bluuebunny/crossref_metadata_2025_split huggingface dataset:
PP112 Review On Change Management Models In Multi-Lateral, Multi-Stakeholder Contexts To Engage Stakeholders
Authors: Lokhorst Ayla , Hogervorst Milou 
Published: December 2021

IntroductionTo facilitate implementation of new health technology assessment (HTA) methods, it is crucial to engage stakeholders. A technically good system may be brought to its knees if the intended users are not willing or able to use it. Therefore, based on these considerations, we aimed to identify relevant aspects of change models and investigated four potentially useful change models in the context of HTA. The four models were: adaptive space; midstream modulation; developmental evaluation; and knowledge brokering.MethodsA narrative literature review was conducted to gather information into a readable and usable format. PubMed and Google Scholar were searched for relevant literature on change management and stakeholder engagement within HTA. Additionally, grey literature was selected after consulting an implementation specialist to gather more information on the background of the change management models.ResultsSeveral enabling factors for successful stakeholder engagement were found, including attention to branding of the coproduction, facilitation/personal safety, and data or indicators to inform activities. Four change methods were described from the enabling factors identified. There was no “perfect model” for our aim, but all models involved relevant aspects to engage stakeholders. Notably, all models paid attention to the project management factor, whereas none of the models paid explicit attention to the branding of the coproduction factor.ConclusionsChange management is a complex and elaborate field in which many factors play a role. Stakeholder engagement is a factor that might be influenced by project leaders within international projects such as the European Union's Next Generation Health Technology Assessment (HTx). To improve stakeholder engagement in modernizing HTA, it is important to keep paying attention to project management, relationships, and how to facilitate fora and meetings to improve mutual understanding. Two factors to pay more attention to are branding of the coproduction and consideration of formal structures.
PP118 A Survival Analysis Of The Lag Times In The Publication Of Network Meta-Analyses
Authors: Tonin Fernanda S. , Araujo Ariane G. , Fachi Mariana M. , Pontarolo Roberto , Fernandez-Llimos Fernando 
Published: December 2021

IntroductionThe use of inconsistent and outdated information may significantly compromise healthcare decision-making. We aimed to assess the extent of lag times in the publication and indexing of network meta-analyses (NMAs).MethodsSearches for NMAs on drug interventions were performed in PubMed (May 2020). Lag times were measured as the time between the last systematic search and the date of the article's submission, acceptance, online publication, indexing, and Medical Subject Heading (MeSH) allocation. Correlations between lag times and time trends were calculated by means of Spearman's rank correlation coefficient. Time-to-event analyses were performed considering independent variables such as geographical origin, journal impact factor, Scopus CiteScore, and open access status.ResultsWe included 1,245 NMAs. The median time from last search to article submission and publication was 6.8 months and 11.6 months, respectively. Only five percent of authors updated their literature searches after submission. There was a very slight decreasing historical trend for acceptance (r =−0.087; p = 0.01), online publication (r =−0.08; p = 0.008), and indexing lag times (r =−0.080; p = 0.007). Journal impact factor influenced the MeSH allocation process (log-rank p = 0.02). Slight differences were observed for acceptance, online publication, and indexing lag times when comparing open access and subscription journals.ConclusionsAuthors need to update their literature searches before submission to reduce evidence production time. Peer reviewers and editors should ensure that authors comply with NMA standards and encourage the development of living meta-analyses.
PP126 Radiofrequency Ablation For Metastatic Spinal Lesions
Authors: Torres-castaño Alezandra , Rivero-Santana Amado , Perestelo-Pérez Lilisbeth , Toledo-chávarri Ana , Duarte-Diaz Andrea , Alvarez-Perez Yolanda , Ramos-García Vanesa , Serrano-Aguilar Pedro 
Published: December 2021

IntroductionAbout 70 percent of metastatic breast, lung, and prostate cancers affect the bones. When this phase of the disease affects the spine, the mobility and quality of life of patients are severely impaired. Radiofrequency ablation (RFA) has become a feasible option in the palliative treatment of vertebral metastases due to its minimal invasiveness and short procedure time. This health technology assessment report aimed to identify, evaluate, and synthesize evidence on the safety, effectiveness, and cost effectiveness of RFA for vertebral metastases.MethodsA systematic search was conducted to identify literature published from December 2016 to July 2019 in the following databases: Medline, Embase, the Cochrane Library, and the Centre for Reviews and Dissemination. Systematic reviews, randomized and non-randomized controlled trials, and case series studies evaluating the efficacy and safety of RFA in patients with vertebral metastases were included.ResultsSixteen studies were included: two systematic reviews, 13 case series studies, and one comparative study. None of the systematic reviews identified any randomized controlled trials. Of the 14 included primary studies, 10 evaluated RFA in combination with vertebroplasty, three evaluated RFA in combination with kyphoplasty, and one study evaluated a combination of RFA and radiation therapy. In all cases, the evaluated patients had different types of cancer (e.g., breast, lung, or liver). The follow-up periods varied between the studies from one day to 12 months. The most commonly used RFA devices were the STAR™ Tumour Ablation System (Merit Medical Systems) and the OsteoCool™ Radiofrequency Ablation System (Medtronic).ConclusionsRFA reduces pain, improves functional capacity, and provides greater local control of disease, potentially giving patients a higher quality of life, even in the context of metastatic disease. Although there is evidence on the safety and efficacy of this technology for the palliative treatment of vertebral metastases, more studies with higher methodological quality are needed. There were no studies available on the cost effectiveness of RFA for this indication.
PP133 Developing A Novel Multifaceted Graphical Visualization For Treatment Ranking Within An Interactive Network Meta-Analysis Application
Authors: Nevill Clareece , Cooper Nicola , Sutton Alex 
Published: December 2021

IntroductionNetwork meta-analysis (NMA) is a key methodology for comparing the effectiveness of multiple interventions or treatments simultaneously. This project aimed to ascertain current methods and visualizations for treatment ranking within an NMA framework and to subsequently develop a novel graphic within MetaInsight (an interactive NMA web application), to aid clinicians and stakeholders when making decisions regarding the “best” intervention(s) for their patient(s).MethodsCurrent literature on the methodology or visualization of treatment ranking published in the last 10 years was collated and studied. Based on the literature, a novel graphical visualization was developed using RShiny (RStudio, PBC) and integrated within MetaInsight, which is currently hosted on shinyapps.io.ResultsBayesian analyses produce rank probabilities from which mean or median rank and surface under the cumulative ranking curve can be calculated. For frequentist analyses the p-value is available. The simpler methods may be easier to interpret, but they are often more unstable and do not encompass the whole analysis (and vice versa). To aid interpretation and facilitate sensitivity analysis, an interactive graphic was developed that presents rankings alongside treatment effect and study quality results.ConclusionsTreatment ranking is useful, but the results should be interpreted cautiously, and the visualization should be transparent and all-encompassing. A ‘living’ version of MetaInsight, with treatment ranking, would allow interested parties to follow the evidence base as it grows.
PP165 Bridging The Gap Of Health Services During The COVID-19 Pandemic Through Telemedicine
Authors: Galvan Pedro , Rivas Ronald , Recalde Luciano , Ortellado José , Arbo Carlos , Portillo Juan , Mazzoleni Juan , Hilario Enrique 
Published: December 2021

IntroductionHealth care for patients with chronic pathologies was scarce and limited worldwide during the COVID-19 pandemic. The challenge for clinical and biomedical engineers is to develop a bridging system to maintain the basic health services for chronic pathologies. Populations living in low-income countries did not have access to basic health services during the pandemic and depended on the scarce resources of their emergency health system. There were also equity issues between urban and rural populations. In this context, telemedicine tools should be directed toward maintaining the basic health services for patients with chronic pathologies. This study evaluated the results of a telemedicine system in remote public hospitals in Paraguay to show how health care for patients with chronic pathologies has been maintained by providing access to tertiary level diagnostic services by specialists.MethodsThis descriptive study evaluated the results of using telemedicine between 2014 and 2020 for diagnosis in remote public hospitals to bridge the gap in providing basic health services for patients with chronic pathologies during the COVID-19 pandemic.ResultsA total of 620,289 telediagnoses were performed in 67 hospitals. The 399,806 electrocardiogram diagnoses performed in 61 hospitals were normal (62%) or showed unspecified arrhythmias (13%) and sinus bradycardia (10%). The 207,597 teletomography tests performed in 12 hospitals were performed on the head because of motorcycle accidents and cerebrovascular diseases (54%), on the chest (14%), and other anatomical regions. The 12,867 electroencephalograms performed in 19 hospitals were for the antecedents of seizure (54%), evolutionary controls (14%), and headache (12%). The 19 ultrasound studies corresponded to prenatal controls.ConclusionsAlthough the telemedicine tool implemented in public health to bridge the gap in basic health services for patients with chronic pathologies during the COVID-19 pandemic offered better equity in the provision of services in remote locations, a widespread use assessment should be undertaken before this tool is adopted.
PP167 Cost Effectiveness Of Universal Childhood Vaccination Against Hepatitis A
Authors: Valcarcel-Nazco Cristina , Guirado-Fuentes Carmen , García-Pérez Lidia , Linertová Renata , Mar Javier , Limia-Sánchez Aurora , Soler-Soneira Marta , Varela-Martínez Carmen , Serrano-Aguilar Pedro 
Published: December 2021

IntroductionHepatitis A (HA) is a liver disease with a low mortality rate, but it can cause debilitating symptoms and fulminant hepatitis in some cases. Its incidence is greater in geographical areas with poor sanitation and hygiene. Spain is considered a low-endemicity country, so universal childhood immunization against HA is currently not financed by the National Health System. The aim of this study was to synthesize the scientific evidence on the cost effectiveness of universal childhood vaccination against HA.MethodsFull economic evaluations, published in the English or Spanish languages, were included if they reported outcome measures related to the prevention of HA, adverse effects, or incremental cost-effectiveness ratios (ICERs). The Medline, Embase and Cochrane Library databases were searched for articles published from the beginning of the databases to April 2018.ResultsA total of 23 economic evaluations were included: one in a country of high endemicity, nine in countries of intermediate endemicity, and 13 in countries with low endemicity. Only one Spanish study, published in 1997, was found. Studies conducted in high- and intermediate- endemicity countries concluded that a universal childhood vaccination program against HA was a cost-effective option. However, in the case of countries with low endemicity the results were heterogeneous, although most agreed that a systematic vaccination strategy would not be a cost-effective option and that the adoption of such a strategy would not be justified given the limited benefits it would offer. The results of the economic evaluations depended on parameters such as the price and duration of the vaccine effect and the program coverage.ConclusionsIn countries with low endemicity the results were heterogeneous, although most studies concluded that the implementation of a universal vaccination strategy is not justified from the point of view of cost effectiveness.
PP168 Quality-Of-Life Study For Caregivers Of People With Drug-Resistant Focal Onset Seizures
Authors: Flint India , Medjedovic Jasmina , O'Flaherty Ewa Drogon , James Samuel , Savic Natasa , Soare Alexandra , Longworth Louise 
Published: December 2021

IntroductionThe quality of life (QoL) of caregivers who look after individuals with drug-resistant focal-onset seizures (FOS) can be significantly affected by their caregiving responsibilities. This is widely recognized by various health technology assessment bodies, including the National Institute for Health and Care Excellence. The aim of this study was to assess the QoL and to generate health-related utility data for individuals caring for adults with drug-resistant FOS. This project will provide critical information on an often neglected and undervalued aspect of epilepsy.MethodsAn online survey including questions on sociodemographic characteristics, caregiver burden and productivity, the EQ-5D-5L, and the Care Related Quality of Life (CarerQol-7D) was administered to caregivers of individuals with drug-resistant FOS in the United Kingdom.ResultsThe analysis included 86 caregivers. The majority were men aged between 25 and 34 years whose caring responsibilities ranged from 25 to 34 hours per week. In the previous 28 days, most individuals they cared for experienced four FOS, with the longest seizure-free period ranging from 6 to 15 days. The patients had previously been prescribed at least four anti-seizure medications.The caregivers’ mean EQ-5D-5L score was 0.66 (range -0.19 to 1), whilst the mean CarerQol-7D score was 71 (range 21 to 100). The most affected dimension of the EQ-5D-5L was self-care, while the most affected dimension of the CarerQol-7D was physical functioning.ConclusionsCaring for people with drug-resistant FOS has a negative impact on the QoL of caregivers, particularly in the domains of self-care and physical functioning.
PP205 The Use Of Real-World Evidence To Support National Institute For Health And Care Excellence Medical Technology Submissions
Authors: Gibson Scott , Saunders Sita , Blüher Maximilian , Hedblom Amanda Hansson , Torres Rafael Torrejon , Saunders Rhodri 
Published: December 2021

IntroductionAlthough randomized controlled trials (RCTs) are recognized as providing the highest level of clinical evidence, few medical device RCTs are available due to underfunding or inherent challenges associated with trial design. This study examines the extent to which real-world evidence (RWE) supports the recommendations made by the National Institute for Health and Care Excellence Medical Technologies Evaluation Programme (MTEP).MethodsAll MTEP guidance documents published online prior to October 2020 were reviewed. The “case for adoption” recommendation, type of clinical data, and clinical critiques for each MTEP submission were extracted and categorized. RWE was defined as studies with neither blinding nor prospective selection or control of patient characteristics.ResultsOf the MTEP submissions reviewed, 34 of 45 (76%) received a positive recommendation. Independent of outcome, all submissions included RWE, but only 19 (42%) utilized RCT evidence (15 were recommended and four were not). Meta-analyses of RWE were used whenever possible. The most common clinical critiques in unsuccessful submissions were the following: (i) not generalizable to the United Kingdom National Health Service (NHS); (ii) low quality; (iii) likelihood of bias; (iv) trial design faults; (v) uncertain benefit; and (vi) evidence unrelated to scope.ConclusionsThis study suggests that while the use of RCTs has not always led to a positive recommendation, RWE can be valuable in decision-making. Evidence that is generalizable to the NHS, is related to the scope, and shows clear indication of benefit is more likely to positively influence MTEP decision-making.
PP219 Combining Healthcare Solutions For Cataract Surgery. An Incremental Benefit Analysis From The Perspective Of The Russian Healthcare System
Authors: O'Boyle Derek , Korolkov Artur , O'Boyle Derek , Poletaeva Victoriya , Hsiao Carine 
Published: December 2021

IntroductionRising health expenditures lead to increasing budgetary pressures, which often manifest in budget managers seeking more for the same resources or trying to maintain the status quo with less. Consequently, enablers that drive efficiencies throughout the entire care pathway have come under increasing focus. This is particularly true in the operating room (OR) setting where considerations around operational efficiency, clinical excellence, and patient-centered care pose challenging questions. While a comprehensive solution set should be formulated, small parts of the solution can be applied now to prime systems for easy integration into future solutions. The objective of this analysis was to estimate the impact of combining custom healthcare solutions for cataract surgery from the perspective of a Russian hospital.MethodsA decision-analytic model was developed to assess the aggregated impact of combining the following products or services for cataract surgery: an intraocular lens delivery-system; process-redesign; a phacoemulsification machine; and a phaco tip. The model and underlying assumptions were validated by clinical experts. OR time-savings was chosen as the variable of efficiency underpinning the analysis. Inputs were estimated from the literature, expert opinion, and the local cost databases. Two scenarios were defined that reflected technologies commonly used in surgical practice. The model scenarios assumed that a hospital performs 2,000 cataract procedures per year, with 100 percent adoption and equal acquisition costs.ResultsChoosing a combination of healthcare solutions for cataract surgery was associated with an incremental benefit of RUB5,935,982 per year (EUR71,364) and generated an OR time saving of approximately 237 cataract procedures.ConclusionsThis analysis highlighted that, compared with treating technologies on an individual level, combining healthcare solutions commonly used for cataract surgery has the potential to drive efficiencies and cost savings for hospitals and to reduce surgical wait lists.
PP234 Analysis Of Discussions On Twitter On The Topic Of COVID-19 Tests: Exploring A Natural Language Processing Approach
Authors: Pandey Savitri , Marshall Christopher , Pokora Maria , Oyewole Anne , Craig Dawn 
Published: December 2021

IntroductionVarious strategies to suppress the Coronavirus have been adopted by governments across the world; one such strategy is diagnostic testing. The anxiety of testing on individuals is difficult to quantify. This analysis explores the use of soft intelligence from Twitter (USA, UK & India) in helping better understand this issue.MethodsA total of 650,000 tweets were collected between September and October 2020, using Twitter API using hashtags such as ‘#oxymeter’, ‘#oximeter’, ‘#antibodytest’, ‘#infraredthermometer’, ‘#swabtest’, ‘#rapidtest’, and ‘#antigen’. We applied natural language processing (TextBlob) to assign sentiment and categorize the tweets by emotions and attitude. WordCloud was then used to identify the single topmost 500 words in the whole tweet dataset.ResultsGlobal analysis and pre-processing of the tweets indicate that 21 percent, seven percent and four percent of tweets originated from the USA, UK, and India respectively. The tweets from #antibody, #rapid, #antigen, and #swabtest were positive sentiments, whereas #oxymeter, #infraredthermometer were mostly neutral. The underlying emotions of the tweets were approximately 2.5 times more positive than negative. The most used words in the tweets included ‘hope’ ‘insurance’, ‘symptoms’, ‘love’, ‘painful’, ‘cough’, ‘fast test’, ‘wife’, and ‘kids’.ConclusionsThe finding suggests that it may be reasonable to infer that people are generally concerned about their personal and social wellbeing, wanting to keep themselves safe and perceive testing to deliver some component of that feeling of safety. There are several limitations to this study such as it was restricted to only three countries, and includes only English language tweets with a limited number of hashtags.
PP259 Invisible Resilience: The Value Of Medical Technology In Reducing Population And Health Systems’ Vulnerability To COVID-19.
Authors: Steuten Lotte , Zamora Bernarda , Lothgren Mickael , Bruce Andrew , Towse Adrian 
Published: December 2021

IntroductionCOVID-19 has exposed population and health systems’ vulnerability to a highly infectious disease. People with diabetes have a higher risk of COVID-19 hospitalization and death than those without. Medicines that control blood glucose reduce this risk. We quantified COVID-19 hospital admissions and deaths averted by diabetes medicines in the UK during the March-May 2020 wave.MethodsWe estimated COVID-19 hospital and intensive care unit (ICU) admissions averted and COVID-19 hospital deaths avoided by diabetes medicines, considering a counterfactual where those medicines were not available. We used published UK-data sources on diabetes prevalence, proportion of patients achieving diabetes control with medicines, COVID-19 infection risk, probabilities for COVID-19 hospital admission, subsequent ICU admission and hospital death. We calculated the relative risk reduction of controlled vs. uncontrolled diabetes on COVID-19 hospital or ICU admission (71% and 66%, respectively), and hospital death (38%) from the UK Open Safely data.ResultsDiabetes medicines are estimated to have averted 17,417 hospital admissions, 2,752 ICU-admissions and 438 hospital deaths due to COVID-19 compared to a counterfactual where those medicines had not been available in the UK.ConclusionsEffective medicines to control diabetes contribute to population and health systems resilience against COVID-19. Health technology assessment and policy makers should recognize that adoption and usage of health technology reduces societies’ vulnerability to similar shocks.