Sites ◽  
Clinical Information ◽  
Health Technology ◽  
Hippocratic Oath ◽  
The Internet ◽  
Team Members ◽  
Privacy Concerns ◽  
Technological Developments ◽  
Potential Benefits ◽  
Medical Privacy

E-health technology has started to become commonplace in the clinical world, with practitioners setting up their own Web sites to disseminate educational information to patients, with physicians and nurses working as team members to access clinical information about a patient using an electronic patient chart, and with patients even conducting their own research to make informed decisions about clinical options.However, these potential benefits must be tempered from the perspective of medical privacy. Ever since the Hippocratic Oath of antiquity, protecting the privacy of patients has been an important precept of medical ethics. With technological developments, however, health information has come into use by many organizations and individuals that may be unsensitized to medical privacy concerns. This report is concerned with these issues.

Pharmacoeconomics for Dermatologists: An Introduction

1997 ◽  
Vol 1 (3) ◽  
pp. 185-189
Author(s):  
Aditya K. Gupta ◽  
Paul I. Oh ◽  
Neil H. Shear
Keyword(s):  
Health Care ◽  
Medical Literature ◽  
Treatment Options ◽  
Decision Makers ◽  
Sensitivity Analyses ◽  
Economic Evaluations ◽  
Therapeutic Decision ◽  
Therapeutic Decision Making ◽  
Care Decision ◽  
Selection Of

Background: The budgets available for health care are becoming constrained and health care decision makers have increasingly begun to scrutinize cost along with efficacy, tolerability, and cost of the different treatment options for each disease state. In keeping with the above, there has been a marked increase in the number of pharmacoeconomic evaluations published in the medical literature, including dermatology journals. Methods: Comprehensive economic evaluations systematically consider the following: statement of question, defining relevant costs, perspective and time-horizon, synthesis of data on efficacy and effectiveness, and selection of the appropriate analytic type and framework. The conclusions should be tested through extensive sensitivity analyses. Conclusions: Economic evaluations are becoming more prevalent in the field of dermatology. A well-constructed analysis may be an aid to more rational therapeutic decision-making.

scholarly journals Rival perspectives in health technology assessment and other economic evaluations for investing in global and national health. Who decides? Who pays?

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 72 ◽  
Author(s):  
Anthony Culyer ◽  
Kalipso Chalkidou ◽  
Yot Teerawattananon ◽  
Benjarin Santatiwongchai
Keyword(s):  
Health Technology Assessment ◽  
Societal Perspective ◽  
Technology Assessment ◽  
Health Technology ◽  
Economic Evaluations ◽  
First Principle ◽  
Explicit Statement ◽  
The One ◽  
Selection Of ◽  
The Ideal

There seems to be a general agreement amongst practitioners of economic evaluations, including Health Technology Assessment, that the explicit statement of a perspective is a necessary element in designing and reporting research. Moreover, there seems also to be a general presumption that the ideal perspective is “societal”. In this paper we endorse the first principle but dissent from the second. A review of recommended perspectives is presented. The societal perspective is frequently not the one recommended. The societal perspective is shown to be less comprehensive than is commonly supposed, is inappropriate in many contexts and, in any case, is in general not a perspective to be determined independently of the context of a decision problem. Moreover, the selection of a perspective, societal or otherwise, is not the prerogative of analysts.

scholarly journals Powered mobility interventions for very young children with mobility limitations to aid participation and positive development: the EMPoWER evidence synthesis

2020 ◽  
Vol 24 (50) ◽  
pp. 1-194
Author(s):  
Nathan Bray ◽  
Niina Kolehmainen ◽  
Jennifer McAnuff ◽  
Louise Tanner ◽  
Lorna Tuersley ◽  
...  
Keyword(s):  
Social Sciences ◽  
Cost Effectiveness ◽  
Young Children ◽  
Impact Analysis ◽  
Budget Impact ◽  
Citation Index ◽  
Evidence Synthesis ◽  
Health Technology ◽  
Mobility Limitations ◽  
Very Young Children

Background One-fifth of all disabled children have mobility limitations. Early provision of powered mobility for very young children (aged < 5 years) is hypothesised to trigger positive developmental changes. However, the optimum age at which to introduce powered mobility is unknown. Objective The aim of this project was to synthesise existing evidence regarding the effectiveness and cost-effectiveness of powered mobility for very young children, compared with the more common practice of powered mobility provision from the age of 5 years. Review methods The study was planned as a mixed-methods evidence synthesis and economic modelling study. First, evidence relating to the effectiveness, cost-effectiveness, acceptability, feasibility and anticipated outcomes of paediatric powered mobility interventions was reviewed. A convergent mixed-methods evidence synthesis was undertaken using framework synthesis, and a separate qualitative evidence synthesis was undertaken using thematic synthesis. The two syntheses were subsequently compared and contrasted to develop a logic model for evaluating the outcomes of powered mobility interventions for children. Because there were insufficient published data, it was not possible to develop a robust economic model. Instead, a budget impact analysis was conducted to estimate the cost of increased powered mobility provision for very young children, using cost data from publicly available sources. Data sources A range of bibliographic databases [Cumulative Index to Nursing and Allied Health Literature (CINHAL), MEDLINE, EMBASE™ (Elsevier, Amsterdam, the Netherlands), Physiotherapy Evidence Database (PEDro), Occupational Therapy Systematic Evaluation of Evidence (OTseeker), Applied Social Sciences Index and Abstracts (ASSIA), PsycINFO, Science Citation Index (SCI; Clarivate Analytics, Philadelphia, PA, USA), Social Sciences Citation Index™ (SSCI; Clarivate Analytics), Conference Proceedings Citation Index – Science (CPCI-S; Clarivate Analytics), Conference Proceedings Citation Index – Social Science & Humanities (CPCI-SSH; Clarivate Analytics), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA) Database and OpenGrey] was systematically searched and the included studies were quality appraised. Searches were carried out in June 2018 and updated in October 2019. The date ranges searched covered from 1946 to September 2019. Results In total, 89 studies were included in the review. Only two randomised controlled trials were identified. The overall quality of the evidence was low. No conclusive evidence was found about the effectiveness or cost-effectiveness of powered mobility in children aged either < 5 or ≥ 5 years. However, strong support was found that powered mobility interventions have a positive impact on children’s movement and mobility, and moderate support was found for the impact on children’s participation, play and social interactions and on the safety outcome of accidents and pain. ‘Fit’ between the child, the equipment and the environment was found to be important, as were the outcomes related to a child’s independence, freedom and self-expression. The evidence supported two distinct conceptualisations of the primary powered mobility outcome, movement and mobility: the former is ‘movement for movement’s sake’ and the latter destination-focused mobility. Powered mobility should be focused on ‘movement for movement’s sake’ in the first instance. From the budget impact analysis, it was estimated that, annually, the NHS spends £1.89M on the provision of powered mobility for very young children, which is < 2% of total wheelchair service expenditure. Limitations The original research question could not be answered because there was a lack of appropriately powered published research. Conclusions Early powered mobility is likely to have multiple benefits for very young children, despite the lack of robust evidence to demonstrate this. Age is not the key factor; instead, the focus should be on providing developmentally appropriate interventions and focusing on ‘movement for movement’s sake’. Future work Future research should focus on developing, implementing, evaluating and comparing different approaches to early powered mobility. Study registration This study is registered as PROSPERO CRD42018096449. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology programme and will be published in full in Health Technology Assessment; Vol. 24, No. 50. See the NIHR Journals Library website for further project information.

CONTEMPORARY ASPECTS IN THE SELECTION OF TOOLS AND TECHNOLOGIES FOR DEVELOPING WEB SITES

2018 ◽  
pp. 125-131
Author(s):  
Petar Halachev ◽  
Aleksandra Todeva ◽  
Gergana Georgieva ◽  
Marina Jekova
Keyword(s):  
Programming Languages ◽  
Web Sites ◽  
Web Site ◽  
Work Process ◽  
Design And Development ◽  
Site Development ◽  
Complicated Process ◽  
The Creation ◽  
Guidelines And Recommendations ◽  
Selection Of

he report explores and analyzes the application of the most popular programming languages from different organizations: GitHub; Stackoverflow; the TIOBE's Community index. The main client technologies: HTML; CSS; JavaScript; Typescript are presented and analysed. Features are characterized and the advantages and the disadvantages of the server technologies are described: Java; PHP; Python; Ruby. The application areas for web site development technologies have been defined. The creation of a quality web site is a complex and complicated process, but by observing some guidelines and recommendations in the work process can help to select the tools and the technologies in its design and development.

A Primer on the Assessment of Economic Impacts of Leisure Events

2020 ◽  
Vol 24 (1) ◽  
pp. 47-56
Author(s):  
Ove Oklevik ◽  
Grzegorz Kwiatkowski ◽  
Mona Kristin Nytun ◽  
Helene Maristuen
Keyword(s):  
Impact Assessment ◽  
Economic Impact ◽  
Study Design ◽  
Impact Analysis ◽  
Sensitivity Analyses ◽  
Primary Data ◽  
Music Festival ◽  
Economic Impact Analysis ◽  
Economic Impact Assessment ◽  
Input Variables

The quality of any economic impact assessment largely depends on the adequacy of the input variables and chosen assumptions. This article presents a direct economic impact assessment of a music festival hosted in Norway and sensitivity analyses of two study design assumptions: estimated number of attendees and chosen definition (size) of the affected area. Empirically, the article draws on a state-of-the-art framework of an economic impact analysis and uses primary data from 471 event attendees. The results show that, first, an economic impact analysis is a complex task that requires high precision in assessing different monetary flows entering and leaving the host region, and second, the study design assumptions exert a tremendous influence on the final estimation. Accordingly, the study offers a fertile agenda for local destination marketing organizers and event managers on how to conduct reliable economic impact assessments and explains which elements of such analyses are particularly important for final estimations.

Consumer involvement in the health technology assessment program

2004 ◽  
Vol 20 (4) ◽  
pp. 493-497 ◽  
Author(s):  
Jane Royle ◽  
Sandy Oliver
Keyword(s):  
Health Technology Assessment ◽  
Organizational Development ◽  
Technology Assessment ◽  
Health Technology ◽  
Consumer Involvement ◽  
Policy Recommendations ◽  
Staff Time ◽  
Job Descriptions ◽  
Assessment Program ◽  
Research Resources

Objectives: This study aims to describe a cycle of development leading to sustainable methods for involving consumers in the management of a program commissioning health technology assessment.Methods: Staff time was dedicated to developing procedures for recruiting and briefing consumers to participate in prioritizing, commissioning, and reporting research. Resources and support were developed in light of early feedback from consumers and those working with them. These were piloted and amended before being used routinely.Results: Over 4 years, procedures and resources have been developed to support six consumers attending seven to eight prioritization meetings a year; thirty to forty-five consumers each year commenting on research need for particular topics; thirty consumers a year commenting on research proposals, and twenty a year commenting on research reports. The procedures include clear job descriptions, induction and development days, clear briefing materials, payment for substantial tasks, and regularly seeking feedback to improve procedures.Conclusions: Explicit, inclusive, and reproducible methods for supporting consumer involvement that satisfy National Health Service policy recommendations for involving consumers in research require dedicated staff time to support a cycle of organizational development.

Telestroke for acute ischaemic stroke: A systematic review of economic evaluations and a de novo cost–utility analysis for a middle income country

2021 ◽  
pp. 1357633X2110324
Author(s):  
Elise Tan ◽  
Lan Gao ◽  
Huong NQ Tran ◽  
Dominique Cadilhac ◽  
Chris Bladin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Rural China ◽  
Stroke Care ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Sensitivity Analyses ◽  
Economic Evaluations ◽  
Utility Analysis

Introduction Telemedicine can alleviate the problems faced in rural settings in providing access to specialist stroke care. The evidence of the cost-effectiveness of this model of care outside high-income countries is limited. This study aimed to conduct: (a) a systematic review of economic evaluations of telestroke and (b) a cost–utility analysis of telestroke, using China as a case study. Methods We systematically searched Embase, Medline Complete and Cochrane databases. Inclusion criteria: full economic evaluations of telemedicine/telestroke networks examining the use of thrombolysis in patients with acute ischaemic stroke, published in English. A cost–utility analysis was undertaken using a Markov model incorporating a decision tree to simulate the delivery of telestroke for acute ischaemic stroke in rural China, compared to no telestroke from a societal and healthcare perspective. One-way deterministic sensitivity analyses and probabilistic sensitivity analyses were performed to test the robustness of results. Results Of 559 publications found, eight met the eligibility criteria and were included in the systematic review (two cost-effectiveness analyses and six cost–utility analyses, all performed in high-income countries). Telestroke was a cost-saving/cost-effective intervention in five out of the eight studies. In our modelled analysis for rural China, telestroke was the dominant strategy, with estimated cost savings of Chinese yuan 4,328 (US$627) and additional 0.0925 quality-adjusted life years per patient. Sensitivity analyses confirmed the base case results. Discussion Consistent with published economic evaluations of telestroke in other jurisdictions, telestroke represents a cost-effective solution to enhance stroke care in rural China.

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