An evidence-based framework for identifying technologies of no or low-added value (NLVT)

2019 ◽  
Vol 36 (1) ◽  
pp. 50-57
Author(s):  
María Eugenia Esandi ◽  
Iñaki Gutiérrez-Ibarluzea ◽  
Nora Ibargoyen-Roteta ◽  
Brian Godman
Keyword(s):  
Ad Hoc ◽  
Added Value ◽  
Evidence Based ◽  
Flexible Tool ◽  
Wide Definition ◽  
Basic Approaches ◽  
Definition Of ◽  
Medical Reversal ◽  
Health Technology Reassessment ◽  
New Framework

ObjectiveTo synthetize the state of the art of methods for identifying candidate technologies for disinvestment and propose an evidence-based framework for executing this task.MethodsAn interpretative review was conducted. A systematic literature search was performed to identify secondary or tertiary research related to disinvestment initiatives and/or any type of research that specifically described one or more methods for identifying potential candidates technologies, services, or practices for disinvestment. An iterative and critical analysis of the methods described alongside the disinvestment initiatives was performed.ResultsSeventeen systematic reviews on disinvestment or related terms (health technology reassessment or medical reversal) were retrieved and methods of 45 disinvestment initiatives were compared. On the basis of this evidence, we proposed a new framework for identifying these technologies based on the wide definition of evidence provided by Lomas et al. The framework comprises seven basic approaches, eleven triggers and thirteen methods for applying these triggers, which were grouped in embedded and ad hoc methods.ConclusionsAlthough identification methods have been described in the literature and tested in different contexts, the proliferation of terms and concepts used to describe this process creates considerable confusion. The proposed framework is a rigorous and flexible tool that could guide the implementation of strategies for identifying potential candidates for disinvestment.

OP177 Identification Of Technologies Of No Or Low Added Value

2018 ◽  
Vol 34 (S1) ◽  
pp. 65-65
Author(s):  
Maria Eugenia Esandi ◽  
Iñaki Gutiérrez-Ibarluzea ◽  
Nora Ibargoyen-Roteta ◽  
Brian Godman
Keyword(s):  
Health Technology Assessment ◽  
Systematic Reviews ◽  
Technology Assessment ◽  
Ad Hoc ◽  
Descriptive Analysis ◽  
Health Gain ◽  
Health Technology ◽  
Added Value ◽  
Limited Health ◽  
Basic Approaches

Introduction:Health technology has no or low added value when it is harmful and/or is deemed to deliver limited health gain relative to its cost, representing inefficient health resource allocation. A joint effort by the Health Technology Assessment International (HTAi) interest group (IG) on disinvestment and early awareness, the IG on ethics, the EuroScan network and the International Network of Agencies for Health Technology Assessment (INAHTA) is aiming to design a toolkit that could aid organizations and individuals considering disinvestment activities. We synthesized state of the art methods for identifying candidate technologies for disinvestment, and propose a framework for executing this task.Methods:We searched systematic reviews on disinvestment and compared the methods used for identifying potential candidates. A descriptive analysis was performed including sources of evidence used and methods for selection / filtration.Results:Ten systematic reviews were retrieved, and the methods of 29 disinvestment initiatives were compared. A new framework for identifying potential candidates was proposed which comprises seven basic approaches based on the wide definition of evidence provided by Lomas et al.; 11 triggers for disinvestment were adapted from Elshaug's proposal, and 13 methods for applying these triggers that were grouped in embedded and ad-hoc methods.Conclusions:Identification methods have been described in the literature, and have been tested in different contexts. Context is crucial in determining the ‘not to do’ practices as they are described in different sources.

scholarly journals Understanding Social Impact and Value Creation in Hybrid Organizations: The Case of Italian Civil Service

2021 ◽  
Vol 13 (7) ◽  
pp. 4058
Author(s):  
Paolo Esposito ◽  
Valerio Brescia ◽  
Chiara Fantauzzi ◽  
Rocco Frondizi
Keyword(s):  
Value Chain ◽  
Social Impact ◽  
Civil Service ◽  
Added Value ◽  
Hybrid Organizations ◽  
Case Study Analysis ◽  
Public Resources ◽  
Five Elements ◽  
Definition Of ◽  
The Impact

The aim of this paper is twofold: first, it aims to analyze what kind of value is generated by hybrid organizations and how; second, it aims to understand the role of social impact assessment (SIA) in the measurement of added value, especially in terms of social and economic change generated by hybrids. Hybrid organizations are a debated topic in literature and have different strengths in responding to needs, mainly in the public interest. Nevertheless, there are not many studies that identify the impact and change generated by these organizations. After highlighting the gap in the literature, the study proposes an innovative approach that combines SIA, interview, interventionist approach and documental analysis. The breakdown of SIA through the five elements of the value chain (inputs, activities, outputs, outcomes, and impact) guarantees a linear definition of the value generated through change with procedural objectivity capable of grasping hybrid organizations’ complexity. The value generated or absorbed is the change generated by the impact measured based on the incidence of public resources allocated. Through the SIA and counterfactual approach, the civil service case study analysis highlights how the value generated by public resources can be measured or more clearly displayed in the measurement process itself.

scholarly journals FEM Simulations for the Optimization of the Inlet Gate System in Rapid Investment Casting Process for the Realization of Heat Exchangers

2021 ◽  
Author(s):  
D. Almonti ◽  
G. Baiocco ◽  
E. Mingione ◽  
N. Ucciardello
Keyword(s):  
Investment Casting ◽  
Heat Exchangers ◽  
Complex Geometry ◽  
Heat Pipes ◽  
Casting Process ◽  
Added Value ◽  
Cad Models ◽  
Gate System ◽  
Definition Of ◽  
Metallic Parts

AbstractOver the last decades, additive manufacturing (AM) has become the principal production technology for prototypes and components with high added value. In the production of metallic parts, AM allows producing complex geometry with a single process. Also, AM admits a joining of elements that could not be realized with traditional methods. In addition, AM allows the manufacturing of components that could not be realized using other types of processes like reticular structures in heat exchangers. A solid mold investment casting that uses printed patterns overcomes typical limitations of additive processes such as expensive machinery and challenging process parameter settings. Indeed, rapid investment casting provides for a foundry epoxy pattern reproducing the component to exploit in the lost wax casting process. In this paper, aluminium radiators with flat heat pipes seamlessly connected with a cellular structure were conceived and produced. This paper aims at defining and investigating the principal foundry parameters to achieve a defect-free heat exchanger. For this purpose, different device CAD models were designed, considering four pipes’ thickness and length. Finite element method numerical simulations were performed to optimize the design of the casting process. Three different gate configurations were investigated for each length. The numerical investigations led to the definition of a castability range depending on flat heat pipes geometry and casting parameters. The optimal gate configuration was applied in the realization of AM patterns and casting processes

Sign in / Sign up

Export Citation Format

Share Document