bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD05 Novel Non-Thermal Ablation Technology For The Treatment Of Atrial Fibrillation
Authors: Hijas-Gómez Ana Isabel , Luengo-Matos Setefilla , Rodriguez-Ortiz-de-Salazar Begoña , Arias-Pacheco Amparo , Sánchez-Gómez Luis Maria , del Mar Polo-de-Santos Maria 
Published: December 2022

IntroductionPulsed-field ablation (PFA) is a new non-thermal ablative approach for treating paroxysmal and persistent atrial fibrillation (AF). It provides an alternative to the conventional thermal techniques of radiofrequency ablation and cryoablation. PFA is currently performed with the Farapulse PFA system (Boston Scientific, USA), which recently received CE marking in Europe. In this study, we describe the current evidence on the efficacy, safety, and cost-effectiveness of this new technology.MethodsThe Early Awareness and Alert System of the Agencia de Evaluación de Tecnologías Sanitarias-at the Instituto de Salud Carlos III- identified this new ablation approach in June 2021. An early technology assessment was conducted by reviewing relevant literature published to November 2021. The literature was identified by searching PubMed, Embase, the International Clinical Trials Registry Platform, ClinicalTrials.gov, and the Cochrane Library.ResultsSeven relevant publications were identified, including three open-label trials for paroxysmal AF and one for persistent AF. Three studies comparing PFA with conventional thermal ablation techniques were also included. The safety results showed a lower incidence of complications (esophageal injury, pulmonary venous stenosis, pericardial effusion, and aortic injury) after PFA relative to conventional techniques. In terms of efficacy, PFA resulted in lower rates of AF recurrence in the medium and long term, compared with conventional techniques, and there were no differences in the lengths or success rates of the procedures. No cost-effectiveness studies were identified. Seven ongoing trials were identified, but no results have been published.ConclusionsThe current evidence for PFA in the treatment of AF showed good safety and promising efficacy. However, there is a lack of information on its effect on quality of life and the risk of death, disabling stroke, or cardiac arrest. Early evaluation of new and emerging technologies makes it possible to gather the minimum information necessary to support decisions on their inclusion in the healthcare system. In this case, based on current evidence, the widespread use of PFA is not recommended, except under a rigorous research protocol.
PD08 A Systematic Review Of Reporting Quality Of Economic Evaluations In TCM In NRDL Of China Based On CHEERS
Authors: Yan Juntao , Bao Shiyi , Liu Liu , Wei Yan , Ming Jian , Chen Yingyao 
Published: December 2022

IntroductionTraditional Chinese Medicine (TCM) has become a common kind of health care in several countries, with increasing demands. This review aimed to appraise the reporting quality of economic evaluations of TCM in the National Reimbursement Drug List (NRDL) of China (2020 version), based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.MethodsThe reporting quality of included economic evaluations was assessed by two independent reviewers using the CHEERS statement.ResultsA total of 360 articles were retrieved, but only 38 economic evaluations met the inclusion criteria. No articles were compliant with all items of the CHEERS checklist. On average, the included economic evaluations satisfactorily met 10.93 of the CHEERS items (51.31%). The least reported CHEERS checklist items included: “Characterizing heterogeneity”, “Conflicts of interest”, “Discount rate”, and “Study perspective”, with an average score of 0.00, 0.05, 0.08, and 0.16, respectively.ConclusionsThe economic evaluation of TCM is still at an early stage, with an urgent need for improving the reporting quality. To promote the reporting quality of economic evaluations and further development of TCM, multiple measures focusing on reporting formula, policy, training, and new methodology are required.
PD22 Exploratory Analysis of a Brazilian Real-World Open Database Applied to Prostate Cancer
Authors: Monteiro Lucilena Rebelo , Oliveira Mércia Liane , Menezes Mario Olímpio , Pozzo Lorena 
Published: December 2022

IntroductionProstate cancer was the second most frequent cancer and the fifth leading cause of cancer death among men in 2020. The incidence rates vary substantially in countries with different Human Development Indexes (HDI), while the mortality rates decrease with improved access to the health system, availability of therapies and earlier detection. Worldwide, population-based cancer registries are important tools for planning and managing health systems. The Fundação Oncocentro de São Paulo (FOSP) is responsible to collect, clean and publicize data from cancer treatment institutions. This study aimed to describe retrospectively the demographic and clinical profile of prostate cancer (PC) in Brazil using this database. It is not an incidence study as data is representative only from specific institutions.MethodsThis was a retrospective observational study of the years 2000 to 2020 from analysis of the publicly available FOSP database (http://www.fosp.saude.sp.gov.br).The records were extracted, merged, and cleaned using a fully documented and validated data process. Only patients included on the register with a primary PC diagnosis were considered.ResultsFrom January 2010 to June 2020, there were 943,660 patients diagnosed with C61 in FOSP database for the considered time period. The majority of the FOSP database records are from patients who live and/or were born in SP (91.8 and 58.4%, respectively) or MG (2.8 and 10.5%, respectively). The mean age of PC at baseline was 69 years. Considering the stage of the disease, the mean ages are 55, 70, 67, 66 and 61, for stages 0, 1, 2, 3 and 4, respectively. This cohort was also analyzed in relation to treatments received, and status at the end of treatment (51.3% are disease-free, 18.4% are alive with cancer, and 30.3% are dead).ConclusionsFOSP population-based cancer registries are a powerful tool to obtain information for planning, and improving the management of healthcare services especially for São Paulo.
PD25 Use Of Real-World Evidence In The Reimbursement Assessment Of Medical Devices
Authors: Crompton Amy , Macmillan Tom , Ferris Jen , Munro Isobel 
Published: December 2022

IntroductionRandomized controlled trials (RCTs) are typically considered the gold standard source of clinical evidence for reimbursement submissions, but they can often be resource-intensive, expensive, and may not always be appropriate. For example, it may be unethical to assign patients to an untreated or undiagnosed control group, or blinding may not be feasible when assessing medical devices. Evidence for medical devices is therefore often limited to nonrandomized studies. We explored the use and value of real-world evidence (RWE) in the reimbursement of medical devices across several health technology assessment (HTA) agencies.MethodsA narrative review was completed to compare the acceptability of RWE for the HTA evaluation of medical devices across a convenience sample of countries. English-language published guidance documents were reviewed, and study design preferences extracted.ResultsIn Australia, France, Germany, Ireland, Norway, and Scotland, HTA agencies prefer RCT evidence but accept RWE as supporting data. In England, there is no preferred study design, with directly observed clinical outcomes, evidence syntheses, nonclinical, and modelling studies accepted. Notably, methods and processes for HTA programs are being reviewed and are expected to place a greater emphasis on RWE. In Australia, pseudo-randomized trials, comparative cohort studies, case series, and other study designs are permitted. In France, nonrandomized or nonblinded trials, patient preference cohorts, prospective comparative observational studies, and propensity score matched cohorts are permitted, accompanied by justification. In Scotland, lived experiences, RWE, and systematic reviews are accepted. In Germany, nonrandomized studies are deemed to provide “minimum”, “very low” or “low” certainty of results. In Norway, RWE may be accepted if no RCT data are available, or to support RCTs.ConclusionsIn the assessment of medical devices, where RCTs are unsuitable, RWE can form a feasible alternative. Real-world evidence is increasingly being recognized as a valuable source of evidence for medical interventions and is accepted by a number of HTA agencies. No funding was received for this study.
PD26 Overscreening For Older Women In Cervical And Breast Cancer Screening In Japan
Authors: Hamashima Chisato 
Published: December 2022

IntroductionAppropriate resource utilization is crucial for cancer screening programs. Overscreening is defined as screening provided beyond the upper age limit of the target age or at a shorter interval than recommended in national programs. In Japan, there are no upper age limits set for cancer screening programs, and the recommended screening interval for cervical and breast cancer screening is 2 years. To examine the efficient use of resources for cervical and breast cancer screening, we investigated how often overscreening occurred in both programs.MethodsThe target age for this study was defined as 20-69 years for cervical cancer screening and 40-69 years for breast cancer screening. We used the national report for cancer screening in 2017 in Japan and estimated the number of participants over 70 years old or those who participated in screening annually. The percentage of overscreening was compared between cervical cancer and breast cancer screening by chi-square test.ResultsThe number of participants was 4,294,127 for cervical cancer screening and 3,087,781 for breast cancer screening in 2017. The percentage of overscreening in total participants was 38.0 percent for cervical cancer screening and 35.7 percent for breast cancer screening (p<0.01). The percentage of screening at overage was higher in breast cancer screening than in cervical cancer screening (21.1% vs. 13.9%, p<0.01), whereas more frequent screening was seen more often in cervical cancer screening than in breast cancer screening (29.7% vs. 19.6%, p<0.01). If the resources used in overscreening could be used for the target population, it was estimated that the participation rate could increase by 4.1% for cervical cancer screening and 4.3% for breast cancer screening.ConclusionsIn Japan, screening for overage participants and short intervals may have contributed to unnecessary screening for cervical cancer and breast cancer. These resources used for overscreening could be allocated to screening for the target population.
PD28 Cost-Effectiveness Of Selective Internal Radiation Therapy Using Y-90 Resin Microspheres For Unresectable Hepatocellular Carcinoma In Brazil
Authors: Agirrezabal Ion , Brennan Victoria , Carion Phuong Lien , Shergill Suki 
Published: December 2022

IntroductionHepatocellular cancer (HCC) is a severe condition with poor prognosis and a significant burden. Selective internal radiation therapy (SIRT) is recommended as an alternative treatment option to overcome some limitations of current treatments. This analysis estimated the cost-effectiveness of SIRT using Y-90 resin microspheres for the treatment of unresectable HCC in Brazil.MethodsThis study was conducted from the Brazilian payer perspective according to local guidelines, with a lifetime horizon. The use of SIRT in patients with intermediate- or advanced-stage HCC, without extrahepatic disease and ineligible to transarterial chemoembolization, was compared with sorafenib, the commonly used HCC systemic treatment in Brazil. A sensitivity analysis included the subgroup of patients with low tumour burden and preserved liver function.A partitioned-survival model was developed, which included a tunnel state for patients downstaged to receive a treatment with a curative intent such as liver surgery, transplantation or ablation. Survival curves, utilities and adverse events incidence were extracted from published sources of pivotal randomized control trials. Effectiveness of health interventions was measured in quality-adjusted-life-years (QALYs) and life-years (LYs). Local costs from Brazil were applied. Future costs and effects were discounted at five percent. A willingness-to-pay threshold of USD 53,936 was used, based on a 2017 review of healthcare technology adoption in Brazil.ResultsLYs and QALYs were higher for SIRT using Y-90 resin microspheres versus sorafenib (0.27 and 0.20 incremental LYs and QALYs, respectively) and costs were slightly higher for SIRT (USD 3,056 incremental costs). The incremental cost-effectiveness ratio (ICER) was USD 14,948 per QALY in the basecase.One-way and probabilistic sensitivity analyses confirmed the robustness of the analyses. Scenario analyses tested different model assumptions and reinforced the basecase results indicating that SIRT using Y-90 resin microspheres was highly likely to be cost-effective compared with sorafenib. Also, the ICER was lower in the subgroup compared with the overall population.ConclusionsSIRT using Y-90 resin microspheres represents a cost-effective option compared with sorafenib in Brazil.
PD33 Development And Validation Of A Machine Learning-Based Prediction Model For COVID-19 Diagnosis Using Patients’ Metabolomic Profile Data
Authors: Cobre Alexandre , Surek Monica , Stremel Dile , Domingues Karime , Tonin Fernanda Stumpf , Pontarolo Roberto 
Published: December 2022

IntroductionWe aimed to develop and validate machine learning (ML) -based algorithms to predict COVID-19 diagnosis as well as to identify new biomarkers associated with the disease.MethodsInitially, 96 blood samples of patients diagnosed with COVID-19 (Thaizhou Hospital, China) were analyzed through liquid chromatography coupled to mass spectrometry. Samples of patients presenting other pneumonias or severe acute respiratory syndrome, but with negative RT-PCR for SARS-CoV-2, were used as positive controls. Samples from healthy volunteers were used as negative controls. The final database included around 1000 metabolites. Exploratory analyses for the development of ML-based models using principal component analysis (PCA) were performed. Leverage plot versus studentized residuals method was used to detect outliers. Three supervised ML-based models were developed: discriminant analysis by partial least squares (PLS-DA), artificial neural networks discriminant analysis (ANNDA) and k-nearest neighbors (KNN). Samples for the training (70%) and testing sets (30%) were randomly selected using the Kenrad Stone algorithm. Models’ performance was evaluated considering accuracy, sensitivity and specificity. Analyses were conducted in SOLO (Eigenvector-Research).ResultsThe PCA model was able to distinguish the three classes of patients’ samples (positive for COVID-19, negative controls, positive controls) with an overall accumulated variance of 94.27 percent. The PLS-DA model presented the best performance (accuracy, sensitivity, and specificity of 93%, 98% and 88%, respectively). Increased levels of the biomarkers uridine (linked to glucose homeostasis, lipid, and amino acid metabolisms), 4-hydroxyphenylacetoylcarnitine (metabolite from the tyrosine metabolism; probably associated with anorexia) and ribothymidine (resulting from oral and fecal microbiota alterations) were significantly associated with COVID-19.ConclusionsThree different and updated ML-based algorithms were developed to predict COVID-19 diagnosis; PLS-DA led to the most accurate results. High levels of some metabolites were found as potentially predictors of the disease. These biomarkers should be further evaluated as potential therapeutic targets in well-designed clinical trials. These ML-based models can help the early diagnosis of COVID-19 and guide the development of tailored interventions.
PD46 Multi-Criteria Decision Analysis In Healthcare: Scientometric And Bibliometric Analysis
Authors: Dai Zeqi , Xu Simin , Wu Xue , Hu Ruixue , Li Huimin , He Haoqiang , Hu Jing , Liao Xing 
Published: December 2022

IntroductionMulti-criteria decision analysis (MCDA) is a useful tool in complex decision-making situations and has been used in medical fields to evaluate treatment options and drug selection. We aimed to provide valuable insights on the use of MCDA in health care through examining the research focus of existing studies, major fields, major applications, most productive authors and countries, and most common journals in the domain using a scientometric and bibliometric analysis.MethodsPublications related to MCDA in health care were identified by searching the Web of Science Core Collection on 14 July 2021. Three bibliometric software programs (VOSviewer, Bibliometrix, and CiteSpace) were used to conduct the analysis.ResultsA total of 410 publications were identified from 196 academic journals (average yearly growth rate of 32% from 1999 to 2021), with 23,637 co-cited references by 871 institutions from 70 countries or regions. The USA was the most productive country (n=80), while the Universiti Pendidikan Sultan Idris (n=16), Université de Montréal (n= 13), and Syreon Research Institute (n=12) were the most productive institutions. The biggest nodes in every cluster of author networks were Aos Alaa Zaidan, Mireille Goetghebeur, and Zoltan Kalo. The top journals in terms of number of articles (n=17) and citations (n=1,673) were Value in Health and the Journal of Medical Systems, respectively. The research hotspots mainly included the analytic hierarchy process (AHP), decision-making, health technology assessment, and healthcare waste management. In the recent literature there was more emphasis on coronavirus disease 2019 (COVID-19) and fuzzy Technique for Order Preference by Similarities to Ideal Solution (TOPSIS). Big data, telemedicine, TOPSIS, and the fuzzy AHP, which are well-developed and important themes, may be the trends in future research.ConclusionsThis study provides a holistic picture of the MCDA-related literature published in health care. MCDA has a broad application in different topic areas and would be helpful for practitioners, researchers, and decision makers working in health care when faced with complex decisions. It can be argued that the door is still open for improving the role of MCDA in health care, both in its technologies and its application.
PD54 Burden Of Disease And Risk Factors Among Children Under 5 Years In China From 1990 To 2019
Authors: Li Fuming , Xie Shiyu , Jiang Zhixin , Bao Shiyi , Ren Yanfeng , Chen Yingyao 
Published: December 2022

IntroductionAccording to the Healthy China 2030 Plan, children under 5 years is the main focus group to achieve universal health and sustainable development of China. To identify the major threats to children’s health, we analyzed and compared the burden of disease and risk factors among children under 5 years in China and other regions.MethodsIndicators were gathered from the Global Burden of Disease 2019, which included the standardized rates and risk factors of mortality and DALYs of children under 5 years in China, Western Europe, North America and the world from 1990 to 2019. Paired t-test or Wilcoxon test were used to compare the rates based on gender. A joinpoint regression model was used to analyze the trend, and the Annual Percent of Change (APC) was calculated and statistically tested.ResultsFrom 1990 to 2019, the all-cause mortality and DALYs of children under 5 years in China decreased from 1 153.81/100 000 to 160.39/100 000 and 104 426.40/100 000 to 16 479.01/100 000, respectively. The top 3 causes of both death and DALYs were neonatal preterm birth, congenital heart anomalies, lower respiratory infections. The top 3 risk factors of both death and DALYs were low birth weight, short gestation, child wasting. Unintentional injuries, behavioral and environmental risks posed greater threats to children compared with other regions. The rates of mortality and DALYs of the top 15 diseases and injuries in boys and girls showed a downward trend (p<0.05), and most of them were higher in boys than girls (p<0.05).ConclusionsThe burden of diseases among children under 5 years in China has decreased significantly from 1990 to 2019. Compared to other regions, it remains to strengthen the prevention and control of preterm birth, birth defects and unintentional injuries, and to adopt targeted gender-specific interventions. Promoting the parenting behavior and multiple social security may also affects children’s health status.
Second language anxiety in conversation and its relationship with speakers’ perceptions of the interaction and their social networks
Authors: Lindberg Rachael , McDonough Kim , Trofimovich Pavel 
Published: December 2022

AbstractSecond language (L2) researchers have long acknowledged the role of language anxiety in communication processes, such that learners with greater language anxiety tend to be less willing to engage in communication. However, little research has explored links between L2 speakers’ perceptions of conversation and dynamic measures of anxiety. Therefore, this study measured 60 L2 English speakers’ galvanic skin response (a physiological index of anxiety) during conversation. After the conversation, speakers evaluated themselves and their partner in terms of speech fluency and comprehensibility, engagement, and anxiety, and responded to trait-anxiety and social network questionnaires. Correlational analyses explored relationships between speakers’ trait-anxiety, social network characteristics, self- and peer-perceptions and five levels of physiological response during conversation. Findings revealed that high arousal during interaction was related to speakers’ negative self-perceptions of speech fluency and negative perceptions of their partner’s engagement. Implications are discussed regarding state-anxiety as triggered by partner- or task-specific experiences.
The effects of multilingual and multicultural practices on divergent thinking. Implications for plurilingual creativity paradigm
Authors: Kharkhurin Anatoliy V. , Koncha Valeriya , Charkhabi Morteza 
Published: December 2022

AbstractThis study opens a project that empirically investigates the Plurilingual Creativity paradigm. This paradigm expands the Multilingual Creative Cognition by making shifts in the conceptualization of the phenomena of multilingualism and creativity, respectively. We examined how multilingual and multicultural factors can contribute to divergent thinking. Online data collection included assessments of language repertoire, multicultural experience, intercultural competence, and divergent thinking. A series of regression analyses obtained evidence for the direct contribution of language repertoire, intercultural competence components and multicultural experience to divergent thinking. In addition, language repertoire was found to moderate the link between management of intercultural interaction and fluency, multicultural experience and both flexibility and originality in divergent thinking. These findings emphasize the importance of considering the contribution of plurilingual/pluricultural factors of language repertoire, multicultural experience, and intercultural competence to creativity. Thereby, these findings provide empirical support for the conceptual shift toward plurilingual creativity.