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1.
Artículo en Inglés | MEDLINE | ID: mdl-33114587

RESUMEN

Aim: In this article, we aim to present a tool for the early assessment of medical technologies. This evaluation system was designed and implemented by the National Centre for HTA and the National Centre for Innovative Technologies of the Istituto Superiore di Sanita, Italy, in order to respond to an institutional commitment within the "Health Technologies Assessment Team" that was established to face the huge demand for the evaluation of Health Technologies during the pandemic event caused by COVID-19, with a smart and easy-to-use framework. Methods: Horizon scanning was conducted through a brief assessment carried out according to the multicriteria decision analysis methodology. Each HTA domain was attributed a score according to a pros/cons and opportunities/threats system, derived from evidence in the literature. Scores were weighted according to different perspectives. Scores were presented in a Cartesian graph showing the positioning according to the potential value and the perceived risk associated with the technology. Results: Two case studies regarding the early assessment were reported, concerning two specific technologies: an individual protection device and a contact tracking system.


Asunto(s)
Infecciones por Coronavirus , Técnicas de Apoyo para la Decisión , Pandemias , Neumonía Viral , Evaluación de la Tecnología Biomédica , Betacoronavirus , Humanos , Italia , Riesgo
2.
BMC Health Serv Res ; 7: 79, 2007 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-17547760

RESUMEN

BACKGROUND: In Italy many diabetics still lack adequate care in general practice. We assessed the effectiveness of different strategies for the implementation of an evidence-based guideline for the management of non-complicated type 2 diabetes among General Practitioners (GPs) of Lazio region. METHODS: Three-arm cluster-randomised controlled trial with GPs as units of randomisation (clusters). 252 GPs were randomised either to an active strategy (training module with administration of the guideline), or to a passive dissemination (administration of the guideline only), or to usual care (control). Data on prescriptions of tests and drugs were collected by existing information systems, whereas patients' data came from GPs' databases. Process outcomes were measured at the cluster level one year after the intervention. Primary outcomes concerned the measurement of glycosilated haemoglobin and the commissioning of micro- and macrovascular complications assessment tests. In order to assess the physicians' drug prescribing behaviour secondary outcomes were also calculated. RESULTS: GPs identified 6395 uncomplicated type 2 patients with a high prevalence of cardiovascular risk factors. Data on GPs baseline performance show low proportions of glycosilated haemoglobin assessments. Results of the C-RCT analysis indicate that the active implementation strategy was ineffective relating to all primary outcomes (respectively, OR 1.06 [95% IC: 0.76-1.46]; OR 1.07 [95% IC: 0.80-1.43]; OR 1.4 [95% IC:0.91-2.16]. Similarly, passive dissemination of the guideline showed no effect. CONCLUSION: In our region compliance of GPs with guidelines was not enhanced by a structured learning programme. Implementation through organizational measures appears to be essential to induce behavioural changes. TRIAL REGISTRATION: ISRCTN80116232.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Medicina Familiar y Comunitaria/normas , Adhesión a Directriz , Hipoglucemiantes/administración & dosificación , Análisis por Conglomerados , Diabetes Mellitus Tipo 2/diagnóstico , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Utilización de Medicamentos/normas , Medicina Basada en la Evidencia , Medicina Familiar y Comunitaria/tendencias , Femenino , Humanos , Italia , Masculino , Pautas de la Práctica en Medicina/normas , Pautas de la Práctica en Medicina/tendencias
3.
Vaccine ; 23(46-47): 5299-305, 2005 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-16112254

RESUMEN

The epidemiology of pertussis in Italy is described by using data from the statutory notification system and from seroepidemiology studies. Starting from the 1990s, the incidence of pertussis in Italy has shown a sharp decline and is now at the lowest level ever reached. During this time period vaccination coverage has increased from 88% in 1998 to 95% in 2003. In 1996-97, the prevalence of subjects with levels of IgG antibodies against PT greater than 2EU/ml was 77.6%. The increase in vaccination coverage will probably change the pattern of disease transmission and increase the number of susceptible adults, unless administration of booster doses to adolescents and adults is considered.


Asunto(s)
Vacunación Masiva , Vacuna contra la Tos Ferina , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Adolescente , Adulto , Factores de Edad , Anticuerpos Antibacterianos/análisis , Niño , Preescolar , Femenino , Humanos , Inmunización Secundaria , Lactante , Italia/epidemiología , Masculino , Programas Obligatorios , Vigilancia de la Población , Sistema de Registros , Estudios Seroepidemiológicos , Tos Ferina/mortalidad
4.
Epidemiol Prev ; 27(3): 154-60, 2003.
Artículo en Italiano | MEDLINE | ID: mdl-12958734

RESUMEN

A mathematical model has been developed in order to assess the effect of extended programs of varicella vaccination on the epidemiology of the disease in Italy. The effect of different vaccination options have been estimated by the change in incidence of the disease and age distribution of cases over a short and long period of time. The developed mathematical model reproduces chickenpox transmission and immunisation; five strategies different for target age of vaccination and/or proportion of vaccinated subjects have been considered. In all scenarios the model pointed out an initial decrease of case frequency observed in the first 3-5 years, followed by a series of epidemic peaks, variable in number and size by vaccination strategy. Moreover, as the number of cases among infants decreases, the number of cases among adults increases. Such event is minimised only by very high vaccination coverage (80% in the first year of life and 50% at 12 years of age). Extensive programmes of vaccination against chickenpox must reach a high coverage as soon as possible in order to avoid undesirable effects that may move forward the age of cases and therefore should be offered to target age groups easy to reach.


Asunto(s)
Vacuna contra la Varicela/administración & dosificación , Varicela/prevención & control , Programas de Inmunización/estadística & datos numéricos , Modelos Estadísticos , Varicela/epidemiología , Niño , Preescolar , Humanos , Lactante , Italia
5.
Epidemiol Prev ; 27(6): 340-7, 2003.
Artículo en Italiano | MEDLINE | ID: mdl-15058362

RESUMEN

Key epidemiological parameters (forces of infection, contact matrices, reproduction ratios) from the basic SEIR age structured model for childhood infectious diseases are estimated for all Italian regions from pre-vaccination case-notification data. Such parameters allow to summarise the pre-vaccination epidemiology of measles in the Italian regions, particularly the amount of effort needed for the eradication of the disease, consistently with the WHO targets. Despite the limited reliability paid to Italian case notifications data, the results show i) that the estimated eradication coverages are nor distant from the levels estimated from Northern-Europe; ii) that regions seemingly demanding the largest eradication effort seem also to be those characterised, up to now, by the lowest coverages; iii) the importance of achieving high coverages without delays in the age of administration of vaccination.


Asunto(s)
Sarampión/epidemiología , Adolescente , Adulto , Factores de Edad , Niño , Preescolar , Trazado de Contacto , Notificación de Enfermedades , Humanos , Lactante , Recién Nacido , Italia/epidemiología , Sarampión/prevención & control , Modelos Teóricos , Vacunación , Organización Mundial de la Salud
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