Welcome to the homepage of LBI-HTA !
The LBI-HTA is an acadmic non-profit institute and belongs to the Ludwig Boltzmann Society. At our website we wish to present our research and give support for health care decision-making. Here all of our reports are available for free. For further information please contact the LBI-HTA team.
Health care personnel regularly carrying out invasive procedures have a higher risk for exposure with HCV positive blood through needle stick injuries The aim of this study was to analyse the appropriateness of preoperative/preinterventional HCV testing in patients using available data on the prevalence and transmission risk and in comparison to international guideline recommendations.
Recent national and international reports were retrieved for estimates of HCV prevalence and incidence in Austria. Data on hepatitis C as an occupational disease were provided by the AUVA. We defined the factors influencing the patient- provider transmission risk and systematically searched the literature for studies on transmission risk and guidelines with recommendations on HCV screening or transmission prevention.
The effectiveness of HCV-tests in patients to prevent infections in HCW or even reduced needle-stick injuries is not supported by evidence. Current guidelines recommend to universally apply precautions to minimise needle stick injuries. Recommendations on preoperative HCV screening prior to elective surgeries are based on expert consensus: no clinical studies could be identified that analysed the effectiveness of the testing on infection prevention.
Publication: Decision Support Document No. 102: http://eprints.hta.lbg.ac.at/1103/
Contact: Agnes Kisser
Outpatient cardiac rehabilitation part VI: prospective multi-centre cohort study (comparing patients with and without phase III)
In 2012, we published the study protocol of a prospective multi-centre cohort study (http://eprints.hta.lbg.ac.at/971/) that aimed at comparing patients who attended an outpatient phase III cardiac rehabilitation after phase II with patients who did not. We defined the mean between group difference of risk factors out of the target range at the end of the observation period as the primary outcome. Now, we report on the results: 16 months after Phase II Rehabilitation, this (adjusted) mean difference was -0,06 [-0.7; 0.6] (non-significant). Roughly spoken, about one out of twenty IG patients (6 of 100) of the sample showed one risk factor out of the target range less than a KG patient. In secondary endpoints, only the change in the exercise stress test (percental increase) and the frequency of inpatient re-rehabilitation showed a statistically significant group difference in favour of the intervention. The higher than expected drop-out should be considered when interpreting the results.
Publication: LBI-HTA Project report No. 90: http://eprints.hta.lbg.ac.at/1101/
Contact: Brigitte Piso
We are pleased to introduce our new HSO report.
Update Re-orientation of the Austrian parent-child preventive care programme Part IX: Recommendations from evidence-based guidelines for screening measures covering early childhood (0-6 yrs.)
We are pleased to present an update report covering evidence-based, international screening recommendations for children (0-6 years). Based on the extensive, original report part IX from 2013 an update was performed in terms of new or updated screening recommendations for children.
Publication: LBI-HTA Project report No. 62 - Update 2016: http://eprints.hta.lbg.ac.at/996/
Contact: Brigitte Piso
We are pleased to introduce our new reports.
Decision Support Documents 2016:
DSD 97: Leadless pacemakers for right ventricle pacin
DSD 98: Single-step scaffold-based cartilage repair in the knee
DSD 99: Radiofrequency denervation for sacroiliac and facet joint pain
DSD 100: Upper airway stimulation for moderate-to-severe sleep apnea
DSD 101: Magnetic sphincter augmentation device (MSAD) in patients with gastroesophageal reflux disease (GERD)
DSD 24/Update 2016:
Percutaneous transluminal coronary angioplasty (PTCA) with drug-eluting balloon (DEB)
Screening, diagnostics and indication for occupational therapy in children and adolescents with Developmental Coordination Disorder
Developmental Coordination Disorder (DCD) is characterized by a severe developmental impairment of the motor coordination, which is not solely caused by mental retardation or specific neurological damage. DCD approximately affects 5 to 6% of school children. It may cause significant difficulties in activities of daily living and lead to consequences in adulthood. Children and adolescents with DCD are primarily referred to paediatric occupational therapists and physiotherapists. The report addresses the research questions, which recommendations on DCD (for screening, diagnostic testing, indication and form of therapy) are provided in evidence-based guidelines, which differentiation criteria between occupational therapy and other forms of treatment are discussed and which of the recommended tools can be introduced in Austria with regard to language (German) and standardization/ adaption (central Europe). Depending on the research question, literature was identified by a systematic and/ or manual search. A population based screening for DCD is not recommended due to the lack of sufficiently sensitive screening tools. For DCD diagnosis, all information sources recommend the use of standardized assessment tools. However, currently there is no gold standard available. Of 85 identified assessment tools, 12 have been translated into German and standardised/ adapted for Central Europe. Recommended interventions for children and adolescents with DCD should target the individual activity- and participation-level of the affected person. Differentiation criteria for various forms of therapy could not be identified.
Publication: Decision Support Document No. 96: http://eprints.hta.lbg.ac.at/1092/
Contact: Brigitte Piso
Austria belongs to those countries that adopt new cancer drugs not only early and fast, but use them also widely. In 2009, the LBI-HTA launched the program “Horizon Scanning in Oncology” (HSO) in order to enable evidence based decisions on the use of cancer drugs and estimations on implications for the health care budget in Austria. Since then numerous (n=59) early assessments of new cancer drugs were published. This review shall provide an overview of all approved cancer drugs 2009–2015 by the European Medicines Agency (EMA) and the knowledge on patient-benefit at time of approval and will analyse which policies for high-prized cancer drugs are applied in other (European) countries.
At the time of approval by EMA, for 26 (23%) of 73 cancer drugs between 2009 and 2015 no information about the two endpoints overall survival (OS) and progression free survival (PFS) was available. For 37 (45%) of cancer drugs, OS was increased up to 3 months, and for 14 (13%) up to 5.8 months in relation to the comparator. The benefit assessments in various countries (Germany, England, Norway, Belgium, Netherlands, Canada) differ in the point in time carried out (before/ after approval), in methods used (only clinical benefit assessment or additional cost-effectiveness analysis), the publication of results (degree of transparency) and the binding character of recommendations (from purely informational to binding). In a comparison of national benefit assessments of cancer drugs 14 drugs in 15 indications, including also some drugs that are in the Austrian MEL-catalogue, have been assessed consistently negative (not recommended). 16 drugs in 22 indications have been assessed consistently positive (recommended). Assessments with (binding) recommendations, health economical evaluations, “Managed-Entry Agreements” and “Value-based pricing” are approaches identifying cancer drugs with the highest benefit and acceptable costs with transparent and traceable methods.
Publication: Rapid Assessment No. 8: http://eprints.hta.lbg.ac.at/1091/
Magnetic resonance imaging (MRI) is an essential component of medical care. Currently, however, the appropriateness of diagnostic imaging is increasingly debated. In a first report we identified via database screening, literature review and interviews with stakeholders recommendations against the use of MRI and opportunities and strategies to drive appropriate imaging relevant to the Austrian context. In the second part we aim to provide additional information (on evidence base, guideline recommendations, diagnostic algorithms/decision support tools and products) on already identified recommendations regarding a set of indications selected by a working group of HVB and WKÖ.
Publication: LBI-HTA Project report No. 80b: http://eprints.hta.lbg.ac.at/1090/
Contact: Agnes Kisser