scholarly journals Biomedical Scent Detection Dogs: Would They Pass as a Health Technology?

2018 ◽  
pp. 1-7
Author(s):  
Catherine Reeve ◽  
Mirkka Koivusalo
Keyword(s):  
Patient Outcomes ◽  
Clinical Effectiveness ◽  
Health Technology ◽  
Point Of View ◽  
Health Technologies ◽  
Training Techniques ◽  
Scent Detection ◽  
Social Organizational ◽  
Micro Organisms ◽  
Regulatory Controls

Biomedical scent detection dogs identify the scent profiles of diseases, such as cancer, diabetes or pathogenic micro-organisms.  What the field of biomedical scent detection has been lacking, however, is the assessment of the method from the point of view of a health technology. All health technologies undergo a thorough evaluation of safety, clinical effectiveness and costs, as well as ethical, social, organizational and legal evaluations in some cases. Passing these regulatory controls is a pre-requisite before a technology is approved for use in decision-making about patient outcomes. Biomedical scent detection has a lot of attractive qualities, such as the sensitivity and specificity of the dogs’ noses, safety and relative cost-effectiveness. But the method also has various challenges, in particular regarding its clinical effectiveness. The most pertinent issues to address before the dogs would pass as a health technology are standardization the training techniques, both intra- and inter-dog reproducibility, and generalization of the detection task to early stages of disease progression. We suggest setting realistic goals in terms of what the dogs can and cannot do and a collaborative approach between clinicians and animal psychophysicists.

scholarly journals IMPLEMENTATION OF HEALTH TECHNOLOGY ASSESSMENT WORK IN A HOSPITAL IN KAZAKHSTAN

2016 ◽  
Vol 32 (1-2) ◽  
pp. 78-80 ◽  
Author(s):  
Lyazzat Kosherbayeva ◽  
David Hailey ◽  
Kural Kurakbaev ◽  
Aleksey Tsoy ◽  
Ormanbek Zhuzzhanov ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
New Technologies ◽  
Clinical Effectiveness ◽  
Hospital Staff ◽  
Health Technology ◽  
Single Incision Laparoscopic Surgery ◽  
City Hospital ◽  
Health Technologies ◽  
Additional Funding

Objectives: The aim of this study was to implement health technology assessment (HA) in the First General City Hospital in Astana, Kazakhstan.Methods: We organized trainings to familiarize hospital staff with the purpose and details of HTA. An HTA committee was established, with representation from hospital physicians and managers, and criteria for prioritization of health technologies determined. Clinical departments of the hospital were asked to prepare applications for new technologies for their services.Results: The HTA committee reviewed five applications and selected a technology from one of these, on single incision laparoscopic surgery (SILS), for assessment. A short HTA report on SILS was prepared, covering its safety, clinical effectiveness, and cost effectiveness. The report was used to support a request to the Department of Health for additional funding to implement this technology within the hospital. This funding was approved and SILS was established in several hospital departments.Conclusions: This successful initial experience with HTA has paved the way for its routine use by the hospital for informing decisions on the procurement and use of new health technologies.

scholarly journals A PROCESS OF PRIORITIZING TOPICS FOR HEALTH TECHNOLOGY ASSESSMENT IN KAZAKHSTAN

2016 ◽  
Vol 32 (3) ◽  
pp. 147-151 ◽  
Author(s):  
Lyazzat Kosherbayeva ◽  
David Hailey ◽  
Kural Kurakbaev ◽  
Adlet Tabarov ◽  
Ainur Kumar ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Budget Impact ◽  
Clinical Effectiveness ◽  
Health Technology ◽  
Policy Makers ◽  
Health Technologies ◽  
Department Staff ◽  
Selection Of

Objectives: The aim of this study was to develop criteria for the prioritization of topics for health technology assessment (HTA) in the healthcare system of Kazakhstan.Methods: Initial proposals for criteria were suggested through consultation with Ministry of Health (MoH) policy areas. These were refined through a workshop attended by HTA department staff, persons from medical universities and research institutes, and MoH policy makers. The workshop included discussion on methods used in international HTA practice. Opinions of participants on selection of criteria from those specified in a review of prioritization processes were used to define a list for inclusion in an instrument for routine use. A scoring system was established in later discussion.Results: Selected criteria for HTA prioritization were burden of disease, availability of alternative technology, clinical effectiveness, economic efficiency, budget impact, and ethical, legal, and/or psychosocial aspects. For each criterion, a health technology under consideration is given a score from 3 (High) to 1 (Low). The total score determines whether the technology is of high to medium priority or of low priority. Determination of priorities for assessment, using the instrument, should be carried out by an expert group appointed by the MoH. The process was applied in 2014 to a selection of topics, and three health technologies were chosen for full assessments.Conclusions: Criteria for prioritization have evolved with development of the HTA program in Kazakhstan. A method for HTA prioritization has been developed that is easy to apply, requires comparatively few resources, and is compatible with processes required by the MoH.

OP279 Monitoring The Effectiveness Of Implementing And Using New Health Technologies In Hospital Practice

2020 ◽  
Vol 36 (S1) ◽  
pp. 5-5
Author(s):  
Andrey Avdeyev ◽  
Valeriy Benberin ◽  
Nasrulla Shanazarov ◽  
Maigul Kudaibergenova ◽  
Aigul Kaptagayeva ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Real Data ◽  
Clinical Effectiveness ◽  
Economic Assessment ◽  
Health Technology ◽  
Economic Effectiveness ◽  
High Tech ◽  
Hospital Practice ◽  
Health Technologies

IntroductionAccording to international experience in the field of hospital-based health technology assessment (HB-HTA), most of the implemented new health technologies must undergo a clinical and economic assessment (CEA) of their viability by creating a mini-health technology assessment report. However, HB-HTA should not be limited only to the initial CEA; further monitoring of the effectiveness of implemented new health technologies is necessary.MethodsWe developed a special reporting form for creating a CEA of implemented new health technologies and integrated it into the hospital information system. Indicators of clinical effectiveness are determined individually for each implemented technology. The main indicators of economic effectiveness are financial results (or net profit) and profitability—high-cost and high-tech health technologies have priority for monitoring.ResultsIn order to ensure a more detailed and complete CEA of implemented health technologies, the following measures were proposed: (i) before implementing the technology, determine the key clinical effectiveness criteria for further monitoring for each implemented health technology; (ii) if possible, determine comparative technologies (alternatives or analogs) for conducting comparative CEA of the implemented health technologies; and (iii) carry out a prospective CEA of the implemented health technologies with a view to publishing the results.ConclusionsThe organization of a continuous monitoring process that analyzes the effectiveness and usage of new health technologies in hospital practice will allow assessment of the following: the clinical effectiveness and safety of the implemented technologies in comparison with world data; the economic effectiveness of the technology, including an accurate calculation of the payback period for investments; and the “real” data on the effectiveness of implemented health technologies in comparison with the initial request for implementation.

scholarly journals Health Technology Optimization Analysis: Conceptual Approach and Illustrative Application

2018 ◽  
Vol 3 (1) ◽  
pp. 238146831877480 ◽  
Author(s):  
Charles Yan ◽  
Yufei Zheng ◽  
Michael D. Hill ◽  
Balraj Mann ◽  
Thomas Jeerakathil ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
Patient Outcomes ◽  
Geographical Location ◽  
Health Technology ◽  
Illustrative Case ◽  
Optimization Approach ◽  
Conceptual Approach ◽  
Health Technologies ◽  
Services Delivery

We present a conceptual approach to determine the optimal solution to delivering a health technology, consistent with the objective of maximizing patient outcomes subject to resources available to a publicly funded health system. The article addresses two key policy questions: 1) adding system values through appropriate planning of health services delivery and 2) considering the tradeoff between patient outcomes and costs to the health system through appropriate use of health technologies for conditions with time-dependent treatment outcomes. We develop a health technology optimization framework that considers geographical variation and searches for the best delivery method through a pairwise comparison of all possible strategies, factoring in controlled variables including disease epidemiology, time or distance to hospitals, available medical services, treatment eligibility, treatment efficacy, and costs. Taking variations of these factors into account would help support a more efficient allocation of health resources. Drawing identified strategies together then creates a map of optimal strategies. We apply the proposed method to a policy-relevant health technology assessment of endovascular therapy (EVT) for treating acute ischemic stroke. The best strategy for providing EVT relies on the geographical location of stroke onset and the decision maker’s preference for either patient outcomes or economic efficiency. The proposed method produced an optimization map showing the optimal strategy for EVT delivery, which maximizes patient outcomes while minimizing health system costs. In the illustrative case study, there were no tradeoffs between health outcomes and costs, meaning that the delivery strategies that were clinically optimal for patients were also the most cost-effective. In conclusion, the health technology optimization approach is a useful tool for informing implementation decisions and coordinating the delivery of complex health services such as EVT.

scholarly journals Valutazione etica in un processo di HTA di un trattamento per l’infertilità

2012 ◽  
Vol 61 (6) ◽  
Author(s):  
Maria Luisa Di Pietro ◽  
Pietro Refolo
Keyword(s):  
Technology Assessment ◽  
Health Technology ◽  
Point Of View ◽  
Theoretical Point ◽  
Ethical Dimension ◽  
Organizational Impact ◽  
Multidisciplinary Research ◽  
Modus Operandi ◽  
Ethical Assessment ◽  
Health Technologies

Come modalità di ricerca multidisciplinare, i programmi di Health Technology Assessment (HTA) hanno da sempre previsto, almeno in via teorica, la realizzazione anche delle valutazioni etiche sull’impiego di tecnologie sanitarie alla stregua di quelle sulla sicurezza, l’efficacia, l’impatto economico, l’impatto organizzativo, ecc. Nella pratica, tutto ciò è stato, però, per lo più disatteso e le valutazioni etiche hanno trovato posto nei report di HTA solo in tempi più recenti e con una frequenza comunque limitata. Con l’obiettivo di presentare il modus operandi e gli esiti di questo tipo di analisi ed eventualmente innescare un dibattito sull’argomento, il contributo riporta la valutazione delle conseguenze di tipo etico sull’uso di un trattamento per la cura della infertilità, il Fostimon. Più in particolare, tale valutazione ha fatto parte di un programma di HTA, organizzato dal Centro di Ricerca in Ingegneria sanitaria ambientale e valutazione delle tecnologie sanitarie dell’Università Cattolica del Sacro Cuore di Roma con lo scopo di stabilirne la preferibilità rispetto ad altri trattamenti. ---------- As multidisciplinary research, from a theoretical point of view, HTA programs should include the ethical assessment on the use of health technologies and also the assessment of safety, efficacy, economic impact, organizational impact, etc.. Nevertheless, in practice, the integration of the ethical dimension into HTA reports has been often limited. The paper includes the evaluation on the ethical consequences of the use of Fostimon, a treatment for infertility, with the aim of presenting modus operandi and results of this type of analysis and possibly opening the debate. Particularly, this assessment is part of an HTA program, organized by the Centro di Ricerca in Ingegneria sanitaria ambientale e valutazione delle tecnologie sanitarie of the Università Cattolica del Sacro Cuore of Rome with the purpose of determining the convenience of the treatment.

scholarly journals Estimating an EQ-5D-3L Value Set for Romania Using Time Trade-Off

2021 ◽  
Vol 18 (14) ◽  
pp. 7415
Author(s):  
Marian Sorin Paveliu ◽  
Elena Olariu ◽  
Raluca Caplescu ◽  
Yemi Oluboyede ◽  
Ileana-Gabriela Niculescu-Aron ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Assessment Process ◽  
Computer Assisted ◽  
Health State ◽  
Health States ◽  
Value Set ◽  
Health Technologies ◽  
Related Quality

Objective: To provide health-related quality of life (HRQoL) data to support health technology assessment (HTA) and reimbursement decisions in Romania, by developing a country-specific value set for the EQ-5D-3L questionnaire. Methods: We used the cTTO method to elicit health state values using a computer-assisted personal interviewing approach. Interviews were standardized following the most recent version of the EQ-VT protocol developed by the EuroQoL Foundation. Thirty EQ-5D-3L health states were randomly assigned to respondents in blocks of three. Econometric modeling was used to estimate values for all 243 states described by the EQ-5D-3L. Results: Data from 1556 non-institutionalized adults aged 18 years and older, selected from a national representative sample, were used to build the value set. All tested models were logically consistent; the final model chosen to generate the value set was an interval regression model. The predicted EQ-5D-3L values ranged from 0.969 to 0.399, and the relative importance of EQ-5D-3L dimensions was in the following order: mobility, pain/discomfort, self-care, anxiety/depression, and usual activities. Conclusions: These results can support reimbursement decisions and allow regional cross-country comparisons between health technologies. This study lays a stepping stone in the development of a health technology assessment process more driven by locally relevant data in Romania.

scholarly journals Extrapolating Parametric Survival Models in Health Technology Assessment Using Model Averaging: A Simulation Study

2021 ◽  
Vol 41 (4) ◽  
pp. 476-484
Author(s):  
Daniel Gallacher ◽  
Peter Kimani ◽  
Nigel Stallard
Keyword(s):  
Survival Time ◽  
Survival Data ◽  
Mean Squared Error ◽  
Model Averaging ◽  
Information Criterion ◽  
Health Technology ◽  
Weighted Averaging ◽  
Health Technologies ◽  
Mean Survival Time ◽  
Restricted Mean Survival Time

Previous work examined the suitability of relying on routine methods of model selection when extrapolating survival data in a health technology appraisal setting. Here we explore solutions to improve reliability of restricted mean survival time (RMST) estimates from trial data by assessing model plausibility and implementing model averaging. We compare our previous methods of selecting a model for extrapolation using the Akaike information criterion (AIC) and Bayesian information criterion (BIC). Our methods of model averaging include using equal weighting across models falling within established threshold ranges for AIC and BIC and using BIC-based weighted averages. We apply our plausibility assessment and implement model averaging to the output of our previous simulations, where 10,000 runs of 12 trial-based scenarios were examined. We demonstrate that removing implausible models from consideration reduces the mean squared error associated with the restricted mean survival time (RMST) estimate from each selection method and increases the percentage of RMST estimates that were within 10% of the RMST from the parameters of the sampling distribution. The methods of averaging were superior to selecting a single optimal extrapolation, aside from some of the exponential scenarios where BIC already selected the exponential model. The averaging methods with wide criterion-based thresholds outperformed BIC-weighted averaging in the majority of scenarios. We conclude that model averaging approaches should feature more widely in the appraisal of health technologies where extrapolation is influential and considerable uncertainty is present. Where data demonstrate complicated underlying hazard rates, funders should account for the additional uncertainty associated with these extrapolations in their decision making. Extended follow-up from trials should be encouraged and used to review prices of therapies to ensure a fair price is paid.

The Ethics of Mobile Health Technology

2017 ◽  
Vol 41 (S1) ◽  
pp. S39-S39
Author(s):  
S. Galderisi ◽  
F. Caputo
Keyword(s):  
Health Equity ◽  
Mobile Health ◽  
New Technologies ◽  
Ethical Issues ◽  
Professional Associations ◽  
Health Technology ◽  
Ethical Guidelines ◽  
High Quality ◽  
Quality Healthcare ◽  
Health Technologies

IntroductionMobile health (m-health) technology has been growing rapidly in the last decades. The use of this technology represents an advantage, especially for reaching patients who otherwise would have no access to healthcare. However, many ethical issues arise from the use of m-health. Health equity, privacy policies, adequate informed consent and a competent, safe and high quality healthcare need to be guaranteed; professional standards and quality of doctor-patient relationship in the digital setting should not be lower than those set for in-person practice.AimsTo assess advantages and threats that may arise from the wide use of m-health technologies, in order to guarantee the application of the best medical practices, resulting in the highest quality healthcare.MethodsA literature search has been conducted to highlight the most pressing ethical issues emerging from the spreading of m-health technologies.ResultsFew ethical guidelines on the appropriate use of m-health have been developed to help clinicians adopt a professional conduct within digital settings. They focus on the need for professional associations to define ethical guidelines and for physicians to take care of their education and online behavior when using m-health technologies.ConclusionsThe rapid spreading of m-health technologies urges us to evaluate all ethical issues related to its use. It would be advisable to produce an ethical code for the use of these new technologies, to guarantee health equity, privacy protection, high quality doctor-patient relationships and to ensure that m-health is not chosen over traditional care for merely economic purposes.Disclosure of interestSG received honoraria or Advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter. All other authors have declared.

scholarly journals Effective colonoscopy training techniques: strategies to improve patient outcomes

2016 ◽  
pp. 201
Author(s):  
Pantelis Karatzas ◽  
Lazaros Varytimiadis ◽  
Athanasios Tsigaridas ◽  
Michael Galanopoulos ◽  
Nikos Viazis ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Training Techniques ◽  
Improve Patient

scholarly journals Current Evidence and Future Perspectives on the Effective Practice of Patient-Centered Laboratory Medicine

2015 ◽  
Vol 61 (4) ◽  
pp. 589-599 ◽  
Author(s):  
Mike J Hallworth ◽  
Paul L Epner ◽  
Christoph Ebert ◽  
Corinne R Fantz ◽  
Sherry A Faye ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Clinical Effectiveness ◽  
Laboratory Medicine ◽  
Current Evidence ◽  
Patient Centered ◽  
Definition Of ◽  
Current Utilization ◽  
Measures Of Effectiveness ◽  
The Impact ◽  
Primary Measure

AbstractBACKGROUNDSystematic evidence of the contribution made by laboratory medicine to patient outcomes and the overall process of healthcare is difficult to find. An understanding of the value of laboratory medicine, how it can be determined, and the various factors that influence it is vital to ensuring that the service is provided and used optimally.CONTENTThis review summarizes existing evidence supporting the impact of laboratory medicine in healthcare and indicates the gaps in our understanding. It also identifies deficiencies in current utilization, suggests potential solutions, and offers a vision of a future in which laboratory medicine is used optimally to support patient care.SUMMARYTo maximize the value of laboratory medicine, work is required in 5 areas: (a) improved utilization of existing and new tests; (b) definition of new roles for laboratory professionals that are focused on optimizing patient outcomes by adding value at all points of the diagnostic brain-to-brain cycle; (c) development of standardized protocols for prospective patient-centered studies of biomarker clinical effectiveness or extraanalytical process effectiveness; (d) benchmarking of existing and new tests in specified situations with commonly accepted measures of effectiveness; (e) agreed definition and validation of effectiveness measures and use of checklists for articles submitted for publication. Progress in these areas is essential if we are to demonstrate and enhance the value of laboratory medicine and prevent valuable information being lost in meaningless data. This requires effective collaboration with clinicians, and a determination to accept patient outcome and patient experience as the primary measure of laboratory effectiveness.

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