https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)61127-1.pdf

Technologies for global health

Health technology assessment (HTA) is frequently used when a new and expensive technology is being introduced into clinical practice. This certainly is the case with the da Vinci surgical robot, with costs ranging from $1 to $2.5 million for each unit. This systematic review documents major variability in the reported cost evaluation studies of da Vinci robot-assisted operations compared with those performed by the direct manual laparoscopic approach. Published studies in the English language related to the period 2000–2010 were searched using economic and clinical electronic databases. All 11 reports included some form of cost analysis, which made it possible for the authors to extract information on certain specific economic outcomes: operating room time, hospital stay, and total costs. With the exception of two studies, the reported operating room time was higher with the robotic approach than with manual laparoscopic surgery, and the hospital stay was the same for the two techniques. Robotic surgery is significantly more expensive if the purchase and maintenance costs of the robot system are included in the total costs. Only 3 of the 11 publications included these costs. The disadvantage of robotic surgery is its higher costs related to purchase and maintenance of technology and its longer operating room time. However, emerging evidence shows that operating room time decreases with experience using the robot. From the HTA viewpoint, the result of this review is that the jury still is out on the HTA of da Vinci-assisted robotic surgery.

Economic evaluation of da Vinci-assisted robotic surgery: a systematic review

We review the various aspects of health technology assessment in osteoporosis, including epidemiology and burden of disease, and assessment of the cost-effectiveness of recent advances in the treatment of osteoporosis and the prevention of fracture, in the context of the allocation of health-care resources by decision makers in osteoporosis. This article was prepared on the basis of a symposium held by the Belgian Bone Club and the discussions surrounding that meeting and is based on a review and critical appraisal of the literature. Epidemiological studies confirm the immense burden of osteoporotic fractures for patients and society, with lifetime risks of any fracture of the hip, spine, and forearm of around 40 % for women and 13 % for men. The economic impact is also large; for example, Europe’s six largest countries spent €31 billion on osteoporotic fractures in 2010. Moreover, the burden is expected to increase in the future with demographic changes and increasing life expectancy. Recent advances in the management of osteoporosis include novel treatments, better fracture-risk assessment notably via fracture risk algorithms, and improved adherence to medication. Economic evaluation can inform decision makers in health care on the cost-effectiveness of the various interventions. Cost-effectiveness analyses suggest that the recent advances in the prevention and treatment of osteoporosis may constitute an efficient basis for the allocation of scarce health-care resources. In summary, health technology assessment is increasingly used in the field of osteoporosis and could be very useful to help decision makers efficiently allocate health-care resources.

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Health Technology Assessment in Osteoporosis

Article Type: Review Article Introduction: Teeth with irreversible pulpitis usually undergo root canal therapy (RCT) This treatment modality is often considered disadvantageous as it removes vital pulp tissue and weakens the tooth structure A relatively new concept has risen which suggests vital pulp therapy (VPT) for irreversible pulpitis VPT with calcium enriched mixture (VPT/CEM) has demonstrated favorable treatment outcomes when treating permanent molars with irreversible pulpitis This study aims to compare patient related factors, safety and organizational consideration as parts of health technology assessment (HTA) of the new VPT/CEM biotechnology when compared with RCT Materials and Methods: Patient related factors were assessed by looking at short- and long-term clinical success; safety related factors were evaluated by a specialist committee and discussion board involved in formulating healthcare policies Organizational evaluation was performed and the social implications were assessed by estimating the costs, availability, accessibility and acceptability The impact of VPT/CEM biotechnology was assessed by investigating the incidence of irreversible pulpitis and the effect of this treatment on reducing the burden of disease Results: VPT/CEM biotechnology was deemed feasible and acceptable like RCT; however, it was more successful, accessible, affordable, available and also safer than RCT Conclusion: When considering socioeconomic implications on oral health status and oral health-related quality of life of VPT/CEM, the novel biotechnology can be more effective and more efficient than RCT in mature permanent molars with irreversible pulpitis

/pdf/health-technology-assessment-of-cem-pulpotomy-in-permanent-18fl4lep0d.pdf

Health Technology Assessment of CEM Pulpotomy in Permanent Molars with Irreversible Pulpitis.

The potential to improve the quality, efficiency, outcomes, patient safety and reduce cost of healthcare by Health Information Technology (HIT) has been established by researchers. But unfortunately HIT systems are not properly utilized or are not widely available. This problem is even more glaring in developing countries. This article presents a review of some available HIT systems in order to assess the level of their presence and the technology used in developing them. Works related to acceptance of HIT systems were also reviewed so as to study the gaps in this area and propose a solution in order to fill the gaps identified. The problems discovered from this review include lack of availability of these systems especially in developing countries, low rate of HIT systems acceptance and insufficient works on patient acceptance of HIT systems. Studying the factors that affect the acceptance of HIT systems by patients
and considering the factors while developing the systems will play a significant role in getting over the aforementioned limitations. As Technology Acceptance Model (TAM) is one of the most popular models for studying users' perception and acceptance of Information System (IS)/Information Technology (IT), we proposed a conceptual model of HIT acceptance in developing countries based on TAM.

/pdf/an-overview-of-patient-acceptance-of-health-information-58juesiqz1.pdf

Giuseppe Barletta

Papers

Introduction to health technology assessment