bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD190 The Brazilian Health Technology Assessment Network Strategy: Capacity Building And Its Importance For The Sustainability Of The Public Health System
Authors: Ottavio Barbara Pozzi , Freitas Marcela , Barbosa Lais , D’agostini Maria Stella , Nóbrega Rafaella , Vidal Ávila , Bonan Luciene 
Published: January 2025

IntroductionThe Brazilian Health Technology Assessment (HTA) Network (REBRATS) dates to 2008, when the Ministry of Health (MoH) launched a call to register Brazil’s first HTA groups to promote and disseminate HTA in the country. To understand whether this strategy is succeeding, this paper evaluated the actions of REBRATS and the degree of advancement of the HTA field in Brazil.MethodsThe following data on the composition of REBRATS were collected and analyzed: the number of HTA groups and professionals registered in the network, the number of professionals that have benefited from qualifying courses, and the evolution of the Brazilian National Committee for Health Technology Incorporation (CONITEC).ResultsREBRATS expanded from 24 HTA groups to 112 groups in 2023, which includes over 800 professionals. From 2019 to 2023, the MoH financed over 90 courses, which have benefited more than 1,000 professionals. More HTA groups (from five to 23) have been hired to support CONITEC, enabling it to respond to a higher demand and more complex topics. These groups have been contributing to the development of HTA by assisting the MoH in defining a cost-effectiveness threshold; evolving the assessment of medical devices and new technologies (i.e., gene and targeted therapies); and creating methodological guideline–there will be 21 by 2024.ConclusionsAlthough the composition and technical capability of its member groups vary greatly, REBRATS has consolidated itself as a key strategy to support decision-making regarding technologies.
PD196 The Importance Of Promoting The Culture Of Health Technology Assessment Among Healthcare Professionals
Authors: Llinàs-Mallol Laura , Mestre-Lleixà Berta , Vivanco-Hidalgo Rosa Maria 
Published: January 2025

IntroductionLast year we developed a survey focused on decision-making in health innovation within the health system of Catalonia. Evaluation of the survey results, coupled with the relationships we established with various members of the Catalan health ecosystem, has highlighted the need for informative activities on health technology assessment (HTA) that aim to bring HTA closer to healthcare professionals.MethodsWe designed a two-hour training workshop divided into three thematic blocks and a group dynamic. The first block addressed HTA and the lifecycle of a health technology. The second and third blocks delved into the development of an HTA report, the role of healthcare professionals, and the formulation of a research question. During the workshops, we showcased a video and an infographic and distributed promotional bags to the attendees. A satisfaction survey was distributed at the conclusion of the workshop. We have conducted three editions of the workshop in a face-to-face format and one in a virtual format.ResultsOf the 56 people who participated in the workshops, 48 responded to the satisfaction survey. The most frequent participants were directors, care coordinators, and health managers. The attendees rated the workshops with 4.6 out of five points. About 66.7 percent of attendees indicated that the workshop had met their training needs. Most attendees (79.2%) considered that the workshop had provided knowledge that they could apply to their daily tasks. Finally, when asked about topics of interest for future workshops, the participants voted for advanced HTA methodology, the development of HTA in healthcare centers, and the evaluation of digital health.ConclusionsThe feedback from participants across all the workshops was very positive. The degree of satisfaction among attendees was high, with the main area for improvement being the need to develop new workshops to delve deeper into HTA. In 2024, we aim to design a training program consisting of HTA workshops that fulfil the requests of the attendees.
PD207 Modelling Co-Financing Scenarios To Address The Financial Challenges Of Implementing A Colorectal Cancer Screening Program For Private Insurance Beneficiaries
Authors: Muñoz-Montecinos Carlos , Quirland Camila , Maza Felipe , Barrientos Carlos , González-Browne Catalina 
Published: January 2025

IntroductionThe World Health Organization (WHO) recommends population-based cancer screening programs for colorectal cancer (CRC). However, CRC screening is not available in Chile´s public health system. The Arturo Lopez Perez Foundation (FALP) is interested in implementing a CRC screening program for their insurance beneficiaries, despite some uncertainties regarding cost effectiveness and budget impact. Exploring co-financing scenarios could reveal feasible choices for program implementation.MethodsA Markov model was developed to assess the cost effectiveness of a biennial fecal immunochemical test (FIT) strategy for individuals aged 50 to 69 years from a private insurer perspective. Survival probabilities and average costs for each cancer stage at diagnosis were derived from our CRC patients. Benefits were measured as life-years gained. The budget impact was calculated using the expected population of beneficiaries for 20 years. Cost-effectiveness results were reported using the incremental cost-effectiveness ratio (ICER), with a referential threshold of one to three times the gross domestic product per capita (USD16,000 to USD48,000). Shared funding scenarios with national public insurers and out-of-pocket payments were simulated.ResultsCRC screening was cost effective in the base case and shared funding scenarios. Indeed, it showed some benefits and savings in the latter scenario. On the other hand, budget impact values were unaffordable for the base case scenario, revealing that implementing the program would be difficult even with the promising ICER. However, in shared funding scenarios, the budget impact decreased and even showed savings after five years due to the decrease in cancer treatment costs.ConclusionsCRC screening with a biennial FIT is a cost-effective strategy for FALP beneficiaries, but the budget impact is substantial and poses challenges for its implementation. The use of shared funding strategies could help alleviate the budget impact, making the implementation of a screening program more feasible.
PD213 An Unmet Health-Related Needs Evidence Database For Informing Policy And Innovation Decisions In Health Care
Authors: Cleemput Irina , Levy Muriel , Schönborn Claudia , De Jaeger Mats , Kohn Laurence , Claerman Rani , De Pauw Robby , de Noordhout Charline Maertens 
Published: January 2025

IntroductionAs there is no standard definition of unmet patient or societal needs, the Needs Examination, Evaluation, Dissemination (NEED) project defined criteria for assessing these needs. This study describes the creation of an exploitable evidence database on unmet health-related patient and societal needs for various health conditions, and how this can be used in decision-making.MethodsThe NEED framework defines explicit dimensions (patient, societal, and future needs), domains (health, healthcare, and social needs), and criteria, along with specific measurable indicators, to identify unmet health-related patient and societal needs for various health conditions. For each indicator, information sources were sought, including both quantitative and qualitative evidence. For some indicators, guidance on evidence generation was developed. Possible uses of the NEED database were discussed with national and international panels of experts, stakeholders, and decision-makers.ResultsData sources were identified for some but not all patient and societal needs criteria. They included existing databases (e.g., the Global Burden of Disease database and administrative databases), literature, and primary data collection. A standardized methodology was defined for primary data collection (quantitative and qualitative). The NEED evidence database can be used by researchers, research funders, regulators, health technology assessment agencies, policymakers, patients, healthcare providers, etcetera for prioritizing areas of research as well as—thanks to the level of detail provided in the database—to assess the extent to which proposed “solutions” meet the most pressing unmet needs of patients or society.ConclusionsOnce operational, an unmet patient and societal needs evidence database, anchored to an explicit framework, can serve different stakeholders and decision-makers for various purposes. It collects evidence on unmet health-related patient and societal needs for various health conditions, given the current standard of care, independent of any new product or service, and therefore supports a needs-driven healthcare innovation and policy system.
PD214 Appraisal Of Reimbursement Thresholds For Medicines In Brazil’s Private Health System
Authors: Borin Marcus Carvalho , Martins Carina Rejane , dos Reis Daniel Pitchon , Coelho Ribeiro Geraldo Jose , Tupinambas Julia Teixeira , de Castro Zocrato Karina , de Almeida Carvalho Lelia Maria , de Freitas Marcela Pinto , da Gloria Cruvinel Horta Maria , Barbosa Mariana Michel , Torres Talim Mariza Cristina , Loureiro Bersan Sergio Adriano , Bruschi Kelles Silvana Marcia 
Published: January 2025

IntroductionBrazil’s public health system serves most of the population, but 25 percent of citizens rely on private health insurance. The National Regulatory Agency for Private Health Insurance and Plans (ANS) regulates private medicine reimbursements, which diverge from the public sector threshold. In 2022, the National Committee for Health Technology Incorporation (CONITEC) set a willingness-to-pay benchmark of BRL40,000 (USD8,215) per quality-adjusted life-year. The ANS has no such benchmark, highlighting a pivotal gap in economic evaluations for private health care.MethodsThis quantitative study investigated the Incremental cost-effectiveness ratios (ICER) for reimbursed medicines in Brazil’s private health sector, comparing them with CONITEC’s benchmarks and international thresholds. Data were extracted from industry reimbursement submissions to the ANS and analyzed for statistical disparity and policy implications.ResultsPreliminary findings found an ICER peak of BRL619,900 (USD127,220) per quality-adjusted life-year for talazoparib, which is used to treat certain advanced breast cancers. This contrasted sharply with CONITEC’s established threshold, indicating a critical need to evaluate ANS policies.ConclusionsEarly results indicate that the ICERs for some medicines surpass CONITEC’s willingness-to-pay limit, suggesting that the ANS should consider establishing a defined cost-effectiveness threshold. This is imperative to harmonize with global standards and maintain sustainable health financing.
PD220 Clinical Expert Opinion To Inform Health Technology Assessment In Ireland
Authors: O’Callaghan Joan , Tilson Lesley , Fogarty Emer , McCullagh Laura 
Published: January 2025

IntroductionThe National Centre for Pharmacoeconomics (NCPE) in Ireland conducts health technology assessments (HTAs) of drugs under consideration by the decision-maker for reimbursement. We analyzed how clinical expert opinion obtained by applicant pharmaceutical companies is used to inform HTA submissions made to the NCPE. We also describe how clinical opinion obtained by the NCPE is used to inform NCPE assessments.MethodsWe conducted a retrospective review of HTA submissions made to the NCPE from July 2019 to June 2020 inclusive. Data were extracted using a bespoke data collection instrument created in Microsoft Excel. To describe how clinical opinion informed the NCPE assessments, we extracted data from NCPE HTA Technical Summary Reports available on the NCPE website.ResultsA total of 18 HTA submissions were reviewed. Clinical expert opinion was used by applicants to support all submissions. The median number of clinical experts who informed each individual HTA submission was seven (range 1 to 33); the majority were hospital physicians. Clinical opinion was used to inform HTA domains, including patient and population estimates (n=14; 78%), use of drugs in clinical practice (n=13; 78%), treatment effectiveness (n=6; 33%), healthcare resource use (n=14; 78%), and health-related quality of life (n=5; 28%). We present examples where clinical opinion, obtained by the NCPE, was used to inform NCPE assessments.ConclusionsClinical expert opinion informed all 18 applicant HTA submissions made to the NCPE during the study period. The NCPE also seeks clinical expert opinion to inform their assessments. Healthcare professionals make an important contribution to HTA and, thus, inform the decision-making processes on drug reimbursement in Ireland.
PD221 Health Regulation And Health Technology Assessment: Brazilian Experience In Developing Actions For Health Regulation
Authors: Silva Elias Flávia Tavares , Camargo Erika Barcosa , de Oliveira Margarete Martins , Ramos Maíra Catharina , da Silva Erica Tatiane 
Published: January 2025

IntroductionIn 2017, the Brazilian Health Regulatory Agency (Anvisa) and the Oswaldo Cruz Foundation (Fiocruz) in Brazil entered into a collaboration that enabled the production of evidence and dissemination of technical scientific information in the regulatory field, with aim of supporting the decision-making process on regulatory issues.MethodsThis qualitative and descriptive study was designed to report on the technical cooperation between Anvisa and Fiocruz in Brazil during from 2017 to 2020.ResultsThe studies developed by the Decentralized Execution Term assisted in the formulation of health policies at the macro, meso, and micro political levels, supporting the strengthening of institutional regulatory policy. The medicines agenda was the most recurrent in cooperation outputs, followed by the food and smoking agendas. The postmarket surveillance agenda played a leading role in actions carried out with the updating of the Technovigilance Manual and the creation of pharmacovigilance bulletins, both of which were available to health professionals and citizens. Finally, 27 courses were offered, and 1,276 certificates were issued (606 to workers linked to health regulation).ConclusionsThe Brazilian experience enabled to capacity building and critical analysis of evidence in regulatory scope. It has facilitated the preparation of productions that align with the regulatory agenda. Health technology assessment and health regulation need to converge in monitoring processes to reduce uncertainties and increase user safety.
PD227 Qualitative Assessment Of The Value Of The Magnetic Resonance Linear Accelerator To Guide Decisions On Its Optimal Use
Authors: Ulehake Marike , Brunenberg Ellen , Tummers Marcia , Verheij Marcel , Grutters Janneke 
Published: January 2025

IntroductionThe added value of medical technology is typically assessed in specific patient groups, which is less useful to guide decisions on optimal use. The magnetic resonance linear accelerator (MR-Linac) is a costly innovation that can enhance radiotherapy precision through daily imaging and plan adaptation. This study aimed to better understand its potential value and inform users on its optimal application.MethodsSemi-structured interviews (n=24) were conducted with stakeholders, ranging from end users (radiation oncologist, clinical physicists, radiotherapy technologists, managers) to patient representatives and policy officers (e.g., procurement, health insurance, health technology assessment agency, and regulatory body). Themes explored with end users focused on the decision-making process of acquisition, current use, potential future deployment, optimal use, and the added value of MR-Linac. Themes explored with policymakers and patient representatives included their roles concerning costly medical technologies and their perspectives on the added value of the MR-Linac. Interview data were analyzed using thematic analysis.ResultsPreliminary results showed stakeholders’ optimism for improved patient outcomes, including reduced toxicity and increased treatment efficacy. Patient representatives highlighted not only the clinical value, but also the importance of ensuring patients’ access to innovative care. End users perceived the MR-Linac as a gradual improvement, placing trust in its theoretical benefits. Additionally, they found value in its contribution to providing innovative treatment, potentially benefiting hospitals by attracting new patients. They also experienced improved job satisfaction. Policy officers emphasized the need for evidence to support potential clinical advantages as well as the significant costs associated with the MR-Linac within the broader healthcare context.ConclusionsThis qualitative, technology focused study deepens our understanding of the potential added value of the MR-Linac, beyond a specific context or patient group. The results not only highlight potential patient benefits, but also show a broader significance of the MR-Linac at other levels (e.g., clinician, hospital, and society). It is important to consider these different levels when guiding decisions on use of the MR-Linac.
PD238 Evolution Of The Consumer Evidence And Engagement Unit And Contribution To Consumer Input In Australian Health Technology Assessment Processes
Authors: Watson Jo , Trowman Rebecca 
Published: January 2025

IntroductionVarious committees provide health technology assessment (HTA) recommendations to the Australian government on health technology subsidization. All committees include consumer members, but operations vary across committees. To support the committee’s consumer members and facilitate consumer input, the Consumer Evidence and Engagement Unit (CEEU) was launched in 2019. The CEEU aims to enhance inclusion of consumer input in Commonwealth HTA processes.MethodsThe CEEU operates within the Australian Government Department of Health and Aged Care in a hybrid format. The core functions of the CEEU include secretariat support for the HTA Consumer Consultative Committee (CCC), which comprises consumer members from all HTA committees. The CEEU also summarizes consumer input for the HTA committees. In 2022, the CEEU launched the Conversations for Change series, which was developed through a range of different consultation activities. As a result, an ongoing “Changing Conversations” mandate is in place, to build and sustain relational, non-transactional partnerships in a true collaborative style.ResultsThe HTA committees and subcommittees operate across cycles with overlapping timelines, requiring consumer input to be gathered at different timepoints for different purposes. The CEEU has launched materials, including the Consultation Hub and HTA Engage, and is developing a Consultation Toolkit to raise awareness and facilitate these processes. The role of the HTA CCC is evolving as a forum to enable consumer committee members to share experiences and receive CEEU support. Improvements in consultation processes have enabled the CEEU to provide consumer comments to consumer committee members to facilitate genuine representation of consumer and other external stakeholder views.ConclusionsManaging consumer input can be resource intensive, however there is increasing recognition of the importance of consumer engagement in Australian HTA. The CEEU expects continued growth and a wider remit from 2024, as new processes and changes occur. Additional materials are planned to support consumer committee members and to build capacity among consumers and consumer organizations.
Embarrassment in English language classrooms
Authors: Khajavy Gholam Hassan , Smid Dávid , Mercer Sarah , Murillo-Miranda Carlos 
Published: January 2025

Abstract
This study is designed to understand embarrassment in the second/foreign language (L2) context. Following a mixed-method design, in Phase 1, a sample of 141 tertiary-level Austrian English language learners were asked to write a narrative about their experiences of embarrassment in their language learning histories. Analyzing the narratives showed that L2 embarrassment is a multidimensional construct that is frequently experienced by a range of language learners. In Phase 2, we developed and validated an L2 classroom speaking embarrassment (L2CSE) scale among a sample of 402 international English language learners drawing on the literature and analysis of the narratives. Data showed that L2 embarrassment is best represented by a bifactor exploratory structural equation model, capturing both general and specific aspects of L2 embarrassment. We found that a supportive classroom environment and fostering a growth mindset can decrease the risk of L2 embarrassment. As expected, L2 embarrassment was a negative predictor of willingness to communicate and self-perceived language proficiency. These initial findings suggest that L2 embarrassment could be an important and influential emotion in the language learning classroom context which requires further research.
The 2023 fatal dengue outbreak in Bangladesh highlights a paradigm shift of geographical distribution of cases
Authors: Hasan Mohammad Nayeem , Rahman Mahbubur , Uddin Meraj , Ashrafi Shah Ali Akbar , Rahman Kazi Mizanur , Paul Kishor Kumar , Sarker Mohammad Ferdous Rahman , Haque Farhana , Sharma Avinash , Papakonstantinou Danai , Paudyal Priyamvada , Asaduzzaman Md , Zumla Alimuddin , Haider Najmul 
Published: January 2025

Abstract
In 2023, Bangladesh experienced its largest and deadliest outbreak of the Dengue virus (DENV), reporting the highest-ever recorded annual cases and deaths. Historically, most of the cases were recorded in the capital city, Dhaka. We aimed to characterize the geographical transmission of DENV in Bangladesh. From 1 January–31 December 2023, we extracted and analyzed daily data on dengue cases and deaths from the Management Information System of the Ministry of Health and Family Welfare. We performed a generalized linear mixed model to identify the associations between division-wise daily dengue counts and various geographical and meteorological covariates. The number of dengue cases reported in 2023 was 1.3 times higher than the total number recorded in the past 23 years (321,179 vs. 244,246), with twice as many deaths than the total fatalities recorded over the past 23 years (1705 vs. 849). Of the 1,705 deaths in 2023, 67.4% (n = 1,015) died within one day after hospital admission. The divisions southern to Dhaka had a higher dengue incidence/1000 population (2.30 vs. 0.50, p <0.01) than the northern divisions. Festival-related travel along with meteorological factors and urbanization are likely to have contributed to the shift of dengue from Dhaka to different districts in Bangladesh.