bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD51 Effectiveness And Safety Of Vitamin D For COVID-19: A Living Evidence Synthesis Informing A Health Technology Assessment Report
Authors: Blasco-Amaro Juan Antonio , Sabalete-Moya Trinidad , Rodríguez-López Rocío , Rojas Maria X. 
Published: January 2025

Introduction
An evidence synthesis developed to inform decision-making on the use of vitamin D for preventing and treating COVID-19 showed that current available evidence is of low to very low quality. We set up a rigorous living evidence to inform health decisions (LE-IHD) approach to provide timely updates of this health technology assessment (HTA) report and aid decision-making.MethodsFollowing the LE-IHD framework, we developed a baseline synthesis and evidence monitoring on the effects of high-dose vitamin D for the prevention and treatment of severe COVID-19 on all-cause mortality, COVID-19-related hospitalization, intensive care unit admission, length of hospital stay, quality of life, adverse events, and long COVID-19. The evidence identification, screening, and selection processes were supported by Epistemonikos technological enablers and the Living Overview of Evidence platform. We searched for ongoing studies in trial registries every three months. New eligible studies were assessed using a systematic and reproducible process to update the HTA report.ResultsFor the baseline synthesis we identified nine randomized control trials (RCTs) assessing high dose vitamin D2, vitamin D3, and their metabolites, which provided very low quality evidence on all the outcomes of interest. Up to date evidence monitoring identified seven studies reporting on all-cause mortality and intensive care unit admission, eight studies reporting on length of hospital stay, and six studies reporting on adverse events. The living evidence synthesis has been updated twice. At the time of the conference, we will report on 10 months of monitoring results and any substantial updates to the HTA report.ConclusionsFor HTA reports based on low and very low quality evidence (uncertain results), the living evidence approach allows for timely updating of conclusions. The LE-IHD framework facilitates the planning and execution of living evidence syntheses to inform health decisions. This living evidence synthesis is being developed as part of a project to strengthen decision-making capacity in the Spanish health system.
PD55 Living Recommendations Within A Type 2 Diabetes Mellitus Guideline
Authors: De Val Soledad Isern , Benavent Patricia Gavin 
Published: January 2025

IntroductionThe Institute for Health Sciences of Aragon (IACS) has coordinated the development of a clinical practice guideline (CPG), funded by the Spanish Ministry of Health, for managing antidiabetic drugs in patients with type 2 diabetes mellitus. We conducted a living systematic review to provide a continuously updated evidence summary for formulating living recommendations on intensifying basal insulin therapy by comparing glucagon-like peptide-1 (GLP-1) receptor agonists with rapid-acting insulin.MethodsIn 2021, the IACS joined the Living Evidence to Inform Health Decisions (LE-IHD) project, which includes the use of technological tools to identify early emerging evidence on a defined topic. We conducted searches in the centralized Living Overview of Evidence (LOVE) and Epistemonikos databases. Specifically, the LOVE topic of interest from which the articles were selected was “glucagon-like peptide analogs and agonists for diabetes mellitus”. We applied the GRADE approach to rate the certainty of evidence and to develop clinical practice recommendations.ResultsThe initial baseline report included six randomized controlled trials (RCTs). We have continuously monitored the evidence and performed a monthly screening. Only one RCT was identified in the first update. The Guideline Development Group (GDG) decided to formulate a strong recommendation in favor of GLP-1 receptor agonists. The GDG considered the reduction in the risk of severe hypoglycemia events among patients treated with GLP-1 receptor agonists, compared with rapid insulin, particularly significant as well as the greater improvement in patient quality of life. Since the guideline was formulated, no new evidence has been identified that would change the recommendation.ConclusionsAdoption of the living systematic approach underscores the commitment to providing continuously updated recommendations within CPGs. Utilizing the GRADE approach, the Guideline Development Group decided to formulate a strong recommendation in favor of GLP-1 receptor agonists over rapid insulin. No new evidence has emerged to alter this recommendation. The living systematic review will remain active, ensuring continuous monitoring until the final draft CPG is disseminated.
PD57 Patient Involvement In The Development Of Clinical Practice Guidelines For Rare Diseases: A Systematic Literature Review
Authors: Dominguez Anabel Granja , Martín-Gómez Carmen , Rodríguez-López Rocío , Gonzalez-Bermudez Lourdes , Blasco-Amaro Juan Antonio 
Published: January 2025

IntroductionOne obstacle to the development of clinical practice guidelines (CPGs) for rare diseases (RDs) is the lack of scientific evidence. This can be partially overcome by involving patients in the development of CPGs. Our aim was to develop a process for involving patients with RDs in all stages of CPG development to ensure that their needs and expectations are addressed.MethodsA literature search was conducted in the MEDLINE, Cochrane Library, and Embase databases and the websites of the European Organization for Rare Diseases, the National Organization for Rare Disorders, and INAHTA. Eligible articles reported methods for involving patients in CPGs, other clinical decision support tools, and research studies. A fit-for-purpose data extraction template was created to capture the following data: author, year, country, type of study, characteristics of the target population, and strategies for participation, engagement, and involvement of patients. Data were synthesized according to methods for recruiting, involving, or engaging patients and obtaining information from them. The entire process was performed by pairs of researchers.ResultsA total of 1,113 records were identified once duplicates were deleted. Of these, 55 were included. The review collected data on types of patients (patient representatives or patient experts) and their recruitment, which could be classified as open or nominated. The various involvement strategies included consultation, participation, and communication. Differences between involving and engaging patients in the CPGs development process were noted. Procedures for obtaining the opinion of patients included surveys, interviews, workshops, and focus groups, among others. The review also provided information on the importance of involving patients in the dissemination and implementation stages of CPG development and the methods for doing so.ConclusionsWhen patients with RDs are actively involved in all phases of CPG development, they can contribute to the identification, prioritization, and inclusion of topics pertinent to RDs as questions to be addressed in the CPGs. These aspects might otherwise be overlooked by clinical experts and researchers. Therefore, involving patients with RDs is a promising approach to addressing gaps in the management of these diseases.
PD68 A Cross-Cultural Validation Study Of The German And English Versions Of The ICEpop CAPability measure for Adults (ICECAP-A)
Authors: Ubels Jasper , Schlander Michael 
Published: January 2025

IntroductionProponents of the capability approach argue that the effect of health technologies should be measured in terms of capabilities, that is, the freedom to live as desired. The ICECAP-A, initially developed in the UK, has been used internationally to measure capability wellbeing. This study examined whether participants from Australia, Canada, Germany, the UK, and the USA similarly interpret and respond to the ICECAP-A.MethodsA multigroup confirmatory factor analysis was conducted. Four types of measurement invariance were tested: configural invariance, metric invariance, scalar invariance, and residual invariance. Measurement invariance was assessed by studying the comparative fit index (CFI) and the root mean square error of approximation (RMSEA) and standardized root mean squared residual (SRMR) fit indices. For this study, data from the multi-instrument comparison database were used to compare response patterns of participants from Australia (n=1,430), Canada (n=1,330), Germany (n=1,269), the UK (n=1,356), and the USA (n=1,460).ResultsThe configural invariant model showed adequate fit (CFI 0.992, RMSEA 0.076, SRMR 0.016), and metric invariance was established (change in variables: CFI -0.002, RMSEA -0.014, SRMR 0.015). Scalar invariance (and consequently residual invariance) was not established (change in variables: CFI -0.036, RMSEA 0.046, SRMR 0.018). Post-hoc analysis indicated that full measurement invariance could be established by excluding the German sample, with improved fit index values for configural invariance (CFI 0.994, RMSEA 0.069, SRMR 0.015), metric invariance (change in variables: CFI-0.000, RMSEA -0.020, SRMR 0.006), scalar invariance (change in variables: CFI -0.007, RMSEA 0.011, SRMR 0.006), and residual invariance (change in variables: CFI -0.002, RMSEA 0.009, RMR 0.006).ConclusionsResponse patterns to the German and English versions of the ICECAP-A differed. Caution should be exercised when using these two versions in the same study. Further research is required to determine whether these differences are due to linguistic variations from translation, or whether they indicate fundamental differences in participant understanding and responses to the different versions of the ICECAP-A.
PD69 Road Map Of Health Equity Considerations In Health Technology Assessments: Identifying The Evidence From Epidemiology To Health Economics
Authors: Sarri Grammati , Radhakrishnan Amruta , Vinals Lydia 
Published: January 2025

IntroductionAchieving health equity through access to new health technologies has not been consistently considered within the health technology assessment (HTA) remit. HTA bodies now recognize that achieving health equity (or reducing health inequities) is a distinct value element for new technologies beyond the restrictive focus on clinical benefits and costs, but they lack familiarity with methods to reliably measure such effects.MethodsWe conducted a targeted literature review in indexed databases (Embase and MEDLINE) to identify relevant literature on methods for measuring health equity in HTAs published in the English language within the last five years. We mapped the literature based on key HTA stages: topic selection (eligible patient population); scoping (description of pre-decision health equities); evidence synthesis (equity impacts on health outcomes from introducing the intervention); comparative clinical comparisons including indirect treatment comparisons and cost-effectiveness analyses (including assessment of equity and efficiency trade-offs); and re-assessment (for conditional marketing). Equity-informed HTA decision frameworks and checklists were separately summarized. A narrative synthesis was performed.Results
The databases returned 2,800 unique publications. After screening 50 percent of the abstracts (30 publications) were found to be relevant. We applied additional selection criteria based on quality and information availability. Findings across the studies were grouped in a health equity methodological map as follows: understanding baseline epidemiological data in the targeted population; assessing diversity in trial populations and need for additional robust real-world evidence; effectiveness methods (subgroup analyses, incorporation of observational data with trials, simulation studies); and expanded economic modeling (distributional cost-effectiveness analysis, augmented cost-effectiveness analysis, extended cost-effectiveness analysis) or the use of multicriteria decision analysis. Two equity checklists and frameworks for HTA were also identified.ConclusionsGreater familiarity with health equity methods will drive its routine implementation in HTA and decision-making. This road map provides a summary of available health equity methodologies across the full HTA cycle and can be used as a guide for future HTA case studies. Decision-makers should directly engage with patients to learn about the experiences of diverse and disadvantaged patient groups.
PD95 Enhancing Clinical Practice Guideline Development In Brazil: A Tutoring Program For Health Technology Assessment Centers
Authors: Falavigna Maicon , Araujo Cintia , Parahiba Suena , Dorneles Gilson , Stein Cinara 
Published: January 2025

IntroductionThis study outlines a tutoring program supported by the Brazilian Ministry of Health (MoH), which aimed to develop clinical practice guidelines (CPGs) through Health Technology Assessment Centers (Nuclei of Health Technology Assessment or NATS) for the Brazilian Unified Health System (SUS). It emphasizes the integration of CPGs into health technology assessment development processes, focusing on methodological rigor, reproducibility, and reliability.MethodsThe program combined face-to-face and virtual meetings and engaged MoH representatives, methodologists, and researchers. It focused on the MoH Methodological Guideline for Developing Clinical Guidelines, which follows the Guidelines International Network and United States Institute of Medicine recommendations. This approach facilitated planning and creation of CPGs across diverse NATS.ResultsBetween 2021 and 2023, 60 professionals from 10 NATS participated, aiding in developing or updating 16 CPGs. These CPGs addressed 93 research questions. The CPG development phase averaged 317 days (interquartile range [IQR] 252 to 402), while the MoH assessment and public consultation took about 63 days (IQR 45 to 94). Additionally, nine Protocolos Clínicos e Diretrizes Terapêuticas (official guidelines from the Brazilian MoH) required technology assessments for SUS reimbursement, leading to 14 HTA reports. Eight technologies were favorably reviewed and recommended in the CPGs.ConclusionsThis tutoring program significantly improved the development of CPGs in Brazil, enhancing their methodological rigor and standardization. It also effectively integrated HTA into the CPG development process, addressing clinical needs and enriching public health decision-making.
PD117 Proposed Matrix For Efficient Reassessment Of Selective Benefits
Authors: Jang Jun , Choi Yoon-Jeong , Kim Myoung-Hwa 
Published: January 2025

IntroductionTo reduce the burden of medical expenses on patients, some noncovered medical technologies with proven safety but uncertain therapeutic effectiveness or cost effectiveness are incorporated into the “selective benefit (SB) system” and reassessed regularly to determine reimbursement scope. This study proposes a matrix based on the usage trends of new technologies (NTs) and alternative therapies (ATs) to facilitate efficient reassessment.MethodsThis study investigated the following five indices: (i) replacement of an NT by an AT; (ii) market shares of NTs; (iii) usage trends of NTs; (iv) usage trends of ATs before and after introduction of NTs; and (v) social demand for NTs. These were combined to generate an algorithm-based matrix that classified 139 NTs into 22 cases and five reimbursement scope categories. Health insurance data from 2009 to 2021 were analyzed to investigate market shares and usage trends. Social demand was evaluated using the last assessment results for each NT.ResultsUsing the matrix, 139 NTs were classified as follows: (i) switch to an essential benefit (copayment 20%; n=11); (ii) stay as a SB (copayment 50%; n=19); (iii) stay as a SB (copayment 80%; n=30); (iv) stay as a SB (copayment 90%; n=8); and (v) convert to noncovered (copayment 100%; n=40). The remaining 31 with an insufficient analysis period were classified as a SB (copayment 80%) for further analysis. Excluding the latter 31 SBs, 57 of the 108 (53%) were classified as “stay as a SB” categories, suggesting that these technologies need to be monitored further.ConclusionsThe usage trend driven matrix may be useful for efficient reassessment of NTs. For example, NTs that have a high market share and an increasing usage trend and ATs with a decreasing usage trend after SB of an NT can potentially be switched to an essential benefit.
PD122 Evaluating The Efficacy Of Cytokine Filtration In Cardiac Surgery For Endocarditis: A Comprehensive Study
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

IntroductionDespite medical advancements, endocarditis still results in high mortality rates. Surgery, while often essential, elevates the risk of hyperinflammation, sepsis, and cytokine release. The use of a cytokine filter to prevent this remains controversial. This study reviewed existing literature to assess the efficacy of cytokine filters and to support its integration into supplementary health services.MethodsAn exhaustive search of the MEDLINE, Cochrane Library, Embase, LILACS, and CytoSorbents Corporation databases was conducted to identify relevant meta-analyses and systematic reviews. The study focused on randomized controlled trials and case series studies assessing the efficacy of cytokine filtration. Key variables considered were the duration of antibiotic treatment, severity of endocarditis, and surgical treatment rationale. These factors were crucial for evaluating clinical outcomes and patient survival after surgery.ResultsThe systematic reviews yielded mixed outcomes. Two found no benefits for hemoadsorption, while one found that it reduced mortality rates and intensive care unit stays based on observational studies. Randomized controlled trials, however, showed no significant impact for cytokine filters on mortality rates or postoperative hemodynamic parameters. In contrast, case series studies reported potential benefits, but these results were confounded by biases in patient allocation and failure to account for critical variables like antibiotic treatment duration, case severity, and surgical rationale. These discrepancies highlight the complexity of evaluating the effectiveness of cytokine filtration in surgical settings.ConclusionsRandomized and non-randomized controlled trials on the role of cytokine filters in cardiac surgery for endocarditis reported contradictory findings. Only case series studies suggested benefits from cytokine filters, necessitating further high quality research before recommending their widespread use. Understanding the implications of these results is essential, underscoring the need for more rigorous studies to resolve these inconsistencies.
PD124 Genicular Artery Embolization For The Treatment Of Knee Osteoarthritis: A Systematic Review And Meta-analysis
Authors: González-Hernández Yadira , Hernández-Yumar Aránzazu , De Armas-Castellano Aythami , Valcárcel-Nazco Cristina , Carmona-Rodríguez Montse , Trujillo-Martín Mar , Pino-Sedeño Tasmania del 
Published: January 2025

IntroductionThe genicular artery embolization (GAE) procedure has been recently adopted for the management of pain secondary to inflammatory diseases of the locomotor apparatus. The number of studies assessing its use in patients with knee osteoarthritis (KO) has been increasing in recent years.MethodsWe included two randomized controlled trials (RCTs) evaluating the use of GAE in patients with chronic pain secondary to KO. A cost analysis was also conducted to compare the costs of GAE and standard treatment from the perspective of the Spanish National Health System over a time horizon of one year. The potential improvement in quality-adjusted life-years necessary to consider GEA as cost effective for this indication was estimated. We also ran extensive sensitivity analyses.ResultsEstimates for pain showed contradictory results, and no significant differences were observed between the two treatments with respect to overall function, health-related quality of life (HRQoL), and need for pain medication. No serious complications or major adverse events were observed. The quality of evidence was assessed by GRADE as moderate to low. The cost analysis showed that GAE results in an incremental cost of EUR3,432.37 per patient. Sensitivity analyses revealed a wide range within which the incremental cost can vary.ConclusionsThere are insufficient data to discern any differences between GAE and standard treatment for patients with KO in terms of pain, function, HRQoL, need for analgesics, and rates of adverse events and complications. Larger RCTs are required to evaluate the effect of GAE in patients with chronic pain secondary to KO and to determine whether its additional cost is warranted.
PD126 A Systematic Review Of Interval Cancer Rates In Colonoscopy Screening For Colorectal Cancer
Authors: Hamashima Chisato , Abe Koichiro , Terasawa Teruhiko , Hosono Satoyo , Katayama Takakafumi , Hoshi Keika , Tadano Toshihiro , Sasaki Seiju 
Published: January 2025

IntroductionColonoscopy screening has been suggested as a potential primary screening method for colorectal cancer (CRC). A 10-year screening interval has been recommended by some academic societies, but the scientific evidence for this needs to be more comprehensive. We performed a systematic review of interval cancer rates in colonoscopy screening in an asymptomatic population.MethodsWe searched the PubMed and Ichushi-Web bibliographic databases for papers published from inception to September 2022. The search terms were “colorectal cancer screening”, “interval cancer”, and “total colonoscopy”. Randomized controlled trials and observational studies were included. The target population was an asymptomatic average-risk population with no polyps or adenomas at the index colonoscopy. Advanced neoplasia (AN) was defined as CRC or an adenoma at least 10 mm in size with a villous component or high-grade dysplasia. The incidence rates of interval CRC and AN per 100,000 person-years (PYs) were estimated.ResultsOf the 694 potentially eligible articles, 15 were included. Rates of interval CRC and AN were reported in 15 and 11 studies, respectively. For the meta-analysis, 287,602 patients with negative colonoscopy results were included, with an average follow-up of 7.98 years. Negative colonoscopy results were defined as no adenoma present. The incidence rate per 100,000 PYs was 9.57 (95% confidence interval [CI]: 2.06, 29.94) for interval CRC and 311.5 (95%CI: 153.4, 550.7) for AN. Similar results were obtained even when a negative colonoscopy result was defined as no polyps present.Conclusions
The selected studies were heterogeneous with respect to the target population, follow-up years, and patient characteristics. Although interval AN was reported in all studies, the interval cancer rate was low after a negative result at the index colonoscopy. While the screening interval might be defined as long term, a definitive screening interval could not be recommended because of insufficient evidence.