bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diffusion of New Technologies in the Treatment of the Medicare Population: Implications for Patient Access and Program Expenditures
Authors: Boutwell Robert C. , Mitchell Janet B. 
Published: March 2009

AbstractPatterns of diffusion were analyzed for three pairs of technologies: one of each pair represents a very recent innovation, and the other is more established. Tremendous growth in utilization from 1985–89 was documented, primarily due to more patients obtaining access to the technologies. Nevertheless, disturbing differences in levels of use remain between black and white patients.
Perspectives on Health Technology Assessment in Latin America: The Case of Perinatal Care in the Literature
Authors: Panerai Ronney B. , Almeida Rosimary T. , Freire Sergio M. , Chaim Deise M. V. R. , Miranda Mauro Z. , Madureira Luiz Claudio A. , Aguiar Neto Miguel A. S. 
Published: March 2009

AbstractThe possibility of referring to the medical literature to support technology assessments in perinatal care was studied by examining more than 40,000 references contained in the Index Medicus of Latin America for the period 1984–88. A total of 1,074 references addressed perinatal technologies, but with irregular distribution. Information on effectiveness, safety, costs, and social impact of perinatal technologies was extremely limited. These results led to the conclusion that immediate action needs to be taken to create the necessary conditions for health technology assessment in Latin America.
Noninvasive Testing of Asymptomatic Patients for the Detection of Silent Ischemia After an Infarction: A Decision Analysis
Authors: Lau Joseph , Adams Miriam E. 
Published: March 2009

AbstractThis decision analysis estimates the overall gain in life expectancy and the relative efficacy of predischarge submaximal exercise electrocardiography, ambulatory cardiac monitoring, and thallium-201 scintigraphy for the identification of silent ischemia in asymptomatic postinfarct patients. A small, virtually equal increase in life expectancy can be obtained from any of the noninvasive tests (as compared to no testing). Large differences in life expectancy may result only when the prevalence of residual coronary artery disease and the probability of left-main and three-vessel lesions are high.
Biomedical Research Councils: Their Role and Function in Transferring Information
Authors: Belaisch Francine 
Published: March 2009

AbstractBiomedical research plays a great part in promoting not only advances in scientific knowledge but also in the continuous flow of technological innovations in health care. One of the first conditions for the successful transformation of research into an innovation is overcoming the divisions between science and technology, between the researchers and their partners in the innovation process.Biomedical Research Councils (BMRCs) have an important role in the transfer of information. To improve the chances of successful developments and transfers of scientific breakthroughs, the BMRCs must adopt new, comprehensive strategies for such transfer. They must learn to recognize as early as possible which new opportunities hold promise, at which stage of development information should be transferred to other areas of expertise, and which target groups in which fields should be made partners in the research.
The Role and Function of Professional Journals in the Transfer of Information
Authors: Lundberg George D. 
Published: March 2009

AbstractAbstract Professional journals are of great importance in the transfer of information about technology, providing most physicians and medical students with the majority of their new information. Professional journals have mission statements and goals and many editorial categories to help achieve their goals. In addition, news media, books, television, and computerized journals are important methods for changing physician knowledge. Physician behavior is changed by many factors of which poor patient outcome is probably the key. Quality of information and activities is best assured by clear definition, goals, proper peer review, and good management. Appropriate use of technology is best approached by separating wants from needs.
Transfer of Information: A Note on the Role of Professional Societies
Authors: Tygstrup Niels 
Published: March 2009

Professional societies in general are designed to support and raise the prestige of the professions they represent, and the most overt way in which they do this is by attempting to keep the level of information concerning their profession as high as possible.Traditionally, the predominant type of transfer of information has been scientific papers presented at meetings for the memebership, and this it still so in many cases. The large amount of information communication in this way, and its significance, is beyoned doubt.
Epilogue: Future Developments in the Transfer of Technology Assessment Information
Authors: Thier Amuel O. 
Published: March 2009

Technology assessment in its broadest sense is essential if the highest quality of health care is to be matched to available resources. The results of technology assessment will be meaningful only if they can be transferred in a manner that affects practice as well as policy. Therefore, although we are still far short of an effective system for technology assessment, it is not too early to begin grappling with the problems of transferring the results of such a system when it exists.In considering future developments in information transfer, it is important to keep several caveats in mind.
When Must a New Approach to Treatment Be Introduced? The Ethics of Technology Assessment
Authors: Tanneberger Stephan 
Published: March 2009

AbstractPrior to the nationwide diffusion of a new technology, evidence must be assembled to demonstrate that a new technology is, in the terminology of WHO, appropriate. Not everything that is new in health technology is good; not all that is good is needed. It is by no means unethical to demand adequate assessment of new technology before it is diffused. On the contrary, it is unethical to squander resources on hazardous and uneffective treatment. Of the methods available for assessment, the randomized clinical trial is among the most valuable. Randomized clinical trials cannot, however, solve all problems. Speed is a critical element. It is not ethical to permit excessive delay. Balanced, relevant, and informative studies must be conducted as quickly as possible and with a maximum of international collaboration. WHO has a valuable role to play in advising on, coordinating, supporting, and disseminating the findings of such studies.
Development of medical Care Technology: The Case of Israel
Authors: Ellencweig Avi Y. 
Published: March 2009

AbstractThis article presents a survey of the public and private agencies and institutions providing health care in Israel and examines the degree and nature of the control that these bodies exercise over medical technology. The author demonstrates that while the Israeli government is highly centralized, the Ministry of Health is able to exercise only limited practical influence and is neutralized because of its circumscribed control of government funds. In addition, the Ministry of Health lacks standardized procedures for the assessment of prospective or existing technologies. The author notes that there has been a clear move toward a system to oversee the rational diffusion of technology and outlines several proposals for the future.
Consensus Conferences in Different Countries
Authors: Andreasen Buch 
Published: March 2009

AbstractThe different models of consensus development conferences (CDC5) are analyzed in relation to democratic technology assessment. In some countries CDCs are mainly concerned with influencing the quality of clinical practice and thus are dominated by medical experts. In other countries, CDCs are directed towards the public and the decision makers on the political and administrative level. The Danish experience demonstrates that CDCs may be a forceful social technology with a strong potential to influence decisions about medical as well as non-medical technology
Cost-Effectiveness Study of the Extracorporeal Shock-Wave Lithotriptor
Authors: Hatziandreu Evi E. , Carlson Karen , Mulley Albert G. , Weinstein Milton C. 
Published: March 2009

AbstractWe performed a cost-effectiveness analysis to examine the relative efficacy and costs of percutaneous ultrasonic lithotripsy (PUL), extracorporeal shock-wave lithotripsy (ESWL), and surgery for the treatment of upper urinary tract stones. We developed a Markov model with 35 states, cycles of 3 months, and a time frame of 5 years. Probability estimates were derived from a meta-analysis of the published literature. For stones less than or equal to 2 cm, ESWL is preferred to PUL, since it prevents 2 additional days of morbidity and saves $440. For larger stones, PUL is preferable to ESWL, avoiding 4 more days of morbidity, and saving $722. Both ESWL and PUL were superior to surgery. Sensitivity analysis showed that the results are sensitive to ESWL efficacy rates, the stone recurrence rate, and the hospital component of the ESWL cost. Our analysis suggests that although ESWL is preferable, relatively small changes in the efficacy and cost can shift the preferred strategy; in addition, these findings underscore the need for more reliable data.
The Pulmonary Artery (Swan-Ganz) Catheter: Evaluation of A Hemodynamic Monitoring Device in Critical Care Medicine
Authors: Pagliarello Giuseppe 
Published: March 2009

AbstractThe pulmonary artery catheter (PAC) is an invasive hemodynamic monitoring device that is used extensively in critical care units. This technological advance allows the critical care physician and nurse to closely monitor physiological functions at the bedside. There have been no formal evaluations of the impact of this device on patient care. Reviews and observational studies have yielded different conclusions regarding risks and benefits to patients. This has resulted in much editorial comment expressing divergent opinions on the value of the PAC, but there has been no scientific evidence to guide practice and no apparent effect on the use of these devices. The PAC and other medical monitoring devices must be evaluated with respect to their impact on patient care.
Methodology of OTA's Report on Drug Labeling in Developing Countries
Authors: Gelband Hellen , Corrigan Jackie , McDonough Robert 
Published: March 2009

AbstractThis article discusses the methodology of the OTA Project onDrug Labeling in Developing Countries. This report describes (a) the process of the project; (b) observations from a field visit to Thailand; (c) the development of the multinational pharmaceutical industry; and (d) influences on multinational pharmaceutical companies from their home countries, host countries, international organizations, selfregulation, and public interest groups. The results of the assessment will appear in the final report to Congress.
Economic Assessment of Magnetic Resonance Imaging for Inpatients: Is It Still Too Early?
Authors: Durand-zaleski Isabelle , Reizine Daniel , Puzin Daniel , Merland Jean-Jacques , Blum-Boisgard Claudine 
Published: March 2009

AbstractThis economic assessment of the implementation of magnetic resonance imaging (MRI) in a French hospital examines data on the diagnostic resources used in neurology and neurosurgery before and after MRI was available. Given a similar patient population and case mix, there was no change in the resources used other than the addition of MRI. So far, MRI appears to be a complement to, and not a substitute for, other imaging techniques used in neuroradiology. The focus of this work is purely economic; its conclusions do not challenge the major scientific contributions of MRI.
Technology Transfer in Medical Information Systems: The Potential for “groupware” and its Implications
Authors: Greenes Robert A. 
Published: March 2009

AbstractThe practice of medicine is intrinsically a cooperative activity, involving not only a number of individuals but requiring access to a wide variety of types of data, produced and maintained by different people. Achieving seamless, integrated access to these data requires a new infrastructure of information systems that supports the construction of applications designed to incorporate and use external information resources. The term groupware may be used to connote this collective set of information resources and tools for access to them. Groupware will generate a variety of new kinds of products and services with implications for medical libraries, electronic publishing, and academic and professional collaboration.
Decision-Support Systems in Health Care: Factors Influencing the Development and Transfer of Technology
Authors: Vian Taryn , Verjee Shabira , Siegrist Richard B. 
Published: March 2009

AbstractNational concern about escalating health care costs and inefficiencies in delivery systems has created demand for informatics technology such as decision-support systems. This paper discusses the pressing need for better cost information in health care and how decision-support technology meets this need. Future directions for the technology also are discussed.
Laminectomy and the Treatment of Lower-Back Pain in Massachusetts
Authors: Milamed Debra R. , Warfield Carol A. , Hedley-whyte John , Mosteller Frederick 
Published: March 2009

AbstractDuring 1984–1985, laminectomy rates in Massachusetts demonstrated a 2.2-fold variation among districts. Thirty-five percent of laminectomies occurred in 7 of the 108 hospitals studied. Approximately 81% of laminectomies were performed by neurosurgeons. Rates of laminectomy decline with increasing age after 65, while rates of hospitalization for lower-back pain rise.
Use of the Seer Cancer Registry for Technology Assessment
Authors: Klawansky Sidney , Burdick Elisabeth , Adams Miriam , Bollini Paola , Orza Michele , Falotico-taylor Jennifer 
Published: March 2009

AbstractThe Surveillance, Epidemiology, and End Results (SEER) cancer registry contributed to technology assessment by providing population-based samples for detailed case-control studies, by serving as the control group in comparisons with various experimental groups, by allowing an assessment of selection bias in clinical trials, and by facilitating evaluations of classification and coding systems.
Technology Assessment in the Veterans Administration Dental Longitudinal Study
Authors: Antczak-bouckoms Alexia , Tulloch J. F. Camilla , Chauncey Howard H. 
Published: March 2009

AbstractOf the 52 studies emanating from the Veterans Affairs Dental Longitudinal Study, 6 were identified as technology assessments. Three of these studies evaluated dental radiographs used for the diagnosis of oral lesions. Two studies compared alternative technologies for the replacement of missing teeth, and one reported the effects of NSAIDs on alveolar bone loss. Four additional articles are discussed that provide data that will be useful in future assessments of dental technologies.
Technology Assessment in the Coronary Artery Surgery Study
Authors: Burdick Elisabeth , Falotico-Taylor Jennifer , Young James M. 
Published: March 2009

AbstractThe majority of the 26 technology assessment articles from the Coronary Artery Surgery Study (CASS) follow the original purpose of the registry and evaluate the therapeutic capabilities of coronary artery bypass graft surgery. However, these registry data have also been used to identify risk factors for cardiovascular disease, to test diagnostic technologies, and to evaluate technological processes. Consideration of quality of life issues and the availability of cost data provide valuable additions to the continued use of the CASS for technology assessment.
Using Administrative Data Bases for Technology Assessment in Health Care: Results of an International Survey
Authors: Blais Régis 
Published: March 2009

AbstractThis study assesses the nature, use, and quality of large administrative data bases available in different countries for technology assessment in health care. Using postal questionnaires, data were collected describing 91 data bases from 15 countries. Current uses are promising, but more efforts are needed if the full potential of administrative data files is to be tapped.
Management of Early Prostatic Cancer in the Nordic Countries:Variations in Clinical Policies and Physicians' Attitudes Toward Radical Treatment Options
Authors: Jonsson Pia M. , Danneskiold-Samsøe Bent , Heggestad Torhild , Iversen Peter , Leisti Seppo 
Published: March 2009

AbstractTo explore the treatment of patients with early localized prostatic carcinoma, we surveyed the departments of urology and general surgery in Denmark, Finland, Norway, and Sweden. Clinical policies and physicians' attitudes toward the radical treatment options varied widely between the countries. A correlation seems to exist between practice patterns and national attitudes toward special technologies.
Evaluation of the Canadian Coordinating Office for Health Technology Assessment
Authors: Battista Renaldo N. , Feeny David H. , Hodge Matthew J. 
Published: March 2009

AbstractThe Canadian Coordinating Office for Health Technology Assessment (CCOHTA) was recently evaluated. We summarize the evaluation process, report, and 17 recommendations for enhancing CCOHTA's effectiveness. This paper may be useful for evaluators of agencies for technology assessment.
Hospital Utilization Reviews Under Field Conditions: Potential and Improvements
Authors: Santos-Eggimann Brigitte 
Published: March 2009

AbstractHospital reviews based on an adaptation of Gertman and Restuccia's Appropriateness Evaluation Protocol were performed by acute care hospitals and the canton of Vaud (Switzerland) public health department in three settings during a six-month period in 1990–1991. Interrater agreement between hospital and public health department reviewers was measured on 1,847 days of consecutively admitted patients during the last weeks of the reviews.
Cost-Effectiveness of Hepatitis-B Vaccine in Greece: A Country of Intermediate HBV Endemicity
Authors: Hatziandreu Evi J. , Hatzakis Angelos , Hatziyannis Stefanos , Kane Mark A. , Weinstein Milton C. 
Published: March 2009

AbstractWe evaluated the cost-effectiveness of (a) a vaccination program for the prevention of hepatitis B; and (b) the two commercially available vaccines (Merck Sharp and Dohme; Pasteur Institute) in Greece, a country of intermediate endemicity. We examined cases of hepatitis-B infection prevented and the expected medical costs among the high-risk groups of medical and nursing students, hospital personnel, and the general population. Employing a vaccination program reduces considerably the risk of infection, especially in the high-risk groups, while it increases the total cost. The vaccines are very comparable in terms of both health and economic outcomes. Sensitivity analysis indicated that vaccine cost, incidence of hepatitis B, and compliance were the key factors for the choice of (a) whether to undertake an extensive program to prevent hepatitis-B infection and its chronic sequelae; and (b) which vaccine to administer.
Screening for Human Immunodeficiency Virus
Authors: Rosenbrock Rolf D. 
Published: March 2009

AbstractScreening for human immunodeficiency virus (HIV) antibodies as a means of preventing both the progress and spread of acquired immunodeficiency syndrome (AIDS) is problematic in terms of efficacy, effectiveness, and ethics. The few desired effects are mostly offset by greater and more certain undesirable effects on individuals and society.
Assessing Population-Based Programs to Reduce Blood Cholesterol Level and Saturated Fats
Authors: Vartiainen Erkki , Heath Gregory , Ford Earl 
Published: March 2009

AbstractThis article reviews seven community-based programs for prevention of cardiovascular disease and their effects on blood cholesterol levels and saturated fat intake. In two programs, cholesterol levels were reduced more in the intervention area than in the reference area. In two other programs, cholesterol increased less in the intervention area than in the reference area. In one program, cholesterol levels initially fell in the intervention group and increased in the reference group; after the first 4 years, the levels also started to increase in the intervention group. The final two programs reduced cholesterol equally in both groups. Only two programs reported on the intake of saturated fats; in both, intake of saturated fat was reduced more in the intervention area than in the reference populations. In one program area, total intake of fat was reduced more than in the reference area. Published data do not allow us to draw conclusions regarding which components of the programs were most important. These studies show that the average blood cholesterol level can be affected in a general population.
Patient-Centered Redesign: More Collaborative Clinical Input Into Capital Budget Decisions
Authors: Stetler Cheryl B. , Fagan John , Hanson Monica , Biancamano John , Curry Stephen 
Published: March 2009

AbstractAs part of a restructuring program at a large, acute care hospital, a new, collaborative form of clinical management called triads has been initiated. Members of these collaborative management teams are being collectively empowered to better enable them to establish a continuously improving, cost-effective clinical service. This article describes the impact of this new structure on the capital budgeting process in changing a centralized, committee-based system of decision making with limited clinical nursing input to one that is increasingly decentralized, interdisciplinary, and focused on patients.
Nurses and Technology: Maintaining a Balance Between Intervention and Nurturing for Childbearing Women
Authors: Cook Sarah Sheets 
Published: March 2009

AbstractInvasive and noninvasive medical technology are employed frequently in the health care of women, particularly childbearing women, often without any demonstrable benefit. Nurses are in a position to be advocates for their childbearing patients and to define and implement a realistic balance between supportive or facilitative caring and technical interventions.
The Relevance of Socioeconomic and Health Policy Issues to Clinical Research: The Case of MRI and Neuroradiology
Authors: Larson Eric B. , Kent Daniel L. 
Published: March 2009

Magnetic resonance imaging (MRI) is a high-cost, new technology with great potential for improving patient care. The lack of a coherent public policy for MRI, or its predecessor computed tomography (CT), has caused considerable problems. Lack of an enunciated public policy has led to inconsistent reimbursement and reimbursement levels that develop in haphazard ways. Furthermore, diffusion has been unpredictable and has led to geographical excesses and deficiencies.Technology assessments of MRI, although numerous, have used inconsistent criteria to rate MRI's clinical efficacy. The lack of methodologically sound studies of MRI severely hampered early evaluation. This article examines these problems and suggests that the medical profession take a stronger leadership role in developing policies for expensive, promising new diagnostic technologies. The profession should promote, demand, and perform rigorous clinical evaluations of new technologies, and help develop a consensus regarding the criteria for what constitutes a clinically valuable advance in diagnostic technology.