bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Open and Arthroscopic Long Head of Biceps Tenodesis
Authors: Saltzman Bryan M. , Leroux Timothy S. , Cotter Eric J. , Basques Bryce , Griffin Justin , Frank Rachel M. , Romeo Anthony A. , Verma Nikhil N. 
Published: January 2019

Background In young and active patients, long head of biceps (LHB) tenodesis has become a common procedure for managing LHB pathology, but it remains unclear whether it is performed in isolation or along with other shoulder procedures and whether open and arthroscopic techniques produce different complications. Questions/Purposes We sought to determine and compare open and arthroscopic LHB tenodesis in terms of (a) trends in overall use, (b) trends in use in isolation and in association with rotator cuff repair (RCR) and superior labral tear from anterior-to-posterior (SLAP) debridement/repair, and (c) the rates of post-operative complications. Methods We performed a retrospective analysis of data from an insurance database to identify LHB tenodesis procedures performed from 2011 to 2014. The overall annual rates of open and arthroscopic LHB tenodesis were determined and then stratified according to concurrent RCR and SLAP repair/debridement. A multivariate logistic regression analysis that controlled for patient demographics (age, sex, comorbidity) was performed. Results Overall, 8547 patients underwent LHB tenodesis, of which 43.5% were open and 56.5% were arthroscopic procedures. There was a significant increase in the utilization of LHB tenodesis from 2011 to 2014. In isolation, open LHB tenodesis was the more common technique overall and by year. Arthroscopic LHB tenodesis was the most common tenodesis technique performed in conjunction with RCR and SLAP repair/debridement. The overall complication rate was 2.9%; only wound dehiscence demonstrated a difference between techniques. Conclusions The rates of open and arthroscopic LHB tenodesis procedures increased significantly from 2011 to 2014, with open techniques more common when LHB tenodesis is performed in isolation and arthroscopic techniques more common when performed as a concomitant procedure. Our use of a population database did not allow us to evaluate biomechanical or cost-related phenomena, and future research should examine these and other relevant differences between these two LHB tenodesis techniques.
Dispersion and degradation of environmental DNA from caged fish in a marine environment
Authors: Murakami Hiroaki , Yoon Seokjin , Kasai Akihide , Minamoto Toshifumi , Yamamoto Satoshi , Sakata Masayuki K. , Horiuchi Tomoya , Sawada Hideki , Kondoh Michio , Yamashita Yoh , Masuda Reiji 
Published: January 2019

AbstractEnvironmental DNA (eDNA) consists of DNA fragments shed from organisms into the environment, and can be used to identify species presence and abundance. This study aimed to reveal the dispersion and degradation processes of eDNA in the sea. Caged fish were set off the end of a pier in Maizuru Bay, the Sea of Japan, and their eDNA was traced at sampling stations located at the cage and 10, 30, 100, 300, 600 and 1000 m distances from the cage along two transect lines. Sea surface water was collected at each station at 0, 2, 4, 8, 24 and 48 h after setting the cage, and again after removing the cage. Quantitative PCR analyses using a species-specific primer and probe set revealed that the target DNA was detectable while the cage was present and for up to 1 h after removing the cage, but not at 2 h or later. Among the 57 amplified samples, 45 (79%) were collected within 30 m from the cage. These results suggest that eDNA can provide a snapshot of organisms present in a coastal marine environment.
Rawlsian Objectivity
Authors: MELENOVSKY C. M. 
Published: January 2019

AbstractIn a 1981 letter to H .L. A. Hart, John Rawls sketches a view of moral objectivity that substantially differs from that of contemporary constructivists. The view he describes does not rely on constitutive features of agency as Korsgaard's does, and it does not bottom out in a form of realism as Scanlon's moral theory does. Instead, Rawls's view grounds objectivity on the fundamental conceptions that could be shared in wide reflective equilibrium. Constructivism grounds objectivity in a kind of intersubjectivity, and Rawls finds the relevant kind of intersubjectivity in the alignment between fundamental convictions. This article develops this Rawlsian view of objectivity and highlights its strengths.
An Alternative Way to Make Knowledge Sharing Work in Online Communities? The Effects of Hidden Knowledge Facilitators
Authors: Li-Ying Jason , Zhang Zhinan , Long Qing 
Published: January 2019

ABSTRACTSome firms use hidden knowledge facilitators (HKFs) to facilitate knowledge sharing among employees within intrafirm online communities. These firms hope for enhanced knowledge sharing outcomes within their organizations without letting employees know that HKFs exist. Yet, the extent to which HKFs’ interventions are effective remains unknown to researchers and managers. Built on the knowledge sharing (KS) literature, this study explores the unique roles of HKFs as moderators between a company and its employees. We develop several hypotheses to test the impact of the quantity and quality of HKFs’ online interventions on several KS outcomes. By analyzing log data of a Chinese corporation's online R&D community, we find that (1) thequantityof HKFs’ intervention has a mostly positive impact on KS outcomes; (2) thequalityof HKFs’ intervention has a mixed impact on several KS outcomes, depending on which aspect of quantity is considered; and (3) thequalityof HKFs’ intervention also moderates the positive impact of thequantityof HKFs’ intervention in different ways on different intended KS outcomes. This study makes a clear contribution to the literature on knowledge sharing and knowledge facilitation by demonstrating the impact of HKFs on KS outcomes in a Chinese context.
OP07 Real World Evidence: How Can It Improve Health Technology Assessment?
Authors: Gillespie John , Erdol Sebnem , Foteff Chris , Strachan Liesl 
Published: January 2019

Introduction:Health Technology Assessment (HTA) considers the question of whether evaluated technologies are cost-effective in real world settings. As observed in HTA conducted by the Australian Medical Services Advisory Committee (MSAC), questions regarding the validity of data inputs to economic analyses that reflect real-world practice is a common reason for uncertainty on the cost effectiveness of new technologies. In addition to resource use and costs, there may be other uncertainties regarding the eligible patient population, patient management pathways and comparator selection. Our objective in this study was to present case studies from Australia where real world linked datasets could be better utilized to inform HTA conducted by the MSAC.Methods:For selected therapy areas, assessment reports and public summary documents of HTA conducted by the MSAC published between January 2015 and November 2017 were reviewed. Our analysis identified HTAs where uncertainties around the inputs for health economic evaluations, as well as uncertainties in defining eligible patient numbers or current patient pathways of care were shown to exist. We then explored whether these uncertainties could have been addressed through real world linked datasets.Results:Our preliminary investigations identified two assessments: MSAC assessment of capsule endoscopy and transcatheter aortic valve implantation - where availability of real world linked data could have addressed uncertainties around the inputs required for the health economic evaluations.Conclusions:Australia has a range of real world datasets with the potential to be used to inform HTA conducted by the MSAC. This can only be achieved if the datasets could be better linked and accessible for use by key stakeholders in the MSAC HTA process (e.g. industry, clinician, patient societies). Use of these data sets in HTA will enable timelier patient access to cost-effective technologies and more effective implementation and review of technologies after adoption into clinical practice.
OP09 Summary Of The 2018 Health Technology Assessment International Latin America Policy Forum Background Paper
Authors: Pichon-Riviere Andres , Trowman Rebecca 
Published: January 2019

Introduction:The Health Technology Assessment International (HTAi) Latin America Policy Forum (LAPF) will meet for the third time on 23 and 24 April 2018 in Montevideo, Uruguay. The topic chosen for this meeting is ‘defining the value of health technologies in Latin America’. Due to the differing levels of maturity in the HTA systems and approaches by countries in the region, this topic deserves specific analysis and consideration for the Latin America region.Methods:A background paper is in development for the LAPF, and will be informed by a review of policy publications in scientific databases, google scholar plus other grey literature. The background paper will summarize the relevance of value frameworks around the world (building on the 2017 HTAi Global Policy Forum background paper and discussions) and will narratively synthesize key findings globally and draw out issues and experiences relevant to the Latin America region. This will be used to provoke the discussions and debates at the LAPF.Results:This presentation will focus on summarizing the background paper that was used to inform the discussion over the two days of the LAPF, highlighting the key findings on value frameworks from the Latin America region. The presentation will also summarize the key questions for deliberation that were brought to the attention of the meeting attendees, plus the key questions that were posed for the guided breakout sessions will be presented.Conclusions:The presentation will provide a great opportunity for HTAi members to hear about the ‘state of the art’ methodologies for valuing health technologies in the Latin America region.
OP10 Key Messages From The 2018 Health Technology Assessment Latin America Policy Forum
Authors: Sampietro-Colom Laura , Trowman Rebecca 
Published: January 2019

Introduction:The third Health Technology Assessment International (HTAi) Latin America Policy Forum (LAPF) will meet on 23 and 24 April 2018 in Montevideo, Uruguay. The format of the LAPF echoes that of the HTAi Global Policy Forum and provides a unique opportunity as a leadership meeting for senior people from public and private sector organizations using HTA. The aim of the LAPF is to provide an environment where senior people can engage in strategic discussions, informed by the perspectives of their different organizations, without the constraints associated with discussions of specific products or organizational policies.Methods:The HTAi LPF will convene around 50 senior representatives from HTA agencies and industry members active in the Latin America region. The topic that has been chosen by the organizing committee is ‘defining the value of health technologies in Latin America’ and this will be discussed over two days by attendees.Results:This presentation will focus on summarizing the key messages that resulted from the two days of discussions at the LAPF. The views reflected will balance those of the not-for-profit agencies and private industry sector attendees, while respecting the ‘Chatham House’ rule (whereby no quotes will be directly attributed to any attendee). It will draw out any conclusions from the plenary sessions and the guided breakout sessions from the event. Any actions that are resulting from the event will also be summarized.Conclusions:The presentation will provide a great opportunity for the wider HTAi membership to hear reflections on the key messages resulting from the event. This could provide an opportunity for further questions and debate surrounding the key issues to occur, such us any difference between valuing technologies in the Latin America Region with the approaches made in the European Union and North America.
OP11 Findings From The 2017 Health Technology Assessment International Asia Policy Forum Survey
Authors: Mundy Linda , Trowman Rebecca , Kearney Brendon 
Published: January 2019

Introduction:Health systems in the Asia region seek to achieve universal health care (UHC) by increasing access to essential healthcare services, while reducing health inequalities and out-of-pocket expenditure. With this in mind, the discussion for the 2017 Health Technology Assessment International (HTAi) Asia Policy Forum (APF) centered around the topic of ‘Universal Healthcare in the Asia Region: Overcoming the Barriers using HTA and Real World Data’.Methods:As part of the background paper prepared to inform discussions at the APF, attendees from public sector HTA agencies from nine countries, and industry attendees from eight companies, were surveyed to explore issues on the barriers and challenges of establishing UHC in the region and use of real world data (RWD).Results:Most countries used evidence-based decision-making when considering which technologies to add to healthcare benefit packages; however, this was at times inconsistently applied. Prioritization criteria included burden of disease, unmet clinical need, clinical effectiveness, cost effectiveness and affordability. The political agenda and deference to expert opinion also played a role. Although all countries reported using RWD to inform decision-making, they also reported issues including lack of capacity, poor quality data and lack of collaboration between private and public sectors, as well as a conservative approach to data-linkage. It became apparent that a disconnect had been identified, as industry overwhelmingly identified access to RWD in the region as a major issue.Conclusions:Discussing the differences in opinion between HTA agencies and industry led to a greater understanding of issues in the Asia region, and will lead to increased dialogue and opportunities to collaborate in the future. Building capacity in the region will assist countries to deliver on their goal of achieving UHC.
OP18 A Patient And Caregiver-Designed Framework For Managed Access Programs
Authors: Young Andrea , Menon Devidas , Street Jackie , Al-Hertani Walla , Stafinski Tania 
Published: January 2019

Introduction:Reimbursement decisions on orphan drugs carry significant uncertainty, and as the amount increases, so does the risk of making a wrong decision, where harms outweigh benefits. Consequently, patients often face limited access to orphan drugs. Managed access programs (MAPs) are a mechanism for managing risk while enabling access to potentially beneficial drugs. Patients and their caregivers have expressed support for these programs and see patient input as critical to successful implementation. However, they have yet to be systematically involved in their design. The objective of this study was to explore what a framework for MAPs might look like when designed by patients and caregivers.Methods:Building upon established relationships with the Canadian Organization for Rare Disorders, the project team collaborated with patients and caregivers using the principles of participatory action research. Data were collected at two workshops and analyzed using a thematic network approach.Results:Patients and caregivers identified six aspects of an ideal MAP relating to accountability (program goals), governance (program-specific committee oversight; patient input; international collaboration), and evidence collection (outcome measures and stopping criteria; ongoing monitoring and registries). Additionally, patients and caregivers recognized that health care resources are finite and considered disease or drug eligibility criteria for deciding when to use a MAP (e.g. drugs treating diseases for which there are no other legitimate alternatives).Conclusions:A patient and caregiver-designed framework was created, which emphasized patient involvement and transparency. Further research is needed to examine the feasibility of this framework and roles for other stakeholders.
OP24 Sensitizing Researchers And Developers For Patient Needs And Value
Authors: Holtorf Anke-Peggy , Sandhu Gurmit , Dresler Martina 
Published: January 2019

Introduction:Valuable health technologies must improve health and well-being of patients. For sensitizing healthcare industry stakeholders for the unique perspective and values of patients we developed a workshop format including both knowledge transfer and experiential modules.Methods:The one-day pilot workshop was attended by two patient representatives and multidisciplinary participants from the healthcare industry (n=12) who wanted to learn about patient involvement in health technology assessment (HTA) and healthcare decision making and the implications for product development. Three content sessions covered key aspects of HTA and patient engagement and each was followed by an session which aimed at discovering the values of participants as healthy individuals or when the diagnosis of a disease and the subsequent therapy decisions (including potential clinical trial participation) impact quality and length of life. The workshop concluded with the participants prioritizing their expectations for innovation and HTA as patients or as citizens.Results:Overall, participants rated the workshop as excellent or good for knowledge and experiential sessions. Integration of both learning modalities was described as innovative, useful, and enjoyable. Participation in the clinical trial session triggered cognitive responses among the industry participants due to a strong focus on advancement of science for innovation. Otherwise, the responses of the industry participants matched those of the patient representatives well. Overall, patient perspectives were considered useful to enrich the value perceptions beyond those of industry. Emotions describing the personal experiences included despair, shock, anger, guilt, hope, and the will to live. As citizens, they emphasized expectations such as finding solutions, remaining independent, enjoying life and “giving back”.Conclusions:Innovative learning structures integrating rational and emotional aspects can allow researchers, marketers, or other stakeholders from the life-science industry to better understand patient perspectives. The format may be well suited for team building and alignment of team values around patient-needs.
OP37 Health Technology Assessment Impact Assessment: Barriers And Enablers Perceived By Members Of The International Network Of Agencies For Health Technology Assessment (INAHTA)
Authors: Berndt Nadine , Schuller Tara , Aleman Alicia , Macpherson Karen , Myles Susan , Perleth Matthias , Werkö Sophie , Hailey David 
Published: January 2019

Introduction:Health technology assessment (HTA) agencies wish to ensure the impact of their HTAs. HTA impact assessment measures the influence of a HTA on decision-making and downstream to patient outcomes. Despite their potential to provide insights, the use of impact assessment frameworks by HTA agencies is limited. Understanding the underlying mechanisms of adopting HTA impact assessment frameworks is therefore important. Using a social cognitions lens, this study aims to provide insights into the enabling and hindering factors associated with the assessment of HTA impact by INAHTA members.Methods:Using an interpretive description design, this cross-sectional study used semi-structured interviews of INAHTA members to gain insight into attitudes, social support, self-efficacy, barriers, and intentions towards HTA impact assessment. Transcriptions were analyzed using a social cognitions lens by two researchers using a constant comparative method to identify themes.Results:Twenty-six of forty-seven INAHTA members participated. Preliminary results showed that interviewees most often perceived support for assessing impact from their ministry of health or from agency staff. Most interviewees noted challenges to measuring impact at the right time and a lack of human resources, methods, and tools as internal barriers. A lack of transparency and a limited impact assessment culture were perceived as the main external barriers. Interviewees reported feeling fairly confident in overcoming internal barriers, but were less confident in overcoming external barriers. Providing feedback for improvement to HTA processes and making achievements visible were the most frequently reported advantages of assessing impact, whereas its time consuming nature was the biggest disadvantage.Conclusions:This is the first study to use a social cognitions model to understand HTA impact assessment. Although the results of this convenience sample need to be interpreted with caution, they contribute knowledge on factors that facilitate and hinder agencies in the assessment of impact and illuminate opportunities for developing effective strategies to support HTA agencies in this area.
OP62 Economic Evaluation Of A Provincial Back Care Pathway
Authors: Woodhouse Linda , Khan Hameed , Wolfaardt Ulrich , Slomp Mel , Lei Vivian (Yu) 
Published: January 2019

Introduction:The high prevalence, disability, and work absenteeism associated with back pain make it the single most costly musculoskeletal health condition in developed countries. However, the majority of back pain has no identifiable pathological cause and resolves without surgery or imaging. This paradox suggests that we need to change how back pain is managed to reduce unnecessary burden to individuals and the healthcare system. This study evaluated the cost of a new model of early triage-based, interprofessional care for patients with back pain.Methods:We evaluated the outcomes and cost of implementing a provincial care pathway for early assessment of patients with back pain at three sites: (i) adjacent to an emergency department in a community hospital; (ii) co-located with an orthopedic surgeon's clinic in a hospital; and (iii) in a primary care network (PCN) with private practice physiotherapists and chiropractors. Time-driven activity-based costing (TDABC), in combination with discrete event simulation, was used to estimate costs.Results:Costs were significantly lower in the models that used hospital-based physiotherapists and in the PCN model that used private practice physiotherapists and chiropractors to triage patients. These costs ranged from CAD 20 (USD 16) to manage patients identified with low severity back pain to CAD 175 to 200 (USD 137 to 156) for those with moderate to severe back pain. Models that implemented the care pathway using family physicians and surgeons to review non-surgical patients were more expensive at CAD 339 (USD 265) and CAD 514 (USD 402), respectively.Conclusions:New models of care that use the skills of physiotherapists and chiropractors to assess and triage patients with back pain adjacent to emergency departments and in the primary care sector are cost effective, compared with traditional physician-led models. The overarching intent is to use these data to enable evidence-informed policy and practice changes, so that more appropriate and cost-effective care is provided to patients with back pain.