GMS health innovation and technologies最新文献

{"title":"Disinvestment initiatives in Malaysia healthcare system: the journey from possibility to reality.","authors":"Hanin Farhana Kamaruzaman, Ku Nurhasni Ku Abd Rahim, Mudla Mohamed Ghazali Izzuna","doi":"10.3205/hta000140","DOIUrl":"10.3205/hta000140","url":null,"abstract":"<p><p>Disinvestment in healthcare allows for strategic reallocation of resources from low-value care to higher-value areas, particularly in promoting clinical effectiveness, improving patient outcomes, and long-term cost savings. The Malaysian Health Technology Assessment Section (MaHTAS) is investigating the incorporation of a disinvestment framework into the health technology life cycle, in accordance with the Ministry of Health Malaysia's recent healthcare transformation strategy. Several health technology assessment (HTA) reports by MaHTAS have integrated concepts of health technology reassessment, with an emphasis on effectiveness and adverse effects. However, the need for additional funds and implementation strategies has impeded the impactful and timely execution of HTA recommendations. This article highlights ongoing efforts to promote disinvestment activities in the Malaysian healthcare system by raising early awareness and engaging with healthcare stakeholders during the planning phase. The journey from the possibility to the reality of implementing healthcare disinvestment initiatives in Malaysia requires addressing both facilitators and challenges. Facilitators identified include strong political will and the presence of global support for collaboration and knowledge sharing, among others. Some of the recognized challenges are getting the trust of the stakeholders, the need for additional funding to support disinvestment programs, and the lack of expertise as well as guideline to carry out the disinvestment process. By highlighting the steps taken and the strategic planning required, this article sheds light on the potential for disinvestment to enhance the efficiency and effectiveness of healthcare delivery in Malaysia, ultimately contributing to a more sustainable healthcare system.</p>","PeriodicalId":92900,"journal":{"name":"GMS health innovation and technologies","volume":"18 ","pages":"Doc03"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11641420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthesis of relevant information around non-core domains to support Multi-Criteria Decision Analysis (MCDA) for decision making.","authors":"Juan Carlos Bayón-Yusta, Asun Gutiérrez-Iglesias, Lorea Galnares-Cordero, Iñaki Gutiérrez-Ibarluzea","doi":"10.3205/hta000139","DOIUrl":"https://doi.org/10.3205/hta000139","url":null,"abstract":"<p><p>Countries fundamentally base macro and micro decision making in the field of health on economic considerations, the budgetary impact of technologies being a major criterion. Nevertheless, the value of the technology of interest and its dimensions are more complex if we seek to take decisions based on the value itself. The use of structured and explicit approaches that require the assessment of multiple criteria that reflect the dimensions of this value may significantly improve the quality of the decision making. Multi-criteria decision analysis (MCDA) is a complementary decision-making tool that is able to systematically incorporate dimensions or domains such as ethical, organisational, legal, environmental and social considerations, as well as costs and benefits of medical interventions, together with the distinct perspectives of the interested parties. The objective of this article is to propose the implementation of analysis of non-core domains, in reports of Health Technology Assessment (HTA) agencies/units. To assess the scientific evidence on MCDA techniques a systematic review was conducted using structured searches in biomedical databases and websites of various HTA organisations. A consensus group was held using the nominal group technique and involving users of healthcare services, providers, managers and academics. Complementary, a survey was sent to HTA agencies to ascertain the degree of implementation of MCDA in their methods. 42 articles reporting the use of non-core criteria for the assessment of health technologies were included in the analysis. From these articles, a total of 216 non-core criteria were retrieved and categorised into domains by the researchers, and of these, 56 were classified as socioeconomic, 59 as organisational, 10 as legal, 8 as environmental and 47 as ethical, while 36 were considered to relate to other domains. The consensus group, based on the 216 non-core criteria obtained from the systematic review, proposed, and defined 26 criteria that participants considered necessary for decision making in healthcare. The consensus group did not consider that any of the domains should be given more weight than others or that any individual criteria should dominate. These approaches can serve as a framework of reference for a well-structured systematic discussion concerning the basis of individual criteria and the evidence supporting them.</p>","PeriodicalId":92900,"journal":{"name":"GMS health innovation and technologies","volume":"18 ","pages":"Doc02"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11035910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Criteria to define innovation in the field of medical devices: a Delphi approach.","authors":"Daniela D'Angela, Antonio Migliore, Iñaki Gutiérrez-Ibarluzea, Barbara Polistena, Federico Spandonaro","doi":"10.3205/hta000138","DOIUrl":"10.3205/hta000138","url":null,"abstract":"<p><p>Defining innovation in the field of medical devices can be extremely challenging due to the peculiarity of the products within this class. Short life-cycle, incrementality, learning curve effect, impact of the organizational setting, uncertainty of effect and level of evidence are only some of these aspects. A clear set of criteria to define innovation would be of paramount relevance in this field. Twelve criteria to define innovation were proposed to a multistakeholder panel within a consensus process. A Delphi method on two rounds was used to reach consensus. In total, 53 of the 93 (47%) invited panelists responded to the first round of the survey. Among them, 51 (96%) completed also the second round. At the first round, consensus was reached for four of the 12 proposed criteria. Three of the remaining eight criteria reached consensus at the second round. It was not possible to reach consensus for the remaining five criteria. The criteria that collected the highest scores (close to 100%) were from the clinical impact domain, namely the ability of the technology to offer significant advantages over existing alternatives in terms of improving relevant clinical outcomes, and the ability to address an unmet need defined in terms of unavailability of diagnosis/treatment alternatives. High levels of consensus (about 80%) were registered on criteria belonging to non-clinical domains of analysis and, in particular, the ability of the technology to introduce organizational benefits, and the ability of the technology to bring cost reduction providing the same clinical benefit of current alternatives.</p>","PeriodicalId":92900,"journal":{"name":"GMS health innovation and technologies","volume":"18 ","pages":"Doc01"},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10967129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the safety, efficacy, effectiveness and cost-effectiveness of implantable Holter for prolonged monitoring in patients with previous stroke: a systematic review.","authors":"Carmen Martín-Gómez,&nbsp;Elena Baños-Álvarez,&nbsp;Rebeca Isabel-Gómez,&nbsp;Juan Antonio Blasco-Amaro","doi":"10.3205/hta000137","DOIUrl":"10.3205/hta000137","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF), which is associated with cryptogenic stroke, is the most common sustained arrhythmia in the general population. Because AF is asymptomatic and intermittent, its detection rate increases with the duration of monitoring. The objective of this study is to review the available evidence on the safety, efficacy, effectiveness and cost-effectiveness of AF diagnosis by prolonged monitoring with an implantable Holter monitor in adult patients with idiopathic or cryptogenic stroke of suspected cardioembolic origin, compared to conventional monitoring.</p><p><strong>Methods: </strong>Two independent reviewers performed a systematic review of the literature, identifying relevant studies through a structured search of Medline (Ovid), EMBASE, Web of Science and Cochrane Library and the databases of national and international health technology assessment agencies. The quality of the included studies was assessed with AGREE-II, AMSTAR-2 and CHEC. GRADE criteria were used to summarise the evidence.</p><p><strong>Results: </strong>Four of the 211 papers identified were included: 1 clinical practice guideline, 2 systematic reviews, and 1 economic evaluation. The quality of the evidence reviewed was low. An implantable Holter monitor might be more effective in detecting AF than conventional monitoring. Serious adverse events were similar in both groups. The economic evaluation suggests that the technology is cost-effective.</p><p><strong>Conclusions: </strong>The available evidence suggests the diagnostic superiority of the implantable Holter monitor over the traditional Holter monitor. Due to the low quality of the evidence, further and higher quality studies on these technologies are needed before solid conclusions can be drawn.</p>","PeriodicalId":92900,"journal":{"name":"GMS health innovation and technologies","volume":"17 ","pages":"Doc01"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The time is now: Achieving FH paediatric screening across Europe - The Prague Declaration.","authors":"Nicole Bedlington,&nbsp;Marianne Abifadel,&nbsp;Birgit Beger,&nbsp;Mafalda Bourbon,&nbsp;Héctor Bueno,&nbsp;Richard Ceska,&nbsp;Kristýna Cillíková,&nbsp;Zdenka Cimická,&nbsp;Magdalena Daccord,&nbsp;Carine de Beaufort,&nbsp;Kanika I Dharmayat,&nbsp;Brian A Ference,&nbsp;Tomáš Freiberger,&nbsp;Marius Geanta,&nbsp;Samuel S Gidding,&nbsp;Urh Grošelj,&nbsp;Martin Halle,&nbsp;Neil Johnson,&nbsp;Tanja Novakovic,&nbsp;Ondrej Májek,&nbsp;Athanasios Pallidis,&nbsp;Noel Peretti,&nbsp;Fausto J Pinto,&nbsp;Kausik Kosh Ray,&nbsp;Bleddyn Rees,&nbsp;John Reeve,&nbsp;Željko Reiner,&nbsp;Raul D Santos,&nbsp;Heribert Schunkert,&nbsp;Jaka Šikonja,&nbsp;Milka Sokolovic,&nbsp;Lale Tokgözoglu,&nbsp;Michal Vrablík,&nbsp;Albert Wiegman,&nbsp;Iñaki Gutiérrez-Ibarluzea","doi":"10.3205/hta000136","DOIUrl":"https://doi.org/10.3205/hta000136","url":null,"abstract":"<p><p>Familial hypercholesterolaemia (FH) is the most common inherited metabolic disorder characterized by high cholesterol and if left untreated leads to premature cardiovascular disease, such as heart attacks. Treatment that begins early in life, particularly in childhood, is highly efficacious in preventing cardiovascular disease and cost-effective, thus early detection of FH is crucial. However, in Europe, less than 10% of people living with FH are diagnosed and even less receive life-saving treatment. The Prague Declaration is a call to action for national and European Union policymakers and decision-makers and a result of the Czech EU Presidency meeting on FH Paediatric Screening (early detection of inherited high cholesterol) at the Czech Senate in Prague on 6th September 2022. It builds on a considerable body of evidence which was discussed at the Technical Meeting under the auspices of the Slovenian EU Presidency in October 2021. The Prague meeting addressed the outstanding barriers to the systematic implementation of FH paediatric screening across Europe. In this article, we present the key points from the Prague meeting and concrete actions needed to move forward.</p>","PeriodicalId":92900,"journal":{"name":"GMS health innovation and technologies","volume":" ","pages":"Doc04"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9583732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40654901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization and comparison of a 2-, 4- and 8-MHz central venous catheter ultrasound probe for venous air emboli detection.","authors":"Philipp Ch Stark,&nbsp;Christoph Kalkbrenner,&nbsp;Werner Klingler,&nbsp;Rainer Brucher","doi":"10.3205/hta000135","DOIUrl":"https://doi.org/10.3205/hta000135","url":null,"abstract":"<p><p>This paper presents a concept for detection of venous air emboli inside the superior vena cava using a central venous catheter with integrated Doppler ultrasound transducer installed on the tip. Several Doppler probes each with a single insonation frequencies of 2 MHz, 4 MHz or 8 MHz are characterized and compared for usefulness in this scenario. During in vitro experiments using an artificial blood circulatory with blood mimicking fluid bubbles with defined volumes were injected and recorded as gaseous embolic events. The in vitro results of measured embolus-blood-ratio values (EBR) in respect to the air bubbles volumes and its echogenicity showed a good correlation with the simulation model of spherical cross section scattering of such air bubbles. It is shown that the probe design still needs some improvements using a 4 MHz insonation frequency to get a useable detection sensitivity in such scenario within vena cava superior. The results suggest that it is possible to estimate the air bubble volume corresponding to the EBR using such a catheter probe.</p>","PeriodicalId":92900,"journal":{"name":"GMS health innovation and technologies","volume":" ","pages":"Doc03"},"PeriodicalIF":0.0,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40589850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The reimbursement coverage decisions and pricing rules for medical devices in Taiwan","authors":"Hsin-Yi Tsai, Yu-Wen Huang, Shu-Ya Chang, Li-Ying Huang, Chii Jeng Lin, Po-Chang Lee","doi":"10.3205/hta000134","DOIUrl":"https://doi.org/10.3205/hta000134","url":null,"abstract":"Medical technology is undergoing rapid transformations, and the classifications of medical devices have also expanded greatly; therefore, it is necessary to develop appropriate reimbursement policies and pricing mechanisms in a timely manner. This paper aims to introduce the reimbursement coverage and pricing rules for medical devices in Taiwan. In addition, this paper identifies and evaluates available health technology assessments (HTA) and literature on published websites concerning medical device decision-making processes and pricing systems in South Korea and Japan, which are near Taiwan and have similar reimbursement coverage processes. Reimbursement policy and pricing mechanisms are constantly being revised in Taiwan, Japan, and South Korea. Recently, all three countries attempted to establish new reimbursement coverage decision-making and pricing rules, adopting a differentiated approach based on the level of evidence required for the appropriated reimbursement in terms of a feasible evaluation mechanism for providing patients with more effective medical devices. This article is expected to contribute to providing references to new reimbursement coverage decision-making and pricing rules.","PeriodicalId":92900,"journal":{"name":"GMS health innovation and technologies","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89235599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disposal practices for unused and expired medications: pilot data from three cities in three countries","authors":"K. Kamal, M. Chiumente, Sari Nakagawa, V. Giannetti, T. Marlin","doi":"10.3205/hta000133","DOIUrl":"https://doi.org/10.3205/hta000133","url":null,"abstract":"Objective: To collect pilot data on medication disposal practices of unused and expired medications from three cities in three countries. Methods: A cross-sectional survey was conducted in Pittsburgh, United States (US); Turin, Italy; and Kobe, Japan. A convenience sampling was utilized through drug take-back programs in Pittsburgh, US; pharmacy customers in Turin, Italy; and pharmacy students and family members in Kobe, Japan. Descriptive analysis was conducted to assess medications disposal practices including attitudes and beliefs of respondents. Results: The sample included 342 respondents [99 (Pittsburgh, US); 168 (Turin, Italy); and 75 (Kobe, Japan)]. The mean unused and expired medications per patient for Pittsburgh, US was (1.60±2.30 and 0.51±1.54); Turin, Italy (1.69±1.86 and 0.49±1.22) and Kobe, Japan (6.69±8.78 and 0.84±2.26). The major reason for unused medications in Pittsburgh, US (31.3%) was “Medication was as needed”; in Turin, Italy (28.0%) “No longer suffer from the condition”; and in Kobe, Japan (54.7%) “No longer suffer from the condition”. The most common reason for expired medications was “No longer suffer from the condition” (Pittsburgh, US 17.2%; Turin, Italy 15.5%; Kobe, Japan 12.0%). The disposal method in Pittsburgh, US was disposing in the toilet (35.4%); returned to the pharmacy in Turin, Italy (51.2%); and disposed the original container in the trash in Kobe, Japan (82.7%). Conclusions: There is a need for counseling protocols regarding proper disposal, which can lead to better adherence, reduction of prescription drug abuse, and less environmental hazards due to improper disposal of prescription medications.","PeriodicalId":92900,"journal":{"name":"GMS health innovation and technologies","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75334046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new HInT in the publishing panorama: an interesting opportunity to those working on health innovation and technologies.","authors":"Antonio Migliore,&nbsp;Hans-Peter Dauben,&nbsp;Iñaki Gutierrez Ibarluzea,&nbsp;Brendon Kearney,&nbsp;Lisa Kurylowicz,&nbsp;Roberta Joppi","doi":"10.3205/hta000131","DOIUrl":"https://doi.org/10.3205/hta000131","url":null,"abstract":"","PeriodicalId":92900,"journal":{"name":"GMS health innovation and technologies","volume":"15 ","pages":"Doc01"},"PeriodicalIF":0.0,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37729335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HTA Metro Map: a patient centred model for optimizing the decision making process.","authors":"Marco Chiumente,&nbsp;Khalid M Kamal,&nbsp;Hans-Peter Dauben,&nbsp;Rainer Riedel,&nbsp;Inaki Gutierrez-Ibarluzea","doi":"10.3205/hta000132","DOIUrl":"https://doi.org/10.3205/hta000132","url":null,"abstract":"<p><p>Health Technology Assessment (HTA) is a systematic evaluation of a health technology, designed to appraise the direct or intended effects and indirect or unintended consequences of the technology with an overall goal of supporting informed decision making regarding the use of these health technologies in the healthcare system. In this paper, we present fundamental HTA concepts and provide a conceptual framework that embraces the processes and outcomes required for integrated healthcare decision-making. The \"HTA Metro Map\" was designed to guide the user through the different areas on: where to use, what and whom to involve within the decision process. The map reflects the complexity and inter-connectedness of the different kind of healthcare services that need to work together to be able to efficiently deliver coordinated decisions at local, regional, national, and international levels. This tool may also serve as base for facilitating developments and improvements of the HTA structure worldwide. The paper discusses the main features of the \"HTA Metro Map\" while reinforcing the key concepts underlying HTA's integrated approach. The first view of the map provides the several layers of complexity seen in HTA and the various lines within the map represent the main actors involved in the assessment processes. The map connections and crossings symbolize the interprofessional and interpersonal collaborations while the stations denote the knowledge, skills, experiences, and attitudes of each professionals as they interact within this framework. Every line represents a HTA stakeholder and the circular line in the centre represents the patient at the centre of the system. The zones, from social to community and hospital level, represent the need for integration from the perspective of health systems. The HTA Metro Map also has different dimensions depicted by the level of profoundness. Finally, the concepts of different healthcare stakeholder perspectives are introduced both in visual and temporal terms. The \"HTA Metro Map\" is designed as a flexible model for easy adaptability and in accurately capturing the complexity inherent in any healthcare system. It is hoped that the map will assist different stakeholders to build network capacity, pool existing resources, and develop a more holistic vision that will result in a sustainable, efficient and collaborative decision-making process.</p>","PeriodicalId":92900,"journal":{"name":"GMS health innovation and technologies","volume":"15 ","pages":"Doc02"},"PeriodicalIF":0.0,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37729336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}