bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD64 Modeling Clinical And Economic Impact Of Integral, Transversal, And Multidisciplinary Management Of Aortic Stenosis In A Catalan Hospital
Authors: Fernandez-Barcelo Carla , Hagemeijer Bàrbara Vidal , Abbas Ismail , Trilla Marc , Carreño Marta Sitges , Sampietro-Colom Laura 
Published: January 2025

IntroductionA program for integral, transversal, and multidisciplinary management of aortic stenosis (MITMEVA) is being implemented at the Clinic Barcelona University Hospital (CBUH) to provide adequate treatment for patients with aortic stenosis (AS). Eleven actions at different care points were implemented (e.g., awareness raising for the general population, a single entry path for patient referral, prehabilitation and rehabilitation, and a risk-sharing agreement). Preliminary results are presented.MethodsA before-and-after implementation study was conducted with 131 patients under MITMEVA and 131 matched (for treatment, New York Heart Association classification, sex, age, and referral place) historical controls. Data were collected on resources used and quality of life and to calculate several key performance indicators (KPIs) (e.g., knowledge improvement in citizens, time from diagnosis to treatment, and patient involvement and satisfaction) for each implemented action. A descriptive analysis of KPIs and a Markov model were performed to simulate clinical and economic outcomes for patient health states over time after the first year until the tenth year after intervention.ResultsThe MITMEVA program increased quality-adjusted life-years by 1.78 (p=0.011) and reduced time from referral to first hospital visit by 24.7 percent (p=0.05), hospital complications by 19.7 percent (p=0.05), mean conventional ward stay from 12.8 to 8 days (p=0.01), and mean intensive care unit stay from 9.75 to 4.25 days, although the latter difference was not statistically significant (p=0.139). The mean cost per patient was reduced from EUR7,573.27 per patient to EUR6,024.61 per patient (p=0.01). The MITMEVA program was a dominant strategy. There was a 46 percent increase in correct AS symptom identification after delivering training on AS to the general population.ConclusionsIntegrated care approaches can potentially improve patient continuum of care if the strategies are deployed in a multidisciplinary and transversal way across healthcare actors. The MITMEVA program significantly improved clinical and economic outcomes and organization of care, benefiting patients and clinicians. Applying health technology assessment methods to such innovative projects can help prove the value of organizational innovations.
PD70 A Mapping Study Of EORTC-QLQ-C30 To EQ-5D-5L Among Korean Patients With Non-Small Cell Lung Cancer
Authors: Lee Hyorim , Ahn Jeonghoon , Seo Hyerin , Jin Doyeon 
Published: January 2025

IntroductionThis study aimed to develop an algorithm to map the clinically popular European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) to the prevailing health technology assessment outcome measure, the EuroQol 5D-5L questionnaire (EQ-5D-5L), to investigate the quality of life in patients with non-small cell lung cancer (NSCLC).MethodsMapping models were estimated using EQ-5D-5L, the EQ visual analogue scale (EQ-VAS), and the QLQ-C30 results from patients with NSCLC. This study used data at baseline from all three quality of life scores (n=289) to estimate the mapping algorithm. Linear regression was conducted on each domain of the QLQ-C30 as follows: physical functioning, global health status, emotional function, diarrhea, financial difficulties, insomnia, fatigue, and pain. Quality of life data collected at six (n=176) and 12 weeks (n=60) were used to evaluate the validity of the estimated mapping algorithm. The EQ-VAS was used to compare correlations with the algorithm.ResultsThe estimated algorithm had a root mean squared error of 0.0937 and an adjusted R-squared of 0.7227. The correlations between the estimated and the observed EQ-5D-5L values at baseline, six weeks, and 12 weeks were 0.8546, 0.8493, and 0.8846, respectively. The estimated and observed values had a high correlation. Also, the bias between the predicted and the observed EQ-5D-5L values at six and 12 weeks was 0.0113 and 0.0292, respectively. Hence, the mapping algorithm had a good predictive validity.ConclusionsThe mapping algorithm can be used to convert a cancer-specific health-related quality of life measure to a preference-based health-related utility measure, which is useful in health technology assessment. Mapping EORTC-QLQ-C30 onto the EQ-5D-5L enables the estimated EQ-5D-5L scores of patients with cancer to be used in economic evaluations such as cost-utility analyses.
PD83 Medication Preferences Of Rural Patients With Chronic Disease: A Discrete Choice Experiment In An Eastern Province Of China
Authors: Li Xiaona , Gao Min , Shao Jiaxian , Yu Yuncong , Yin Wenqiang , Chen Zhongming 
Published: January 2025

IntroductionWith the aging population, chronic diseases have become a serious threat to public health in China. Adhering to the doctor’s advice is an effective strategy for controlling chronic diseases, and the preferences of patients with chronic disease has an important impact on compliance with medication. However, there is insufficient research exploring this aspect.MethodsIn this study patients with chronic disease were selected by stratified random sampling to participate in a survey carried out in three cities of a province in eastern China. The discrete choice experiment used a questionnaire of D-efficiency experimental design to measure the medication choices of patients with chronic disease. The main attributes included drug price, onset of action, adverse reactions, traditional Chinese or Western medicine, domestic drug, and reimbursed by medical insurance. The data were analyzed using a mixed logit model.ResultsA total of 1,062 valid questionnaires were received. The 1,045 questionnaires that passed the consistency test covered three prefecture-level cities, nine counties, and 216 villages. All drug attributes were statistically significant for selection preferences. The preference of patients in rural areas with chronic disease was “quick onset of action” (β=2.491), “Western medicine” (β=0. 826), “medical insurance” (β=0.556), “domestic drugs” (β=0.286), and “very few adverse reactions” (β=0.170). “Drug price” also had an impact on medication preferences among patients in rural areas with chronic disease (β=−0.013).ConclusionsOnset of action is the attribute of medications that is of most concern for patients in rural areas with chronic disease. Subgroup analysis showed that these patients were predominantly female, had a primary school education or lower, were younger than 69 years, were unemployed, and had an annual income between CNY10,000 (USD1,396.78) and CNY50,000 (USD6,983.92). They were willing to pay more for drugs with a quick onset of action, Western medicines, and drugs with reimbursed by medical insurance.
PD85 Are Current Payment Models For Integrated Care Promoting The Uptake of Medical Device Innovations?
Authors: Granados Paula Closa , Soto Marcelo , Abbas Ismail , Alonso Albert , Sampietro-Colom Laura 
Published: January 2025

IntroductionIntegrated care (IC) is a patient-centered approach to the provision of health care that overcomes the fragmentation in the delivery of services that often occurs in older people with multiple comorbidities. Medical device innovations could help tackle this and other challenges of health systems when facing the adoption of high quality IC. Nevertheless, this should be accompanied by the right innovation funding scheme to encourage adoption.MethodsA systematic search strategy to identify payment models for IC was performed in PubMed for the period from 2014 to 2023 using the International Foundation for Integrated Care Knowledge Tree tool. This was complemented with both a gray literature search in Google and a benchmark of payment models for innovative medicines. A scoping review was then performed identifying the following information: payment scheme; advantages and disadvantages for IC; inclusion of innovation; type of IC program or initiative described (sectors and providers); population (therapeutic area); country; and whether the information was conceptual or empirical.ResultsAccording to the literature reviewed, five payment schemes used in IC were identified. However, they were rarely used in isolation; more often a mix of payment schemes was used. Based on conceptual and empirical articles, the combination of bundled payment, shared savings, and pay for performance (based on the quality of care delivered) seemed to be the most comprehensive payment scheme. However, references to inclusion of innovation were not mentioned even in this mixed system. Payment systems for innovative medicines were benchmarked for medical devices.ConclusionsA mixed system of bundled payment, shared savings, and pay for performance appears to be the most complete payment model for IC, since it counteracts the limitations of individual funding schemes. No evidence was found on how to incentivize medical device innovation in the context of IC delivery. However, inspiration from current payment schemes for innovative medicines can provide a starting point for innovative medical device schemes.
PD90 Use Of Medicinal Herbs In Natura By Pregnant Women In The Amazon Region
Authors: da Silva Moura Souza Celsa , Camargo Erika Barbosa , Riera Rachel , Lima Regismeire Viana , de Oliveira Andrade Edson , Betrán Betrán Ana Pilar , Torloni Maria Regina 
Published: January 2025

IntroductionThere are few studies on the use medicinal herbs by pregnant women in Brazil, even though there is a wealth of knowledge about medicinal herbs among Brazilians of Indigenous, African, and European ancestry. The aim of this study was to assess the prevalence and type of herbs used by pregnant women living in the Amazon region.MethodsThis was a cross-sectional study conducted with 811 pregnant women attending 10 public antenatal clinics in Manaus, Amazonas state, Brazil. The consumption of medicinal herbs was assessed through individual 24-hour dietary recall.ResultsA total of 811 women in their second trimester (16 to 20 weeks) of pregnancy were included and 69 (8.5%) reported that they used herbs to make teas. There was a significant difference between users and non-users of medicinal teas, with a higher proportion of overweight women in the group that used teas (46.4% versus 31.9%; p=0.005). Nearly half (47.8%) of those who used medicinal teas consumed herbs with sedative effects, 23 percent consumed herbs for the relief of urinary tract symptoms, and 13 percent used herbs with digestive properties. Most women reported using natural herbs from their own gardens.Conclusions
Approximately 10 percent of Brazilian women in the Amazon region consumed medicinal herbs to alleviate common symptoms of pregnancy. The most frequently used plants had sedative, urinary tract, or gastrointestinal effects. Most plants were obtained in natura from local gardens. Many of these plants have known adverse effects and their use is contraindicated during pregnancy.
PD93 Uncertainty Metric To Guide PICOS Assessment And Evidence Synthesis Planning For Joint Clinical Assessment Submission
Authors: van Schoubroeck Hannah Marjolein , Kroep Sonja , Arca Emanuele , Fenwick Elisabeth 
Published: January 2025

IntroductionWith the European Union Regulation on health technology assessment (HTA) approaching, there is concern about how to accommodate the large number of expected population, intervention, comparator, outcome(s), and study type (PICOS) questions and their uncertainty. Navigating uncertainty will prove essential to anticipate evidence requirements. This abstract presents preliminary results of the development of a metric that assesses uncertainty surrounding PICOS questions to eventually guide planning of evidence synthesis for joint clinical assessment (JCA) submission.MethodsThe metric will consist of pillars representing overarching themes of uncertainty. Each pillar will contain several elements influencing uncertainty for proposed PICOS questions. This study was conducted in two phases. In phase one, targeted literature searches of peer-reviewed and gray literature were conducted to identify the overarching metric pillars. These pillars were then validated by expert opinion. Similar research methods were used in phase two to inform the content of each of the pillars. Here we present the findings for phase one.ResultsThe targeted literature review in phase one resulted in multiple candidate elements for the uncertainty pillars. Elements were selected based on expert opinion, resulting in five main pillars. These pillars were considered most valuable for the determination of uncertainty surrounding individual PICOS questions and were considered crucial to HTA acceptance. Phase one resulted in the following pillars: (i) indication and subpopulations; (ii) type of intervention and comparators; (iii) societal and patient unmet need; (iv) type and quality of evidence source informing evidence synthesis; and (v) methodology of evidence synthesis.ConclusionsThis study lays the foundation for a metric to assess the uncertainty surrounding proposed PICOS questions for JCAs. The metric identifies existing uncertainties for PICOS questions, assesses potential issues for HTA acceptance, and guides possible evidence synthesis planning. A clear framework for anticipating uncertainty will prove essential in managing resources and expectations.
PD102 Evaluating The Clinical Effectiveness Of Portable Ultrasonic Scalpels For Urological Surgery
Authors: Yan Juntao , Yang Yi , Tao Ying , Chen Yingyao 
Published: January 2025

IntroductionUltrasonic scalpels are widely used in urological surgery. Although portable ultrasonic scalpels are convenient to use and install, the existing evidence on their safety and effectiveness is scarce. This study aimed to compare the safety and effectiveness of portable ultrasonic scalpels in urological surgery with traditional ultrasonic scalpels to aid clinical decision-making.MethodsA multicenter, prospective, non-randomized controlled trial was conducted from February to August 2023 in three tertiary hospitals in China. The intervention group included 90 prospectively enrolled patients undergoing urological surgery during the same period of hospitalization: 45 with portable ultrasonic scalpels and 45 with traditional scalpels. Demographic and clinical data of patients in the study were collected. Data on quality of life were obtained using the EuroQol EQ-5D-5L scale preoperatively, at discharge, and one month and three months after surgery. Descriptive analysis and a generalized linear model were used in the data analysis.ResultsA total of 82 patients were included in the study: 39 in the intervention group and 43 in the control group. The average hospital stay and intraoperative and postoperative blood loss in the intervention group were lower than in the control group (p>0.05). From baseline to discharge, the decrease in quality-adjusted life-years (QALYs) in the intervention group was smaller (–0.134 versus –0.287; p<0.05) than in the control group. During the follow-up period, there were no significant differences in the changes in QALYs between the two groups. The decline in QALYs was significantly influenced by variables such as intraoperative blood loss and surgical site.ConclusionsThere were no significant differences in baseline characteristics or changes in QALYs between the intervention and control groups. Portable ultrasonic scalpels in urological surgery may be as equally effective as traditional scalpels with respect to clinical outcomes, with additional benefits in reducing QALY decline at discharge. Further research with large samples and long-term follow-up should be conducted.
PD110 Ward Round Woes: Accuracy Of Ward Round Documentation
Authors: Treloar Ellie , Ting Ying Y. , Bruening Martin , Reid Jessica , Edwards Suzanne , Bradshaw Emma L. , Ey Jesse D. , Wichmann Matthias , Herath Matheesha , Maddern Guy J. 
Published: January 2025

IntroductionWard round quality is a pivotal component of surgical care and is intimately associated with patient outcomes. Despite this, ward rounds remain largely understudied and underrepresented in medical literature. Accurate and thorough ward round documentation is known to improve communication and patient outcomes and to reduce hospital expenditure. This study aimed to determine the accuracy of ward round documentation.MethodsA prospective observational cohort study was performed as a sub-analysis of a larger study by reviewing 135 audiovisual recordings of surgical ward rounds over two years at two hospitals. The recordings were transcribed verbatim, and content was designated a level of importance by an external reviewer. This was then compared to the written case notes to determine the accuracy and importance of omitted documentation. Patient age, sex, and length of stay, as well as the senior doctor leading and the intern documenting the ward round, were assessed using multivariable linear mixed-effect models to determine their impact on documentation accuracy.ResultsNearly one-third (32.4%) of spoken information on the surgical ward round that was deemed “important”, including discharge plans and bookings for surgery, was absent from the patients’ electronic medical records. Additionally, in 11 percent of case notes there was a major conflict between the ward round discussion and what was documented. Younger patients (p=0.04) and patients who had been on the ward longer (p=0.005) were less likely to have accurate documentation. Some interns were significantly worse at documenting discussions than were others (p<0.0001). Day of the week, location, and the senior doctor present did not affect documentation accuracy.ConclusionsThis study demonstrates that a significant amount of important discussion during surgical ward rounds regarding patient care is not recorded accurately, or at all, in the patient medical record. This can lead to preventable patient complications and longer hospital stays, resulting in increased strain on hospital resources. This study emphasizes the need for further research to address this problem.
PD115 Digital Health Solutions: Health Technology Assessment Of Digital Platforms For Personalized Management, Education, And Support For People With Diabetes
Authors: Bowles Charlotte , Prettyjohns Matthew , Bromham Nathan , Evans Alice , Washington Jenni , Shepherd Rebecca 
Published: January 2025

IntroductionApproximately five million people live with diabetes in the UK. The cost of this is approximately 10 percent of the National Health Service (NHS) budget. Wales has the highest prevalence of diabetes of any country in the UK. Educating people on how to best manage their condition can minimize associated complications. Digital platforms can aid self-management and improve risk factors.MethodsThis rapid review aimed to address the following research question: What is the clinical and cost effectiveness of digital platforms for personalized diabetes management to inform decision-making and guidance in the NHS? Digital platforms for this rapid review can be driven using artificial intelligence, machine learning, or through the application of data rules. Clinical evidence published since 2008 on health economics and patient, carer, and family perspectives relevant to Wales was identified by searching relevant databases such as MEDLINE. One relevant economic analysis was conducted using the UK Prospective Diabetes Study Outcomes Model 2.ResultsOutcomes included improvements in glycemic control, healthcare resource use (e.g., number of total general practitioner and emergency department visits per year), reduction in body weight among participants, reduction in cholesterol levels, and positive patient-reported outcome measures. An economic analysis identified in the literature review found that a digital platform was more effective and less costly than routine diabetes care and was, therefore, dominant. The analysis was based on observed reductions in glycosylated hemoglobin levels from a database of people with diabetes in NHS Scotland.ConclusionsThe evidence suggests there are benefits in using digital platforms to aid self-management among people with diabetes. Studies reporting on glycosylated hemoglobin levels found statistically significant and clinically important benefits from using digital platforms. Digital platforms also have the potential to be more effective and less costly than routine diabetes care in Wales and the UK.
PD125 Safety, Efficacy, And Effectiveness Of Robotic Surgery In General And Digestive Surgery
Authors: Ruiz-Baena Jessica , Segur-Ferrer Joan , Masdeu Laia Ramos , Sabadell Maria-Dolors Estrada , Vivanco-Hidalgo Rosa Maria 
Published: January 2025

IntroductionRobotic surgery (RS) is a minimally invasive surgical modality performed with the support of a console and mechanical arms that enable remote control. The advantages of RS are clear from the point of view of surgeons but remain unclear in terms of clinical results. We evaluated the safety, efficacy, and clinical effectiveness of RS compared with open or laparoscopic surgery.MethodsA systematic review of randomized controlled trials and systematic reviews with meta-analyses was conducted to assess RS in the following surgical procedures: Nissen fundoplication, Heller myotomy, cholecystectomy, rectopexy, splenectomy, pediatric Kasai portoenterostomy, and gastric banding. Outcomes of interest were related to safety (complications, blood loss, and risk of infection) and efficacy or effectiveness (length of hospital stay, quality of life [QoL], recovery, patient satisfaction, conversion to another technique, urinary function, and rates of mortality, readmission, reoperation, and esophageal perforation). The evidence quality was assessed with version two of the Cochrane risk-of-bias tool for randomized trials, AMSTAR 2, and GRADE.ResultsNissen fundoplication RS was similar to laparoscopy in terms of complication and conversion rates, recovery, and QoL. Heller myotomy RS reduced the rate of esophageal perforations but had similar perioperative blood loss and rates of mortality, conversion, and re-admission to laparoscopy. Cholecystectomy RS was similar to laparoscopy with respect to rates of readmission and complications, blood loss, and risk of infection. Rectopexy RS was similar to laparoscopy in terms of conversion, reoperation, and complications rates, blood loss, recovery, patient satisfaction, and QoL. Splenectomy RS decreased blood loss but was similar in risk of infection and rates of complications and conversion to laparoscopy. There were no studies that used open surgery as a comparator or evaluated RS in pediatric Kasai portoenterostomy or gastric banding.ConclusionsCurrent evidence on the safety, efficacy, and clinical effectiveness of RS in general or digestive surgical procedures is limited. Multicenter studies with follow-up beyond the immediate postoperative period are needed to evaluate patient outcomes.