OP21 Involving Clinical Experts In Prioritizing Topics For Health Technology Assessment: A Randomized Controlled Trial

2017 ◽  
Vol 33 (S1) ◽  
pp. 9-10
Author(s):  
Andrew Cook ◽  
Elke Streit ◽  
Gill Davage
Keyword(s):  
Randomized Controlled Trial ◽  
Health Services ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Controlled Trial ◽  
Health Technology ◽  
Free Text ◽  
Usual Practice ◽  
Randomized Controlled ◽  
The Difference

INTRODUCTION:The National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme commissions research to inform health services in the United Kingdom. The program prioritises research ideas from literature, guidelines, patients, and clinicians, to decide which research should be funded. We get clinical input on these ideas through (i) committees of clinicians and patients and (ii) seeking written advice from multiple clinicians — a refereeing process. Chairs of our committees suggested that the material we sent to clinicians was too extensive and the method of response too burdensome. We set out to determine whether reducing the information provided or burden of response would improve the engagement of clinicians with our processes, and hence improve the quality of advice provided, and the research available to health services.METHODS:We undertook a factorial randomized controlled trial (University of Southampton Faculty of Medicine Ethics Committee #8192, Trial registration: ACTRN12614000167662). Each participant was randomized to receive one of two types of material to comment on, and one of two means to respond. In the first allocation participants were randomised in a 1:1 ratio between receiving a ‘vignette’ (a briefing paper of up to ten pages discussing possible research = usual practice), or a ‘commissioning brief’ (a single page summarising the proposed research). In the second allocation, the method of response was randomized, between a structured form and free text email.RESULTS:We randomized 460 clinical experts, and 356 (77.4 percent) responded. The responses were graded for quality on a scale of 0 to 4 (higher scores better). Non-response was scored as 0. Analysis using ANOVA gave results of a structured response scoring .34 points (Standard Deviation, SD .36) over a freeform response (p = .02); and the commissioning brief as .04 points over a vignette (p = .81).CONCLUSIONS:This was the first randomized trial to take place inside the secretariat of the HTA program. The difference in quality score between the brief and the vignette allocations was neither statistically nor practically important. The difference between the structured and freeform response was statistically significant, and sufficiently large to be important in practice. While the choice of material to share with clinicians seems unimportant we have shown that it is worth sending a structured response form to experts.

Introduction: Using Medical Registries and Data Sets for Technology Assessment

1991 ◽  
Vol 7 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Alexia Antczak-bouckoms ◽  
Elisabeth Burdick ◽  
Sidney Klawansky ◽  
Frederick Mosteller
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Health Services ◽  
Study Design ◽  
Technology Assessment ◽  
Controlled Trial ◽  
Data Sets ◽  
National Data ◽  
Medical Technologies ◽  
Randomized Controlled

The rising costs of health care and interest in the evaluation of health services and systems have sparked an increased need for technology assessment. A variety of available methods of assessment are described in the Institute of Medicine's book Assessing Medical Technologies (1). Although such methods as the randomized controlled trial (RCT) are widely accepted and used, obtaining information by such methods often takes a considerable amount of time, expense, and sophistication in study design. These costs suggest that a broader range of methods for collecting information about health care technologies should be considered. A vast resource of data collected on patients, ranging from a provider's practice records to national data sets, might be useful for technology assessment if it could be properly appraised.

The Alberta hip and knee replacement project: A model for health technology assessment based on comparative effectiveness of clinical pathways

2009 ◽  
Vol 25 (02) ◽  
pp. 113-123 ◽  
Author(s):  
Katherine L. Gooch ◽  
Douglas Smith ◽  
Tracy Wasylak ◽  
Peter D. Faris ◽  
Deborah A. Marshall ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Knee Replacement ◽  
Study Design ◽  
Technology Assessment ◽  
Comparative Effectiveness ◽  
Clinical Pathways ◽  
Controlled Trial ◽  
Health Technology ◽  
Randomized Controlled

Background:The Alberta Hip and Knee Replacement Project developed a new evidence-based clinical pathway (NCP) for total hip (THR) and knee (TKR) replacement. The aim was to facilitate the delivery of services in a timely and cost-effective manner while achieving the highest quality of care for the patient across the full continuum of care from patient referral to an orthopedic surgeon through surgery, recovery, and rehabilitation. The purpose of this article is to provide an overview of the study design, rationale, and execution of this project as a model for health technology assessment based on comparative effectiveness of alternative clinical pathways.Methods:A pragmatic randomized controlled trial study design was used to evaluate the NCP compared with the standard of care (SOC) for these procedures. The pragmatic study design was selected as a rigorous approach to produce high quality evidence suitable for informing decisions between relevant interventions in real clinical practice. The NCP was evaluated in three of the nine regional health authorities (RHAs) in Alberta with dedicated central intake clinics offering multidisciplinary care teams, constituting 80 percent of THR and TKR surgeries performed annually in Alberta. Patients were identified in the offices of twenty orthopedic surgeons who routinely performed THR or TKR surgeries. Evaluation outcome measures were based on the six dimensions of the Alberta Quality Matrix for Health (AQMH): acceptability, accessibility, appropriateness, effectiveness, efficiency and safety. Data were collected prospectively through patient self-completed questionnaires at baseline and 3 and 12 months after surgery, ambulatory and inpatient chart reviews, and electronic administrative data.Results:The trial design was successful in establishing similar groups for rigorous evaluation. Of the 4,985 patients invited to participate, 69 percent of patients consented. A total of 3,434 patients were randomized: 1,712 to SOC and 1,722 to the NCP. The baseline characteristics of patients in the two study arms, including demographics, comorbidity as measured by CDS and exposure to pain medications, and health-related quality of life, as measured by Western Ontario and McMaster Universities Osteoarthritis Index and Short Form-36, were similar.Conclusions:The Alberta Hip and Knee Replacement Project demonstrates the feasibility and advantages of applying a pragmatic randomized controlled trial to ascertain comparative effectiveness. This is a model for health technology assessment that incorporates how clinical pathways can be effectively evaluated.

scholarly journals Effect of Linear and Nonlinear Pedagogy Physical Education Interventions on Children’s Physical Activity: A Cluster Randomized Controlled Trial (SAMPLE-PE)

Children ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 49
Author(s):  
Matteo Crotti ◽  
James R. Rudd ◽  
Simon Roberts ◽  
Lynne M. Boddy ◽  
Katie Fitton Davies ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Physical Education ◽  
Primary Schools ◽  
Controlled Trial ◽  
Control Group ◽  
Usual Practice ◽  
Randomized Controlled ◽  
Children’S Physical Activity ◽  
Pedagogical Approaches

Background: School-based interventions are a key opportunity to improve children’s physical activity (PA); however, there is lack of evidence about how pedagogical approaches to motor learning in physical education (PE) might affect PA in children. Therefore, this study aimed to assess how different pedagogical approaches in PE might affect children’s PA. Methods: Participants (n = 360, 5–6 years) from 12 primary schools within the SAMPLE-PE randomized controlled trial were randomly allocated to either Linear Pedagogy (LP: n = 3) or Nonlinear Pedagogy (NP: n = 3) interventions, where schools received a 15-week PE intervention delivered by trained coaches, or to a control group (n = 6), where schools followed usual practice. ActiGraph GT9X accelerometers were used to assess PA metrics (moderate-to-vigorous PA, mean raw acceleration and lowest acceleration over the most active hour and half hour) over whole and segmented weeks at baseline, immediately post-intervention and 6 months follow-up. Intention to treat analysis employing multilevel modelling was used to assess intervention effects. Results: LP and NP interventions did not significantly affect children’s PA levels compared to the control group. Conclusion: PE interventions based on LP and NP alone might not be effective in improving habitual PA in children.

Citation Advantage of Promoted Articles in a Cross-Publisher Distribution Platform: 36-month Follow-up to a Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Paul Kudlow ◽  
Tashauna Brown
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Control Group ◽  
Digital Tool ◽  
Randomized Controlled ◽  
Subject Areas ◽  
The Subject ◽  
The Difference ◽  
Citation Advantage

BACKGROUND There are limited evidence-based strategies that have been shown to increase the rate at which peer-reviewed articles are cited. In a previously reported randomized controlled trial we demonstrated that promotion of article links in an online cross-publisher distribution platform (TrendMD) persistently augments citation rates after 12 months, leading to a statistically significant, 50% increase in citations relative to control. OBJECTIVE To investigate if the citation advantage of promoted articles upholds after 36-months. METHODS Three thousand two hundred articles published in 64 peer-reviewed journals across eight subject areas were block randomized at the subject level to either the TrendMD group (n=1600) or the control group (n=1600) of the study. Articles were promoted in the TrendMD Network for 6 months. We compared the citation rates in both groups after 36 months. RESULTS At 36 months, we found the citation advantage endured; articles randomized to TrendMD showed a 28% increase in mean citations relative to control. The difference in mean citations at 36 months for articles randomized to TrendMD versus control was 10.52, 95% CI [3.79, 17.25] and was statistically significant (p=0.001). CONCLUSIONS To our knowledge, this is the first randomized controlled trial to demonstrate how a post-publication article promotion intervention can be used to persistently augment citations of peer-reviewed articles. TrendMD is an efficient digital tool for knowledge translation and dissemination to targeted audiences to facilitate uptake of research.

Effects of Guitar Accompaniment Patterns on Hospitalized Infants: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Kory Antonacci ◽  
Nicole Steele ◽  
Jacob Wheatley ◽  
Donna M Weyant ◽  
Beverly Brozanski ◽  
...  
Keyword(s):  
Heart Rate ◽  
Randomized Controlled Trial ◽  
Music Therapy ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Pain Scale ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Stressful Environment ◽  
The Difference

Abstract A neonatal intensive care unit (NICU) can be an extremely stressful environment for infants receiving complex medical care at a pediatric facility. Music therapy can help address the stressful environment by increasing comfort and relaxation as well as decreasing a patient’s physiological response of heart rate and respiratory rate. A randomized controlled trial was completed, examining the effects of 2 guitar accompaniment patterns on infants (an arpeggiated pattern and a bass/chord pattern) in a NICU. There were 180 infants enrolled with mean chronological ages of 7.4 ± 6.1 weeks and postmenstrual ages (gestational age at birth + their chronological age) of 39.8 ± 7.9 weeks. All subject enrollees participated in a 12-minute initial music therapy session. Outcome measures included heart rate, respirations, and comfort responses. The results of the research study demonstrated that the arpeggiated guitar pattern had a lower mean heart rate and respiratory across all 3 data points (pre, during, and post intervention); however, the difference in means between the 2 accompaniment pattern groups was not statistically significant. Using the Neonatal Infant Pain Scale (NIPS) to measure comfort response, the results demonstrated no difference between the 2 group accompaniment patterns. Although the results show no significant differences among accompaniment pattern groups, the researchers describe the clinical significance that supports the use of both accompaniment patterns as suitable interventions for infants in the NICU receiving music therapy intervention.

scholarly journals Organisational models of health services for children and adolescents in out‐of‐home care: Health technology assessment

2019 ◽  
Vol 109 (2) ◽  
pp. 250-257
Author(s):  
Tita Mensah ◽  
Anders Hjern ◽  
Kickan Håkanson ◽  
Pia Johansson ◽  
Ann Kristine Jonsson ◽  
...  
Keyword(s):  
Health Services ◽  
Home Care ◽  
Health Technology Assessment ◽  
Children And Adolescents ◽  
Technology Assessment ◽  
Health Technology ◽  
Out Of Home Care ◽  
Care Health

scholarly journals Effect of Acupuncture on Intraocular Pressure in Glaucoma Patients: A Single-Blinded, Randomized, Controlled Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Shu-Yuan Chen ◽  
Feng-Shuen Yieh ◽  
Wen-Ling Liao ◽  
Tsai-Chung Li ◽  
Ching-Liang Hsieh
Keyword(s):  
Randomized Controlled Trial ◽  
Intraocular Pressure ◽  
Sham Group ◽  
Ganglion Cells ◽  
Controlled Trial ◽  
Ocular Blood Flow ◽  
Retinal Ganglion ◽  
Randomized Controlled ◽  
Ocular Perfusion ◽  
The Difference

Glaucoma is characterized by the degeneration of retinal ganglion cells that cause progressive optic neuropathy, finally resulting in changes to the optic nerve head. Lowering intraocular pressure (IOP) is the only method proven for treating glaucoma. Several studies have discovered that acupuncture can reduce IOP and also increase ocular perfusion and ocular blood flow. Therefore, the present study investigated the effect of acupuncture on IOP in glaucoma patients. We conducted a single-blinded, randomized, controlled trial involving 45 glaucoma patients. The results indicated that the difference between the IOP 60 min after the intervention and IOP immediately before the intervention was greater in the acupuncture group (AG) and electroacupuncture group (EG) than in the sham group (SG) for all four of the interventions performed and in both eyes (all p<0.05). The IOP difference between immediately before the first intervention and after finishing the final intervention was also greater in the AG and EG than in the SG in both eyes (all p<0.05). In conclusion, IOP was reduced at 60 min after acupuncture or electroacupuncture was performed at BL1 and EX-HN7. Additionally, IOP was reduced after finishing four acupuncture or electroacupuncture sessions. Therefore, our results suggest that acupuncture and electroacupuncture are beneficial for lowering IOP in glaucoma patients. This trial is registered with NCT04157530.

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