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1.
Stud Health Technol Inform ; 263: 35-48, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31411151

RESUMO

Information value chain theory provides a straightforward approach to information system evaluation and design. It first separates the different benefits and costs that might be associated with the use of a given information technology at different stages along a value chain stretching from user interaction to real world outcome. Next, using classical decision theoretic measures such as probabilities and utilities, the resulting value chain can be used to create a profile for a particular technology or technology bundle. Value chain analysis helps focus on the reasons for system implementation success or failure. It also assists in making comparative assessments amongst different solutions, to understand which might be best suited for different clinical contexts.


Assuntos
Tecnologia Biomédica , Tomada de Decisões , Avaliação da Tecnologia Biomédica , Probabilidade , Tecnologia
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46649

RESUMO

Utilizando o GRADE em recomendações para incorporação de tecnologias (ATS)


Assuntos
Abordagem GRADE , Avaliação da Tecnologia Biomédica
3.
Khirurgiia (Mosk) ; (6): 119-124, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31317952

RESUMO

The purpose of the present research was to analyze the validity of the choice for biomedical disciplines fixed by the passport of the national project 'Science' for the following priority of the Strategy for the scientific and technological development of the Russian Federation: 'the transition to personalized medicine, high-tech medical care and health saving technologies ...'. We assessed the degree of relevance of this choice to great challenges facing the Russian Federation, as well as trends in the development of global biomedicine. The hypothesis of this study was the assumption that when determining priority areas it is necessary to proceed from the analysis and comparison of two arrays: the list of nosologies which account for the maximum morbidity, mortality, disability level of, primarily, the able-bodied population of Russia, and scientometric data identifying trends in the development of global biomedicine.


Assuntos
Medicina de Precisão , Avaliação da Tecnologia Biomédica , Humanos , Federação Russa
6.
Expert Rev Pharmacoecon Outcomes Res ; 19(4): 379-381, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31159614

RESUMO

Introduction: The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) organized its first Central Eastern European regional meeting in 2019 in Warsaw, Poland. Area covered: The scientific program of the two-day conference covered a broad range of topics presented from the perspective of the region. Specifically, the focus was on cross-country collaboration within different steps of health technology assessment (HTA) and the need for local HTA adaptations in decision-making. Expert commentary: Attended by approximately 200 delegates from many countries and by several high level ISPOR leaders, the conference provided a valuable opportunity to exchange knowledge and strengthen the scientific network among experts from different stakeholder groups on issues specific to the region.


Assuntos
Farmacoeconomia/organização & administração , Avaliação de Resultados (Cuidados de Saúde)/organização & administração , Avaliação da Tecnologia Biomédica/organização & administração , Custos e Análise de Custo , Tomada de Decisões , Europa Oriental , Humanos , Agências Internacionais , Cooperação Internacional
7.
Work ; 63(2): 165-180, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156198

RESUMO

BACKGROUND: A standard, reliable, objective measure is needed for identifying individuals with mild to moderate traumatic brain injury (TBI). OBJECTIVE: The purpose of this study was to examine balance using an AMTI OR6-7 force platform (FP), neurocognition and mood using the Automated Neuropsychological Assessment Metric4 (ANAM4), blood flow comparisons using a Brain Acoustic Monitor (BAM), and voice using Voice Analysis software (VA) for screening service members for a mild to moderate TBI. METHODS: Active duty and retired service member volunteers (n = 88, 35 with a diagnosis of mild to moderate TBI and 53 who never had a TBI) completed an informed consent document, and evaluations using the four technologies. RESULTS: Development of a clinical prediction rule yielded two FP variables and one ANAM4 Mood Scale variable (vigor) as helpful in predicting the presence of a TBI. Assuming a 15% pre-test probability, these predictors yield a post-test probability of 75.7% for a positive result with any two or more measures being positive, and a post-test probability of 2.3% for a negative result with zero measures being positive. CONCLUSIONS: This study demonstrated the usefulness of a force platform and a self-reported mood scale for predicting presence of mild to moderate TBI.


Assuntos
Lesões Encefálicas Traumáticas/diagnóstico , Programas de Rastreamento/instrumentação , Militares/estatística & dados numéricos , Avaliação da Tecnologia Biomédica/métodos , Adulto , Instituições de Assistência Ambulatorial/organização & administração , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Análise de Variância , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/psicologia , Circulação Cerebrovascular/fisiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Programas de Rastreamento/métodos , Militares/psicologia , Testes Neuropsicológicos , Autorrelato , Estados Unidos , Voz/fisiologia
8.
Work ; 63(2): 291-298, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156210

RESUMO

BACKGROUND: Spinal symptoms of pain and stiffness on waking have been linked to sleep posture. Sleep posture is commonly classified as supine, side lying and prone. It is clinically postulated that sleeping postures with sustained end of range rotation and extension may influence pain sensitive spinal tissues. However, the lack of a valid and reliable method of assessing sleep posture, means clinicians are unable to provide corrective advice based upon evidenced based research. OBJECTIVE: To determine the validity and reliability of a sleep posture recording protocol in the home environment. METHOD: Twenty health professionals viewed a pre-recorded video recording of randomised sleep postures under natural and infrared light situations, with a variety of bed coverings, to represent the habitual environment. Sleep postures were classified into six categories including two intermediate postures (supported side lying and provocative side lying). Viewing was repeated after two days. RESULTS: Intra-and inter-rater reliability were excellent; Cohen's Kappa = .93 (95% CI 0.80 to 1.0) and Fleiss Kappa = 0.83 (95% CI 0.82 to 0.84) respectively. Validity, determined as concordance between the health professionals' classifications and the known postures, was also excellent Cohen's Kappa = .91 (95% CI 0.77 to 1.0). CONCLUSIONS: Reliable and valid assessment of sleep posture, including intermediate postures, could be achieved using low cost, portable, infrared video recording equipment, under a variety of lighting conditions and a variety of bed cover situations typical of the home environment.


Assuntos
Protocolos Clínicos/normas , Postura/fisiologia , Sono/fisiologia , Adulto , Idoso , Dor nas Costas/complicações , Dor nas Costas/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Avaliação da Tecnologia Biomédica , Gravação em Vídeo/métodos
9.
BMJ ; 365: l4223, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31221622

RESUMO

The studyClare L, Kudlicka A, Oyebode J R, et al. Goal-oriented cognitive rehabilitation for early-stage Alzheimer's and related dementias: the GREAT RCT. Health Technol Assess 2019;23:1-242.The trial was funded by the NIHR Health Technology Assessment Programme (project number11/15/04).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000767/goal-setting-in-early-stage-dementia-can-improve-function.


Assuntos
Disfunção Cognitiva/economia , Disfunção Cognitiva/reabilitação , Demência/psicologia , Atividades Cotidianas , Disfunção Cognitiva/psicologia , Análise Custo-Benefício , Demência/economia , Demência/epidemiologia , Demência/reabilitação , Metas , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Autoeficácia , Avaliação da Tecnologia Biomédica , Resultado do Tratamento , Reino Unido
10.
Expert Rev Pharmacoecon Outcomes Res ; 19(4): 409-420, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31210065

RESUMO

Introduction: Orphan diseases are low-prevalence conditions with chronically debilitating or life-threatening consequences. Their treatments are generally called orphan drugs (OD). Health-technology assessment processes have traditionally considered cost-effectiveness analysis (CEA), when making reimbursement and pricing decisions for health-care plans. Valuing OD with standard CEA raises important issues due to uncertain evidence, inability to meet cost-effectiveness thresholds for reimbursement and high budget impact, among others. Multi-criteria decision analysis (MCDA) allows to overcome these issues and improve the technical and ethical quality of decisions regarding prioritization, coverage, and reimbursement of OD. Areas covered: A scoping review was conducted in order to characterize MCDA frameworks for assessing OD and implementation experiences. We reviewed electronic databases (Medline, Embase, Cochrane Library, EBSCO, CINAHL, EconLit, Web of Science, LILACS, Google Scholar) key journals (Orphanet Journal of Rare Diseases and Value in Health) and organization repositories. Expert opinion: The theoretical framework for MCDA considers areas related to characteristics of orphan diseases and their technologies' clinical and economic impact. Participation processes are critical in incorporating societal values in weighting different dimensions and constructing decision rules. Local implementation pilots considering different stakeholders are necessary in order to pinpoint specific barriers and opportunities.


Assuntos
Técnicas de Apoio para a Decisão , Produção de Droga sem Interesse Comercial/métodos , Doenças Raras/tratamento farmacológico , Orçamentos , Análise Custo-Benefício , Tomada de Decisões , Humanos , Produção de Droga sem Interesse Comercial/economia , Doenças Raras/economia , Mecanismo de Reembolso , Avaliação da Tecnologia Biomédica/métodos
11.
Stud Health Technol Inform ; 261: 168-173, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156110

RESUMO

INTRODUCTION: Telehealth has a high potential for delivering healthcare by overcoming the geographical distance, increased access to care, and efficiency. To obtain the potential benefits of telehealth, this system should be usable to the patients and healthcare providers. The aim of this study was to report a new comprehensive tool for assessing the usability of telehealth services and systems, covering different aspects of usability. METHOD: We searched the keywords, such as telemedicine, telehealth, usability, satisfaction, questionnaires, and evaluation in Google, Scopus, PubMed, and Google Scholar from 1988 to 2019. All the studies that used the Telehealth services and computer& information technology evaluation tools were included. RESULT: We identified 204 items and extracted 10 criteria that were classified into two categories. The first category is system usability, which includes Efficiency, Memorability, Learnability, Usefulness, and Satisfaction. Second category system reliability, included Interaction, Interface design, Saving, System capabilities, and Getting rid of Errors. This tool consider many aspects of telehealth service evaluation from the usability aspect. CONCLUSION: Further studies are warranted to evaluate other aspects of Telehealth services and measuring reliability so that researchers can have access to a comprehensive tool for assessing interventions in the field of Telemedicine and Telehealth.


Assuntos
Avaliação da Tecnologia Biomédica , Telemedicina , Assistência à Saúde , Pessoal de Saúde , Humanos , Reprodutibilidade dos Testes
13.
Recurso na Internet em Inglês, Espanhol, Catalão, Eu, Gl | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46509

RESUMO

O Site Web da Agência de Avaliação de Tecnologias em Saúde oferece avaliações objetivas dos impactos de saúde, sociais, éticos, organizacionais e econômicos das técnicas e procedimentos para uso médico-sanitário, que contribuem para sustentar as decisões de autoridades e outros agentes de saúde em bases científicas.


Assuntos
Avaliação da Tecnologia Biomédica
14.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46473

RESUMO

O Sistema de Informação da Rede Brasileira de Avaliação de Tecnologia em Saúde (SISREBRATS) foi desenvolvido em novembro de 2009, pela Coordenação Geral de Avaliação de Tecnologias em Saúde (CGATS/DECIT/MS), em parceria com o DATASUS e com a Coordenação Geral de Comunicação e Gestão do Conhecimento (CGGC/DECIT/MS). A ferramenta viabiliza a interlocução entre os membros da rede e a sociedade, sendo o veículo de divulgação de produtos e de disseminação do conhecimento sistematizado. É a única base de dados de estudos de Avaliação de Tecnologia em Saúde (ATS) na língua portuguesa e na América Latina, disponível via web (www.saude.gov.br/sisrebrats). O SISREBRATS tem como objetivo divulgar estudos de ATS, buscando evitar duplicidades e subsidiar os formuladores de politicas na tomada de decisão e a sociedade civil no processo de apropriação social do conhecimento em ATS. Para que um estudo seja inserido na base, deve ter como tema a ATS e ser de um membro da REBRATS e/ou ter sido financiado pelo DECIT. A consulta dos estudos da base é aberta ao público.


Assuntos
Avaliação da Tecnologia Biomédica , Planejamento em Saúde
15.
Expert Rev Pharmacoecon Outcomes Res ; 19(4): 383-396, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31070048

RESUMO

Introduction: There is a growing trend of using patient preference studies to help incorporate the patient perspective into clinical drug development, care management, and health-care decision-making. Collecting and interpreting patient preference data is integral to multi-stakeholder engagement, patient-centric drug development, and clinical care management. Operationally, challenges exist in understanding 'when' and 'how' to embark on patient preference studies. This review will provide a brief overview of stated-preference methods, discuss applications throughout the clinical drug development and care management, and highlight how preference studies serve as a powerful tool for quantifying patient experiences for better outcomes. Areas covered: We present case studies to complement the different applications of stated-preference methods in clinical drug development and care management. We discuss the applications of preference data to help inform evidence-based patient advocacy, clinical development strategy, operational feasibility, regulator benefit-risk assessments, health technology assessments, and clinical decision-making. Expert commentary: Patient preference studies can serve as a powerful tool to engage patients and their communities as well as quantify the patient voice across different stages of clinical drug development and care management to support patient-centric health-care decision-making. It is expected that the application of these strategies will quickly advance in the coming years.


Assuntos
Tomada de Decisões , Preferência do Paciente , Avaliação da Tecnologia Biomédica/métodos , Tomada de Decisão Clínica , Desenvolvimento de Medicamentos/métodos , Prática Clínica Baseada em Evidências/métodos , Humanos , Defesa do Paciente , Assistência Centrada no Paciente/métodos , Medição de Risco/métodos
16.
Value Health Reg Issues ; 18: 145-150, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31082794

RESUMO

OBJECTIVE: To describe the process and role of health technology assessment (HTA) in the context of drug policy in Malaysia. METHODS: We summarized the HTA process through review of documents and reports available in the public domain combined with the authors' experience. RESULTS: Health technology assessment plays an integral part in prioritizing treatment in public health facilities in Malaysia, particularly for the Ministry of Health Medicines Formulary (MOHMF). The MOHMF is the reference list of drugs allowed to be prescribed in the Ministry of Health (MOH) facilities. There are 2 organizations within the MOH that conduct HTA as their core activities, namely the Malaysian Health Technology Assessment Section and the Formulary Management Branch of Pharmacy Practice & Development Division. The assessment of pharmaceuticals for the purpose of listing medicines into the MOHMF is under the purview of the Formulary Management Branch. The evidence-based assessment focuses on safety, efficacy, effectiveness, and budget impact of the drug. Cost-effectiveness evidence is currently not mandatory but is of interest to the decision makers. The assessment outcomes are considered by the MOH Medicines List Review Panel for formulary decisions. CONCLUSIONS: Health technology assessment has supported formulary decisions in MOH. Evidence generation needs to progress beyond efficacy or effectiveness, safety, and budget impact to incorporate cost-effectiveness. Nevertheless, there are challenges to be met to achieve this. The impact of the HTA process is currently unknown and is yet to be evaluated formally.


Assuntos
Controle de Medicamentos e Entorpecentes/tendências , Avaliação da Tecnologia Biomédica/métodos , Tomada de Decisões , Controle de Medicamentos e Entorpecentes/métodos , Humanos , Singapura
18.
Value Health ; 22(5): 518-526, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31104729

RESUMO

BACKGROUND: Health inequalities can be partially addressed through the range of treatments funded by health systems. Nevertheless, although health technology assessment agencies assess the overall balance of health benefits and costs, no quantitative assessment of health inequality impact is consistently undertaken. OBJECTIVES: To assess the inequality impact of technologies recommended under the NICE single technology appraisal process from 2012 to 2014 using an aggregate distributional cost-effectiveness framework. METHODS: Data on health benefits, costs, and patient populations were extracted from the NICE website. Benefits for each technology were distributed to social groups using the observed socioeconomic distribution of hospital utilization for the targeted disease. Inequality measures and estimates of cost-effectiveness were compared using the health inequality impact plane and combined using social welfare indices. RESULTS: Twenty-seven interventions were evaluated. Fourteen interventions were estimated to increase population health and reduce health inequality, 8 to reduce population health and increase health inequality, and 5 to increase health and increase health inequality. Among the latter 5, social welfare analysis, using inequality aversion parameters reflecting high concern for inequality, indicated that the health gain outweighs the negative health inequality impact. CONCLUSIONS: The methods proposed offer a way of estimating the health inequality impacts of new health technologies. The methods do not allow for differences in technology-specific utilization and health benefits, but require less resources and data than conducting full distributional cost-effectiveness analysis. They can provide useful quantitative information to help policy makers consider how far new technologies are likely to reduce or increase health inequalities.


Assuntos
Análise Custo-Benefício , Equidade em Saúde , Disparidades nos Níveis de Saúde , Medicina Estatal/economia , Avaliação da Tecnologia Biomédica/economia , Humanos , Anos de Vida Ajustados por Qualidade de Vida , Reino Unido
19.
Value Health ; 22(5): 570-574, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31104736

RESUMO

BACKGROUND: In this commentary, celebrating the 20th anniversary of the journal Value in Health, I present a brief overview and illustration of the evolution over the past 20 years of the methodological literature providing guidelines for multivariable and structural uncertainty analysis for cost-effectiveness estimates. METHODS: To illustrate the impact of the guidelines for uncertainty analyses, I show how the inclusion of multivariable and structural uncertainty analyses in cost-effectiveness analyses published in Value in Health changed over the past 20 years using publications from 1999/2000, 2007 and 2017. RESULTS: The commentary is organized in three sections: past, focusing on the development and use of methods for multivariable uncertainty analysis; present, focusing on the growing awareness of the need for structural uncertainty analysis, suggested frameworks for structural uncertainty analysis and how it is currently implemented; and future, considering different methods for combining multivariable and structural uncertainty analyses over the next decades. CONCLUSIONS: I conclude by suggesting how the continued evolution of uncertainty analyses in published studies and health technology assessment submissions can best take into account an important goal of cost-effectiveness analyses: to provide useful information to decision makers.


Assuntos
Análise Custo-Benefício/métodos , Interpretação Estatística de Dados , Incerteza , Tomada de Decisões , Humanos , Anos de Vida Ajustados por Qualidade de Vida , Avaliação da Tecnologia Biomédica/métodos
20.
Value Health ; 22(5): 575-579, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31104737

RESUMO

Economic models are used in health technology assessments (HTAs) to evaluate the cost-effectiveness of competing medical technologies and inform the efficient use of healthcare resources. Historically, these models have been developed with specialized commercial software (such as TreeAge) or more commonly with spreadsheet software (almost always Microsoft Excel). Although these tools may be sufficient for relatively simple analyses, they put unnecessary constraints on the analysis that may ultimately limit its credibility and relevance. In contrast, modern programming languages such as R, Python, Matlab, and Julia facilitate the development of models that are (i) clinically realistic, (ii) capable of quantifying decision uncertainty, (iii) transparent and reproducible, and (iv) reusable and adaptable. An HTA environment that encourages use of modern software can therefore help ensure that coverage and pricing decisions confer greatest possible benefit and capture all scientific uncertainty, thus enabling correct prioritization of future research.


Assuntos
Análise Custo-Benefício/métodos , Modelos Econômicos , Software , Avaliação da Tecnologia Biomédica/economia , Tomada de Decisões , Humanos
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