bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD91 Gaps And Challenges In The Health Technology Assessment Of Genetic And Genomic Applications: A Systematic Review
Authors: Siena Leonardo Maria , Sciurti Antonio , Migliara Giuseppe , Isonne Claudia , Di Lorenzo Giuseppe , De Blasiis Maria Roberta , Marzuillo Carolina , Villari Paolo , Baccolini Valentina 
Published: January 2025

IntroductionEvaluating genetic and genomic applications is critical for their adoption in healthcare practice, but this has several challenges, including limited evidence on clinical and non-clinical benefits and rapid development processes. Since these challenges lack comprehensive discussion, this study aimed to identify and analyze all the barriers emerging in the health technology assessment (HTA) of genetic and genomic tests.MethodsThe protocol of this study was registered in the Open Science Framework database. A systematic search of the PubMed, Scopus, and Web of Science bibliographic databases was undertaken to identify all studies that specifically discussed any difficulty, gap, or barrier in the HTA evaluation of genetic or genomic technologies. No restrictions were imposed on HTA domain, study type, or publication date. Gaps and challenges were then grouped into domains outlined in the EUnetHTA HTA Core Model®. A narrative synthesis of the results was performed for each HTA domain.ResultsOf the 457 publications identified, 23 were included. Article designs exhibited considerable diversity, ranging from systematic reviews to semi-structured interviews, and stakeholder involvement varied from universities to national research groups. The challenges we found referred to the general HTA framework or, in most cases, to specific domains. More than 25 percent of the challenges were associated with economic aspects, with cost-effectiveness analysis being the focal point of debate. In addition, clinical effectiveness, in terms of non-health outcomes, lack of evidence, and clinical utility, was also frequently discussed, accounting for 23 percent of the challenges identified.ConclusionsOur study systematically summarized gaps and barriers in the HTA of genetic and genomic applications, providing a thorough analysis and categorization of these issues. Various challenges surfaced across different domains, notably related to costs, economic evaluation, and clinical effectiveness. There is a need for exhaustive discussions on potential solutions to facilitate and enhance the assessment process for these genetic and genomic applications.
PD94 Adapting Existing Evidence-Based Clinical Practice Guidelines: A Case Example with Sexually Transmitted Infections Guidelines In Catalonia, Spain
Authors: Estrada Sabadell Maria Dolors , Caro Mendivelso Johanna Milena , Pla Anna Godo , Vivanco-Hidalgo Rosa Maria , Sáez Caridad Almazán , Botey Paula Lletjós , Lou Rosa Mansilla , Sebastià Mercè Armelles , Iglesias Mireia Alberny 
Published: January 2025

IntroductionIn the field of sexually transmitted infections (STI), high quality clinical practice guidelines (CPGs) have already been developed using rigorous methodology. To avoid duplicating effort, make cost-effective use of available resources, and facilitate customization to reflect local contexts, we adapted a CPG for prevention, care, and control of STIs in Catalonia, Spain.MethodsThe Guideline Adaptation Group (GAG) used the ADAPTE framework to guide transcontextual adaptation. The ADAPTE model has three phases: set-up; adaptation, with five main criteria for determining the relevance of a CPG and the adaptability of its recommendations (quality, currency, content, consistency, and acceptability or applicability); and finalization. We used the Spanish version of the AGREE II instrument to rate and select appropriate CPGs and the RIGHT-AD@pt checklist to guide reporting of the adaptation process. Each recommendation was given a level of evidence and a grade using the GRADE framework.ResultsOnce the feasibility of carrying out the adaptation was confirmed, the governance structure was defined, which comprised a steering committee (n=8 members) and an expert committee (n=93 members). Clinical questions were defined from 164 recommendations taken from a CPG published in 2009. The systematic search identified 759 records published from 2016 to 2023. Of these, 57 CPGs met the inclusion criteria. On average, items 10 and 12 of the AGREE II scored between five and seven points (moderate to high quality methodological rigor). Content and consistency are being analyzed and matrices are being prepared to assess acceptability and applicability.ConclusionsThe ADAPTE methodology provides structure, rigor, and efficiency to the transcontextual adaptation of CPG recommendations. We expect that its application will provide practical and timely recommendations on the prevention, care, and control of STIs in the Catalan context.
PD96 Are Continuous Noninvasive Blood Pressure Monitoring Devices Accurate Enough To Replace Invasive Monitoring? A Rapid Review
Authors: Tan Yin Zhien , Ho Pwee Keng 
Published: January 2025

IntroductionThe intra-arterial catheter (invasive method) is the clinical and reference standard for continuous blood pressure (BP) monitoring. Continuous noninvasive blood pressure (CNBP) monitoring methods, for example applanation tonometry, volume clamp, and cuffless BP monitoring devices are gaining popularity. This review clarified the evidence on the accuracy of CNBP monitoring devices, which could potentially replace invasive monitoring in clinical care.MethodsA systematic search was carried out to look for systematic reviews with the following elements:•Population: patients needing continuous BP monitoring;•Intervention: CNBP monitoring devices;•Comparator: intra-arterial BP monitoring; and•Outcomes: accuracy of BP monitoring.The databases searched included PubMed (MEDLINE), Epistemonikos, and the Cochrane Database of Systematic Reviews. Two reviewers independently reviewed the search results and shortlisted relevant articles for retrieval of full texts. Included reviews were critically appraised with the AMSTAR 2 instrument and the findings were summarized in a narrative synthesis.ResultsThree systematic reviews with meta-analyses of fairly good quality were included. The included primary studies were conducted in perioperative or critical care settings. Subgroup analyses by CNBP monitoring method were included in each meta-analysis. The findings from the systematic reviews were consistent. On average, CNBP devices consistently measured lower systolic BPs than the invasive method (mean difference <0) and measured higher diastolic BPs and mean arterial pressures than the invasive method (mean difference >0), with wide ranging 95 percent limits of agreement. It was evident from subgroup analyses that the measurements obtained from different CNBP methods varied significantly.ConclusionsThis rapid review found the accuracy of CNBP monitoring devices to be suboptimal in comparison with invasive monitoring. CNBP devices should not be routinely used but may be considered when there is difficult arterial access, or in patients who do not require arterial puncture for other purposes.
PD99 Effectiveness And Safety Of Bioelectrical Stimulation Techniques In Fibromyalgia: A Systematic Review
Authors: Álvarez-Pérez Yolanda , Duarte-Díaz Andrea , Rivero-Santana Amado , García Vanesa Ramos , Cazaña-Pérez Violeta , Llamas-Ramos Inés , Trujillo Elisa , Téllez-Santana Teresa , Brocalero Ángela , Perestelo-Pérez Lilisbeth 
Published: January 2025

IntroductionFibromyalgia, a musculoskeletal ailment of unknown origin, profoundly affects quality of life. Emerging bioelectrical stimulation techniques, including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and pulsed low-frequency magnetic field stimulation (PEMF), show promise in short-term pain alleviation. This study aimed to rigorously evaluate the effectiveness and safety of these techniques in treating fibromyalgia.MethodsA systematic review (SR) of available literature on the effectiveness and safety of bioelectrical stimulation techniques was carried out according to the Cochrane Collaboration methodology and PRISMA reporting guideline. Evaluated studies included SRs (with or without meta-analyses) and randomized controlled trials (RCTs) published after the SRs. SRs were appraised with the AMSTAR-2 tool and RCTs were assessed with version two of the Cochrane Collaboration risk-of-bias tool for randomized trials. The findings were synthesized narratively. In the absence of SRs with meta-analyses for specific techniques, we conducted a meta-analysis for each available outcome measure, including pain, fatigue, symptom severity, quality of life, anxiety, and depression.ResultsSeven SRs incorporating 35 RCTs were included. Two SRs evaluated TMS effectiveness, while five focused on tDCS. Additionally, 17 RCTs were included: two on repetitive TMS, six on tDCS, and eight on PEMF (three assessing targeted PEMF). General confidence in the SR results varied, with most having critically low confidence. Three additional RCTs were rated as low risk of bias, seven were rated as unclear risk of bias, and the remaining seven were rated as high risk of bias. A meta-analysis covered additional RCTs on PEMF and assessed pain intensity, symptom severity, general health-related quality of life, and fibromyalgia-related quality of life.ConclusionsOverall, the results suggest that repetitive TMS, tDCS, and PEMF could improve pain and quality of life in patients with fibromyalgia. It is, however, necessary to conduct high quality studies to demonstrate the clinical relevance of these effects. While the techniques evaluated appear to be safe, mild adverse effects involving the area of stimulation may occur.
PD119 Interventions To Improve Long COVID Symptoms: A Systematic Review Of Randomized Controlled Trials
Authors: McDowell Cillian , Tyner Barrie , Shrestha Shibu , McManus Leah , Comaskey Fearghal , Harrington Patricia , Walsh Kieran A. , Neill Michelle O’ , Ryan Máirín 
Published: January 2025

IntroductionLong COVID, which encompasses a range of prolonged and persistent symptoms that occur after the acute SARS-CoV-2 infection period, can have substantial negative physical, mental, social, and economic effects. This systematic review aimed to assess the effectiveness and safety of interventions to improve long COVID symptoms to inform updates to the interim long COVID model of care in Ireland.MethodsStudies were identified in the MEDLINE, Embase, and CENTRAL databases through February 2023. Inclusion criteria were: (i) participants with long COVID, as defined by the study authors; (ii) random assignment to either an intervention or a comparison group; and (iii) quantitative assessment of the severity or frequency of long COVID symptoms. Exclusion criteria were: (i) signs or symptoms not reasonably attributable to prior SARS-CoV-2 infection; (ii) interventions not intended to treat long COVID; and (iii) not a randomized controlled trial. Two reviewers independently screened studies, extracted data, and assessed study quality using the Cochrane risk-of-bias tool for randomized trials. The results were synthesized narratively.ResultsFifty-seven studies were included, and 283 potentially relevant ongoing trials were identified. Twenty-four trials investigated pharmaceutical and other medical interventions, most of which were examined in single studies. Thirty-three trials investigated non-pharmaceutical interventions. Risk of bias was high in 41 of the 57 (72%) studies. Interventions targeted a diverse range of long COVID symptoms. Studies generally had small sample sizes and short follow-up periods and did not adequately examine intervention safety. Evidence for the effectiveness of pharmaceutical and other medical interventions was limited. Potential short-term improvements were seen for some people following personalized exercise and physiotherapy and rehabilitation programs. However, long-term outcomes were not assessed.ConclusionsEffective interventions to improve the symptoms of long COVID remain elusive and those included in this review do not yet have sufficient evidence to support them. In the absence of strong evidence for specific interventions, a holistic approach should be used to support people with long COVID.
PD127 A Systematic Review Of The Clinical Effectiveness Of Recombinant Zoster Vaccine For Preventing Herpes Zoster In Adults
Authors: Byrne David , Reece Emma , Jenkins Orla , Bergin Aoife , McLoughlin Carol , Quigley Joan , Teljeur Conor , Harrington Patricia , Ryan Máirín 
Published: January 2025

IntroductionThe herpes zoster (HZ) virus is associated with significant morbidity. Its incidence and severity are higher among older adults and immunocompromised individuals. This systematic review assessed the clinical efficacy and effectiveness of recombinant zoster vaccine (RZV) for the prevention of HZ and associated complications in adults at least 50 years of age and in adults (≥18 years) at increased risk of HZ.MethodsElectronic searches restricted to between 2008 and July 2023 were conducted in Embase, MEDLINE, the Cochrane Library, and clinical trial registries. Two reviewers independently screened articles and extracted data. The review adhered to the PRISMA reporting guidelines. Quality appraisal was assessed using version two of the Cochrane risk-of-bias tool for randomized trials tool and the Risk of Bias in Non-Randomized Studies - of Interventions tool. Meta-analysis was undertaken using Cochrane methodology, with preference given to random effects meta-analysis because of study heterogeneity.ResultsTwelve RCTs and five cohort studies were identified. Vaccine efficacy was defined as one minus the incidence rate ratio, multiplied by 100. For the general population, vaccine efficacy was 92 percent (n=29,311 individuals) and vaccine effectiveness was 70 percent (n=43,990,671 individuals). Based on one trial, vaccine efficacy in the general population (aged ≥50 years) waned from an initial 97.7 percent to 73.2 percent by year 10. Two RCTs reported vaccine efficacy for those at increased risk: 68.2 percent in hematopoietic stem cell transplant recipients and 87.2 percent in those with hematological malignancies. Secondary analyses were limited by sample size.ConclusionsThere is clear, consistent evidence that RZV is effective in reducing HZ incidence. Although the vaccine is effective in those who are least 18 years of age and are at increased risk of HZ, efficacy may be lower compared with a general population aged at least 50 years. Secondary analyses (age subgroups, HZ complications, and HZ-related hospitalizations) were limited by small sample size, leading to inconclusive results.
PD131 Literature Analysis And Hot Topics In Congenital Heart Disease Screening In China: A Bibliometrics Study Using CiteSpace
Authors: Liu Liu , Yang Yi , Liu Shimeng , Wei Yan , Chen Yingyao 
Published: January 2025

IntroductionCongenital heart disease (CHD), the most common congenital malformation affecting fetuses and infants, poses a significant and rapidly emerging global challenge in children’s health. Prenatal and newborn screening are very important for preventing CHD. Therefore, this study aimed to analyze the status and corresponding foci of articles on CHD screening in the Chinese or English language using bibliometric methods.MethodsPublications on prenatal or newborn screening for CHD were included. The Web of Science Core Collection (WoS) and China National Knowledge Infrastructure (CNKI) databases were searched to identify literature published from inception to 31 March 2023. CiteSpace was used to perform bibliometric analysis on the number of publications, institutions, authors, and keywords to generate corresponding knowledge maps.ResultsA total of 582 publications were retrieved from the WoS and 233 from the CNKI databases. There was an increasing trend in the number of English and Chinese articles published, with the trend beginning in 2010 for Chinese language articles and in 2007 for English language articles. In English language publications, GR Martin was the most influential author, and the top five institutions were from high-income countries. Among the Chinese language publications, Wenhong Ding was the most influential author and the Hunan Province Maternal and Child Health Care Hospital was the most commonly reported institution. Keyword analysis revealed that the most frequently occurring terms in both language publications were as follows: antenatal diagnosis, cardiac auscultation, and fetal echocardiography in English language articles and screening, prenatal screening, and fetal in Chinese language publications.ConclusionsIncreasingly, articles on CHD screening have been listed in the WoS and CNKI databases. This bibliometric study provides the status and trends in the research on screening for CHD and may help researchers identify hot topics and explore new research directions in this field.
PD158 Optimizing The Management Of Patients With Mitral Regurgitation Beyond Technological Innovations: A Proposed Set Of Actions
Authors: Campelos Paula , Díaz José Francisco , López-Haldón José , Nombela-Franco Luis , Pinar Eduardo , González-Pinto Ángel , Reina Margarita , Tarrío Rubén , Vidal Laura , Lorenzo-Herrero Seila , Cuervo Jesús , Mengual Marta , González Paloma 
Published: January 2025

IntroductionMitral regurgitation (MR) is the most prevalent valvular heart disease worldwide and is frequently underdiagnosed and undertreated, resulting in a substantial healthcare burden. This project aimed to define an optimized patient journey, identifying specific unmet needs and pain points in the management of MR in Spain, and to propose a set of recommendations that can be implemented at a clinical level.MethodsUsing the Population, Intervention, Comparator, and Outcomes search strategy, a pragmatic literature review was conducted to contextualize the comprehensive management of patients with MR in Spain. Subsequently, a Delphi panel consisting of two rounds of questionnaires was implemented. Unmet needs detected for MR management along the patient journey were validated by a panel of clinical experts incorporating different profiles. A battery of actions to improve the MR patient journey was also gathered (first round), which were then systematically reviewed and prioritized by the experts using hierarchical point allocation methods (second round) based on their relevance and feasibility within the National Health System.ResultsA set of actions was proposed for the following core phases: detection-diagnosis, treatment-decision, treatment, and follow up. Actions for detection-diagnosis should be prioritized since boosting patient referral to specialized centers was considered crucial. Within the treatment-decision stage, experts emphasized strengthening healthcare services communication and training on risk stratification. For treatment, early referral to specialized centers was prioritized. Optimizing follow up required educating patients and relatives on adherence and self-care. Finally, experts supported a common pathway for heart valve diseases such as MR, tricuspid regurgitation, and aortic stenosis. Specifically, they concluded that optimization of tricuspid regurgitation management aligned with the actions proposed for MR.ConclusionsAltogether, unmet needs and critical aspects in each of the management steps of MR in Spain were detected and an array of potential actions was suggested by clinical experts. The evaluation of such actions resulted in a preliminary strategic plan that can help prioritize interventions and healthcare policies regarding the optimization of the healthcare journey for patients with MR (and other valvulopathies) in Spain.
PD167 Charting A Sustainable Way To Subsidize Implants In Singapore
Authors: Soon Swee Sung , Ding Wayne , Ee Wong Yen , Ho Yan Teck , Ooi Lydia , See-Toh Rachel , PM Batcagan-Abueg Ada , Yi Ho Jun , Low Foo Eng , Unni Bindhu , Gan Hua Pey , Ye Yeo Chong , Heng Jeshuan , Chew Sarah , Lim Qinyi , Lim Elysia , Ng Zhen Long , Ng Jaryl , Ju Hong , Ng Kwong 
Published: January 2025

IntroductionThe diverse implant landscape, the rising and disparate costs of implants in public healthcare institutions (PHIs), and the limited application of health technology assessment (HTA) impede fair and sustainable implant subsidies in Singapore. This study described the Agency for Care Effectiveness (ACE) Implant Subsidy List (ISL) methodology and the key enablers for supporting government subsidy of clinically effective and cost-effective implants in Singapore.MethodsA multi-tiered implant grouping scheme on the ISL was established by adapting overseas implant classifications, consulting clinicians, and conducting HTA evaluations, with subsidy extensions at the product group tier. Implants within a product group share similar biomechanical actions and patient outcomes and are subject to the same clinical criteria and pricing requirement. Implants on the ISL must be approved by the regulatory authority. Patients who meet the clinical criteria for ISL implants are eligible for subsidy. ACE conducted value-based pricing (VBP) and partnered with the public healthcare supply chain agency to harmonize PHI implant prices. The ISL is updated three times per year.ResultsImplants listed on the ISL were deemed clinically and cost effective. Underpinned by HTA principles, the implant grouping scheme promoted parsimonious classification, while allowing the creation of new product groups for implants offering superior benefits for patients. Reasonable prices set for the product groups aided affordability and cost sustainability. The ISL clinical criteria and standardized implant identifiers encouraged the appropriate use of subsidized implants and facilitated implementation. By ISL implementation in December 2023, ACE assessed 42,165 implants and listed 22,689 ISL implants spanning 143 product groups. Industry can apply for ISL listing three times per year, which keeps the ISL updated and relevant.ConclusionsThe ISL adopts a fit-for-purpose methodology to standardize implant classifications, enable scalable application of HTA, drive appropriate use of subsidized implants, and bring cost sustainability to the government subsidy of implants in Singapore. A strategic partnership with the public healthcare supply chain agency to concurrently establish national procurement contracts reduced disparate implant prices in PHIs and provided greater leverage for better implant prices.