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Borycki EM, Farghali A, Kushniruk AW. Do Health Technology Safety Issues Vary by Vendor? Stud Health Technol Inform 2022; 295:345-349. [PMID: 35773880 DOI: 10.3233/shti220734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There is a need to determine the relative similarity and differences in safety issues across specific types of software and medical devices in order to develop standardized solutions that can be used across these technologies. Over the past several years, health informatics researchers have identified differing types of technology-induced errors or safety issues. This work has led to a literature that has been effective in identifying varying technology-induced errors. Less effort has been made in attempting to understand if there are common types of safety issues and outcomes across vendors for specific types of technology such as electronic health records (EHRs). Our findings demonstrate that some safety issues are common across the same type of software. The findings suggest there is a need to develop standardized approaches to managing technology-induced errors.
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Affiliation(s)
| | - Amr Farghali
- School of Health Information Science, University of Victoria, Canada
| | - Andre W Kushniruk
- School of Health Information Science, University of Victoria, Canada
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2
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Aydoğdu N, Öztel ON, Karaöz E. Isolation, Culture, Cryopreservation, and Preparation of Skin-Derived Fibroblasts as a Final Cellular Product Under Good Manufacturing Practice-Compliant Conditions. Methods Mol Biol 2021; 2286:85-94. [PMID: 33349903 DOI: 10.1007/7651_2020_333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Cell-based therapies have become a popular approach in the field of regenerative medicine. Human fibroblast cells, one of the cell types widely used in clinical applications, have been used for skin regeneration and wound healing procedures. Furthermore, they are utilized for aesthetic purposes since fibroblasts lose their abilities such as collagen synthesis with age. Here, we describe detailed procedures for isolation, culture, cryopreservation, and preparation of fibroblasts derived from adult human skin as a final product under good manufacturing practice-compliant conditions.
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Affiliation(s)
- Nurullah Aydoğdu
- Liv Hospital, Center of Regenerative Medicine and Stem Cell Research, Istanbul, Turkey
| | - Olga Nehir Öztel
- Liv Hospital, Center of Regenerative Medicine and Stem Cell Research, Istanbul, Turkey
| | - Erdal Karaöz
- Liv Hospital, Center of Regenerative Medicine and Stem Cell Research, Istanbul, Turkey.
- Istinye University, Faculty of Medicine, Department of Histology and Embryology, Istanbul, Turkey.
- Istinye University, Center for Stem Cell and Tissue Engineering Research & Practice, Istanbul, Turkey.
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Andriolo G, Provasi E, Brambilla A, Lo Cicero V, Soncin S, Barile L, Turchetto L, Radrizzani M. GMP-Grade Methods for Cardiac Progenitor Cells: Cell Bank Production and Quality Control. Methods Mol Biol 2021; 2286:131-166. [PMID: 33381854 DOI: 10.1007/7651_2020_286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Cardiac explant-derived cells (cEDC), also referred as cardiac progenitors cells (CPC) (Barile et al., Cardiovasc Res 103(4):530-541, 2014; Barile et al., Cardiovasc Res 114(7):992-1005, 2018), represent promising candidates for the development of cell-based therapies, a novel and interesting treatment for cardioprotective strategy in heart failure (Kreke et al., Expert Rev Cardiovasc Ther 10(9):1185-1194, 2012). CPC have been tested in a preclinical setting for direct cell transplantation and tissue engineering or as a source for production of extracellular vesicles (EV) (Oh et al., J Cardiol 68(5):361-367, 2016; Barile et al., Eur Heart J 38(18):1372-1379, 2017; Rosen et al., J Am Coll Cardiol 64(9):922-937, 2014). CPC cultured as cardiospheres derived cells went through favorable Phase 1 and 2 studies demonstrating safety and possible efficacy (Makkar et al., Lancet 379(9819):895-904, 2012; Ishigami et al., Circ Res 120(7):1162-1173, 2017; Ishigami et al., Circ Res 116 (4):653-664, 2015; Tarui et al., J Thorac Cardiovasc Surg 150(5):1198-1207, 1208 e1191-1192, 2015). In this context and in view of clinical applications, cells have to be prepared and released according to Good Manufacturing Practices (GMP) (EudraLex-volume 4-good manufacturing practice (GMP) guidelines-Part I-basic requirements for medicinal products. http://ec.europa.eu/health/documents/eudralex/vol-4 ; EudraLex-volume 4-good manufacturing practice (GMP) guidelines-Part IV-guidelines on good manufacturing practices specific to advanced therapy medicinal products. http://ec.europa.eu/health/documents/eudralex/vol-4 ). This chapter describes GMP-grade methods for production and testing of a CPC Master Cell Bank (MCB), consisting of frozen aliquots of cells that may be used either as a therapeutic product or as source for the manufacturing of Exo for clinical trials.The MCB production method has been designed to isolate and expand CPC from human cardiac tissue in xeno-free conditions (Andriolo et al., Front Physiol 9:1169, 2018). The quality control (QC) methods have been implemented to assess the safety (sterility, endotoxin, mycoplasma, cell senescence, tumorigenicity) and identity/potency/purity (cell count and viability, RT-PCR, immunophenotype) of the cells (Andriolo et al., Front Physiol 9:1169, 2018).
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Affiliation(s)
- Gabriella Andriolo
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Elena Provasi
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Andrea Brambilla
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Viviana Lo Cicero
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Sabrina Soncin
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Lucio Barile
- Laboratory for Cardiovascular Theranostics, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Lucia Turchetto
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Marina Radrizzani
- Lugano Cell Factory, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
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Garza KP, Weil LEG, Anderson LM, Naranjo D, Barnard-Kelly KD, Laffel L, Hood KK, Weissberg-Benchell J. You, me, and diabetes: Intimacy and technology among adults with T1D and their partners. Fam Syst Health 2020; 38:418-427. [PMID: 33591783 DOI: 10.1037/fsh0000485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Limited research has examined the impact of technology on intimacy and relationships among individuals with type 1 diabetes (T1D). The current study examined the experiences of individuals with T1D and their partners and evaluated the expectations for how advances in technology such as automated insulin delivery systems may impact physical intimacy. METHOD The Insulin Delivery Systems: Perceptions, Ideas, Reflections and Expectations (INSPIRE) study is a multisite study examining expectations for automated insulin delivery systems among adults and youth with T1D as well as partners and caregivers. For the current analysis, data regarding the impact of diabetes on relationship intimacy were extracted from focus groups or individual semistructured interviews with adults with T1D (n = 113) and partners of individuals with T1D (n = 55). RESULTS Three independent coders conducted thematic analysis utilizing NVivo software. Two primary themes were identified: vulnerability in romantic relationships because of managing diabetes and the unique challenges of physical intimacy because of the use of diabetes technology. CONCLUSIONS Participants expressed the hope that diabetes technology, and automated insulin delivery systems in particular, will offer opportunities for flexibility in their diabetes management. These options may decrease their sense of vulnerability through provision of greater control over diabetes management and when/whether to disclose diabetes, minimizing discomforts in the context of sexual intimacy, and reduction of fear about diabetes complications. Patient-reported outcomes and expectations for diabetes technology should be incorporated into patient-provider conversations about sensitive issues. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Tsai T, Ling T, Lee C. Adoption of Regulations for Cell Therapy Development: Linkage Between Taiwan and Japan. Clin Transl Sci 2020; 13:1045-1047. [PMID: 32407601 PMCID: PMC7719390 DOI: 10.1111/cts.12813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/04/2020] [Indexed: 11/28/2022] Open
Abstract
Although cell-based therapy has become a promising treatment, its practice and evaluation process remain unstandardized. Therefore, Japan initiated a dual-track regulatory framework for cell-based therapy aiming to promote and regulate the therapies to ensure that patients can access safe and effective treatments. Influenced by such pathway, Taiwan adopted the framework and initiated its own cell-based therapy regulation in 2018. This paper discusses how Japan has influenced Taiwan in developing regulations for cell-based therapy.
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Affiliation(s)
- Teng‐Huang Tsai
- PhD Program in Biotechnology Research and DevelopmentSchool of PharmacyTaipei Medical UniversityTaipeiTaiwan
| | - Thai‐Yen Ling
- Department of PharmacologyCollege of MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Chung‐Hsi Lee
- Graduate Institute of Health and Biotechnology LawTaipei Medical UniversityTaipeiTaiwan
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Khanh TQ, Hao PN, Roitman E, Raz I, Marganitt B, Cahn A. Digital Diabetes Care System Observations from a Pilot Evaluation Study in Vietnam. Int J Environ Res Public Health 2020; 17:ijerph17030937. [PMID: 32028707 PMCID: PMC7037177 DOI: 10.3390/ijerph17030937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 01/31/2020] [Accepted: 02/01/2020] [Indexed: 11/29/2022]
Abstract
Digital technologies are gaining an important role in the management of patients with diabetes. We assessed clinical outcomes and user satisfaction of incorporating a digital diabetes care system in diabetes clinics of a developing country. The system integrated a wireless blood glucose monitor that communicates data to any smartphone utilizing a patented acoustic data transfer method, a mobile-app, and cloud-based software that stores, analyzes, and presents data. Five hospital endocrinology clinics in Vietnam sequentially recruited all patients willing to join the study, providing they had a smartphone and access to internet connectivity. Face-to-face visits were conducted at baseline and at 12 weeks, with monthly digital visits scheduled in the interim and additional digital visits performed as needed. HbA1c levels were measured at baseline and at 12 weeks (±20 days). The study included 300 patients of whom 279 completed the evaluation. Average glucose levels declined from 170.4 ± 64.6 mg/dL in the first 2 weeks to 150.8 ± 53.2 mg/dL in the last 2 weeks (n = 221; p < 0.001). HbA1c levels at baseline and 12 weeks declined from 8.3% ± 1.9% to 7.6% ± 1.3% (n = 126; p < 0.001). The digital solution was broadly accepted by both patients and healthcare professionals and improved glycemic outcomes. The durability, scalability, and cost-effectiveness of this approach merits further study.
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Affiliation(s)
- Tran Quang Khanh
- Head of Endocrinology Department, University of Medicine and Pharmacy, Ho Chi Minh City 72000, Vietnam;
| | - Pham Nhu Hao
- Department of Endocrinology, University of Medicine and Pharmacy, Ho Chi Minh City 72000, Vietnam;
| | - Eytan Roitman
- Head Diabetes Technologies Clinic, Diabetes consultant to the Clalit Health Services, Tel Aviv 6209804, Israel;
| | - Itamar Raz
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem 91120, Israel;
| | | | - Avivit Cahn
- Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem 91120, Israel;
- Correspondence: ; Tel.: 97-226-776-498; Fax: 97-226-437-940
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Arjmand B, Alavi-Moghadam S, Payab M, Goodarzi P, Sheikh Hosseini M, Tayanloo-Beik A, Rezaei-Tavirani M, Larijani B. GMP-Compliant Adenoviral Vectors for Gene Therapy. Methods Mol Biol 2020; 2286:237-250. [PMID: 32504293 DOI: 10.1007/7651_2020_284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Recently, gene therapy as one of the most promising treatments can apply genes for incurable diseases treatment. In this context, vectors as gene delivery systems play a pivotal role in gene therapy procedure. Hereupon, viral vectors have been increasingly introduced as a hyper-efficient tools for gene therapy. Adenoviral vectors as one of the most common groups which are used in gene therapy have a high ability for humans. Indeed, they are not integrated into host genome. In other words, they can be adapted for direct transduction of recombinant proteins into targeted cells. Moreover, they have large packaging capacity and high levels of efficiency and expression. In accordance with translational pathways from the basic to the clinic, recombinant adenoviral vectors packaging must be managed under good manufacturing practice (GMP) principles before applying in clinical trials. Therein, in this chapter standard methods for manufacturing of GMP-compliant Adenoviral vectors for gene therapy have been introduced.
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Affiliation(s)
- Babak Arjmand
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sepideh Alavi-Moghadam
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Payab
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Goodarzi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Motahareh Sheikh Hosseini
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Tayanloo-Beik
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Abimbola S, Patel B, Peiris D, Patel A, Harris M, Usherwood T, Greenhalgh T. The NASSS framework for ex post theorisation of technology-supported change in healthcare: worked example of the TORPEDO programme. BMC Med 2019; 17:233. [PMID: 31888718 PMCID: PMC6937726 DOI: 10.1186/s12916-019-1463-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evaluation of health technology programmes should be theoretically informed, interdisciplinary, and generate in-depth explanations. The NASSS (non-adoption, abandonment, scale-up, spread, sustainability) framework was developed to study unfolding technology programmes in real time-and in particular to identify and manage their emergent uncertainties and interdependencies. In this paper, we offer a worked example of how NASSS can also inform ex post (i.e. retrospective) evaluation. METHODS We studied the TORPEDO (Treatment of Cardiovascular Risk in Primary Care using Electronic Decision Support) research programme, a multi-faceted computerised quality improvement intervention for cardiovascular disease prevention in Australian general practice. The technology (HealthTracker) had shown promise in a cluster randomised controlled trial (RCT), but its uptake and sustainability in a real-world implementation phase was patchy. To explain this variation, we used NASSS to undertake secondary analysis of the multi-modal TORPEDO dataset (results and process evaluation of the RCT, survey responses, in-depth professional interviews, videotaped consultations) as well as a sample of new, in-depth narrative interviews with TORPEDO researchers. RESULTS Ex post analysis revealed multiple areas of complexity whose influence and interdependencies helped explain the wide variation in uptake and sustained use of the HealthTracker technology: the nature of cardiovascular risk in different populations, the material properties and functionality of the technology, how value (financial and non-financial) was distributed across stakeholders in the system, clinicians' experiences and concerns, organisational preconditions and challenges, extra-organisational influences (e.g. policy incentives), and how interactions between all these influences unfolded over time. CONCLUSION The NASSS framework can be applied retrospectively to generate a rich, contextualised narrative of technology-supported change efforts and the numerous interacting influences that help explain its successes, failures, and unexpected events. A NASSS-informed ex post analysis can supplement earlier, contemporaneous evaluations to uncover factors that were not apparent or predictable at the time but dynamic and emergent.
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Affiliation(s)
- Seye Abimbola
- School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia
- Centre for Health Systems Science, The George Institute for Global Health, University of New South Wales, Level 5/1 King St, Newtown, NSW, 2042, Australia
| | - Bindu Patel
- Centre for Health Systems Science, The George Institute for Global Health, University of New South Wales, Level 5/1 King St, Newtown, NSW, 2042, Australia
| | - David Peiris
- Centre for Health Systems Science, The George Institute for Global Health, University of New South Wales, Level 5/1 King St, Newtown, NSW, 2042, Australia
| | - Anushka Patel
- Centre for Health Systems Science, The George Institute for Global Health, University of New South Wales, Level 5/1 King St, Newtown, NSW, 2042, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Tim Usherwood
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Trisha Greenhalgh
- Centre for Health Systems Science, The George Institute for Global Health, University of New South Wales, Level 5/1 King St, Newtown, NSW, 2042, Australia.
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
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Greaves F, Joshi I, Campbell M, Roberts S, Patel N, Powell J. What is an appropriate level of evidence for a digital health intervention? Lancet 2019; 392:2665-2667. [PMID: 30545779 DOI: 10.1016/s0140-6736(18)33129-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 12/03/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Felix Greaves
- Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK; Public Health England, London, UK.
| | | | - Mark Campbell
- National Institute for Health and Care Excellence, London, UK
| | | | | | - John Powell
- National Institute for Health and Care Excellence, London, UK; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Abstract
Access to health care has long been considered to be a human right. It was formally declared in 1946 when the heads of states wrote the constitution of the World Health Organization (WHO). But more than 70 years after the fact, the global community still has yet to achieve it.
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Deagle H. Technology in Healthcare: Differing Points of View. Nurs Leadersh (Tor Ont) 2019; 32:46-47. [PMID: 31613213 DOI: 10.12927/cjnl.2019.25962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this poem, the author considers healthcare technology from the perspective of the patient, and of the nurse.
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Affiliation(s)
- Heidi Deagle
- Clinical Instructor and Academic Advisor Bachelor of Science in Nursing Program North Island College, Comox Valley, BC
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12
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Crispi F, Naci H, Barkauskaite E, Osipenko L, Mossialos E. Assessment of Devices, Diagnostics and Digital Technologies: A Review of NICE Medical Technologies Guidance. Appl Health Econ Health Policy 2019; 17:189-211. [PMID: 30367349 DOI: 10.1007/s40258-018-0438-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND The Medical Technologies Evaluation Programme (MTEP) of NICE in England aims to evaluate medical devices that are deemed to be cost-saving or cost-neutral and produce Medical Technology Guidance (MTG) to encourage their adoption. OBJECTIVE To review the MTGs since MTEP's inception in 2009 until February 2017. METHODS One researcher assessed all published MTGs and extracted data on the clinical and economic evidence supporting each technology. The NICE Committee's decision outcome for each assessment was also recorded. A qualitative analysis was performed on technologies that were not supported for adoption to identify the main drivers of the decision. RESULTS Thirty-one MTGs were reviewed. The committee fully supported the medical devices in 14 MTGs, 11 were partially supported and six were not supported. Of the MTGs, 58% had no RCT data available and the main source of evidence came from non-experimental studies. There was no statistically significant difference in the average number of RCTs and non-experimental studies between the fully-supported, partially-supported, and not-supported technologies. Whilst all the fully-supported MTGs demonstrated cost-saving results, only 50% of the not-supported MTGs did. The sponsor estimated a higher average cost-saving than the EAC in most of the cases (20/31). The qualitative evaluation suggests that the main drivers for negative decisions were the quantity or quality of studies, and costs incurred in the economic evaluation results. CONCLUSIONS The main drivers of the decision-making process are the quality and quantity of the submitted evidence supporting the technologies, as well as the economic evaluation results.
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Affiliation(s)
- Francisca Crispi
- LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, 20 Houghton St, London, WC2A 2AE, UK
| | - Huseyin Naci
- LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, 20 Houghton St, London, WC2A 2AE, UK.
| | - Eva Barkauskaite
- NICE Scientific Advice, National Institute for Health and Care Excellence, 10 Spring Gardens, London, SW1A 2BU, UK
| | - Leeza Osipenko
- NICE Scientific Advice, National Institute for Health and Care Excellence, 10 Spring Gardens, London, SW1A 2BU, UK
| | - Elias Mossialos
- LSE Health, Department of Health Policy, London School of Economics and Political Science, Houghton Street, 20 Houghton St, London, WC2A 2AE, UK
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Crossley B. Multigas Monitors: Overview and Preventive Maintenance Essentials. Biomed Instrum Technol 2019; 52:477. [PMID: 30479150 DOI: 10.2345/0899-8205-52.6.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Braithwaite-Nelson C, Benjamin T, Parker RD. What to Expect in the Third Edition of ST72. Biomed Instrum Technol 2019; 52:474-476. [PMID: 30479139 DOI: 10.2345/0899-8205-52.6.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Carolyn Braithwaite-Nelson
- Carolyn Braithwaite-Nelson, MS, is senior sterility and biocompatibility engineer at Philips in Colorado Springs, CO, and cochair of AAMI ST/WG 08.
| | - Tami Benjamin
- Tami Benjamin, BS, is director of quality and compliance for Johnson and Johnson in Lititz, PA, and a member of AAMI ST/WG 08.
| | - Rodney D Parker
- Rodney D. Parker, PhD, is senior principal scientist at Stryker in Kalamazoo, MI, and chair of the Orthopedic Surgical Manufacturers Association industry group task force on sterilization.
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15
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Wirth A. Keeping Track of All the Moving Pieces. Biomed Instrum Technol 2019; 52:467-471. [PMID: 30479149 DOI: 10.2345/0899-8205-52.6.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Abstract
Meaningful participant engagement has been identified as a key contributor to the success of efforts to share data via a "Medical Information Commons" (MIC). We present findings from expert stakeholder interviews aimed at understanding barriers to engagement and the appropriate role of MIC participants. Although most interviewees supported engagement, they distinguished between individual versus collective forms. They also noted challenges including representation and perceived inefficiency, prompting reflection on political aspects of engagement and efficiency concerns.
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Affiliation(s)
- Mary A Majumder
- Mary A. Majumder, J.D., Ph.D., is an Associate Professor of Medicine at the Center for Medical Ethics and Health Policy, Baylor College of Medicine. Juli M. Bollinger, M.S., is a Research Associate in the Center for Medical Ethics and Health Policy at the Baylor College of Medicine and a Research Associate and Associate Faculty at the Berman Institute of Bioethics at Johns Hopkins University. Angela G. Villanueva, M.P.H., is a Research Associate at the Center for Medical Ethics and Health Policy at Baylor College of Medicine. Patricia A. Deverka, M.D., M.S., M.B.E., is Director, Value Evidence and Outcomes at Geisinger National Precision Health, where she focuses on demonstrating the value of genomic sequencing for health systems and policymakers. Barbara A. Koenig, Ph.D., is Professor of Bioethics and Medical Anthropology, based at the Institute for Health & Aging, University of California, San Francisco. She serves as Director of the UCSF Program in Bioethics. Previously, Prof. Koenig was the founding executive director of the Center for Biomedical Ethics at Stanford University; she created and led the Bioethics Research Program at the Mayo Clinic in Rochester, Minn
| | - Juli M Bollinger
- Mary A. Majumder, J.D., Ph.D., is an Associate Professor of Medicine at the Center for Medical Ethics and Health Policy, Baylor College of Medicine. Juli M. Bollinger, M.S., is a Research Associate in the Center for Medical Ethics and Health Policy at the Baylor College of Medicine and a Research Associate and Associate Faculty at the Berman Institute of Bioethics at Johns Hopkins University. Angela G. Villanueva, M.P.H., is a Research Associate at the Center for Medical Ethics and Health Policy at Baylor College of Medicine. Patricia A. Deverka, M.D., M.S., M.B.E., is Director, Value Evidence and Outcomes at Geisinger National Precision Health, where she focuses on demonstrating the value of genomic sequencing for health systems and policymakers. Barbara A. Koenig, Ph.D., is Professor of Bioethics and Medical Anthropology, based at the Institute for Health & Aging, University of California, San Francisco. She serves as Director of the UCSF Program in Bioethics. Previously, Prof. Koenig was the founding executive director of the Center for Biomedical Ethics at Stanford University; she created and led the Bioethics Research Program at the Mayo Clinic in Rochester, Minn
| | - Angela G Villanueva
- Mary A. Majumder, J.D., Ph.D., is an Associate Professor of Medicine at the Center for Medical Ethics and Health Policy, Baylor College of Medicine. Juli M. Bollinger, M.S., is a Research Associate in the Center for Medical Ethics and Health Policy at the Baylor College of Medicine and a Research Associate and Associate Faculty at the Berman Institute of Bioethics at Johns Hopkins University. Angela G. Villanueva, M.P.H., is a Research Associate at the Center for Medical Ethics and Health Policy at Baylor College of Medicine. Patricia A. Deverka, M.D., M.S., M.B.E., is Director, Value Evidence and Outcomes at Geisinger National Precision Health, where she focuses on demonstrating the value of genomic sequencing for health systems and policymakers. Barbara A. Koenig, Ph.D., is Professor of Bioethics and Medical Anthropology, based at the Institute for Health & Aging, University of California, San Francisco. She serves as Director of the UCSF Program in Bioethics. Previously, Prof. Koenig was the founding executive director of the Center for Biomedical Ethics at Stanford University; she created and led the Bioethics Research Program at the Mayo Clinic in Rochester, Minn
| | - Patricia A Deverka
- Mary A. Majumder, J.D., Ph.D., is an Associate Professor of Medicine at the Center for Medical Ethics and Health Policy, Baylor College of Medicine. Juli M. Bollinger, M.S., is a Research Associate in the Center for Medical Ethics and Health Policy at the Baylor College of Medicine and a Research Associate and Associate Faculty at the Berman Institute of Bioethics at Johns Hopkins University. Angela G. Villanueva, M.P.H., is a Research Associate at the Center for Medical Ethics and Health Policy at Baylor College of Medicine. Patricia A. Deverka, M.D., M.S., M.B.E., is Director, Value Evidence and Outcomes at Geisinger National Precision Health, where she focuses on demonstrating the value of genomic sequencing for health systems and policymakers. Barbara A. Koenig, Ph.D., is Professor of Bioethics and Medical Anthropology, based at the Institute for Health & Aging, University of California, San Francisco. She serves as Director of the UCSF Program in Bioethics. Previously, Prof. Koenig was the founding executive director of the Center for Biomedical Ethics at Stanford University; she created and led the Bioethics Research Program at the Mayo Clinic in Rochester, Minn
| | - Barbara A Koenig
- Mary A. Majumder, J.D., Ph.D., is an Associate Professor of Medicine at the Center for Medical Ethics and Health Policy, Baylor College of Medicine. Juli M. Bollinger, M.S., is a Research Associate in the Center for Medical Ethics and Health Policy at the Baylor College of Medicine and a Research Associate and Associate Faculty at the Berman Institute of Bioethics at Johns Hopkins University. Angela G. Villanueva, M.P.H., is a Research Associate at the Center for Medical Ethics and Health Policy at Baylor College of Medicine. Patricia A. Deverka, M.D., M.S., M.B.E., is Director, Value Evidence and Outcomes at Geisinger National Precision Health, where she focuses on demonstrating the value of genomic sequencing for health systems and policymakers. Barbara A. Koenig, Ph.D., is Professor of Bioethics and Medical Anthropology, based at the Institute for Health & Aging, University of California, San Francisco. She serves as Director of the UCSF Program in Bioethics. Previously, Prof. Koenig was the founding executive director of the Center for Biomedical Ethics at Stanford University; she created and led the Bioethics Research Program at the Mayo Clinic in Rochester, Minn
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Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Maier-Hein L, Eisenmann M, Reinke A, Onogur S, Stankovic M, Scholz P, Arbel T, Bogunovic H, Bradley AP, Carass A, Feldmann C, Frangi AF, Full PM, van Ginneken B, Hanbury A, Honauer K, Kozubek M, Landman BA, März K, Maier O, Maier-Hein K, Menze BH, Müller H, Neher PF, Niessen W, Rajpoot N, Sharp GC, Sirinukunwattana K, Speidel S, Stock C, Stoyanov D, Taha AA, van der Sommen F, Wang CW, Weber MA, Zheng G, Jannin P, Kopp-Schneider A. Why rankings of biomedical image analysis competitions should be interpreted with care. Nat Commun 2018; 9:5217. [PMID: 30523263 PMCID: PMC6284017 DOI: 10.1038/s41467-018-07619-7] [Citation(s) in RCA: 143] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/07/2018] [Indexed: 11/08/2022] Open
Abstract
International challenges have become the standard for validation of biomedical image analysis methods. Given their scientific impact, it is surprising that a critical analysis of common practices related to the organization of challenges has not yet been performed. In this paper, we present a comprehensive analysis of biomedical image analysis challenges conducted up to now. We demonstrate the importance of challenges and show that the lack of quality control has critical consequences. First, reproducibility and interpretation of the results is often hampered as only a fraction of relevant information is typically provided. Second, the rank of an algorithm is generally not robust to a number of variables such as the test data used for validation, the ranking scheme applied and the observers that make the reference annotations. To overcome these problems, we recommend best practice guidelines and define open research questions to be addressed in the future.
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Affiliation(s)
- Lena Maier-Hein
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.
| | - Matthias Eisenmann
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Annika Reinke
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Sinan Onogur
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Marko Stankovic
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Patrick Scholz
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Tal Arbel
- Centre for Intelligent Machines, McGill University, Montreal, QC, H3A0G4, Canada
| | - Hrvoje Bogunovic
- Christian Doppler Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology, Medical University Vienna, 1090, Vienna, Austria
| | - Andrew P Bradley
- Science and Engineering Faculty, Queensland University of Technology, Brisbane, QLD, 4001, Australia
| | - Aaron Carass
- Department of Electrical and Computer Engineering, Department of Computer Science, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Carolin Feldmann
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Alejandro F Frangi
- CISTIB - Center for Computational Imaging & Simulation Technologies in Biomedicine, The University of Leeds, Leeds, Yorkshire, LS2 9JT, UK
| | - Peter M Full
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Bram van Ginneken
- Department of Radiology and Nuclear Medicine, Medical Image Analysis, Radboud University Center, 6525 GA, Nijmegen, The Netherlands
| | - Allan Hanbury
- Institute of Information Systems Engineering, TU Wien, 1040, Vienna, Austria
- Complexity Science Hub Vienna, 1080, Vienna, Austria
| | - Katrin Honauer
- Heidelberg Collaboratory for Image Processing (HCI), Heidelberg University, 69120, Heidelberg, Germany
| | - Michal Kozubek
- Centre for Biomedical Image Analysis, Masaryk University, 60200, Brno, Czech Republic
| | - Bennett A Landman
- Electrical Engineering, Vanderbilt University, Nashville, TN, 37235-1679, USA
| | - Keno März
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Oskar Maier
- Institute of Medical Informatics, Universität zu Lübeck, 23562, Lübeck, Germany
| | - Klaus Maier-Hein
- Division of Medical Image Computing (MIC), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Bjoern H Menze
- Institute for Advanced Studies, Department of Informatics, Technical University of Munich, 80333, Munich, Germany
| | - Henning Müller
- Information System Institute, HES-SO, Sierre, 3960, Switzerland
| | - Peter F Neher
- Division of Medical Image Computing (MIC), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Wiro Niessen
- Departments of Radiology, Nuclear Medicine and Medical Informatics, Erasmus MC, 3015 GD, Rotterdam, The Netherlands
| | - Nasir Rajpoot
- Department of Computer Science, University of Warwick, Coventry, CV4 7AL, UK
| | - Gregory C Sharp
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | | | - Stefanie Speidel
- Division of Translational Surgical Oncology (TCO), National Center for Tumor Diseases Dresden, 01307, Dresden, Germany
| | - Christian Stock
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Danail Stoyanov
- Centre for Medical Image Computing (CMIC) & Department of Computer Science, University College London, London, W1W 7TS, UK
| | - Abdel Aziz Taha
- Data Science Studio, Research Studios Austria FG, 1090, Vienna, Austria
| | - Fons van der Sommen
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB, Eindhoven, The Netherlands
| | - Ching-Wei Wang
- AIExplore, NTUST Center of Computer Vision and Medical Imaging, Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, 106, Taiwan
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, 18051, Rostock, Germany
| | - Guoyan Zheng
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, 3014, Switzerland
| | - Pierre Jannin
- Univ Rennes, Inserm, LTSI (Laboratoire Traitement du Signal et de l'Image) - UMR_S 1099, Rennes, 35043, Cedex, France
| | - Annette Kopp-Schneider
- Division of Biostatistics, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
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Kontogiannopoulos S, Vangelatos Z, Bertos GA, Papadopoulos E. A Biomechatronic EPP upper-limb prosthesis controller and its performance comparison to other topologies. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2018:1755-1758. [PMID: 30440735 DOI: 10.1109/embc.2018.8512698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Historically, Classic Extended Physiological Proprioception (EPP) as an upper-limb prosthesis control topology has been outperforming functionally all other topologies of the past. A novel Biomechatronic EPP controller has been designed to overcome shortcomings of the classic EPP control topology, and has been hypothesized to be functionally equivalent to the classic EPP topology. Using the dSpace realtime hardware platform and other mechanical and electronic components, the following were developed in the lab: (a) A Biomechatronic EPP controller, (b) a classic EPP controller, (c) an "unconnected" controller and (d) an EMG controller. All four topologies were tested in the lab using the target experiments methodology. Initial results of one subject show that performance of (a) is superior or comparable to (b) and superior to (c) and (d).
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Sheffer J. Frontlines: Curbing Medical Device Misuse. Biomed Instrum Technol 2018; 51:444. [PMID: 29161125 DOI: 10.2345/0899-8205-51.6.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Sheffer J, Bettinardi C, Cohen T, Fennigkoh L, Lipschultz A, Jacques S. A Roundtable Discussion: Leveraging Data to Benefit Healthcare Technology Management. Biomed Instrum Technol 2018; 51:498-503. [PMID: 29161127 DOI: 10.2345/0899-8205-51.6.498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Crossley B. Considerations Surrounding TENS Units and Patient-Used CPAP and BPAP Machines. Biomed Instrum Technol 2018; 51:522-523. [PMID: 29161130 DOI: 10.2345/0899-8205-51.6.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Mills G. Reflections on HTM, Compliance, and Patient Safety. Biomed Instrum Technol 2018; 51:456. [PMID: 29161131 DOI: 10.2345/0899-8205-51.6.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Lynch PK. How to Get What You Need (or Want). Biomed Instrum Technol 2018; 51:524. [PMID: 29161133 DOI: 10.2345/0899-8205-51.6.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Torous J, Grunau Z, Thom R, Boland R, Meyer F. Connecting Through Technology: a Collaborative Psychiatry Trainee and Educator Online Platform. Acad Psychiatry 2018; 42:426-427. [PMID: 29589339 DOI: 10.1007/s40596-018-0910-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/19/2018] [Indexed: 06/08/2023]
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Abstract
PURPOSE OF REVIEW As digital technology becomes more ubiquitous, understanding the current state-of-the-art in digital information use for clinical care and research for patients with rheumatoid arthritis (RA) is timely and relevant. RECENT FINDINGS The opportunities for recording and utilizing high-quality data from rheumatologists are reviewed, as well as opportunities from collecting, integrating and analysing patient-generated data to deliver a step-change in the support and management of RA. SUMMARY Once greater adoption, standardization and implementation of relevant RA measures are in place within electronic health records (EHRs), patient care will improve and the ability to learn from aggregate experiences increases dramatically. Incorporating passive and patient-reported outcomes into self-management apps and integrating such data into the patient's health record will provide more responsive and better treatment results.
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Affiliation(s)
- William G. Dixon
- Arthritis Research UK Centre for Epidemiology, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester
| | - Kaleb Michaud
- Division of Rheumatology and Immunology, Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska and The National Databank for Rheumatic Diseases, Wichita, Kansas, USA
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Schoener B, Baird P, Dorn L, Giuliano KK, Ho M, Jump M, Sahiner B, Zink R. Using Data-Based Decisions to Transform Health Technology and Improve Patient Care. Biomed Instrum Technol 2018; 52:7-16. [PMID: 29775385 DOI: 10.2345/0899-8205-52.s2.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Stern G. Creating a 'Guiding Light' Form to Coordinate HTM and IT Projects. Biomed Instrum Technol 2018; 52:314-317. [PMID: 30070905 DOI: 10.2345/0899-8205-52.4.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Sheffer J, Berek B, Jacobs K, Knapp J, Maguire B, Waninger K. A Roundtable Discussion: Embedding Quality Management Principles into Health Technology and Patient Care. Biomed Instrum Technol 2018; 52:305-309. [PMID: 30070911 DOI: 10.2345/0899-8205-52.4.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Sheffer J. Frontlines: To Hatch a Standard. Biomed Instrum Technol 2017; 51:356. [PMID: 28934573 DOI: 10.2345/0899-8205-51.5.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Brady TC, Panagiotopoulos G. An Integrated Nine-Step Approach to Managing Clinical Technology Risks. Biomed Instrum Technol 2017; 51:398-407. [PMID: 28934580 DOI: 10.2345/0899-8205-51.5.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Houngbo PT, De Cock Buning T, Bunders J, Coleman HLS, Medenou D, Dakpanon L, Zweekhorst M. Ineffective Healthcare Technology Management in Benin's Public Health Sector: The Perceptions of Key Actors and Their Ability to Address the Main Problems. Int J Health Policy Manag 2017; 6:587-600. [PMID: 28949474 PMCID: PMC5627786 DOI: 10.15171/ijhpm.2017.17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 02/07/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Low-income countries face many contextual challenges to manage healthcare technologies effectively, as the majority are imported and resources are constrained to a greater extent. Previous healthcare technology management (HTM) policies in Benin have failed to produce better quality of care for the population and costeffectiveness for the government. This study aims to identify and assess the main problems facing HTM in Benin's public health sector, as well as the ability of key actors within the sector to address these problems. METHODS We conducted 2 surveys in 117 selected health facilities. The first survey was based on 377 questionnaires and 259 interviews, and the second involved observation and group interviews at health facilities. The Temple-Bird Healthcare Technology Package System (TBHTPS), tailored to the context of Benin's health system, was used as a conceptual framework. RESULTS The findings of the first survey show that 85% of key actors in Benin's HTM sector characterized the system as failing in components of the TBHTPS framework. Biomedical, clinical, healthcare technology engineers and technicians perceived problems most severely, followed by users of equipment, managers and hospital directors, international organization officers, local and foreign suppliers, and finally policy-makers, planners and administrators at the Ministry of Health (MoH). The 5 most important challenges to be addressed are policy, strategic management and planning, and technology needs assessment and selection - categorized as major enabling inputs (MEI) in HTM by the TBHTPS framework - and installation and commissioning, training and skill development and procurement, which are import and use activities (IUA). The ability of each key actor to address these problems (the degree of political or administrative power they possess) was inversely proportional to their perception of the severity of the problems. Observational data gathered during site visits described a different set of challenges including maintenance and repair, distribution, installation and commissioning, use and training and personnel skill development. CONCLUSION The lack of experiential and technical knowledge in policy development processes could underpin many of the continuing problems in Benin's HTM system. Before solutions can be devised to these problems, it is necessary to investigate their root causes, and which problems are most amenable to policy development.
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Affiliation(s)
| | | | - Joske Bunders
- Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Daton Medenou
- Polytechnic School, University of Abomey-Calavi, Cotonou, Republic of Benin
| | - Laurent Dakpanon
- Polytechnic School, University of Abomey-Calavi, Cotonou, Republic of Benin
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Abstract
The complexity of medical devices and the processes by which they are developed pose considerable challenges to producing safe designs and regulatory submissions that are amenable to effective reviews. Designing an appropriate and clearly documented architecture can be an important step in addressing this complexity. Best practices in medical device design embrace the notion of a safety architecture organized around distinct operation and safety requirements. By explicitly separating many safety-related monitoring and mitigation functions from operational functionality, the aspects of a device most critical to safety can be localized into a smaller and simpler safety subsystem, thereby enabling easier verification and more effective reviews of claims that causes of hazardous situations are detected and handled properly. This article defines medical device safety architecture, describes its purpose and philosophy, and provides an example. Although many of the presented concepts may be familiar to those with experience in realization of safety-critical systems, this article aims to distill the essence of the approach and provide practical guidance that can potentially improve the quality of device designs and regulatory submissions.
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Abstract
This article discusses the role of healthcare technology management (HTM) in medical device cybersecurity and outlines concepts that are applicable to HTM professionals at a healthcare delivery organization or at an integrated delivery network, regardless of size. It provides direction for HTM professionals who are unfamiliar with the security aspects of managing healthcare technologies but are familiar with standards from The Joint Commission (TJC). It provides a useful set of recommendations, including relevant references for incorporating good security practices into HTM practice. Recommendations for policies, procedures, and processes referencing TJC standards are easily applicable to HTM departments with limited resources and to those with no resource concerns. The authors outline processes from their organization as well as best practices learned through information sharing at AAMI, National Health Information Sharing and Analysis Center (NH-ISAC), and Medical Device Innovation, Safety, and Security Consortium (MDISS) conferences and workshops.
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Carroll C, Kaltenthaler E, Hill-McManus D, Scope A, Holmes M, Rice S, Rose M, Tappenden P, Woolacott N. The Type and Impact of Evidence Review Group Exploratory Analyses in the NICE Single Technology Appraisal Process. Value Health 2017; 20:785-791. [PMID: 28577696 DOI: 10.1016/j.jval.2016.08.729] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 08/08/2016] [Accepted: 08/17/2016] [Indexed: 06/07/2023]
Abstract
BACKGROUND As part of the UK National Institute for Health and Care Excellence (NICE) single technology appraisal process, independent evidence review groups (ERGs) critically appraise a company's submission relating to a specific technology and indication. OBJECTIVES To explore the type of additional exploratory analyses conducted by ERGs and their impact on the recommendations made by NICE. METHODS The 100 most recently completed single technology appraisals with published guidance were selected for inclusion. A content analysis of relevant documents was undertaken to identify and extract relevant data, and narrative synthesis was used to rationalize and present these data. RESULTS The types of exploratory analysis conducted in relation to companies' models were fixing errors, addressing violations, addressing matters of judgment, and the provision of a new, ERG-preferred base case. Ninety-three of the 100 ERG reports contained at least one of these analyses. The most frequently reported type of analysis in these 93 ERG reports related to the category "Matters of judgment," which was reported in 83 reports (89%). At least one of the exploratory analyses conducted and reported by an ERG is mentioned in 97% of NICE appraisal consultation documents and 94% of NICE final appraisal determinations, and had a clear influence on recommendations in 72% of appraisal consultation documents and 47% of final appraisal determinations. CONCLUSIONS These results suggest that the additional analyses undertaken by ERGs in the appraisal of company submissions are highly influential in the policy-making and decision-making process.
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Affiliation(s)
| | | | | | | | | | | | - Micah Rose
- University of Southampton, Southampton, UK
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Sheffer J, Hettinger Z, Lowry L, Mander A, Suarez W, Weinger MB, Wiklund M. A Roundtable Discussion: Usability, Human Factors, and Health IT: Providing Effective Guidance While Nurturing Innovation. Biomed Instrum Technol 2017; 51:252-259. [PMID: 28530884 DOI: 10.2345/0899-8205-51.3.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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DeFrancesco J. Arguing for Capability, Competence, and Capacity in HTM. Biomed Instrum Technol 2017; 51:195-196. [PMID: 28530886 DOI: 10.2345/0899-8205-51.3.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Lewelling J. AAMI Standards: A History of Ensuring Medical Technology Quality and Performance. Biomed Instrum Technol 2017; 51:210-211. [PMID: 28530882 DOI: 10.2345/0899-8205-51.3.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Baird P, Sparnon E. Unexpected Learning in 30 Minutes or Less. Biomed Instrum Technol 2017; 51:276. [PMID: 28530881 DOI: 10.2345/0899-8205-51.3.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Ridgway M, Clark M, Bettinardi C. Commentary: Reliability-Centered Maintenance: A Tool for Optimizing Medical Device Maintenance. Biomed Instrum Technol 2016; 50:412. [PMID: 27854489 DOI: 10.2345/0899-8205-50.6.412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Wirth A. 'The Cyber Arms Race Is On': Lessons from the U.S. Presidential Election. Biomed Instrum Technol 2016; 50:463-465. [PMID: 27854481 DOI: 10.2345/0899-8205-50.6.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Affiliation(s)
- Jeffrey Shuren
- US Food and Drug Administration, Silver Spring, Maryland
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Stern G. To Be the Best, Department Starts 'Cert Now!'. Biomed Instrum Technol 2016; 50:377-379. [PMID: 27632044 DOI: 10.2345/0899-8205-50.5.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Maetzler W, Klucken J, Horne M. A clinical view on the development of technology-based tools in managing Parkinson's disease. Mov Disord 2016; 31:1263-71. [PMID: 27273651 DOI: 10.1002/mds.26673] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/04/2016] [Accepted: 04/14/2016] [Indexed: 12/22/2022] Open
Abstract
Recently, quantitative, objective, and easy-to-use technology-based tools that can assess PD features over long time periods have been developed and generate clinically relevant and comparable patient information. Herein, we present a clinician's view on technological developments that have the potential to revolutionize clinical management concepts in PD. According to prominent examples in clinical medicine (e.g., blood glycosylated hemoglobin and blood pressure), we argue that the consideration of technology-based assessment in the clinical management of PD must be based on specific assumptions: (1) It provides a valid and accurate parameter of a clinically relevant feature of the disease; (2) there is confirmed evidence that the parameter has an ecologically relevant effect on the specific clinical application; (3) a target range can be defined wherein the parameter reflects the adequate treatment response; and (4) implementation is simple to allow repetitive use. Currently, there are no technology-based tools available that fulfil all these assumptions; however, assessments of akinesia, dyskinesia, motor fluctuations, physical inactivity, gait impairment, and postural instability seem relatively close to the specifications described. An iterative process of integration is recommended to bring technology-based tools into clinical practice. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Walter Maetzler
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany.
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany.
| | - Jochen Klucken
- Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Malcolm Horne
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- St. Vincent's, Neurology Department, Fitzroy, Victoria, Australia
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L'OFSP aura une nouvelle unité chargée d'évaluer I'efficacité des prestations. Rev Med Suisse 2016; 12:959. [PMID: 27352597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Preston C, Chahal HS, Porrás A, Cargill L, Hinds M, Olowokure B, Cummings R, Hospedales J. Regionalization as an approach to regulatory systems strengthening: a case study in CARICOM member states. Rev Panam Salud Publica 2016; 39:262-268. [PMID: 27706404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 01/06/2016] [Indexed: 06/06/2023] Open
Abstract
Improving basic capacities for regulation of medicines and health technologies through regulatory systems strengthening is particularly challenging in resource-constrained settings. "Regionalization"-an approach in which countries with common histories, cultural values, languages, and economic conditions work together to establish more efficient systems-may be one answer. This report describes the Caribbean Regulatory System (CRS), a regionalization initiative being implemented in the mostly small countries of the Caribbean Community and Common Market (CARICOM). This initiative is an innovative effort to strengthen regulatory systems in the Caribbean, where capacity is limited compared to other subregions of the Americas. The initiative's concept and design includes a number of features and steps intended to enhance sustainability in resource-constrained contexts. The latter include 1) leveraging existing platforms for centralized cooperation, governance, and infrastructure; 2) strengthening regulatory capacities with the largest potential public health impact; 3) incorporating policies that promote reliance on reference authorities; 4) changing the system to encourage industry to market their products in CARICOM (e.g., using a centralized portal of entry to reduce regulatory burdens); and 5) building human resource capacity. If implemented properly, the CRS will be self-sustaining through user fees. The experience and lessons learned thus far in implementing this initiative, described in this report, can serve as a case study for the development of similar regulatory strengthening initiatives in resource-constrained environments.
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Sheffer J. Group's Best Practices for PM Dovetail with Competency Checklists. Biomed Instrum Technol 2016; 50:207-209. [PMID: 27164208 DOI: 10.2345/0899-8205-50.3.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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