bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD128 Evaluating The Implementation Of An Abdominal Aortic Aneurysm Screening Program In Spain
Authors: Pla Anna Godo , Soto Gonzalo Bravo , Sisó-Almirall Antoni , de Céniga Melina Vega , Bertran Marta Trapero , Vargas Martínez Ana Magdalena , Estrada Sabadell Maria Dolors , Vivanco-Hidalgo Rosa Maria 
Published: January 2025

IntroductionAbdominal aortic aneurysm (AAA) is a progressive and silent enlargement of the aorta, but aortic rupture is associated with a high mortality rate. The main objectives of this study were to assess evidence on the clinical safety, efficacy, and cost effectiveness of an AAA screening program using abdominal ultrasound. An economic evaluation was also conducted to assess the introduction of AAA screening into the Spanish Healthcare System.MethodsA systematic literature search was conducted according to PRISMA recommendations. Randomized controlled trials were selected to assess clinical safety and efficacy. Systematic reviews were selected to identify prognostic factors for AAA and full economic evaluations were selected for the cost-effectiveness analysis. Data extraction and assessment of evidence certainty were performed using the GRADE methodology. A Markov model was developed to perform an economic evaluation and budget impact analysis of an AAA screening program in the Spanish context.ResultsScreening had a beneficial effect on AAA detection and rates of all-cause and AAA-related mortality in men older than 65 years. It had no effect on rates of AAA rupture or emergency surgery and may increase rates of elective surgery. The evidence was very uncertain for women older than 65 years. Sex and family history of AAA were the most important prognostic factors. Economic evaluation of a program screening men older than 65 years in primary care centers resulted in 0.33 life-years gained, 0.18 quality-adjusted life-years (QALYs) gained, and an incremental cost-effectiveness ratio of EUR81.98 per QALY. The program’s implementation would cost an additional EUR15.68 to EUR28.40 per patient.ConclusionsThe implementation of an AAA screening program in men older than 65 years in Spain is considered effective and could be implemented using the infrastructure, materials, and human resources already present in the Spanish health system. Relevant indicators and dynamic monitoring of the program should be established to allow for continuous and flexible evaluation of results over time.
PD132 A Target Trial Emulation Application Assessing The Survival Of Erythropoiesis-Stimulating Agents In Patients With Lower Risk Myelodysplastic Syndrome
Authors: Bennett Alastair , Manca Andrea 
Published: January 2025

IntroductionPatients with myelodysplastic syndromes (MDS) can be treated with erythropoiesis-stimulating agents (ESAs) to alleviate anemia-related symptoms and delay the need for expensive transfusions. However, clinicians disagree on prescribing ESAs because evidence on the effectiveness of ESAs is limited. This study aimed to reliably estimate the survival of a dynamic ESA treatment regimen using a novel causal inference approach.MethodsThe European MDS Registry collects data on patients with MDS every six months. We followed a two-step framework to develop a hypothetical and emulated trial protocol. The eligible population consisted of patients with intermediate-1 to low-risk MDS who were treatment-naïve, had a hemoglobin concentration of less than 10 grams per deciliter, and did not have a chromosome 5q deletion (non-del(5q) MDS). Red blood cell transfusion was allowed before the date of diagnosis. Patients were cloned and assigned to both treatment groups, thereby eliminating immortal time bias, and were censored as soon as they stopped following the assigned treatment strategy. This artificial censoring introduced selection bias, which was adjusted for by using inverse probability of censoring weighting. The weights model adjusted for time varying confounders.ResultsOf the 611 patients qualifying for the study, 282 started ESAs within the six-month grace period and 329 did not take ESAs. The median follow-up was 2.4 years (interquartile range 1.3 to 4.2). A naïve analysis of our cohort suggested that no ESA was significantly more beneficial than taking ESAs (hazard ratio [HR] at year four: 1.24, 95% confidence interval [CI]: 1.03, 1.50). However, after correcting for biases the adjusted Kaplan-Meier curves showed that ESAs were beneficial over the first two years (HR at year one: 0.75, 95% CI: 0.41, 1.39), compared with no ESAs. Thereafter there was no difference between treatment groups (HR at four years: 1.01, 95% CI: 0.80, 1.27).ConclusionsWe found that early—within six months of becoming eligible—initiation of ESAs as first-line therapy for treatment-naïve patients with non-del(5q) low-risk MDS and hemoglobin levels of less than 10 grams per deciliter improves survival over for the first two years. Using target trial emulation to make accurate survival estimates can improve decision-making in health technology assessment.
PD134 Projecting The 10-Year Cost Of Care Burden For Depression Until 2032 In Hong Kong: A Real-World Evidence Based Markov Model
Authors: Yi Chan Vivien Kin , Mallory Leung Man Yee , Man Chan Sandra Sau , Yang Deliang , Knapp Martin , Luo Hao , Craig Dawn , Chen Yingyao , Bishai David Makram , Yan Wong Gloria Hoi , Lum Terry , Yin Chan Esther Wai , Kei Wong Ian Chi , Li Xue 
Published: January 2025

IntroductionWe developed a real-world evidence (RWE) based Markov model to project the 10-year cost of care for patients with depression from the public payer’s perspective to inform early policy and resource planning in Hong Kong.MethodsThe model considered treatment-resistant depression (TRD) and development of comorbidities along the disease course. The outcomes included costs for all-cause and psychiatric care. From our territory-wide electronic medical records, we identified 25,190 patients with newly diagnosed depression during the period from 2014 to 2016, with follow-up until December 2020 for real-world time-to-event patterns. Costs and time varying transition inputs were derived using negative binomial and parametric survival modeling. The model is available as a closed cohort, which studies a fixed cohort of incident patients, or an open cohort that introduces new patients every year. Utilities values and the number of incident cases per year were derived from published sources.ResultsThere were 9,217 new patients with depression in 2023. Our closed cohort model projected that the cumulative cost of all-cause and psychiatric care for these patients would reach USD309 million and USD58 million by 2032, respectively. In our open cohort model, 55,849 to 57,896 active prevalent cases would cost more than USD322 million and USD61 million annually in all-cause and psychiatric care, respectively. Although less than 20 percent of patients would develop TRD or its associated comorbidities, they contribute 31 to 54 percent of the costs. The key cost drivers were the number of annual incident cases and the probability of developing TRD and associated comorbidities and of becoming a low-intensity service user. These factors are relevant to early disease stages.ConclusionsA small proportion of patients with depression develop TRD, but they contribute to a high proportion of the care costs. Our projection also demonstrates the application of RWE to model the long-term costs of care, which can aid policymakers in anticipating foreseeable burden and undertaking budget planning to prepare for future care needs.
PD139 Investigation Of The Current Status Of New Health Technology Assessment In Korea And The Factors Influencing Assessment Results
Authors: Kang Jihyun , Kim Jinho , Shin Chae Min , Park Boyoung 
Published: January 2025

IntroductionThis study aimed to evaluate factors influencing assessment results in the new health technology assessment (nHTA) system in Korea.MethodsPublicly available HTA reports obtained from the nHTA website were selected as a data source. A total of 258 nHTA reports including 305 technologies were included in the analysis. The detailed information in the reports was classified into three major categories: technical characteristics, evaluation methods, and publication types. A chi-squared test was used to investigate differences in the levels of evidence (high, medium, or low) and assessment results (pass or fail) according to the three categories. Univariate and multivariate logistic regression analyses were performed to identify factors associated with the levels of evidence and assessment results.ResultsnHTA reports that performed a meta-analysis and included randomized controlled trials for evidence synthesis were associated with higher levels of evidence. The corresponding odds ratios were 5.008 (95% confidence interval [CI]: 1.265, 18.826) and 27.052 (95% CI: 7.802, 103.330), respectively. The analysis showed that as the level of evidence increased, the likelihood of the assessment passing was significantly higher (odds ratio 2.789, 95% CI: 1.284, 6.057). However, univariate analysis indicated that performing a meta-analysis or including randomized controlled trials, both of which affect evidence level, did not have a statistically significant association with assessment results.ConclusionsThis study is the first systematic analysis of the factors influencing the results of nHTA reports in Korea. While higher evidence levels were associated with positive assessment outcomes, factors affecting the evidence level itself did not directly influence assessment results. More efforts are needed to integrate high levels of evidence into assessments.
PD142 Implantable Neurostimulation Devices For The Treatment Of Drug-Resistant Pediatric Epilepsy
Authors: García Vanesa Ramos , Álvarez-Pérez Yolanda , Sacks Analía Abt , Rivero-Santana Amado , Duarte-Díaz Andrea , Santos-Álvarez Anthea , González-Hernández Yadira , Rivas-Ruiz Francisco , Perestelo-Pérez Lilisbeth 
Published: January 2025

IntroductionEpilepsy affects approximately 10.5 million individuals under the age of 15 years worldwide. In Spain, 3.7 per 1,000 inhabitants aged 6 to 14 years have epilepsy, making it the third most common neurological emergency. Drug resistance is observed in eight to 33 percent of cases. Responsive neurostimulation (RNS) systems could improve seizure control in pediatric patients who are not eligible for brain surgery.MethodsWe systematically searched for articles published up to September 2022 in the following bibliographic databases: MEDLINE, Embase, Web of Science, and CINAHL. We included primary experimental and observational studies as well as case series studies addressing the safety, efficacy, and cost effectiveness of RNS in the treatment of drug-resistant pediatric epilepsy.ResultsTwo systematic reviews of prospective and retrospective case series studies and four primary experimental studies were identified. The case series studies found that a large proportion of pediatric patients responded to RNS, with a reduction of between 50 and 75 percent in the frequency of seizures. The intensity and duration of seizures also decreased after using RNS. Adverse effects of the RNS implantation process were related to infections, erythema, and hematomas. Only one study (n=17) reported moderate adverse effects related to stimulation (dysesthetic pain in the upper and lower right limb), but there were no serious reactions leading to RNS discontinuation.ConclusionsRandomized controlled trials in pediatric drug-resistant populations ineligible for brain surgery with adequate sample sizes are needed to determine the effectiveness of RNS in terms of seizure frequency, duration, and intensity. No cost-effectiveness studies have been conducted on RNS in this cohort.
PD147 Overview Of Multiplex Antigen Near-Patient Tests For Acute Respiratory Infections
Authors: Lynch Tom , McDowell Cillian , Burke Eimear , McLoughlin Carol , O’Neill Michelle , Spillane Susan , Ryan Máirín 
Published: January 2025

IntroductionMultiplex antigen near-patient tests (NPTs) can detect multiple virus-specific antigens during acute infection. This project aimed to provide an overview of evidence on the effectiveness, advantages and disadvantages, and feasibility of multiplex antigen NPTs to identify common respiratory pathogens (including SARS-CoV-2 and one or both of the influenza and respiratory syncytial viruses) in residential and primary care settings.MethodsA non-systematic literature search was conducted on the 28 July 2023 in the MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov databases to identify relevant literature. National and international agency websites were searched for guidance or recommendations relating to multiplex antigen NPTs. Relevant citations were screened and extracted by one reviewer and cross-checked by a second reviewer. Health technology assessments, systematic reviews, observational studies, and randomized and non-randomized controlled trials were considered eligible for inclusion in the overview. No formal quality appraisal of included documents was conducted. Due to the variation in study types, study findings were narratively assessed.Results
Ten documents were identified in total. One complete prospective evaluation and seven incomplete clinical trials were identified. No relevant primary studies were identified for effectiveness outcomes such as time to appropriate treatment with antibiotics or antivirals. An evaluation published by the Haute Autorité de Santé in France reported that there was insufficient performance data regarding multiplex antigen NPTs in clinical practice. In a joint statement on respiratory virus testing, the Public Health Laboratory Network and Communicable Diseases Network in Australia indicated that antigen NPTs were not recommended due to their poor ability to identify influenza A.ConclusionsEvidence on the effectiveness, advantages, disadvantages, and feasibility of multiplex antigen NPTs to detect common respiratory pathogens in primary and residential care settings is sparse. Studies are required to assess the diagnostic performance (relative to reverse transcription polymerase chain reaction tests) and clinical utility of multiplex antigen NPTs in residential and primary care settings.
PD153 Horizon Scanning Analysis Of The Obesity Medicines Pipeline
Authors: Akinbolade Sola , Nesworthy Jane , Fairbairn Ross , O’Connor Nicole , Hussain Amy , Harris Bethan , Craig Dawn 
Published: January 2025

IntroductionHorizon scanning provides timely intelligence about innovative health technologies in clinical development by commercial and non-commercial organizations. The horizon scanning for obesity medicines, carried out by the National Institute for Health and Care Research Innovation Observatory (IO), aimed to identify emerging obesity medicines to inform decision-making by national stakeholders and to shape future research.MethodsIn July 2023, the IO utilized horizon scanning methodology to identify medicines for preventing and treating obesity either primarily or as a comorbidity. The scans included medicines in preclinical and clinical development (phase I, I/II, II, II/III, III, or IV) sponsored by industry and non-industry for all population groups. Trial locations included Australia, Canada, the European Union, the UK, and the USA. Data were collected from the IO’s internal database (the Medicines Innovation Database), ClinicalTrials.gov, the European Union Drug Regulating Authorities Clinical Trials Database, the World Health Organization International Clinical Trials Registry Platform, and the Citeline Pharmaprojects database. The data were systematically screened and analyzed.ResultsA total of 405 clinical trials were identified that evaluated 177 unique medicinal interventions. Among these, 47 unique preclinical interventions were identified from preclinical studies. A total of 256 (63%) trials were sponsored by industry, 139 (34%) by non-industry, and 10 (3%) by industry and non-industry jointly. The top five drug classes included anorectic or anti-obesity medicines (n=75; 42%), antihyperglycemics (n=24; 14%), anti-inflammatories (n=8; 5%), hepatoprotectants (n=7; 4%), and antihyperlipidemics (n=4; 2%). At the time of scanning, 48 (27%) medicines were unlicensed in the UK and 129 (73%) were not. Among the licensed medicines, 37 (77%) were off patent and 11 (23%) were on patent.ConclusionsThe IO’s horizon scanning process can identify and deliver timely intelligence to support decision-making and facilitate adoption of new medicines to target areas of unmet clinical need. The obesity medicines scan identified medicinal interventions in preclinical and clinical development and provides valuable insights into the trends and research gaps in preventing and treating obesity.
PD165 To What Extent Do Health Technology Assessment Bodies Cross-Reference Each Other In Their Reports?
Authors: Wagner Peter , Szawara Paula , Panda Sattwik Kumar , Kanthi Vinay M 
Published: January 2025

IntroductionDue to different timing of drug launches across countries, published health technology assessment (HTA) findings from one country may impact HTA outcomes in other countries. The aim of our work was to identify the most influential HTA bodies by analyzing to what extent HTA bodies cross-reference each other in their HTA reports.MethodsWe analyzed the HTA reports on single drug assessments (SDA) published by 46 HTA bodies from 28 countries (and cross-country collaborations) with decision dates between January 2011 and November 2023. We searched the identified HTA reports by using natural language processing and a predefined set of keywords to identify whether, and to what extent, HTA bodies reference each other in their HTA reports. Additionally, we assessed if there is a trend over time in the cross-referencing, and whether any clusters could be identified.ResultsBased on the analysis of 24,793 SDAs, the National Institute for Health and Care Excellence (NICE) was referenced the most (in 4,198 HTA reports across 39 HTA bodies), followed by the Canadian Agency for Drugs and Technologies in Health (in 2,034 reports across 35 HTA bodies), and the Scottish Medicines Consortium (SMC) (in 1,960 reports across 31 HTA bodies). The HTA bodies that most often referenced other HTAs were the Agency for Health Technology Assessment and Tariff System, the Haute Autorité de santé, and NICE. Seven HTA bodies were not referenced in any HTA report, while four did not reference any other HTA body.ConclusionsOur research shows that most of the analyzed HTA agencies not only referenced other HTA bodies in their HTA reports but were also referenced by other HTA bodies. The most often referenced HTA agencies were mostly from English-speaking countries, were well recognized, and had well defined methodologies.
PD170 Modification Of The All Wales Medicines Strategy Group Appraisal Process Provides Faster Access To Children’s Medicines In Wales
Authors: Wood Kelly , Varnava Alice , Lang Ruth , Williams Anthony , Coulson Professor James , Champion Andrew , Ganderton Claire 
Published: January 2025

IntroductionMedicines routinely funded for use in Wales undergo health technology appraisal by the All Wales Medicines Strategy Group (AWMSG) or the National Institute for Health and Care Excellence (NICE). This includes pediatric license extensions (PLE) notwithstanding any existing advice in adults. A review of the PLE process was conducted with the aim of providing faster access to children’s medicines in Wales.MethodsData were collected for PLE appraisals of medicines previously approved for adults by the AWMSG or NICE that subsequently went through the original PLE process between January 2010 and December 2020, or a simplified PLE process between January 2021 and March 2023. Data were analyzed using descriptive statistics and a two-tailed t-test (unequal variance) to test the null hypothesis that the difference between the two means was zero. An alpha of less than 0.05 was considered significant. Feedback was obtained from relevant stakeholders including the Association of the British Pharmaceutical Industry (Wales) and the Royal College of Paediatrics and Child Health.ResultsThe AWMSG issued positive recommendations for all PLE appraisals included in the data collected, and these were endorsed by the Welsh Government. Appraisals that went through the original PLE process (n=56) took a mean 229.8 days (standard deviation 55.6), whereas those that went through the simplified PLE process (n=15) took a mean 102.6 days (standard deviation 48.1; p < 0.0001). The rapid access to children’s medicines was welcomed by the Association of the British Pharmaceutical Industry and the Royal College of Paediatrics and Child Health.ConclusionsReview of the 2020 and 2023 PLE processes facilitated faster access to clinically effective and cost-effective medicines for children in Wales. In March 2023, the AWMSG and the Welsh Government reviewed these results and agreed that because all PLE medicines were approved for use within Wales irrespective of the process used, the AWMSG would no longer be required to routinely appraise PLEs.
PD188 Step-By-Step Introduction Of Hospital-Based Health Technology Assessment In Ukraine
Authors: Filiniuk Olena , Siromaha Serhii , Dorohina Anna , Leskiv Bohdan , Yarynych Kostiantyn , Kosyachenko Kostiantyn , Babenko Mykhailo , Sucu Rabia 
Published: January 2025

IntroductionHealth technology assessment (HTA) became mandatory in Ukraine in 2020 for public coverage of new medicines. This review outlines the steps Ukraine took to introduce HTA at the hospital level through hospital-based HTA (HB-HTA). HB-HTA is a globally recognized, science-based tool that helps hospital stakeholders answer questions on the safety, efficacy, and cost effectiveness of health technologies they are planning to introduce.MethodsThe authors examined the steps taken to introduce and implement HB-HTA in Ukraine, the impacts reached thus far, and the implications for further national scale-up. Key steps associated with the intervention included the following: awareness raising activities in HB-HTA; structured stakeholder engagement; review of global HB-HTA tools and their adaptation to the local context; training for key hospital staff; piloting tools in a select hospital; and review of the pilot experience to inform future application.ResultsStarting from 2021, HB-HTA was introduced through awareness raising activities. The regulatory framework for introducing health technologies into hospitals was analyzed, outlining the need for updated regulations. Review of global HB-HTA tools revealed that tools developed by the Adopting Hospital Based Health Technology Assessment in European Union project were the most applicable for Ukraine and were subsequently adapted to the country’s context by an expert panel of 13 hospital stakeholders. Following this, Safe, Affordable, and Effective Medicines for Ukrainians (SAFEMed) organized HB-HTA training for key hospital stakeholders. The Amosov National Institute of Cardiovascular Surgery was chosen for the pilot due to its high level of operational activity. The results of the pilot are expected soon.ConclusionsIntroducing globally recognized HB-HTA tools and piloting them in a real-world setting provides basic concepts to the HTA experts who will be involved in scaling up HB-HTA in Ukraine. Initial recommendations point to the need to scale-up HB-HTA slowly, first working with one hospital to gain HB-HTA experience that will inform further application across the country.