bluuebunny/crossref_metadata_2025_split huggingface dataset:
OP86 Exploring Public Utilization Data For Primary Care Education Programs
Authors: Mak Jason , Granger Renee 
Published: December 2019

IntroductionNPS MedicineWise delivers nationwide educational programs to improve quality use of medicines and medical tests in Australia. Targeted horizon scanning approaches are required to detect and address emerging challenges in the healthcare landscape such as overutilization and unexpectedly high expenditure on medicines and medical tests. Publicly available utilization and expenditure data from the Australian Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) may provide insights into identifying potential areas for intervention.MethodsFive financial years (2013-18) of publicly available PBS/MBS data was extracted from Australian Government websites and clustered according to medicine class, disease groups or anatomical therapeutic chemical classification (ATC). Usage and expenditure trends were explored with signals of potential inappropriate use identified as unusual spikes or changes.ResultsPBS data showed two fixed dose combination inhalers for respiratory conditions, three direct oral anticoagulants, four analgesics (including opioids) and two blood glucose lowering agents had high volume and expenditure growths in the 2016-17 financial year. Cholesterol-reducing medicines and anti-hypertensives also commonly had high utilisation growth. The highest growth classified by ATC level two codes were for urologicals. These signals were collated into themes of stroke prevention, cardiovascular, respiratory, pain management and type two diabetes. MBS data on pathology tests showed viral and bacterial testing had the highest growth, followed by vitamin B12 testing and vitamin D testing. Magnetic resonance imaging had the highest growth in expenditure and volume of services of the various imaging modalities and X-ray of the lower leg had the highest volume of services.ConclusionsSeveral medicines and medical tests were detected as possible targets for interventions based on high volume or expenditure growth. Themes identified from the data can then be further investigated and contextualized to inform topic areas for primary care education to support quality use of medicines and medical tests.
OP91 Developing A Celtic Connections Regional Health Technology Assessment Alliance
Authors: Myles Susan 
Published: December 2019

IntroductionThe Irish, Scottish and Welsh national Health Technology Assessment (HTA) bodies (Health Information and Quality Authority, Health Technology Assessment Group, Scottish Health Technologies Group, Health Technology Wales) have recently (2018) established a ‘Celtic connections’ regional HTA alliance on non-medicine technologies. The primary purpose is to add value by realizing potential economies of scale and scope in non-medicine HTA efforts.MethodsA Memorandum of Understanding (MoU) was agreed to: formalize collaboration and partnership working; improve shared understanding of work programs and processes; collaborate on and co-produce evidence reviews of mutual interest; increase both the volume and range of technology topics for which advice is developed in each nation; promote knowledge exchange; and enhance professional and personal development for each agency's staff.ResultsEarly benefits include: collaboration on one technology topic resulting in the production of bespoke guidance in three countries; an update of a partner's rapid review; identification of a further potential topic collaboration (sacral nerve stimulation); a six month senior staff secondment; and reciprocal observer membership on each country's national committees. Other general benefits have included: reduced duplication of effort; improved quality assurance through ‘critical friend’ peer review; enhanced access to methodological advice and a broader range of stakeholders; and development of a forum for discussion and peer support.ConclusionsThe alliance offers real potential to optimize use of the scarce resources for non-medicine technologies across the three countries and increase evidence review and guidance volume through adapting or co-producing outputs. Longer term benefits are anticipated to include: improved knowledge exchange; advancing skills of staff; building and broadening capacity through shared learning and access to a wider professional peer group; improved staff recruitment and retention; production of joint publications and other modes of dissemination; and increased profile for each country's work.
OP109 The Need For Building Pharmacists’ Health Technology Assessment Capacity; The Nigerian Scenario
Authors: Chukwu Otuto Amarauche , Chukwu Chizaram 
Published: December 2019

IntroductionThe role of Health technology assessment (HTA) as a systematic approach in the evaluation of health interventions and technologies is becoming increasingly important as the quest for attaining universal health coverage globally continues to increase. Some developed countries in Europe and the Americas now apply HTA extensively in healthcare policy decisions, however, developing regions and countries like sub-Saharan Africa and Nigeria respectively, seem not to be making significant progress in this area. Given that evidence suggests that Nigeria and indeed several countries in sub-Saharan Africa are performing poorly on most healthcare indices as the region continues to be ravaged by predictable and avoidable epidemics and disease outbreaks, the need to build HTA capacity has never been more paramount.MethodsA review of HTA capability in Nigeria was done. Pharmacists in Nigeria's Capital were randomly sampled. Semi-structured questionnaires were administered. Descriptive statistics were used in data analysis. P values less than 0.05 were considered to be significant.ResultsIn Nigeria, there is no institution tasked with undertaking HTA and there seems to be limited knowledge, capacity and awareness on the issue. Pharmacists, being the most accessible healthcare professionals according to evidence, are a key group that could play an active role in HTA and its implementation in developing countries like Nigeria. However, out of 322 pharmacists randomly sampled, 93 percent were not aware of HTA and its application in healthcare decision-making.ConclusionsThere is no paucity of healthcare programs and plans in Nigeria but they seem to fail due to lack of evidence-based assessment, decision-making and implementation. Hence, there is an increasing need to raise awareness on the importance of HTA in healthcare decision-making; strengthen HTA capacity by developing and sustaining institutional capacity and adequate human resource for HTA; and creating regional annexes of HTA organizations in Africa.
OP115 Expanding Perspectives: The Role Of Environmental Scanning In Health Technology Assessment
Authors: Pollock Michelle , Guo Bing 
Published: December 2019

IntroductionEnvironmental scan reports, usually consisting of literature reviews and/or key informant consultations (such as online surveys or personal interviews), broadly describe the current local, national, and international landscape surrounding health care practices, programs, or the use of technologies. Funding agencies and health organizations recognize environmental scans as a valuable way to inform decision-makers about the context, practice variations, and knowledge gaps surrounding a topic. Despite their increasing popularity in health technology assessment (HTA), there is limited guidance available for conducting environmental scans, variation in methods used across and within HTA agencies, and lack of consensus on an appropriate definition, purpose, and process.MethodsWe conducted an informal literature review and consulted experienced researchers from other HTA agencies to identify existing methods guidance for conducting environmental scans. We then adapted these methods to conduct an environmental scan of initiatives to accelerate cancer diagnosis.ResultsThere was limited and vague guidance on the definition, purpose, and process of conducting environmental scans in the context of HTA. This introduced challenges but provided the flexibility to modify our approach to meet requestor needs. Our environmental scan included: (i) a literature review, to identify and describe relevant initiatives and to locate data on effectiveness (which is often out-of-scope for environmental scans but was of priority to the requestor); (ii) stakeholder surveys, which helped “fill in the gaps” of the literature review and helped locate additional initiatives; and (iii) targeted key informant interviews, which provided rich follow-up data on the initiatives most important to the requestor.ConclusionsBy describing our experiences adapting limited methods guidance to meet requestor needs, we hope to contribute to the evolving discussion about the definition, purpose, and process of environmental scans to inform health policy decision-making. We will reflect on challenges encountered, potential solutions, and lessons learned, and will discuss ongoing areas of methodological uncertainty.
PP02 Using Real World Data To Identify The Market For A New Technology
Authors: Macmillan Thomas , Chalkidou Anastasia 
Published: December 2019

IntroductionKing's Technology Evaluation Centre (KiTEC), a United Kingdom- based health technology assessment consultancy, was tasked with identifying a specific group of heart failure patients who had repeat readmissions in order to accurately identify the potential market for an innovative device designed to diagnose heart failure as a way to avoid costly and avoidable hospital readmissions. The device enables clinicians to remotely diagnose heart failure and appropriate medication can be administered instead of a hospital visit. Our methodology describes an accurate way to quantify the at risk population without the need for a costly trial.MethodsUsing big data from national registries – the heart failure specific National Institute for Cardiovascular Outcomes Research (NICOR) database and the national Hospital Episodes Statistics for the National Health Service (HES) – KiTEC has devised a methodology of linking the two datasets in order to (i) accurately identify patients with repeat readmissions over a 5-year period and (ii) calculate the risk factors for readmissions. Data is linked using a common field, meaning information from both databases can be analyzed at patient level (it is pseudo-anonymized before KiTEC receives it). This allows for unprecedented granularity, as we are able to exploit the heart failure specific detail of NICOR alongside the wealth of admissions data available in HES.ResultsThere are significant challenges surrounding the use of registry data, especially in the enormous size of the datasets and in privacy legislation aimed at protecting personally identifying data. The usual regulatory approvals for health research are also more complex when linked datasets are proposed. These are important considerations, especially when linking two complementary databases.ConclusionsThe use of real world data has the potential to paint a true and accurate picture of a patient population, while avoiding many of the biases inherent in typically research studies. However, there are other important challenges to overcome, namely difficulties analyzing huge datasets and navigating complex legislation to access patient data.
PP05 The First Choice Of Health Institutions Of Elderly In Zhejiang And Qinghai, China
Authors: Zhang Hao , Wei Jingming , Gao Qilong , Zhao Can , Dong Hengjin , Hu Xiaoqian 
Published: December 2019

IntroductionThe utilization of medical resources in China is unbalanced and insufficient. In order to find a way to maximize their utilization to face challenges in the upcoming decade, this study aims to investigate the elderly's first choice of health institutions when they were ill in the Zhejiang and Qinghai provinces, and to explore the potential pathways related to their choices, respectively.MethodsThe data used in this study was from cross-sectional surveys in Zhejiang and Qinghai. According to the Anderson Health Service Utilization Model, we applied structural equation modeling to explore the complex pathways from socioeconomic status (SES), accessibility, and health status to the elderly's first choice of health institutions.ResultsThe proportion of the elderly who selected community health institutions (CHI) as their first choice of medical institutions in Qinghai was higher than in Zhejiang. The Zhejiang model revealed a significantly negative direct effect of SES and significantly positive direct effects of accessibility to CHI and health status on the choice of institutions, and a significantly positive indirect effect of SES on choice of institutions, through the mediating factor of health status. SES played an important role in the Zhejiang model in direct and indirect ways. In the Qinghai model, only SES and accessibility to CHI had significantly direct effects on the choice of institutions, with accessibility to CHI having the biggest effects. SES had a significant and positive indirect impact on choice of institutions, through the factor of accessibility to CHI.ConclusionsA better understanding of the complex pathways from factors to elderly's choices of health institutions was essential, which may inform priorities for maximizing the utilization of CHI further and prepare to face challenges in the new decade. Through this research method, policymakers could explore the specific pathways based on their own economic and societal status.
PP10 Quality Of Reporting Economic Evaluations In Rehabilitation Research
Authors: Flemming Julie , Armijo-Olivo Susan , Chojecki Dagmara , Paulden Mike 
Published: December 2019

IntroductionEconomic evaluations are a growing field of interest in the rehabilitation area. Research has questioned the quality of reporting of health economic evaluations. Poor reporting hinders the ability to provide accurate information for health care decision making. Therefore, the objectives of this study are to document on overall reporting quality of the published literature for rehabilitation economic evaluations; to identify if reporting quality has improved in health economic evaluations within the field of rehabilitation therapy since the publication of the Consolidated Health Economic Evaluation Reporting Standards (CHEERS); and to identify factors that could influence the reporting trends.MethodsWe searched databases for economical evaluations performed in the rehabilitation area published between 2013 and 2018. Study selection was performed by two independent reviewers using Covidence software. Data extraction was conducted by one reviewer using Microsoft Excel and independently verified by another reviewer. The quality of reporting was evaluated independently by two reviewers using the CHEERS checklist.ResultsThe search of the literature resulted in a total of 2195 published articles. Of these, 117 were considered to be potentially relevant. Independent review of these 117 articles led to the inclusion of 88 articles. This study is ongoing and complete results will be presented at the conference. Fifty papers have been analyzed in full. In general, the quality of reporting of the economical evaluations in the rehabilitation field was poor. The total mean and median for the CHEERS checklist was 17 points (out of 25) (range 8-24). Most of the analyzed studies did not report important methodological features of the economical evaluation as evaluated by the CHEERS checklist.ConclusionsThe quality of reporting of economic evaluations in the rehabilitation field is poor and inconsistent. Commonly the methods of the analyzed studies are under reported, thereby creating challenges in determining whether the information presented is sound.
PP27 Additional Capabilities In Health Technology Assessment To Support Decision Making
Authors: Larocque Brigitte , Rhainds Marc , Coulombe Martin , Nourissat Alice 
Published: December 2019

IntroductionDecision-making regarding an open or a closed fluid waste management system (FWMS) in the planning of thirty operating rooms (ORs) of a new hospital at the CHU de Québec-Université-Laval was an opportunity to explore additional capabilities in health technology assessment (HTA) to support evidence-based planning.MethodsIssues related to FWMSs in ORs were assessed from multiple data sources including: (i) systematic review in indexed databased and grey literature, (ii) waste management laws and regulations, (iii) local registry of reported incidents/accidents, (iv) occupational health and safety database, (v) electronic patient records (EPRs), (vi) field evaluation of two closed FWMSs, (vii) costs, and (viii) survey on FWMSs in ORs of other Quebec hospitals.ResultsClosed FWMSs in ORs could reduce health care professional exposure to blood and body fluids (BBF) according to two low-quality studies. Cases of occupational and patient exposure to BBF with closed FWMSs, some of which had severe issues, were reported to the U.S. Food and Drug Administration. Depending on the volume, discharge of BBF to the sanitary sewer may be authorized upon the approval of the competent municipal authorities. Compared to an open system, a closed FWMS has the potential to reduce manipulation of canisters during the cases because of large canister capacity (24 L). However, local data showed that BBF and irrigation fluid amounts in ORs are <2 L in 84 percent of cases and >2 L in a minority of surgeries, whereas a closed FWMS is associated with higher costs for BBF volumes <12 L. Other issues were observed during field evaluation (e.g., occupational noise). Closed FWMS implementation in other hospitals was very limited in the survey.ConclusionsAvailable evidence does not support the widespread use of a closed FWMS. Use of mixed-methods in this particular HTA allowed to assist decision makers on the choice of an FWMS in the OR planning.
PP38 Productivity Loss In Patients With Chronic Diseases: A Pooled Analysis
Authors: Rashdan Omar , Brodszky Valentin 
Published: December 2019

IntroductionDue to the unprecedented increase in medicine prices in recent years, the socio-economic perspective started gaining importance in health economic evaluations. Productivity loss evaluations provide a long-term economic impact visualization for a more informed reimbursed medicine decisions.MethodsA pooled analysis of patient-level data from 11 cross-sectional, retrospective, cost-of-illness studies was performed. SPSS software was used for our statistical analysis. Analysis of variance (ANOVA) and correlation analysis were utilized to measure the effect of different variables on lost productivity hours. All costs were recalculated to account for the cumulative inflation till 2018.ResultsThe sample size of included studies ranged between 68 (Multiple Sclerosis) and 480 (Diabetes), and the total number of patients enrolled in the analysis was 1,881 of which 956 were female. A total of 6,795 hours were reported as missed working hours per year. Overall, the female population reported a mean of 689.5 lost productive hours compared to 324.7 in males (p < 0.001). This translated into higher indirect costs at EUR 2,748 and EUR 1,530 for females and males, respectively. Patients with a college degree or higher reported lower yearly lost productive hours and indirect costs (358.4 hours and EUR 1,749) (p < 0.001) compared to patients with lower education level (845.6 hours and EUR 3,534) (p < 0.001). The average indirect cost as a percentage of gross domestic product per capita was highest in Schizophrenia patients at 97.5 percent and lowest in Benign Prostatic Hyperplasia at 1.9 percent. In patients below 65 years of age, a weak positive correlation was observed between age and lost productive hours with a Pearson value of 0.1 (p < 0.001).ConclusionsFemale gender and older age resulted in higher productivity loss, and Schizophrenia was the disease with the highest indirect costs per patient per year.
PP55 The Effectiveness Of Viabahn In Peripheral Artery Aneurysms
Authors: Soares dos Santos Augusto Cesar , Horta Maria da Glória Cruvinel , Carvalho Lélia Maria de Almeida , Fernandes Mariana , Rodrigues Luíza , Avelar Sandra de Oliveira Sapori , Scherrer Luciano Rios , Biscione Fernando Martin , Kelles Silvana Marcia 
Published: December 2019

IntroductionOpen repair was considered for several years the gold standard therapy for the treatment of peripheral artery aneurysms (PAAs). However, with advancements in endovascular technology increasing attention has been directed toward repairing PAAs using an endovascular stent graft.MethodsThis retrospective study evaluated a cohort of patients after the correction of PAAs with Viabahn. Patients treated from January 2011 to January 2018 were assessed for all-cause mortality, amputation and the need for re-intervention. Data were extracted from an administrative database from a healthcare organization in Belo Horizonte, Brazil.ResultsFifty-two patients were included in the study (median age 69.1 years, range 15 to 90 years; male 63.5 percent), three of whom also received Viabahn for contralateral PAAs. In total, 84 devices were used (average 1.5 per PAA); distribution: popliteal and tibial arteries (n = 30; 57 percent), femoral and iliac arteries (n = 19; 37 percent), axillary artery (n = 1; 2 percent), splenic artery (n = 1; 2 percent), abdominal aorta (n = 1; 2 percent). After a mean follow up time of 1.98 ± 1.68 years, we observed death (n = 3; 5.8 percent), amputation (n = 3; 5.8 percent) and the need for re-intervention (n = 17; 32.6 percent) in 23 patients (44.2 percent). The combined overall survival for the first, second and third year of follow up was 70.2 percent (Confidence Interval [95% CI]: 58.9 - 83.6); 63 percent (95% CI: 51.0 - 78.0) and 57.3 percent (95% CI 44.6 - 73.6).ConclusionsThere are still several unanswered questions regarding the best approach for patients with PAAs. In the absence of well-designed clinical studies, the assessment of databanks on real-world patients may contribute to improve our understanding of treatment alternatives and provide guidance to improve current clinical results.