bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implications of new technologies for future food supply systems
Authors: Asseng S. , Palm C. A. , Anderson J. L. , Fresco L. , Sanchez P. A. , Asche F. , Garlock T. M. , Fanzo J. , Smith M. D. , Knapp G. , Jarvis A. , Adesogan A. , Capua I. , Hoogenboom G. , Despommier D. D. , Conti L. , Garrett K. A. 
Published: December 2021

AbstractThe combination of advances in knowledge, technology, changes in consumer preference and low cost of manufacturing is accelerating the next technology revolution in crop, livestock and fish production systems. This will have major implications for how, where and by whom food will be produced in the future. This next technology revolution could benefit the producer through substantial improvements in resource use and profitability, but also the environment through reduced externalities. The consumer will ultimately benefit through more nutritious, safe and affordable food diversity, which in turn will also contribute to the acceleration of the next technology. It will create new opportunities in achieving progress towards many of the Sustainable Development Goals, but it will require early recognition of trends and impact, public research and policy guidance to avoid negative trade-offs. Unfortunately, the quantitative predictability of future impacts will remain low and uncertain, while new chocks with unexpected consequences will continue to interrupt current and future outcomes. However, there is a continuing need for improving the predictability of shocks to future food systems especially for ex-ante assessment for policy and planning.
What are the Barriers to Taxing Wealth? The Case of a Wealth Tax Proposal in the UK
Authors: PRABHAKAR RAJIV 
Published: December 2021

AbstractOver the past decade there have been repeated calls for the greater taxation of wealth. These calls have had little impact on policy. There has been a global trend to reduce or abolish taxes on wealth. The contrast suggests that it may be better now to explore how taxes on wealth may be made a reality rather than designing new tax proposals. What are the barriers to tax wealth? This paper addresses this by conducting a case study of a high profile plan for introducing a one-off wealth tax in the UK. It identifies a tyranny of the status quo, framing and the policy process as key barriers to tax reform. It uses thematic analysis to study how the plans for a one-off wealth tax were discussed in the media and the UK Parliament. This paper argues that there were important shortfalls in both the way the case for a wealth tax was framed as well as the engagement with the policy process. It claims that a stronger framing would have discussed wealth inequality in greater depth and there was a need for a less equivocal case to Parliamentarians.
OP123 The Use Of Surrogate Outcomes In National Institute For Health And Care Excellence (NICE) Highly Specialised Technology Evaluations: A Review Of Published Guidance
Authors: Guo Yelan , Bregman Caroline , Elliott Nicole 
Published: December 2021

IntroductionThe use of surrogate outcomes in health technology assessment (HTA) is increasing and methods for validating surrogate relationships have been published. However, these may not be fully applicable to ultra-rare diseases due to challenges such as scarcity of evidence and heterogenous populations. This study reviews and summarizes the use of surrogate outcomes and committee's considerations in the evaluations within the National Institute for Health and Care Excellence's (NICE) Highly Specialised Technology (HST) programme, which was established in 2013 in response to the challenges associated with the assessment of ultra-rare diseases.MethodsAll HST evaluation documents published before November 2020 were reviewed. Data extracted included surrogate outcomes used, rationales, the committee's considerations on the validity and generalizability of the surrogate relationships, related uncertainties, and other factors considered in decision-making.ResultsSeven out of the eighteen published HST topics used surrogate outcomes. The rationale for most of the surrogate relationships focused on biological plausibility. Common concerns raised by the committee included the generalizability of the surrogate relationship to the condition of interest, the lack of validation, and inability to prove or quantify the magnitude of benefits associated with the surrogate relationships. In some topics, other aspects of the evidence and clinical/patient expert's opinions were also considered by the committee.ConclusionsThe use of surrogate outcomes is common in NICE HST evaluations and the challenges in supporting surrogate relationships with more than biological plausibility are recognized. However, our review indicates that, the committee considers more than just biological plausibility and will take into account other related factors.
OP130 Economic Evaluation Of High-Cost Drugs For Relapsing-Remitting Multiple Sclerosis In Thailand
Authors: Khuntha Sarayuth , Budtarad Nuttakarn , Kingkaew Pritaporn , Hadnorntun Phorntida , Leelahavarong Pattara 
Published: December 2021

IntroductionDrugs for relapsing-remitting multiple sclerosis (RRMS) are costly and not included in the National List of Essential Medicines of Thailand yet. This study aims to conduct an economic evaluation of high-cost drugs for RRMS.MethodsThe Markov model was used to estimate lifetime costs and quality-adjusted life years (QALYs) gained. The treatment options include Interferon beta-1a (IFN) and Teriflunomide (TERI) (first-line), Fingolimod (FIN) and Natalizumab (NATA) (second-line), and Alemtuzumab (ALEM) (third-line) compared with usual care. The effectiveness of drugs was retrieved by network meta-analysis. The probability of health state transition was obtained from primary data. Treatment-related costs were derived from the national database. Other costs and utilities were obtained from the study in Thai RRMS patients.ResultsThe lowest lifetime costs option was usual care (THB2 million) (USD65,808), while the highest QALY gained option was IFN-NATA-ALEM (8.6 QALY gained). All treatment options were not cost-effective compared with usual care at the threshold of THB160,000 (USD5,300) per QALY gained. However, the option of IFN-NATA-ALEM yielded the lowest incremental cost-effectiveness ratio (ICER), which was THB4.4 million (USD144,778) per QALY gained.ConclusionsHigh-cost drugs were not cost-effective; nonetheless, the IFN-NATA-ALEM option could increase QALY gained with the lowest additional budget. The government should negotiate the price of IFN to decrease by eighty percent.
OP244 Tools And Experiences To Facilitate Effective Patient Participation In Health Technology Assessment
Authors: Toledo-chávarri Ana , Remón Lucia Prieto , Ibargoyen Nora , Linde Máximo Molina , Pego Yolanda Triñanes , Reviriego Eva , Iglesias Asun Gutierrez , García Vanesa Ramos , López-Argumedo Marta , Álvarez-Pérez Yolanda 
Published: December 2021

IntroductionIn 2017, a Patient Involvement Interest Group (PIIG) was created in the Spanish Network for Health Technology Assessment of the National Health System (RedETS) to facilitate and promote Patient Involvement (PI) in Health Technology Assessment (HTA). The PIIG proposed a decisional flowchart to guide researchers’ in decisions regarding PI methods in HTA. The flowchart proposed a combination of direct involvement and incorporation of patient-based evidence depending on the scope and the aims of the assessment.This work aims to present the flowchart and the results of the evaluation of the latest experiences in PI in HTA in RedETS (2018–2020), including direct-involvement and patient-based evidence.MethodsA survey was sent to the HTA researchers who implemented PI initiatives in RedETS assessments. The survey asked to describe their experiences, lessons learned, challenges and added value regarding the use of direct-involvement, systematic reviews (SR) and primary studies. A descriptive analysis was performed and the results were discussed in an online PIIG workshop.ResultsThirty-two assessments included direct PI, twenty-one SR synthesized qualitative and quantitative studies about patient experiences, values and preferences and eight included primary studies, mainly of qualitative design. Recruitment and the lack of methodological resources were the main barriers both for direct PI and primary studies. Relevance of the included studies was the main barrier for SR. Added value was found in all PI methods. Direct-involvement had an impact on the project plan and PICO definition, outcomes relevance, information about the health condition and treatments. SR contributed with relevant patient-based evidence, deeper assessment of patient experiences, values and preferences and implementation factors. Primary studies developed new or contextualized knowledge directly applicable to decision-making.ConclusionsThe PI flowchart has served to facilitate the incorporation of patient input in HTA reports. The different approaches implemented have allowed to provide relevant and well-grounded data in each report to inform decision-making in patient-centered healthcare provision, but it is necessary that specific training and resources are provided to enable adequate and timely implementation.
OP277 Rapid Development Of An Evaluation Framework: Capturing The Impact Of COVID-19 Activities By A Health Technology Assessment Body
Authors: Elston Lauren , Hughes Sophie , Myles Susan 
Published: December 2021

IntroductionHealth Technology Wales (HTW) is committed to evaluating the impact of our work. In March 2020, HTW directed efforts to support Welsh Government and health and social care providers in response to the COVID-19 pandemic. We adapted the HTW evaluation framework to specifically capture the impact of our additional COVID-19 work. Here we analyze data collected since the framework was implemented.MethodsBoth formal and informal feedback was analyzed. Formal feedback was obtained through the HTW Impact Questionnaire, which was developed to support more formalized data capture for all HTW workstreams and to facilitate feedback from all stakeholder groups. It was piloted with a targeted list of individuals and responses were received for COVID-19 work. Informal feedback included feedback received via email or through word of mouth.ResultsHTW COVID-19 products to date include Topic Exploration Reports, rapid evidence summaries and an Evidence Appraisal Report (EAR) on COVID-19 diagnostic tests (molecular and antibody tests). Stakeholders were positive about these outputs, describing them as valuable and informative. Reported impacts included informing policy and decision making, reducing duplication of efforts and helping to target development. The EAR received national and international focus, leading to HTW involvement in the European Network for Health Technology Assessment (EUnetHTA) COVID-19 reviews. Survey participants who gave feedback on COVID-19 activities included two members of Health Technology Assessment organizations, a health board representative and an industry representative; all agreed that HTW's COVID-19 work was useful, that the methods were reliable and robust and that HTW is responsive. All participants also felt that HTW's COVID-19 work had a positive impact in the wider health and social care context.ConclusionsHTW was able to respond rapidly to the COVID-19 pandemic and adapt current evaluation practices to capture the impact of COVID-19 work. We will continue to evaluate our COVID-19 activities. Future work will involve following up on the developing impact of our COVID-19 work and expanding our methods for data capture, for example conducting stakeholder interviews.
OP279 Data Protection In The European Union Post-General Data Protection Regulation (GDPR): A Barrier Or An Enabler Of Pharmaceutical Innovation?
Authors: Cole Amanda , Towse Adrian 
Published: December 2021

IntroductionThe expansion of health data offers exciting opportunities to support better and more efficient drug discovery, development and implementation. Data protection and governance provide the legal framework to balance safeguarding patients’ privacy with the benefits to society of medical research. Our aim is to highlight current legal barriers to the better use of health data and propose ways to address them.MethodsAnalysis of the relevant legislative texts was supplemented by interviews with external experts in data protection, health research, informatics and cyber security and a workshop with pharmaceutical industry members. We investigated the legal issues arising for six key activities along the pharmaceutical lifecycle, from identifying unmet need through to health technology assessment and pharmacovigilance.ResultsThe General Data Protection Regulation (GDPR) was introduced in May 2018 to Harmonise data protection across Europe. However, considerable ambiguity remains, particularly around the appropriate legal bases for data processing in the absence of consent: scientific research, public interest, or provision of health or social care. Other key themes included data subject rights, anonymization, compatibility of primary and secondary (re-)use of data, heterogeneity arising from divergent interpretation, the need for guidance on digital health, and the importance of trust.ConclusionsWe speculate which legal bases are most appropriate for the six pharmaceutical activities studied, but clear guidance and consensus is required. The GDPR was not designed to hamper scientific research, and the issues identified arose from uncertainties rather than barriers per se. Industry and academic researchers should therefore deal proactively with the prevailing uncertainties, share good practice, and engender trust by co-creating a code of conduct and outlining principles of responsible use. Engagement with patients will be critical in encouraging a shared understanding of the value to society of health data for research.
OP303 Do You Get The Message? Making HTA Findings Easier For Decision-Makers To Implement
Authors: Kandulu Jess , Clifton Ed , Robertson Iain , Smart Neil , Macpherson Karen 
Published: December 2021

IntroductionOften health technology assessment (HTA) products developed by the Scottish Health Technologies Group (SHTG) did not reach clear directive conclusions because the evidence base for a technology was weak. Despite being methodologically robust, these products did not meet the needs of decision-makers and may have had negligible impact.MethodsSHTG set out to equip and empower the recommendation-making council (that is, appraisal committee) to reach clear conclusions. SHTG broadened the HTA components and types of evidence that could be considered. The increased breadth of evidence included: clinicians attending council meetings to respond to questions; patient groups making submissions and presenting at council meetings; Scotland-specific economic modelling; and consultation on draft recommendations. SHTG also restructured the council for improved deliberative decision-making.ResultsClear directive conclusions were reached in a substantially higher proportion of HTA products (eighty-eight percent in 2019 compared with eight percent in 2017). It became possible for decision-makers to implement findings. It also became feasible to assess the impact and implementation of recommendations.ConclusionsBroadening SHTG's consideration of HTA components has led to a clearer conclusion being reached and stronger messaging for decision makers. This positions SHTG to increase its influence in the use of health technologies in Scotland.
OP312 Developing A Tool-kit For Assessment Of Autism Spectrum Disorder
Authors: Watson Leah , Jonathan Shirley 
Published: December 2021

IntroductionBefore the coronavirus pandemic, children who were on the Early Years Neurodevelopment (EYND) assessment pathway and suspected to have possible Autism Spectrum Disorder (ASD), received clinic based appointments. This process included a parental interview by a doctor, a specialist speech and language therapy assessment, autism diagnostic observation schedule (ADOS), which were all carried out on hospital sites. These were postponed in March following national guidance. Our aim was to continue providing accurate evidence-based service for ASD diagnosis.MethodsWe utilised evidence-based telehealth methods to perform a specialist speech and language assessment in a child's home via video call. Parents were also invited to share videos of everyday activities via a secure portal. We could observe the child in a meaningful setting and witness functional impact of their needs. Each case is discussed by a multiagency panel based on DSM-V criteria.Online training was undertaken by professionals to deliver the Brief Observation of Autism Symptoms (BOSA) based on the ADOS for COVID times. Parents were coached by the therapist to enable them to become the administrator, rather than a professional.ResultsTelephonic feedback from the first ten parents whose children underwent a telehealth assessment has been positive; the home was deemed more natural and for some less distressing than clinic. Formal patient surveys have been devised for both the telehealth and BOSA clinic assessments. Analysis is expected by the end of March.To date we have been able to reach an outcome for thirty children, the diagnosis of ASD for twenty-four children and the other six received a diagnosis of global developmental delay or language disorder.ConclusionsWe expect that telehealth will reduce the number of assessments before an ASD diagnosis is made resulting in more prudent healthcare. The new methods have demonstrated clear increased parental participation.
OP314 What Happened Next? Assessing Health Technology Assessment Impact In Scotland
Authors: Kandulu Jess 
Published: December 2021

IntroductionThe Scottish Health Technologies Group (SHTG) set out to assess the impact of HTA products. Two questions were posed: Does advice from SHTG have influence? How is SHTG advice used?MethodsSHTG adapted a tool developed by the International Network of Agencies for Health Technology Assessment (INAHTA). The INAHTA framework investigates indications of impact and categorizes outputs into levels of impact. Over three years, potential users of SHTG advice were contacted six to twelve months after advice was published and asked how the advice had been used. HTA outputs were categorized into the four levels of influence they achieved: ‘major influence’, ‘some influence’, ‘some consideration’ and ‘no known influence’.ResultsHTA products were found to have been used in four main ways: ‘informed discussion’, ‘referenced’, ‘informed policy’ or ‘directly informed practice’. Levels of influence had steadily increased over the three years assessed. The findings were well received by internal audiences, with particular interest in the various ways HTA recommendations had been used. There was also feedback about ‘marking our own homework’. These results have informed a new SHTG strategy and supported clear messaging around the value of HTA.ConclusionsSHTG has found a pragmatic, resource-light way to explore the impact of HTA outputs, which has proved valuable for driving strategy and messaging.
OP318 Health Technology Assessment And Decision-Making Processes: The Purchase Of Magnetic Resonance Imaging Technology
Authors: Maia Maria 
Published: December 2021

IntroductionMedical devices play an essential role in health care, but they are also a leading causes of increasing healthcare expenditures. The purchase of technologies and the determination of how and when they should be used are among the most important decisions made by decision-makers, at the institutional level.The present research focuses on the Portuguese health system and sheds light on the characterization of decision-making process by those involved in Magnetic Resonance Imaging (MRI) purchases.MethodsTo characterize the decision-making process, results from forty questionnaires and twenty-seven semi-structured interviews with key decision-makers were merged, using a mixed method approach. To assess competences for decision-making, a questionnaire was applied, and Exploratory and Confirmatory Factorial Analysis conducted.ResultsCost and suppliers’ characteristics are seen as the most important indicators to guide decisions. The decision is undertaken by a committee, in a bottom-up process, characterized by a bounded rationality, influenced by intuition and a consultant decision-maker. The reasoning and justification for selection of the committee members is unclear. The decision process is considered to be bureaucratic, time-consuming and long. Patients are negatively perceived as stakeholders in the process. Few studies were performed (mostly related to the workload of the Radiology Department) to support the decision and no national or international health technology assessment (HTA) study was used in the process, to guide decisions. Decision-makers have limited knowledge and training in areas of decision-making in the areas of health informatics, health economics and especially HTA. This may limit their ability to truly understand the future implications of their purchase decisions.ConclusionsTo foster HTA in decision-making processes, recommendations are made, in particular, to: (i) establish an HTA in-house unit, able to carry out studies considering the hospital context and aiming to inform managerial local decisions (ii) promote a team comprised of technology assessment multidisciplinary researchers but also professionals from the health institution able to carry out HTA studies (iii) foster common languages and values to increase uptake of HTA studies.
OP338 Involving Patients In Research: Early Consultation Of Women To Improve Study Design And Investigate Trial Acceptability
Authors: Erskine Jamie , Castanon Alejandra 
Published: December 2021

IntroductionGaining the perspective of patients is invaluable in the design, management and reporting of research. As part of the process of facilitating clinical research into the effectiveness of a digital colposcope in a cervical cancer pathway, patients were involved from the outset.MethodsUsing funding made available by a Public Involvement Fund, a patient consultation group was established. The group's initial discussions informed the design of a feasibility study and funding application, which was submitted to the UK National Institute of Health Research (NIHR). A Patient and Public Involvement (PPI) representative was recruited and along with the consultation group, contributed to the ethical approvals for the study. The Patient Information Sheet and Consent Form were reviewed by the patients, to ensure readability, understandability and accessibility. The patient questionnaires and interview topics that are part of the feasibility study were also developed in conjunction with the PPI group, to make sure that women's concerns are being addressed in the research design and protocols.ResultsThe PPI consultation group's contributions helped strengthen the funding application and funding for a feasibility study was granted as part of the NIHR's Research for Patient Benefit funding scheme. Part of the grant will be used for training and reimbursement for time spent for the PPI representative. Data collection for the study is due to commence in the summer of 2021. The PPI group will be consulted at the beginning and end of the data collection period and will contribute to the data analysis and dissemination of the research output, including a Plain English Summary.ConclusionsInvolving patients greatly amplified the quality of the funding and ethical applications and will continue to benefit the ongoing research. Resources were widely available within the researcher's University and also through UK-wide schemes. Such resources are crucial and should be encouraged as part of all clinical research.