bluuebunny/crossref_metadata_2025 huggingface dataset:
PD39 First Approach For Assessing Statistical Significance In Industry Funded Matching-Adjusted Indirect Comparison Studies: A Scoping Review
Authors: Farinasso Cecilia , da Rocha Aline , Medeiros Flávia , Marra Lays , Parreira Patricia , Oliveira Layssa , Ferreira Vinicius , Lucchetta Rosa , De Oliveira Junior Haliton Alves
Published: January 2025

Introduction

When indirectly compared trials are too heterogeneous to provide a reliable estimate, matching-adjusted indirect comparison (MAIC) studies can be employed. This technique is commonly used for oncology treatments. MAIC is an indirect comparison that adjusts effect-modifying variables through propensity score methods. The objective of this study was to map the characteristics of MAIC studies in oncology.

Methods

We performed a scoping review of the characteristics of MAIC studies that applied MAIC to compare active treatments in oncology. The literature search was last updated in August 2023 in PubMed, Embase, and the Cochrane Library. We extracted sources of funding, outcomes reported, and whether the results were significantly in favor of the trial for which individual patient data (IPD) were available or for the aggregate data. We then calculated the relative risk (RR) and confidence interval (CI) of an outcome favoring the IPD trial technology that was also funded by industry.

Results

A total of 90 studies were included in the review. The pharmaceutical industry was the most frequent funder (n=78; 87%); the source of the IPD data was not reported in 68 studies (76%). In total, 391 efficacy outcome estimates were reported in base case analyses. The risk of favoring IPD while being funded by industry was 93 percent, while the risk of favoring IPD while having other sources of funding was 61 percent (RR 1.520, 95% CI: 1.146, 2.016; p=0.004). Specifically, the RR was 1.246 (95% CI: 0.891, 1.743) for overall survival and 1.426 (95% CI: 0.959, 2.120) for progression-free survival.

Conclusions

MAIC results are influenced by the choice and number of effect-modifying variables used for matching the population. National Institute for Health and Care Excellence guidelines consider it necessary to provide evidence that the matched estimate will be less biased than the unmatched one. We have concluded that industry funded MAIC studies may be more likely to report results favoring IPD than studies with another funding source.
PD50 Does The New Healthcare Reform Improve Job Satisfaction Among Village Clinic Doctors In China? A Meta-Analysis
Authors: Zhou Lifang , Yu Yuncong , Liu Junping , Shao Jiaxian , Yin Wenqiang , Yu Qianqian , Chen Zhongming
Published: January 2025

Introduction

Since 2009, the Chinese government has launched a new health system reform that affected primary healthcare significantly. We aimed to analyze the factors associated with job satisfaction among village clinic doctors since the new healthcare reform, and to provide a reference for the next stage of reform.

Methods

We systematically searched one English (PubMed) and two Chinese literature databases (CNKI and Wanfang Data). Cross-sectional studies containing information related to job satisfaction among village clinic doctors in China were included. The total job satisfaction among village clinic doctors was estimated using a random effects meta-analysis. Differences in study-level characteristics among groups were estimated using subgroup analysis and meta-regression.

Results

We identified 17 cross-sectional studies investigating a total of 28,468 village clinic doctors in China. The pooled job satisfaction value was 0.40 (95% confidence interval [CI]: 0.32, 0.49). The results showed that lower job satisfaction was reported in the period from 2016 to 2020 (0.33, 95% CI: 0.23, 0.42) than in the period from 2010 to 2015 (0.51, 95% CI: 0.33, 0.70). The main factors influencing job satisfaction among village clinic doctors were salary (odds ration [OR] 1.71, 95% CI: 1.23, 2.36), number of training sessions (OR 2.56, 95% CI: 1.68, 3.90), age (OR 3.45, 95% CI: 2.22, 5.35), and level of education (OR 0.68, 95% CI: 0.40, 1.15).

Conclusions

Since the new health system reform, only 40 percent of village clinic doctors in China are satisfied with their work and it is likely this figure will continue to decrease. Those with higher salaries, more training sessions, and greater age had higher job satisfaction. In contrast, village clinic doctors with a higher level of education had lower job satisfaction.
PD64 Modeling Clinical And Economic Impact Of Integral, Transversal, And Multidisciplinary Management Of Aortic Stenosis In A Catalan Hospital
Authors: Fernandez-Barcelo Carla , Hagemeijer Bàrbara Vidal , Abbas Ismail , Trilla Marc , Carreño Marta Sitges , Sampietro-Colom Laura
Published: January 2025

Introduction

A program for integral, transversal, and multidisciplinary management of aortic stenosis (MITMEVA) is being implemented at the Clinic Barcelona University Hospital (CBUH) to provide adequate treatment for patients with aortic stenosis (AS). Eleven actions at different care points were implemented (e.g., awareness raising for the general population, a single entry path for patient referral, prehabilitation and rehabilitation, and a risk-sharing agreement). Preliminary results are presented.

Methods

A before-and-after implementation study was conducted with 131 patients under MITMEVA and 131 matched (for treatment, New York Heart Association classification, sex, age, and referral place) historical controls. Data were collected on resources used and quality of life and to calculate several key performance indicators (KPIs) (e.g., knowledge improvement in citizens, time from diagnosis to treatment, and patient involvement and satisfaction) for each implemented action. A descriptive analysis of KPIs and a Markov model were performed to simulate clinical and economic outcomes for patient health states over time after the first year until the tenth year after intervention.

Results

The MITMEVA program increased quality-adjusted life-years by 1.78 (p=0.011) and reduced time from referral to first hospital visit by 24.7 percent (p=0.05), hospital complications by 19.7 percent (p=0.05), mean conventional ward stay from 12.8 to 8 days (p=0.01), and mean intensive care unit stay from 9.75 to 4.25 days, although the latter difference was not statistically significant (p=0.139). The mean cost per patient was reduced from EUR7,573.27 per patient to EUR6,024.61 per patient (p=0.01). The MITMEVA program was a dominant strategy. There was a 46 percent increase in correct AS symptom identification after delivering training on AS to the general population.

Conclusions

Integrated care approaches can potentially improve patient continuum of care if the strategies are deployed in a multidisciplinary and transversal way across healthcare actors. The MITMEVA program significantly improved clinical and economic outcomes and organization of care, benefiting patients and clinicians. Applying health technology assessment methods to such innovative projects can help prove the value of organizational innovations.
PD70 A Mapping Study Of EORTC-QLQ-C30 To EQ-5D-5L Among Korean Patients With Non-Small Cell Lung Cancer
Authors: Lee Hyorim , Ahn Jeonghoon , Seo Hyerin , Jin Doyeon
Published: January 2025

Introduction

This study aimed to develop an algorithm to map the clinically popular European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) to the prevailing health technology assessment outcome measure, the EuroQol 5D-5L questionnaire (EQ-5D-5L), to investigate the quality of life in patients with non-small cell lung cancer (NSCLC).

Methods

Mapping models were estimated using EQ-5D-5L, the EQ visual analogue scale (EQ-VAS), and the QLQ-C30 results from patients with NSCLC. This study used data at baseline from all three quality of life scores (n=289) to estimate the mapping algorithm. Linear regression was conducted on each domain of the QLQ-C30 as follows: physical functioning, global health status, emotional function, diarrhea, financial difficulties, insomnia, fatigue, and pain. Quality of life data collected at six (n=176) and 12 weeks (n=60) were used to evaluate the validity of the estimated mapping algorithm. The EQ-VAS was used to compare correlations with the algorithm.

Results

The estimated algorithm had a root mean squared error of 0.0937 and an adjusted R-squared of 0.7227. The correlations between the estimated and the observed EQ-5D-5L values at baseline, six weeks, and 12 weeks were 0.8546, 0.8493, and 0.8846, respectively. The estimated and observed values had a high correlation. Also, the bias between the predicted and the observed EQ-5D-5L values at six and 12 weeks was 0.0113 and 0.0292, respectively. Hence, the mapping algorithm had a good predictive validity.

Conclusions

The mapping algorithm can be used to convert a cancer-specific health-related quality of life measure to a preference-based health-related utility measure, which is useful in health technology assessment. Mapping EORTC-QLQ-C30 onto the EQ-5D-5L enables the estimated EQ-5D-5L scores of patients with cancer to be used in economic evaluations such as cost-utility analyses.
PD83 Medication Preferences Of Rural Patients With Chronic Disease: A Discrete Choice Experiment In An Eastern Province Of China
Authors: Li Xiaona , Gao Min , Shao Jiaxian , Yu Yuncong , Yin Wenqiang , Chen Zhongming
Published: January 2025

Introduction

With the aging population, chronic diseases have become a serious threat to public health in China. Adhering to the doctor’s advice is an effective strategy for controlling chronic diseases, and the preferences of patients with chronic disease has an important impact on compliance with medication. However, there is insufficient research exploring this aspect.

Methods

In this study patients with chronic disease were selected by stratified random sampling to participate in a survey carried out in three cities of a province in eastern China. The discrete choice experiment used a questionnaire of D-efficiency experimental design to measure the medication choices of patients with chronic disease. The main attributes included drug price, onset of action, adverse reactions, traditional Chinese or Western medicine, domestic drug, and reimbursed by medical insurance. The data were analyzed using a mixed logit model.

Results

A total of 1,062 valid questionnaires were received. The 1,045 questionnaires that passed the consistency test covered three prefecture-level cities, nine counties, and 216 villages. All drug attributes were statistically significant for selection preferences. The preference of patients in rural areas with chronic disease was “quick onset of action” (β=2.491), “Western medicine” (β=0. 826), “medical insurance” (β=0.556), “domestic drugs” (β=0.286), and “very few adverse reactions” (β=0.170). “Drug price” also had an impact on medication preferences among patients in rural areas with chronic disease (β=−0.013).

Conclusions

Onset of action is the attribute of medications that is of most concern for patients in rural areas with chronic disease. Subgroup analysis showed that these patients were predominantly female, had a primary school education or lower, were younger than 69 years, were unemployed, and had an annual income between CNY10,000 (USD1,396.78) and CNY50,000 (USD6,983.92). They were willing to pay more for drugs with a quick onset of action, Western medicines, and drugs with reimbursed by medical insurance.
PD85 Are Current Payment Models For Integrated Care Promoting The Uptake of Medical Device Innovations?
Authors: Granados Paula Closa , Soto Marcelo , Abbas Ismail , Alonso Albert , Sampietro-Colom Laura
Published: January 2025

Introduction

Integrated care (IC) is a patient-centered approach to the provision of health care that overcomes the fragmentation in the delivery of services that often occurs in older people with multiple comorbidities. Medical device innovations could help tackle this and other challenges of health systems when facing the adoption of high quality IC. Nevertheless, this should be accompanied by the right innovation funding scheme to encourage adoption.

Methods

A systematic search strategy to identify payment models for IC was performed in PubMed for the period from 2014 to 2023 using the International Foundation for Integrated Care Knowledge Tree tool. This was complemented with both a gray literature search in Google and a benchmark of payment models for innovative medicines. A scoping review was then performed identifying the following information: payment scheme; advantages and disadvantages for IC; inclusion of innovation; type of IC program or initiative described (sectors and providers); population (therapeutic area); country; and whether the information was conceptual or empirical.

Results

According to the literature reviewed, five payment schemes used in IC were identified. However, they were rarely used in isolation; more often a mix of payment schemes was used. Based on conceptual and empirical articles, the combination of bundled payment, shared savings, and pay for performance (based on the quality of care delivered) seemed to be the most comprehensive payment scheme. However, references to inclusion of innovation were not mentioned even in this mixed system. Payment systems for innovative medicines were benchmarked for medical devices.

Conclusions

A mixed system of bundled payment, shared savings, and pay for performance appears to be the most complete payment model for IC, since it counteracts the limitations of individual funding schemes. No evidence was found on how to incentivize medical device innovation in the context of IC delivery. However, inspiration from current payment schemes for innovative medicines can provide a starting point for innovative medical device schemes.
PD90 Use Of Medicinal Herbs In Natura By Pregnant Women In The Amazon Region
Authors: da Silva Moura Souza Celsa , Camargo Erika Barbosa , Riera Rachel , Lima Regismeire Viana , de Oliveira Andrade Edson , Betrán Betrán Ana Pilar , Torloni Maria Regina
Published: January 2025

Introduction

There are few studies on the use medicinal herbs by pregnant women in Brazil, even though there is a wealth of knowledge about medicinal herbs among Brazilians of Indigenous, African, and European ancestry. The aim of this study was to assess the prevalence and type of herbs used by pregnant women living in the Amazon region.

Methods

This was a cross-sectional study conducted with 811 pregnant women attending 10 public antenatal clinics in Manaus, Amazonas state, Brazil. The consumption of medicinal herbs was assessed through individual 24-hour dietary recall.

Results

A total of 811 women in their second trimester (16 to 20 weeks) of pregnancy were included and 69 (8.5%) reported that they used herbs to make teas. There was a significant difference between users and non-users of medicinal teas, with a higher proportion of overweight women in the group that used teas (46.4% versus 31.9%; p=0.005). Nearly half (47.8%) of those who used medicinal teas consumed herbs with sedative effects, 23 percent consumed herbs for the relief of urinary tract symptoms, and 13 percent used herbs with digestive properties. Most women reported using natural herbs from their own gardens.

Conclusions

Approximately 10 percent of Brazilian women in the Amazon region consumed medicinal herbs to alleviate common symptoms of pregnancy. The most frequently used plants had sedative, urinary tract, or gastrointestinal effects. Most plants were obtained in natura from local gardens. Many of these plants have known adverse effects and their use is contraindicated during pregnancy.
PD93 Uncertainty Metric To Guide PICOS Assessment And Evidence Synthesis Planning For Joint Clinical Assessment Submission
Authors: van Schoubroeck Hannah Marjolein , Kroep Sonja , Arca Emanuele , Fenwick Elisabeth
Published: January 2025

Introduction

With the European Union Regulation on health technology assessment (HTA) approaching, there is concern about how to accommodate the large number of expected population, intervention, comparator, outcome(s), and study type (PICOS) questions and their uncertainty. Navigating uncertainty will prove essential to anticipate evidence requirements. This abstract presents preliminary results of the development of a metric that assesses uncertainty surrounding PICOS questions to eventually guide planning of evidence synthesis for joint clinical assessment (JCA) submission.

Methods

The metric will consist of pillars representing overarching themes of uncertainty. Each pillar will contain several elements influencing uncertainty for proposed PICOS questions. This study was conducted in two phases. In phase one, targeted literature searches of peer-reviewed and gray literature were conducted to identify the overarching metric pillars. These pillars were then validated by expert opinion. Similar research methods were used in phase two to inform the content of each of the pillars. Here we present the findings for phase one.

Results

The targeted literature review in phase one resulted in multiple candidate elements for the uncertainty pillars. Elements were selected based on expert opinion, resulting in five main pillars. These pillars were considered most valuable for the determination of uncertainty surrounding individual PICOS questions and were considered crucial to HTA acceptance. Phase one resulted in the following pillars: (i) indication and subpopulations; (ii) type of intervention and comparators; (iii) societal and patient unmet need; (iv) type and quality of evidence source informing evidence synthesis; and (v) methodology of evidence synthesis.

Conclusions

This study lays the foundation for a metric to assess the uncertainty surrounding proposed PICOS questions for JCAs. The metric identifies existing uncertainties for PICOS questions, assesses potential issues for HTA acceptance, and guides possible evidence synthesis planning. A clear framework for anticipating uncertainty will prove essential in managing resources and expectations.
PD102 Evaluating The Clinical Effectiveness Of Portable Ultrasonic Scalpels For Urological Surgery
Authors: Yan Juntao , Yang Yi , Tao Ying , Chen Yingyao
Published: January 2025

Introduction

Ultrasonic scalpels are widely used in urological surgery. Although portable ultrasonic scalpels are convenient to use and install, the existing evidence on their safety and effectiveness is scarce. This study aimed to compare the safety and effectiveness of portable ultrasonic scalpels in urological surgery with traditional ultrasonic scalpels to aid clinical decision-making.

Methods

A multicenter, prospective, non-randomized controlled trial was conducted from February to August 2023 in three tertiary hospitals in China. The intervention group included 90 prospectively enrolled patients undergoing urological surgery during the same period of hospitalization: 45 with portable ultrasonic scalpels and 45 with traditional scalpels. Demographic and clinical data of patients in the study were collected. Data on quality of life were obtained using the EuroQol EQ-5D-5L scale preoperatively, at discharge, and one month and three months after surgery. Descriptive analysis and a generalized linear model were used in the data analysis.

Results

A total of 82 patients were included in the study: 39 in the intervention group and 43 in the control group. The average hospital stay and intraoperative and postoperative blood loss in the intervention group were lower than in the control group (p>0.05). From baseline to discharge, the decrease in quality-adjusted life-years (QALYs) in the intervention group was smaller (–0.134 versus –0.287; p<0.05) than in the control group. During the follow-up period, there were no significant differences in the changes in QALYs between the two groups. The decline in QALYs was significantly influenced by variables such as intraoperative blood loss and surgical site.

Conclusions

There were no significant differences in baseline characteristics or changes in QALYs between the intervention and control groups. Portable ultrasonic scalpels in urological surgery may be as equally effective as traditional scalpels with respect to clinical outcomes, with additional benefits in reducing QALY decline at discharge. Further research with large samples and long-term follow-up should be conducted.
PD110 Ward Round Woes: Accuracy Of Ward Round Documentation
Authors: Treloar Ellie , Ting Ying Y. , Bruening Martin , Reid Jessica , Edwards Suzanne , Bradshaw Emma L. , Ey Jesse D. , Wichmann Matthias , Herath Matheesha , Maddern Guy J.
Published: January 2025

Introduction

Ward round quality is a pivotal component of surgical care and is intimately associated with patient outcomes. Despite this, ward rounds remain largely understudied and underrepresented in medical literature. Accurate and thorough ward round documentation is known to improve communication and patient outcomes and to reduce hospital expenditure. This study aimed to determine the accuracy of ward round documentation.

Methods

A prospective observational cohort study was performed as a sub-analysis of a larger study by reviewing 135 audiovisual recordings of surgical ward rounds over two years at two hospitals. The recordings were transcribed verbatim, and content was designated a level of importance by an external reviewer. This was then compared to the written case notes to determine the accuracy and importance of omitted documentation. Patient age, sex, and length of stay, as well as the senior doctor leading and the intern documenting the ward round, were assessed using multivariable linear mixed-effect models to determine their impact on documentation accuracy.

Results

Nearly one-third (32.4%) of spoken information on the surgical ward round that was deemed “important”, including discharge plans and bookings for surgery, was absent from the patients’ electronic medical records. Additionally, in 11 percent of case notes there was a major conflict between the ward round discussion and what was documented. Younger patients (p=0.04) and patients who had been on the ward longer (p=0.005) were less likely to have accurate documentation. Some interns were significantly worse at documenting discussions than were others (p<0.0001). Day of the week, location, and the senior doctor present did not affect documentation accuracy.

Conclusions

This study demonstrates that a significant amount of important discussion during surgical ward rounds regarding patient care is not recorded accurately, or at all, in the patient medical record. This can lead to preventable patient complications and longer hospital stays, resulting in increased strain on hospital resources. This study emphasizes the need for further research to address this problem.
PD115 Digital Health Solutions: Health Technology Assessment Of Digital Platforms For Personalized Management, Education, And Support For People With Diabetes
Authors: Bowles Charlotte , Prettyjohns Matthew , Bromham Nathan , Evans Alice , Washington Jenni , Shepherd Rebecca
Published: January 2025

Introduction

Approximately five million people live with diabetes in the UK. The cost of this is approximately 10 percent of the National Health Service (NHS) budget. Wales has the highest prevalence of diabetes of any country in the UK. Educating people on how to best manage their condition can minimize associated complications. Digital platforms can aid self-management and improve risk factors.

Methods

This rapid review aimed to address the following research question: What is the clinical and cost effectiveness of digital platforms for personalized diabetes management to inform decision-making and guidance in the NHS? Digital platforms for this rapid review can be driven using artificial intelligence, machine learning, or through the application of data rules. Clinical evidence published since 2008 on health economics and patient, carer, and family perspectives relevant to Wales was identified by searching relevant databases such as MEDLINE. One relevant economic analysis was conducted using the UK Prospective Diabetes Study Outcomes Model 2.

Results

Outcomes included improvements in glycemic control, healthcare resource use (e.g., number of total general practitioner and emergency department visits per year), reduction in body weight among participants, reduction in cholesterol levels, and positive patient-reported outcome measures. An economic analysis identified in the literature review found that a digital platform was more effective and less costly than routine diabetes care and was, therefore, dominant. The analysis was based on observed reductions in glycosylated hemoglobin levels from a database of people with diabetes in NHS Scotland.

Conclusions

The evidence suggests there are benefits in using digital platforms to aid self-management among people with diabetes. Studies reporting on glycosylated hemoglobin levels found statistically significant and clinically important benefits from using digital platforms. Digital platforms also have the potential to be more effective and less costly than routine diabetes care in Wales and the UK.
PD125 Safety, Efficacy, And Effectiveness Of Robotic Surgery In General And Digestive Surgery
Authors: Ruiz-Baena Jessica , Segur-Ferrer Joan , Masdeu Laia Ramos , Sabadell Maria-Dolors Estrada , Vivanco-Hidalgo Rosa Maria
Published: January 2025

Introduction

Robotic surgery (RS) is a minimally invasive surgical modality performed with the support of a console and mechanical arms that enable remote control. The advantages of RS are clear from the point of view of surgeons but remain unclear in terms of clinical results. We evaluated the safety, efficacy, and clinical effectiveness of RS compared with open or laparoscopic surgery.

Methods

A systematic review of randomized controlled trials and systematic reviews with meta-analyses was conducted to assess RS in the following surgical procedures: Nissen fundoplication, Heller myotomy, cholecystectomy, rectopexy, splenectomy, pediatric Kasai portoenterostomy, and gastric banding. Outcomes of interest were related to safety (complications, blood loss, and risk of infection) and efficacy or effectiveness (length of hospital stay, quality of life [QoL], recovery, patient satisfaction, conversion to another technique, urinary function, and rates of mortality, readmission, reoperation, and esophageal perforation). The evidence quality was assessed with version two of the Cochrane risk-of-bias tool for randomized trials, AMSTAR 2, and GRADE.

Results

Nissen fundoplication RS was similar to laparoscopy in terms of complication and conversion rates, recovery, and QoL. Heller myotomy RS reduced the rate of esophageal perforations but had similar perioperative blood loss and rates of mortality, conversion, and re-admission to laparoscopy. Cholecystectomy RS was similar to laparoscopy with respect to rates of readmission and complications, blood loss, and risk of infection. Rectopexy RS was similar to laparoscopy in terms of conversion, reoperation, and complications rates, blood loss, recovery, patient satisfaction, and QoL. Splenectomy RS decreased blood loss but was similar in risk of infection and rates of complications and conversion to laparoscopy. There were no studies that used open surgery as a comparator or evaluated RS in pediatric Kasai portoenterostomy or gastric banding.

Conclusions

Current evidence on the safety, efficacy, and clinical effectiveness of RS in general or digestive surgical procedures is limited. Multicenter studies with follow-up beyond the immediate postoperative period are needed to evaluate patient outcomes.
PD130 Health Technology Assessment Of Cervical Cancer Screening In Indonesia
Authors: Mongan Suzanna , Byrnes Joshua , Lam Alfred , Kim Hansoo
Published: January 2025

Introduction

Cervical cancer is the most common gynecological cancer and the second most common cancer among women in Indonesia, and its incidence is projected to increase. In 2018, the mortality rate of cervical cancer was 60 percent, since patients often have advanced stage disease at diagnosis. We aimed to identify the status and cost of cervical cancer screening in Indonesia.

Methods

We conducted a literature review with search terms relevant to cervical cancer, screening, and Indonesia in two major databases—Embase and Medline—and by citation searching through the World Health Organization (WHO) website, human papillomavirus (HPV) reports, and Indonesian reports on cervical cancer.

Results

Indonesia’s national cervical cancer screening program began in 2007 and uses visual inspection with acetic acid (VIA) or the Papanicolaou (Pap) test. VIA has high sensitivity (94%) and specificity (95%). It is the preferred option due to the limited number of pathologists and its lower cost (IDR25,000 [USD1.64]), compared with the Pap test (IDR200,000 [USD13.13]) and the HPV DNA test (IDR550,000 [USD36.00] to IDR1,400,000 [USD 91.90]). VIA and the Pap test are covered by national health insurance, whereas the HPV test is not. Nevertheless, national screening coverage was less than 10 percent, with a wide regional disparity due to the limited number of screening providers, resource constraints, and lack of awareness.

Conclusions

In Indonesia, VIA is the primary screening method because of its affordability, accessibility, and applicability in low-resource settings. However, low screening coverage has led to a high incidence of cervical cancer. New policies and incentives are needed to ensure adequate numbers of screening providers and monitoring systems. Health technology assessment can help choose cost-effective strategies for primary HPV DNA testing.
PD151 Informal Networking For Health Technology Assessment Capacity Building In African Countries
Authors: Mueller Jani , Schuller Tara
Published: January 2025

Introduction

The HTAfrica group is an informal network of individuals enthusiastic about health technology assessment (HTA) in Africa. In 2021, a grassroots network was founded to explore HTA issues relevant to African countries. Through webinars and information exchanges, the group aims to cultivate social capital and cohesion among members to co-create knowledge on key HTA issues that are important in the region.

Methods

The HTAfrica group uses a social media platform to convene and deliver programming. Individual users request to join and are approved by the group coordinators. Once joined, users can read and make blog posts and participate in webinars offered on relevant topics. Despite the size of the group (177 members in 2024), engagement in 2021 and 2022 was relatively low (average 3.1 people per session). In 2023, a structured eight-part introductory HTA webinar series was offered to improve engagement, in place of the ad hoc discussions on topics that were offered the previous year.

Results

Eight webinars were offered to group members to introduce them to HTA and its potential importance for African countries. They included journal-based case studies of five African countries (Egypt, Ethiopia, Ghana, Malawi, and South Africa) and a concluding webinar to summarize learnings. A co-creation approach was taken where the perspectives of all participants contributed to the group’s learnings. The webinar series ended in June 2024 and had a lower participation rate (average of two per session) but = greater cohesion among participants than did the ad hoc topics approach.

Conclusions

The eight-part series was offered from October 2023 to June 2024. While the number of participants per session was lower in the structured series, the individuals formed stronger connections and gained more intangible benefits. To form a strong network, a mix of both ad hoc hot topics and a structured series approach may be optimal for the formation of looser peripheral parts of the network (ad hoc approach) as well as fostering stronger cohesion in the network core (structured series approach).
PD154 Horizon Scanning Report Identifying Technologies For Pediatric Neurological Trauma
Authors: Oparah Chizoba , Eastaugh Claire , Lanyi Kate , Hussain Amy , Woltmann James , Pearson Fiona , Still Madeleine , Brush Emily , Kolehmainen Niina
Published: January 2025

Introduction

Children and young people comprise one quarter of the UK’s population. Neurological trauma (e.g., traumatic brain injury and spinal cord injury) is one of the most common causes of death and disability in this population group, yet health technology innovations for these patients lag behind those for adults.

Methods

Using the horizon scanning methodologies developed by the Innovation Observatory, systematic searches were performed to identify registered clinical trials, published funding awards, and news articles that focused on innovative devices and digital and diagnostic health technologies developed for use in children and young people (from 28 days after birth up to and including 18 years of age) with actual or suspected neurological trauma. The search results were screened for relevance, and key information on the included technologies was extracted and summarized.

Results

Twenty-nine technologies were identified, of which 10 were commercially available. The majority were developed in the UK or the USA. Overall, the development pipeline was evenly split amongst technologies considered to be a device (37%), digital (34%), or diagnostic (29%). Most technologies were intended for use across settings by healthcare professionals, either for initial onsite assessment, for in-hospital management, or for rehabilitation in hospital or in the community.

Conclusions

Results from this horizon scan show that development of technologies for pediatric neurological trauma is currently limited, with only a small number of the technologies being developed covering an area of unmet need. To complement the horizon scan, we also sought stakeholder insights on medical technologies for this population group. The combined results and final conclusions will be shared in a future publication.
PD155 RedETS Horizon Scanning: Impact In The Decision-Making Process
Authors: Puñal-Riobóo Janet , López-Loureiro Ignacio , Carmen Maceira Rozas María del , Acción Beatriz Casal , Faraldo Vallés María José , Roldán Margarita Segovia , Mestre-Lleixà Berta , Benguria-Arrate Gaizka , Pino-Sedeño Tasmania del , Navarro Gustavo Mora , Polo-deSantos Mar , Méndez Aurora Llanos , Guerra Jutta Knabe , Martín Sánchez Juan Ignacio , Estrada Maria-Dolors , Pastells-Peiró Roland , Galnares-Cordero Lorea , Rivero-Santana Amado , Luengo-Matos Setefilla
Published: January 2025

Introduction

The RedETS horizon scanning (HS) program in Spain is focused on identifying non-pharmaceutical emerging health technologies. HS is organized in three steps: (i) identification using different sources (PubMed, the biomedical press, and others); (ii) screening performed by the HS Working Group and clinicians; and (iii) prioritization using the PriTec tool. This study aimed to evaluate the accuracy of RedETS HS in identifying disruptive emerging technologies for our health system.

Methods

Data from brief files and full reports related to the identified emerging technologies were collected. Full health technology assessment (HTA) reports were also reviewed. The period of analysis was from 2016 to 2023. The information collected included the name, type, category, and indication of the emerging technology and the source of identification. An ad hoc Excel spreadsheet was designed to collect the information. The analysis consisted of a description of the variables and an assessment of concordance between the emerging technologies identified and those with full HTA reports.

Results

There were 338 emerging technologies identified. These technologies were mainly therapeutic (52.1%) or diagnostic (25.7%). In addition, about 45 percent were medical devices and 15.7 percent were in vitro diagnostic tests; imaging comprised 7.4 percent. Most of the emerging technologies were identified through the biomedical press (22.2%), PubMed (23.6%) and industry (20.3%). In a preliminary analysis of these main sources, 31 percent of the technologies identified by HS had full HTA reports, with all of these being identified three years before the HTA.

Conclusions

HS systems might help identify the most relevant technologies for healthcare systems, enabling them to be more ready to incorporate the new technologies. Therefore, HS must be able to detect emerging technologies that will have an impact on the health system. Periodic evaluation of the accuracy of HS programs will improve their impact in the HTA process.
PD156 Scanning The Right Horizons: Does Singapore’s Horizon Scanning Identify And Assess The Relevant Technologies?
Authors: Ng Jaryl , Ju Hong , Ng Zhen Long , Soon Swee Sung , Ng Kwong
Published: January 2025

Introduction

In Singapore, a horizon scanning (HS) system was established in 2020 by the Agency for Care Effectiveness (ACE) to provide early alerts of new and emerging medical technologies (medtechs) for service planning and to warn against the diffusion of low value technologies. This study compared the medtechs identified and assessed by ACE with health technology trends identified by our reference agency.

Methods

Medtechs identified and assessed by ACE between 2020 and 2023 were analyzed to examine their distribution. Most of the identified medtechs were classified as digital health technologies, precision medicine, robotics, or implants. The prioritized technologies with a completed in-depth assessment were compared with the top 10 health technology trends identified in 2022 by our reference health technology assessment (HTA) agency, the Canadian Agency for Drugs and Technologies in Health (CADTH). Additionally, feedback from key stakeholders such as clinicians and policymakers on the HS reports was summarized to understand the relevance and value of the HS reports.

Results

From 2020 to 2023, there were 1,703 medtechs identified from various databases and manufacturer submissions. Digital health technologies were the largest proportion of technologies identified during this period, increasing from 26 percent in 2020 to 31 percent in 2023. Of the 20 evaluated technologies, 70 percent belonged to the top trending medtech fields identified by CADTH. These included artificial intelligence for diagnostics (n=5), point-of-care testing (n=4), companion diagnostics (n=2), wearables (n=2), and remote monitoring (n=1). Initial stakeholder feedback was positive, citing HS reports as being relevant for clinical practice. Some HS reports were also referenced by other policymakers to support regulatory decisions.

Conclusions

In summary, similarities were observed between medtechs identified and assessed by the ACE HS system and the top trending medtech fields identified by CADTH. Additionally, digital health technologies were the largest proportion of technologies identified by the ACE HS system in 2023. This was substantiated by feedback from our key stakeholders, indicating the relevance and value of the ACE HS work.
PD161 Distribution Patterns And Economic Assessments Of Gaucher Disease Therapies In Brazil: A National Health System Analysis (1999 to 2022)
Authors: Borin Marcus Carvalho , de Assis Acurcio Francisco , Alvares-Teodoro Juliana , Guerra Augusto
Published: January 2025

Introduction

Gaucher disease, an inherited lysosomal storage disorder, requires chronic management with enzyme replacement therapies (ERTs). In Brazil, the Unified Health System (SUS) plays a pivotal role in providing access to such treatments. This study aimed to analyze the distribution and associated costs of medications for Gaucher disease within the SUS, offering a comprehensive view of resource allocation over 23 years.

Methods

Utilizing the TabNet system from the Brazilian Health Ministry, medication dispensation data from 1999 to 2022 were analyzed. In addition, annual and total expenditures on imiglucerase, miglustat, and taliglucerase alfa were evaluated using the Ambulatory Information System and the Hospital Information System databases for a cohort of patients from 2000 to 2015. Demographic factors such as sex, age, self-declared skin color, body mass index, and area of residence were correlated with spending patterns. Trends were contextualized with events that could potentially affect medication availability, such as ministry alerts and regulatory changes.

Results

The dispensation analysis revealed a fluctuating pattern in medication distribution over the study period. The data revealed a peak in imiglucerase dispensation in the mid-2000s, followed by a stark decrease after 2010 that coincided with global shortages. Total costs from 2000 to 2015 reached USD1.138 billion, with annual expenditures averaging USD120,631.15. After 2010 there was a diversification in therapy utilization, with an increase in alternative treatments such as miglustat and taliglucerase alfa.

Conclusions

The study reveals a significant financial burden on the SUS from Gaucher disease treatments and demographic disparities. Trends in the dispensation and costs of ERTs within the SUS are a direct response to drug availability and regulatory actions, with adoption of alternative ERTs after 2010 demonstrating the system’s flexibility. Strategic health policy planning is vital for treatment sustainability and affordability.
PD169 Is China Embracing Innovation? An Analysis Of Early Access In The Boao Lecheng International Medical Pilot Zone
Authors: Leong Katherine , Macaulay Richard
Published: January 2025

Introduction

Since 2018, medicines approved by regulators outside of China (e.g., the United States Food and Drug Administration) can be used in China’s Boao Lecheng International Medical Pilot Zone if approved by the Hainan authority. In 2019, the Implementation Plan for the Clinical Real-World Data Application Pilot was also introduced to facilitate real-world data generation in Boao Lecheng. This research examined the status of authorized medicines in Boao Lecheng.

Methods

Information on authorized medicines and insurance coverage was extracted from the Boao Lecheng Administration Bureau’s website and official WeChat account. Regulatory information was extracted from the National Medical Products Administration (NMPA) website on 31 October 2023.

Results

To date, 101 medicines have been authorized for use in Boao Lecheng. Of these, 45 (45%) were included in the Lecheng Global Special Drug Insurance Scheme, which provides commercial supplementary insurance for Hainan citizens, and 28 (28%) had received NMPA approval. In addition, 10 (10%) were included in Boao Lecheng’s Clinical Real-World Data Application Pilot, four of which have since received NMPA marketing authorizations using the real-world data generated to support their applications (pralsetinib, trilaciclib, inclisiran, and the fluocinolone acetonide intravitreal implant). Three of these four medicines passed preliminary review for the National Reimbursement Drug List (NRDL) in 2022, and one was listed on the NRDL in 2023.

Conclusions

Boao Lecheng has become a channel for providing foreign medicines with early access to the Chinese market, with a considerable proportion being covered by commercial supplementary insurance or subsequently obtaining NMPA approval. Although few products have gone through Boao Lecheng’s real-world data pilot to date, early examples show that it offers a route for local real-world data collection to support NMPA marketing authorizations.
PD171 National Health Service Wales - First UK Nation To Approve Dostarlimab For The Treatment Of Rectal Cancer
Authors: Jonas Rachel , Spears Rosie , Woodland Gail , Coulson James
Published: January 2025

Introduction

Dostarlimab is a monoclonal antibody that blocks the programmed cell death protein 1 receptor. Emerging evidence has shown complete clinical response with dostarlimab in patients with locally advanced, treatment-naïve stage II or III rectal cancer where the tumor is either mismatch repair deficient or has high microsatellite instability. Dostarlimab has the potential to replace standard treatments such as chemoradiotherapy and surgery.

Methods

As part of the One Wales medicines assessment process, a literature search was performed and the marketing authorization holder was contacted to ensure the most up-to-date information was available. Clinical experts were consulted to advise where the medicine would sit within current therapy pathways in National Health Service Wales and to ensure that outcome data could be collected if dostarlimab were approved. After reviewing the evidence, an evidence summary report was written by the All Wales Therapeutics and Toxicology Centre that included the clinical and cost effectiveness, safety, and budget impact of dostarlimab.

Results

The One Wales Medicines Advisory Group assessed the evidence in June 2023, recommending access to dostarlimab for patients meeting the criteria for treatment. This recommendation was endorsed by the All Wales Medicines Strategy Group and ratified by the Welsh Government in August 2023. Starting and stopping criteria for dostarlimab were developed in collaboration with clinical experts to complement the One Wales decision. All patients in Wales who meet the agreed starting criteria will now be given the option for routine treatment with dostarlimab. To date, two patients have started treatment with dostarlimab, both of whom have reported treatment response at three months.

Conclusions

Wales is the first nation in the UK to approve routine access to dostarlimab for rectal cancer. The One Wales process allows access to dostarlimab, with the associated potential for avoiding life-changing surgery. Monitoring patient outcomes will provide real world data to enhance the immature dataset currently available on the clinical and cost effectiveness of dostarlimab for rectal cancer.
PD173 Semi-Automation Of Systematic Literature Review Title And Abstract Screening Using Text Mining And Classification Techniques
Authors: Morgan Ciara , Carey Niamh , White Arthur
Published: January 2025

Introduction

Researchers are increasingly faced with the challenge of producing a robust systematic literature review (SLR) within the confines of time and budget. Semi-automating the title and abstract screening phase has been proposed to reduce the workload burden of SLRs. This research aimed to evaluate the efficacy of text mining and machine learning techniques in the semi-automation of the title and abstract screening phase of SLRs.

Methods

Two SLRs that had been manually screened by one screener (manual SLRs) were examined. The titles and abstracts of these SLRs were tokenized and the datasets were split into training and test sets. Support vector machines (SVM), Naïve Bayes (NB), and k-nearest neighbors (k-NN) classification machine learning models were used to predict whether documents in the test set were classed as relevant during the manual SLR. Diagnostic evaluation was carried out using Shapley Additive explanations and local interpretable model-agnostic explanations to explain the predictions of the optimal model.

Results

SVM achieved a sensitivity of one for both SLRs, successfully identifying all documents classed as relevant in the manual SLR. For one SLR, diagnostic evaluation indicated that the model used relevant features to generate its predictions. For the second SLR, the model had the tendency to predict using less relevant or misinterpreted variables. This may be because certain features (i.e., words) the model was trained on had different meanings depending on the clinical context and were present in both relevant and irrelevant citations. This demonstrates the inability of such models to extract semantic meaning from text.

Conclusions

For the second SLR, domain expertise was required to evaluate the features driving the SVM model predictions. This highlights the importance of using discretion when determining the trustworthiness of results generated by such models. This is important to researchers, who need assurance that the use of such techniques will not compromise the validity of their results.