bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD42 Should Antibiotics Be Used To Treat Recurrent Otitis Media In Children? Updating A Recommendation
Authors: Ruiz-Ramos Alba , Sabalete-Moya Trinidad , Carmona-Hidalgo Beatriz , Rosario Lozano María Piedad , Fernández-Urrusuno Rocío , Blasco-Amaro Juan Antonio 
Published: January 2025

IntroductionAcute otitis media (AOM) is one of the most common childhood infections. Recurrent AOM (rAOM) is defined as the presence of three or more AOM episodes in a period of six months. We describe the methodology used to update the recommendation of the 2018 Spanish National Antimicrobial Therapeutic Guide on the use of antibiotic treatments for rAOM in children.MethodsWe followed the GRADE-ADOLOPMENT approach to update the recommendation on antibiotic treatment for rAOM. Firstly, the research question was framed in a Population, Intervention, Comparison, and Outcome format. A comprehensive search strategy was developed, the results of which were screened according to the inclusion criteria. The selected studies were reviewed, and the quality of the evidence was assessed. Subsequently, an Evidence to Decision (EtD) framework was created and the new evidence was presented to the Guideline Development Group (GDG), which updated the recommendation on rAOM treatment in children.ResultsAmong the 1,934 references identified by the database searches, only one guideline from the National Institute for Health and Care Excellence (NICE91, updated in 2022) met our inclusion criteria. This CPG included five individual studies comparing antibiotic treatments for rAOM. None of the studies demonstrated a significant advantage for any treatment. The overall quality of the evidence for these comparisons was considered low. A GRADE EtD framework was elaborated using the NICE91 recommendations but contextualized to the Spanish National Health System. Based on the evidence, the GDG did not modify the current recommendation provided in 2018.ConclusionsThe overall quality of the available evidence regarding antibiotic use for rAOM in children was considered low. Further research is therefore needed to resolve the controversy and increase confidence in the appropriateness of using antibiotics in the treatment of rAOM, thereby improving the quality of life of children with this condition.
PD52 Evidence Review Of Universal Ultrasound Screening For Developmental Dysplasia Of The Hip In Infants
Authors: Maher Arielle , Jordan Karen , Finnegan Eanan , Spillane Susan , Neill Michelle O’ , Ryan Máirín 
Published: January 2025

IntroductionDevelopmental dysplasia of the hip (DDH) is a congenital disease in which there is abnormal development of the hip in infancy. Ultrasound screening has the potential to enable earlier identification and diagnosis of DDH, facilitating earlier and less invasive treatment. Ultrasound screening programs can be selective or universal, but the optimal method is unclear.MethodsThe aim of this review was to examine the comparative effectiveness of universal and selective ultrasound screening for DDH in infants. The domains of the Health Technology Assessment Core Model® selected for assessment were consistent with a rapid relative effectiveness assessment approach (i.e., focusing on the clinical benefit of the intervention) and included the following: (i) the health problem; (ii) a description of the technology; and (iii) clinical effectiveness and safety outcomes. An expert advisory group comprising nominated representatives from key stakeholder groups was convened for the purposes of quality assurance and to assist in interpreting the evidence.ResultsDDH severity can range from mild dysplasia to complete dislocation, with incidence varying internationally. Ultrasound screening can result in unnecessary treatment given the potential for spontaneous correction of hip instability. Furthermore, treatment may give rise to complications. Appropriate governance of a screening program and associated training may reduce the risk of unnecessary treatment. Limited high quality evidence from four studies was identified. This evidence suggested that increased rates of non-surgical intervention were associated with universal ultrasound screening, compared with selective screening, without a corresponding reduction in the incidence of late DDH or requirement for surgical intervention.ConclusionsThe relative benefit of universal ultrasound screening, compared with selective screening, remains unclear. Screening all infants has the potential to lead to unnecessary treatment, with the risk of clinically significant consequences. Consideration could be given to implementing a selective ultrasound screening program, with appropriate governance, end-to-end care, quality assurance, and outcome monitoring.
PD54 Impact Of Experiencing Vaso-Occlusive Crisis In Patients With Sickle Cell Disease: Systematic Review And Meta-Analysis Of Prognostic Studies
Authors: Ascef Bruna , Marques Mariana Oliveira , Kashiura Diego , Bertinato Juliano , De Oliveira Haliton Alves 
Published: January 2025

IntroductionSickle cell disease (SCD) is characterized by recurrent painful ischemic vaso-occlusive episodes (VOEs). Acute episodes of pain, often termed sickle cell pain crises or vaso-occlusive crises (VOCs), are one of the most common and debilitating manifestations of SCD. Here we present a systematic review of 31 trials of 202,758 patients with SCD.Methods
This study followed the guidelines of Riley et al. for conducting a systematic review and meta-analysis of prognostic factor studies and was reported according to PRISMA guidelines. Literature searches were conducted in the PubMed, Embase, and LILACS databases. The websites of the Annual Academy for Sickle Cell and Thalassemia Conferences, the European Hematology Association, and the American Society of Hematology were also searched. Additionally, manual searches were conducted in Google Scholar, Epistemonikos, and the reference lists of included studies. The searches were performed on 22 March 2023.Results
In total, 31 studies were included in this systematic review. There was considerable heterogeneity in the definition of prognostic factors of interest across the included studies. Findings revealed a link between VOCs and reduced health-related quality of life (HRQoL), severe pain, and a high rate of hospitalization. Although VOCs were related to an increased mortality risk, the mortality rate remained relatively low, with acute chest syndrome being a common cause of death. Despite the study heterogeneity, consistent evidence highlighted the impact of VOCs on SCD-related hospitalizations (pooled hospitalization rate due to VOEs of 47%, 95% confidence Interval: 33, 61; 16 studies, 139,752 participants).ConclusionsThis study suggests that VOCs reduce HRQoL, cause severe pain, and lead to high rates of hospitalization in patients with SCD. Furthermore, VOEs were related to an increased mortality risk. Future research should prioritize more well-designed comparative prospective studies and standardization of the definition of VOCs. A better understanding of VOCs as a prognostic factor could enhance HRQoL, alleviate healthcare system burden, and inform more effective interventions for patients with SCD.
PD58 The Repellent Effects Of Cymbopogon Nardus On Aedes Aegypti Mosquitoes: A Rapid Review
Authors: Rocha Medeiros Ana Célia , Galdino Allancleriston Alves , Gurjão Edmar Candeia , Camargo Erika Barbosa 
Published: January 2025

IntroductionArboviruses transmitted by the A. aegypti mosquito are a public health problem in Brazil. Citronella, known for its repellent properties, has been suggested as a possible sustainable and natural preventive measure against the arbovirus triad. This study aimed to carry out a rapid review of the efficacy and safety of the repellent properties of citronella for the A. aegypti mosquito.MethodsThe rapid review followed methods proposed by the Joanna Briggs Institute. Searches were conducted in the following literature databases: PubMed, LILACS, Embase, Scopus, Web of Science, and the Cochrane Library. Quality assessment was carried out using the AMSTAR-2 tool. The review aimed to determine the efficacy and safety of citronella (C. nardus) as a repellent for the A. aegypti mosquito, compared with usual methods.ResultsCitronella repels A. aegypti mosquitoes for between 12 and 480 minutes, depending on the concentration and formulation of the product. Considering its protection time, reapplying the product doubles the protective effect. Adding vanillin to the formula reduces the product’s volatility. Citronella is not absorbed through the skin like DEET products, making it less toxic.ConclusionsCitronella-based products can be used as a complementary measure of protection against arboviruses. Additional investigations are needed on the percentage of essential oil present in homemade formulations. Studies addressing the safety of citronella are imperative for its use in the public health system. Controlled studies evaluating its degree of repellency are also needed.
PD59 Review Of The International Epidemiology Of Long COVID
Authors: Norris Michelle , Comaskey Fearghal , Mc Loughlin Carol , Merriman Niamh , Tyner Barrie , O’Mahony Aislinn , Carrigan Marie , Harrington Patricia , Ryan Máirín , Neill Michelle O’ 
Published: January 2025

IntroductionApproximately 65 million people worldwide have Long COVID. Long COVID is a complex condition with more than 200 symptoms, which can substantially affect the lives of individuals. The evidence base for Long COVID is evolving rapidly and, therefore, an up-to-date understanding of the prevalence and risk factors of Long COVID is necessary to inform service delivery and allocation of healthcare resources.MethodsA systematic literature review was conducted. Long COVID epidemiological literature published after October 2021 was identified in the MEDLINE, Embase, and Cochrane Library databases. Data extraction and quality appraisal were completed by one reviewer and checked for accuracy and omissions by a second reviewer. The following subgroups of interest were identified: general population; children and older adults; individuals who are medically vulnerable; and individuals with a history of severe COVID-19. Narrative synthesis of the prevalence and symptoms of Long COVID and of risk factors associated with the development of Long COVID was conducted.ResultsOver 3,000 documents were identified, of which 51 primary research studies met the inclusion criteria and were deemed of fair or good quality. Long COVID prevalence estimates ranged from 1.8 to 53.1 percent in the general population; 0.1 to 65.7 percent in children; 5.6 to 80.8 percent in older adults; 12.4 to 29.7 percent in medically vulnerable individuals; and 9.8 to 94.6 percent in individuals with a history of severe COVID-19. A wide range of symptoms were identified, with fatigue and neurological and respiratory symptoms being commonly reported. Female sex and increased age were identified as risk factors for developing Long COVID.ConclusionsLong COVID is a complex condition involving a wide range of symptoms, which may result in significant reductions in quality of life and functioning in some individuals, a substantial burden on healthcare systems, and broader economic impacts. In planning healthcare delivery for this population, a focus on multidisciplinary holistic care will be necessary.
PD71 Survival Outcomes And Adherence To Defined Daily Doses Of Imiglucerase: A 16-Year Brazilian Cohort Study In Gaucher Disease
Authors: Borin Marcus Carvalho , de Assis Acurcio Francisco , Alvares-Teodoro Juliana , Guerra Augusto 
Published: January 2025

IntroductionGaucher disease is characterized by a deficiency of the enzyme glucocerebrosidase and requires lifelong enzyme replacement therapy. Imiglucerase is the standard treatment, which improves patient survival and quality of life. While defined daily doses (DDD) offer a standardized metric, the relative efficacy of adhering strictly to these guidelines, compared with tailored lower doses, has not been fully explored.MethodsA retrospective cohort study was conducted on 1,234 patients to investigate the survival outcomes associated with various levels of adherence to DDDs of imiglucerase, factoring in demographic diversity and comorbidity profiles, and to evaluate the feasibility of a more personalized dosing approach in the management of Gaucher disease. DDD adherence was categorized as equal to DDD, higher than DDD, or lower than DDD. Kaplan-Meier survival analysis, log-rank tests, and Cox proportional hazards models were used to assess survival probabilities over 16 years. Data on age, sex, comorbidities, and other demographic factors were collected to adjust for potential confounders.ResultsOver the 16-year period, our Kaplan-Meier survival analysis revealed distinct survival probabilities across the three groups based on their adherence to DDD of imiglucerase. Patients who received doses lower than DDD (n=880) had a survival probability of 91.8 percent. In contrast, those receiving doses equal to the DDD (n=15) had a 100 percent survival probability, since no events were observed in this group. The greater than DDD group (n=339) exhibited a survival probability of 81 percent. A log-rank test indicated a borderline statistical significance (p=0.058) in the survival distributions among the various DDD adherence levels, with a favorable trend in the lower dose group.ConclusionsOur research indicates that lower than usual doses of imiglucerase may improve survival rates in patients with Gaucher disease. This finding suggests that reduced dosages could lead to better clinical outcomes with fewer side effects, highlighting the potential benefits of personalized dosing strategies. Further studies are needed to confirm these preliminary results and optimize dosing protocols.
PD75 Using The Quality-Adjusted Life-Year For Economic Evaluations Of Public Health Interventions: Benefits And Criticisms
Authors: Atika Nur 
Published: January 2025

IntroductionThe number of economic evaluations of public health intervention is gradually increasing, which corresponds to the increasing interest of policymakers in public health interventions. However, there are some methodological challenges and debates regarding economic evaluations of public health interventions due to the nature and complexity of public health programs. One of the challenges is related to the outcome measure used.MethodsThis narrative review explored the advantages and disadvantages of using the quality-adjusted life-year (QALY) as an outcome measure in economic evaluations of public health interventions.ResultsThe QALY is a preferred outcome measure in cost-utility analyses because of its simplicity, clarity, face validity, and ease of application. The QALY provides a measure of overall health and allows for comparability across different cases. However, there are some criticisms of using the QALY in economic evaluations of public health interventions. Many public health programs aim to affect not only health outcomes, but also other aspects such as participation and empowerment. In addition, public health programs might have positive externalities. The QALY is unable to detect minor changes resulting from community-based health interventions and does not capture equity aspects of public health interventions.ConclusionsIt is necessary to establish a common framework for a transparent and consistent decision-making process that accounts for the multidimensional and complex outcomes of public health interventions.
PD101 Evaluating The Budget Impact Of Introducing RefluxStop™ As A Novel Treatment Option For Gastroesophageal Reflux Disease In Italy
Authors: Harper Sam , Kartha Muralikrishnan , Mealing Stuart , Pavanello Maurizio , Bonavina Luigi 
Published: January 2025

IntroductionIn Italy, the first-line treatment for gastroesophageal reflux disease (GERD) is proton pump inhibitors (PPIs). Other options considered after PPI failure include Nissen fundoplication and magnetic sphincter augmentation. RefluxStop is a novel device for treating GERD. The aim of this study was to evaluate the budget impact of introducing RefluxStop into the Italian National Health Service (SSN).MethodsThe analysis, which used a five-year time horizon, one-year cycle length, and Italian payer perspective, was developed in line with ISPOR recommendations. Estimates for the Italian population and growth projections, GERD prevalence and incidence rates, and rates of anti-reflux surgery were obtained from relevant literature sources. The current market share of those requiring surgery was based on market research by Implantica (Zug, Switzerland). The cost of treatment was based on an adaptation of an economic model from the UK applied to the Italian setting. Unit costs were derived from available literature and diagnosis-related groups averaged across five Italian regions. Extensive sensitivity analyses involving key model inputs were also conducted.ResultsThe overall one-year, three-year, and five-year financial impacts of introducing RefluxStop were EUR 242,641, EUR 710,651, and EUR 1,004,946 per year, respectively, corresponding to 0.063 percent, 0.197 percent, and 0.316 percent annual increases in overall Italian SSN expenditure for GERD. Use of more optimistic and pessimistic market uptake and surgery rates (i.e., doubled and halved) for RefluxStop led to one-year increases in Italian SSN expenditure of 0.126 percent and 0.032 percent and five-year increases of 0.636 percent and 0.155 percent, respectively. In our study, introducing RefluxStop avoided 95 surgical failures, 11 reoperations, and 64 endoscopic esophageal dilatations over five years.ConclusionsThe introduction of RefluxStop is likely to provide substantial benefits for patients with GERD at the cost of a marginal budget impact on the Italian healthcare system. Though Italian health care is organized at a regional level, this study is an example of a health technology assessment using budget impact analysis at a national level.
PD104 Percutaneous Ethanol Injection In Thyroid Nodular Pathology And Metastatic Cervical Adenopathies: A Systematic Review, Meta-Analysis, And Economic Evaluation
Authors: León-salas Beatriz , Hernández-Yumar Aránzazu , Infante-Ventura Diego , De Armas-Castellano Aythami , González-Hernández Yadira , Linertová Renata , Téllez-Santana Teresa , de Pablos-Velasco Pedro , Trujillo-Martín Mar 
Published: January 2025

IntroductionPercutaneous ethanol injection (PEI) is a valuable treatment for several health conditions. However, its beneficial and harmful effects in patients with thyroid nodular pathology and metastatic cervical adenopathies have not been assessed in a systematic review.MethodsA systematic review of available scientific literature on the safety, effectiveness, and cost effectiveness of PEI in thyroid nodular pathology and metastatic cervical adenopathies was performed according to Cochrane Collaboration methods and reported in accordance with the PRISMA statement. A cost-minimization analysis was carried out using a decision tree model. Assuming equal effectiveness between two minimally invasive techniques (PEI and radiofrequency ablation [RFA]), the model compared the costs of the alternatives with a horizon of six months from the perspective of the Spanish National Health System.ResultsThree randomized controlled trials (n=157) evaluating PEI and RFA in patients diagnosed with benign thyroid nodules, 96 with predominantly cystic nodules and 61 with solid nodules, were identified. No evidence was found on other techniques or thyroid nodular pathology. No statistically significant differences were observed between PEI and RFA in proportion of volume reduction, symptom score, cosmetic score, therapeutic success, or major complications. No economic evaluations were identified. The cost-minimization analysis estimated the cost per patient of the PEI procedure to be EUR326, compared with EUR4,781 for RFA, with an incremental difference of −EUR4,455.ConclusionsThere are no differences between PEI and RFA in terms of safety and effectiveness, but the economic evaluation determined that the former option is cheaper.
PD111 A Health Technology Management Approach To Dupilumab Reimbursement In Ireland – Data From Year One
Authors: Barrett Rosealeen , Gorry Claire , Smith Amelia , Barry Michael , McCullagh Laura 
Published: January 2025

IntroductionFollowing a health technology assessment, the Health Service Executive (HSE) supported reimbursement of dupilumab subject to a managed access protocol (MAP) being implemented. Reimbursement is restricted to a subgroup of the fully licensed indication, that is, moderate-to-severe refractory atopic dermatitis (AD) in adults and adolescents 12 years and older. This study provides an overview of the first year of the MAP.MethodsAll reimbursement applications submitted to the HSE Medicines Management Programme between 1 April 2021 and 31 March 2022 were reviewed. Key demographic and clinical characteristics of the approved population were analyzed. Reimbursement claims data within the specified period were extracted from the HSE Primary Care Reimbursement Services national pharmacy claims database. All data were compiled and analyzed using SPSS Statistics 27. Expenditure estimates were based on wholesale prices and were exclusive of value-added tax, fees, and confidential rebates.ResultsDuring the study period, 382 applications were submitted, 96 percent (n=365) of which were approved. Among approved patients, the mean age was 35 years (range 12 to 79 years), the mean number of years between AD diagnosis and approval was 22.65 years (range 1 to 78 years), and 65 percent (n=238) were men. The mean Eczema Area and Severity Index score was 28.72 and the mean (Children’s) Dermatology Life Quality Index score was 19.72. Approved patients who had unsuccessfully tried other systemic immunosuppressants had trialed up to five different medicines (mean=1.6). Year one expenditure was EUR2.4million, with 70 percent of approved patients accessing treatment.ConclusionsMost applications submitted through the MAP were approved. These patients met the predefined evidence-based eligibility criteria for treatment. Patient numbers were higher than estimated, suggesting that the MAP did not hinder access. Utilizing health technology management by way of a MAP has facilitated access to expensive medicines for patients with the greatest need, while controlling expenditure for the payer.