News and archive
Evaluation methods for the benefit assessment of easily accessible, out-patient health centers for vulnerable groups - Target group focus: Homeless and non-insured people
Vulnerable groups, such as homeless and non-insured people, have a poorer physical and mental health status than comparable populations and usually have no or difficult access to standard health care. Social organisations provide basic health and social care services for these groups of people. Against this background, we searched for evaluation methods for the benefit assessment of easily accessible, outpatient health centers and described the methods, indicators, and instruments used in evaluation studies and reports of comparable services.
Publication: LBI-HTA Project report No. 114: http://eprints.hta.lbg.ac.at/1195/
C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections
Infection markers such as the C-reactive protein (CRP) can be used in addition to the clinical diagnosis of an infectious disease. So far, CRP tests have been carried out in the laboratory; CRP "point-of-care-testing" (POCT) refers to measurements close to the patient in primary care. The result is available within minutes. CRP POCT is intended to assist the physician to rule out a severe bacterial infection and support a decision on the need for antibiotic prescription.
Publication: LBI-HTA Project report No. 116: http://eprints.hta.lbg.ac.at/1194/
Contact: Sabine Ettinger
We are pleased to introduce our two new HSO reports.
CAD is a disease defined as the manifestation of arteriosclerosis in the coronary arteries and is the leading cause of death in Europe. This systematic review evaluates the current evidence on the efficacy and safety of bioresorbable stents, the latest generation of stents in percutaneous coronary intervention (PCI) in the treatment of CAD, compared to traditional revascularisation strategies (PCI with permanent metal stents or coronary artery bypass graft surgery).
Based on evidence from eight RCTs, the fully bioresorbable everolimus-eluting stent Absorb® BVS is considered to be less effective and to have a worse safety profile compared with everolimus- or biolimus-eluting permanent metal stents. There is insufficient evidence to determine whether Absorb® BVS is considered less effective or less safe than other revascularisation strategies. There is insufficient evidence to determine whether the other four currently CE-certificated fully bioresorbable sent systems [DESolve®, Magmaris (Dreams 2G), Art Pure or Fantom®] are more effective than (or at least as effective as) and/or have better (or at least similar) safety profiles compared with drug-eluting permanent metal stents or other revascularisation strategies.
Publication: Decision Support Document No. 81/1.Update: http://eprints.hta.lbg.ac.at/1191/
Contact: Judit Erdos
Since 2006, natalizumab is used for the treatment of relapsing-remitting multiple sclerosis. Assessing seven studies, which met the inclusion criteria, the present project report investigated the clinical efficacy and safety of natalizumab compared to alternative immunomodulating drugs for a treatment period of at least 36 months.
Publication: LBI-HTA Project report No. 112: http://eprints.hta.lbg.ac.at/1190/
Contact: Eva Fuchs
Transcatheter aortic valve implantation (TAVI, also called percutaneous aortic valve replacement) is the insertion of a bioprosthesis into the aortic valve using a catheter. Since the introduction of TAVI in 2007 for patients at high surgical risk, TAVI is being used more and more frequently. The EUnetHTA report with a German summary analyzes the results from 2 RCTs on patients with moderate operative risk.
Publication: LBI-HTA Projektbericht No.115: http://eprints.hta.lbg.ac.at/1188/
Contact: Claudia Wild
Wearable cardioverter-defibrillator (WCD) therapy in primary and secondary prevention of sudden cardiac arrest in patients at risk. Updtae 2018
Sudden cardiac arrest (SCA) is the most common cause of death in patients with coronary artery disease. In Europe, there are about 350 000 out of hospital SCAs per year. Mostly, ventricular tachycardia and ventricular fibrillation are the underlying aetiology of SCA. The wearable cardioverter defibrillator (WCD) – a novel defibrillation therapy – claims to prevent sudden cardiac deaths that may result from SCA. To date, it is unclear whether the plausible and promising theoretical benefits can be translated into clinically relevant benefits.
Therefore, the project at hand aimed at synthesising the current available evidence regarding the use of the WCD: A systematic review regarding the effectiveness and safety of the WCD was hereby performed.
In total, 11 studies were identified: 1 RCT was eligible for the evidence synthesis of the effectiveness of the WCD and further 10 observational studies were additionally included for the evaluation of safety of the device. The scientific evidence from 1 RCT indicates the WCD in combination with guideline-directed medical therapy (GDMT) is not proven to be more effective than GDMT alone based on the endpoint arrhythmic mortality. The studies included in the evaluation of safety of the device suggest that the WCD could be a relatively safe device.
To date, the comparative effectiveness of the WCD could not be established – it is unclear if and especially for whom the plausible theoretical advantages of using the WCD can be translated into clinically relevant benefits. Further research is needed in this context.
Publication: Decision Support Document No. 103/Update 2018: http://eprints.hta.lbg.ac.at/1186
Contact: Gregor Götz
We are pleased to introduce our two new HSO reports.
Drug reimbursement in the inpatient sector in Austria: Approaches for a transparent and evidence-based process taking into account international experience
On the one hand, reimbursement decisions on medicines in Austria are divided into outpatient and inpatient sector, on the other hand, decisions are made regionally in the inpatient sector (on a federal state level). Both can result in an unequal availability in particular of high-priced drugs. In favour of equal access to medical services, often there are deliberative decision-making processes that seek to make public (health policy) decisions fairly, transparently, and evidence-based. The present HTA report provides a basis for discussion of an Austria-wide standardised and transparent reimbursement process for high-priced hospital drugs taking into account deliberative processes.
Publication: LBI-HTA Projektbericht No. 109: http://eprints.hta.lbg.ac.at/1183/