bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE LEBANESE STUDY COMMITTEE: A CHRISTIAN THINK TANK IN WARTIME LEBANON (1975–1982)
Authors: KATTAR CHLOE 
Published: December 2020

AbstractThis article seeks to shed light on the Lebanese Study Committee, an overlooked centre of intellectual production and political activity during the Lebanese Civil War. It was comprised of legal experts and Maronite monks of the Lebanese Maronite Order, and emerged at the Holy Spirit University of Kaslik in 1975. The committee was created at the initiative of the Catholic clergy in order to endow the Christian war effort with an ‘intellectual pole’ capable of studying recent developments and provide solutions aimed at defending the interests of the Christian society. By making use of hitherto inaccessible primary sources, its internal and external publications, the article elucidates the activities and ideas of the committee, which worked to counteract leftist discourse and propaganda. By paying attention to the context of the Lebanese Study Committee's emergence, the article also brings to light a history of interaction between lay, clerical, state, and para-military institutions. It concludes that its creation is the direct consequence of the grassroots mobilization of conservative agents, which is reminiscent of the ways in which Western conservatism was revived in the same years.
OP206 Expert Elicitation Of Probabilistic Distributions to Inform Survival Modelling of CD19 Chimeric Antigen Receptor T-Cell Therapies
Authors: Carey Niamh , Hickey Conor , Mc Cullagh Laura , Barry Michael 
Published: December 2020

IntroductionIn 2018, the National Centre for Pharmacoeconomics (NCPE) was commissioned to conduct a health technology assessment (HTA) of one of the first commercially available chimeric antigen receptor (CAR) T-cell therapies, tisagenlecleucel. CAR T-cells are a major advance in personalized cancer treatment, demonstrating promising outcomes in relapsed/refractory pediatric acute lymphoblastic leukemia (pALL). However, the results are based on short-term follow up, limiting their value in predicting long-term survival and leading to uncertainty about the most appropriate survival modeling method to employ. This study aimed to address these limitations by means of expert elicitation.MethodsAn expert elicitation method, the histogram technique, was employed. A predefined discrete numerical scale was presented in Microsoft Excel® and the expert was asked to place twenty crosses on a frequency chart. These crosses represented the expert's beliefs about the distribution of particular quantities. Each cross represented five percent of the probabilistic distribution. Individual distributions were then aggregated across experts using linear pooling.ResultsA total of seventeen experts were invited to take part; eight agreed to participate and five completed the exercise. Three experts did not consider tisagenlecleucel to be a “curative” therapy because patients had a higher risk of death, compared with the age- and sex-matched general population. The aggregated distributions indicated the five-year overall survival rate to be thirty-three percent (95% CI 8.65–56.88) in patients who do not receive a subsequent stem cell transplant and twenty percent (95% CI 2.38 -52.04) in those who do.ConclusionsThe results of this study will be used to calibrate CD19 CAR T-cell therapy survival estimates presented in HTA submissions to the NCPE to ensure more robust assessments. They will also be used to inform the construction of a de novo cost-utility model for examining the cost effectiveness of CD19 CAR T-cell therapies for relapsed/refractory pALL in the Irish healthcare setting.
OP441 Testing The Sensitivity And Precision Of The Cochrane MEDLINE Randomized Controlled Trial Search Filters
Authors: Glanville Julie , Kotas Eleanor , Featherstone Robin , Dooley Gordon 
Published: December 2020

IntroductionThe Cochrane Handbook of Systematic Reviews contains two search filters to find randomized controlled trials (RCT) in Ovid MEDLINE: a sensitivity maximizing RCT filter and a sensitivity and precision maximizing RCT filter. The RCT search strategies were originally published in 1994 have been adapted and updated, most recently in 2008. To determine whether the Cochrane filters are still performing adequately to inform Cochrane reviews, we tested the performance of the Cochrane filters and 36 other MEDLINE filters in a large new gold standard set of relevant records.MethodsWe identified a gold standard set of RCT reports published in 2016 from the Cochrane CENTRAL database of controlled clinical trials. We retrieved the records in Ovid MEDLINE using their PubMed identifiers. Each RCT filter was run in MEDLINE and combined with the gold standard set of records, to determine their sensitivity, precision and f-scores.ResultsThe gold standard comprised 27,617 records and the searches were run on 16 July 2019. The most sensitive RCT filter was Duggan (sensitivity 0.99). The Cochrane sensitivity maximizing RCT filter had a sensitivity of 0.96, but was more precise than Duggan (0.14 compared to 0.04 for Duggan). The most precise RCT filter was Chow, Glanville/Lefebvre, Royle/Waugh, Dumbrique (precision 0.97, sensitivity 0.83). The best precision Cochrane filter was the sensitivity and precision maximising RCT filter.ConclusionsThe Cochrane MEDLINE sensitivity maximizing RCT filter can continue to be used by Cochrane reviewers and CENTRAL compilers as it has very high sensitivity but a more acceptable precision than many higher sensitivity filters. Slightly more sensitive filters are available, but with lower precision than the Cochrane sensitivity maximizing RCT filter. These other filters may be preferred when combining with a subject search when record numbers may be more manageable than searching the whole of MEDLINE.
OP509 Do They Care? Debates About Nursing And Health Technology Assessment In The German Bundestag
Authors: Wübbeler Markus , Geis Sebastian 
Published: December 2020

IntroductionOpposition parties in Germany are allowed to send formal requests to the government to control actions and pass important political debates to the parliament. These formal requests include a comprehensive analysis report issued by the scientific service of the German parliament. A systematic overview of these reports would support a deeper understanding about healthcare topics and assessments discussed by parties in the highest German decision body, particularly in the field of nursing.MethodsWe conducted a review using the German parliament “Bundestag” database for all formal requests since 1949. To systemize the formal requests we performed a quantitative category analysis using descriptive statistics.ResultsWe identified 26,197 formal requests with 146 reports related to nursing issued between 1978 and 2019. The 146 reports related to nursing accounted for 0.54 percent of all requests. Almost 30 percent of these requests were related to recruitment and qualification. The second major topic, with 15 percent, was financing of the nursing sector. Of all 146 formal requests in the history of the Bundestag, 55 percent (n = 81) were issued in the last 10 years.ConclusionsNursing is an emerging topic in the German parliament, highlighting the demographic shift in Germany and the growing pressure in the nursing care sector. Health Technology Assessment bodies should be informed and work together with the scientific services of parliamentary bodies. This would support a more transparent and evidence based healthcare system, aside from lobbyism.
OP513 Disparities In Cancer Premature Mortality In Brazil: Predictions Up To 2030 And Sustainable Development Goals
Authors: Cancela Marianna De Camargo , Schilithz Arthur Correa , de Souza Leonardo Borges , Martins Luís Felipe , de Souza Dyego Bezerra , Hanly Paul , Barchuk Anton , Soerjomataram Isabelle , Sharp Linda , Pearce Alison 
Published: December 2020

IntroductionPremature mortality affects the economy directly due to the loss of productivity of individuals who die, thus ceasing to contribute economically to the country. The one-third reduction in premature mortality (30–69 years) from chronic noncommunicable diseases is goal 3.4 of the United Nations Sustainable Development Goals (UN SDG). Although cancer is a chronic disease, it comprises more than 100 different conditions, with different risk factors and prognosis. This study aimed to calculate current and predicted premature mortality by 2030 for Brazil and regions, compared with the SDG 3.4 target and identify regional progress and future needs.MethodsMortality data were extracted from the National Mortality Information System of Brazil (SIM) and subsequently corrected for ill-defined causes. Crude and age-standardized mortality rates per 100,000 inhabitants were calculated. NordPred package by software R was used to calculate predictions up to 2030 and compared with the goal of one-third reduction of premature deaths.ResultsComparison of observed (2011–2015) and predicted (2026–2030) mortality rates show a 12.0% reduction in the likelihood of death among men and 4.6 percent among women nationally. Although predicted rates for 2026–2030 are lower than those observed in 2011–2015, the predicted number of deaths increases by 75,341 for men and 90,513 for women. Lung cancer mortality rates are predicted to decrease more among men than women, while colorectal cancer mortality will increase for both sexes.ConclusionsThe profile of cancer premature mortality is diverse in Brazil. Nationally, only male lung cancer will be close to reaching the SDG 3.4 target, endorsing the government's long-term efforts to reduce tobacco consumption. Colorectal cancer mortality increases in most regions, reflecting the epidemiological transition. Despite progress in cervical cancer control, it will continue to be a major challenge, especially in the North and Northeast. Our results provide a baseline for public policies for both prevention and access to treatment to reduce premature mortality in Brazil. Differences in cancer patterns show the need to plan and to adapt regionally for each reality.
OP535 Cost-Effectiveness Of Internet-Based HIV Screening In Men Who Have Sex With Men in Vancouver, British Columbia, Canada
Authors: Zhang Wei , de Anda José , Irvine Michael , Chang Hsiu-Ju , Gilbert Mark 
Published: December 2020

IntroductionIn Canada, individuals test for HIV commonly through clinic-based screening services (CBSS). However, gay, bisexual and other men who have sex with men (GBMSM) may face barriers accessing such services due to, for example, feeling discomfort disclosing their sexual history or fearing judgment from healthcare providers. To reduce barriers and increase uptake and frequency of screening for sexually-transmitted infections (STIs) including HIV, the British Columbia Centre for Disease Control implemented an internet-based screening service, GetCheckedOnline.com (GCO), in September 2014 in Vancouver, Canada. We assessed the cost-effectiveness of GCO at different uptake scenarios compared to CBSS in Vancouver GBMSM.MethodsCost-utility analyses were conducted from a healthcare payer's perspective using an established dynamic GBMSM HIV compartmental model. The model estimated the probability of becoming infected with HIV, progressing through diagnosis, disease stages, and treatment over a 30-year time horizon. The base case assumed 4.7 percent uptake of GCO, and 74 percent of high-risk and 44 percent of low-risk infrequent testers becoming regular testers in five years. Scenario analyses tested GCO 10 and 15 percent uptakes.ResultsCompared with the conventional CBSS alone, a 4.7 percent GCO uptake increased the costs by CAD90,059 (USD75,680; 95% confidence interval (CI): -CAD420,836, CAD273,987) and gained 3 (95% CI: 0, 6) quality-adjusted life years (QALYs) in a 30-year time horizon. There was a 71 percent probability that GCO was cost-effective at a cost-effectiveness threshold of CAD50,000 (USD42,000) per QALY. The results were consistent in other two uptake scenarios.ConclusionsExpanding HIV screening for GBMSM through increasing uptake of GCO is a cost-effective alternative to expanding the conventional CBSS. We noted that difference in total costs might be smaller if a battery of STI tests is considered, which in turn may affect our cost-effectiveness estimate. For the next phase of cost-utility analysis, we will expand our model to include testing for other STIs.
PP138 Current Status Of Healthcare Decision Making And Future Perspective Of The Health Technology Assessment Implementation Roadmap In Turkey
Authors: Atikeler Enver Kagan , Fasseeh Ahmad Nader , Leufkens Bert , Goettsch Wim 
Published: December 2020

IntroductionTurkey's health reforms, which started in 2003, have led to increased access to health care and pharmaceuticals as well as rising public pharmaceutical expenditures. The need to improve healthcare decision making by implementing health technology assessment (HTA) has become an important priority for Turkey. This study sought to provide a tailor-made HTA implementation roadmap, drawing on insights from national stakeholders.Our study aimed to describe the current HTA environment in Turkey and to explore long-term perspectives and suggestions from a wide spectrum of Turkish stakeholders regarding the preferred status of HTA in ten years (by 2029).MethodsWe conducted an online survey using a questionnaire previously applied in other HTA research. We assessed the current evaluation of medical and economic decision-making processes and examined the need for HTA. We also ascertained stakeholder perspectives on potential developments that can be done together with policymakers, representatives of pharmaceutical companies, and patient organizations. We also included general information about the pharmaceutical market and decision making processes in Turkey.ResultsThe survey was sent to various stakeholders from different areas within the health system. Additional face-to-face interviews were conducted with a few respondents to clarify some of their answers. A total of twenty-seven Turkish stakeholders completed the survey. Of these, twenty-one (78%) participants were employed in the public sector and six (22%) were from the private sector. The majority of the participants would introduce HTA for all new health technologies being considered for public reimbursement and institute an additional review process for currently reimbursed technologies. Most of the respondents considered that only new technologies with significant budget impact should be evaluated in the next ten years.ConclusionsIt is clear that Turkey needs to implement an HTA process in the future. Our study shows stakeholder expectations, which will be helpful for creating an HTA implementation roadmap, and it is clear that different stakeholders have different views and expectations about HTA implementation in Turkey. The experiences of other countries will also be helpful during the implementation process.
PP256 Cost-Utility Analysis of Robot-Assisted Partial Nephrectomy Versus Open Or Laparoscopic Radical Nephrectomy In Korean Patients With Renal Cancer
Authors: Ahn Jeonghoon , Kang Yejee , Lee Juyeon , Bae Seowoo , Shin Minkyung , Igarashi Ataru 
Published: December 2020

IntroductionPartial nephrectomy is recommended over radical nephrectomy for the surgical treatment of patients with stage cT1 renal cancer in multiple guidelines. The objective of this study is to examine the cost effectiveness of robot-assisted partial nephrectomy (RAPN), compared with open radical nephrectomy (ORN) or laparoscopic radical nephrectomy (LRN), for treating stage cT1 renal cancer in Korea.MethodsA Markov model was applied in patients with cT1 renal cancer that consisted of the following six health states: post-surgery, normal, chronic kidney disease (CKD), dialysis, death from renal failure, and natural death. Utilities and transition probabilities were obtained from systematic literature reviews. Costs were obtained from the current Korean National Health Insurance fee schedule, the Korean medical literature, and 2016 Health Insurance Review and Assessment Service inpatient claims data. Univariate and probabilistic sensitivity analyses were performed to check for uncertainty.ResultsRAPN was the dominant treatment, costing KRW 2.1 to 3.6 million (USD 1,700 to 2,900) less than the comparators while providing 0.45 to 0.61 more utility. Univariate sensitivity analysis showed that the most sensitive parameter was the relative risk reduction of CKD after partial nephrectomy. The sensitivity analysis also showed that the acceptability of RAPN at a cost-effectiveness threshold of KRW 30.5 million was high relative to both comparators (85.9% against LRN and 78.9% against ORN).ConclusionsThough there might be uncertainties in non-Korean utility data and some transition probabilities derived from Japanese data, the current study suggested that partial nephrectomy is a more cost-effective option than ORN or LRN in Korea for patients with stage cT1 renal cancer.
PP313 Patient Preference For Blood Pressure Measurement: Sphygmomanometers Or Automatic Monitors?
Authors: Albuquerque Nila , Araujo Thelma , Borges Samantha , Silva Liana Queren , da Silva Lais Vitoria , Rabelo Talita , Lino Maria Kecia , Elery da Rocha Fabian , Sibele de Freitas Luzia 
Published: December 2020

IntroductionThe development of more accurate algorithms has encouraged the replacement of sphygmomanometers with automatic blood pressure (BP) monitors in adults. From the perspective of health professionals, these technologies are advantageous for their practicality and are less susceptible to observer errors, and many devices validated by standardized protocols are available for both clinical and home use. However, adherence to these technologies also depends on patient acceptance. No studies to date have examined patient preference for BP measurement in the Brazilian population, although Brazil has undertaken initiatives to replace auscultatory measurement with oscillometric measurement. This study aims to analyze patient preferences between sphygmomanometers and automatic monitors for BP measurement.MethodsAn analytic study was conducted with 93 subjects in a Brazilian outpatient care facility. A random sampling method was used to select participants. After obtaining informed consent, all subjects had their BP measured using a sphygmomanometer and then an automatic monitor for clinical use, both in a quiet room after 10 minutes rest. A structured interview on discomfort and preferences was then conducted. An unpaired t-test and a chi-square test were used.ResultsThe mean age was 39.11 (±14.22) years. Minor discomfort was identified when an automatic monitor was used (2.34 versus 2.52). Confidence was higher with the sphygmomanometers (73.11%), and 60.21 percent preferred this technology. There was no association between gender and preferences (p = 0.88), but an association with age was identified. The average age of subjects who preferred sphygmomanometers was higher compared to those who preferred automatic monitors (p < 0.05).ConclusionsThis study revealed that, although BP measurement using automatic monitors is less uncomfortable, patients rely more on sphygmomanometers. Results show that preference is related to age, as younger people tend to prefer automatic monitors. The findings of this study indicate the need to widely disseminate information regarding the accuracy of automatic monitors among patients, especially older ones, in order to make them part of the decision-making process for replacing sphygmomanometers with automatic monitors.
PP406 Academic Detailing For Judges: Concepts Of Evidence-Based Medicine And Health Policies Adopted In Brazil
Authors: Borin Marcus Carvalho , Alves Carla Barbosa Morais , Junior Nelio Gomes Ribeiro , de Fátima Guimarães Melissa , de Assis Acurcio Francisco , Álvares-Teodoro Juliana , Guerra Junior Augusto Afonso 
Published: December 2020

IntroductionThe Brazilian health system has not been able to enforce the constitutional Right to Health for the entire population, leaving litigation as the last alternative for the fulfillment of the right. In order to harmonize and underpin the decision making of federal judges, an Academic Detailing (AD) program with concepts of evidence-based medicine and health policies for federal judges will be conducted nationwide in Brazil. AD is a strategy to provide information, combining an interactive outreach approach with the best evidence. This study reports the method used to define key messages to be used during visits.MethodsGovernment, federal judges and academy representatives were invited to a workshop on health litigation in Brazil. They were divided into six groups to discuss five hypothetical scenarios. In each scenario, groups listed two possible key messages to disseminate during AD, addressing the legal, scientific, economic or ethical dimensions. After the definition, a vote was taken, according to the importance that each participant attributed to them (1 to 10), and then a score was generated.ResultsOf the thirty-one participants, five were from the judiciary, three prosecutors, one health insurance representative, nine managers and thirteen from the academy. From the case study presented, fifty-five key messages were suggested. After removing duplicates, twenty-five were selected to assign importance values by each participant. The key messages were sorted from highest to lowest score, the most important being “Explain what evidence-based medicine means and what scientific evidence means”.ConclusionsKnowledge of theoretical concepts of evidence-based medicine, health policies and the technology incorporation process seem to be of fundamental importance to federal judges. This information will serve as a basis for decision making regarding litigious proceedings involving the constitutional Right to Health in Brazil. From the selected key messages, bulletins to the academic detailing program to federal judges shall be produced.