News and archive
The intention of the present MRI report, part 3, is to identify methods for the identification of inappropriate care. In addition, relations between MRI of lower extremities and subsequent (surgical) interventions are evaluated.
In total, we were able to identify 8 methodological approaches to detect in-appropriate care. All methods have certain strengths and weaknesses. The analysis of the relations of MRI to subsequent interventions showed that more knee replacements were in OECD in countries with higher MRI utilization rates. Finally, we were able to identify a series of refunding policies that could exert an influence on MRI utilization.
Publication: LBI-HTA Project report No. 80c: http://eprints.hta.lbg.ac.at/1159/
Contact: Robert Emprechtinger
Echocardiography: Guideline recommendations and options to identify inappropriate use as well as rate of use in Austria.
Aim of the report at hand is to describe the use of echocardiography in Austria and set it into context with the international literature on the appropriateness of echocardiography.
Repeated echocardiographic exams within one year are often related to inappropriate use. Some districts had notable differences in the ratio of over-all exams to repeated exams. With an increase in the number of overall exams there is a tendency for a higher percentage of repeated exams, especially for regions with very high rates of the use of echocardiography. Since the aim is to improve medical care, a discussion with the stakeholders should be conducted.
Publication: LBI-HTA Project report No. 98: http://eprints.hta.lbg.ac.at/1158/
Contact: Robert Emprechtinger
Part I: Predictors, theories and models to explain and recommend courses of action to avoid discontinuation of therapy
Part II: "Overview of Reviews" on dropouts in psychotherapy
The project dealt in two parts with dropouts in psychotherapies. The first part of the report focused on definitions, parameters for describing psychotherapy dropouts and explanatory models. In addition, dropout predictors were identified at a meta-level, which were further empirically recorded in the second report part by an "Overview of systematic reviews". In this context, evidence synthesis (including 14 systematic reviews/meta-analyses) showed that a (young) age of psychotherapy patients and certain mental disorders (such as personality disorders) can represent relevant risk factors for an unplanned termination of psychotherapy. Dropout predictors, which are more likely to be attributed to psychotherapists, are currently only partially researched. With regard to suitable prevention strategies, eight measures were proposed in the report which, among other things, aimed at organisational aspects (e.g. clarification of therapy goals, possibilities and limits of psychotherapy) and interpersonal factors (e.g. strengthening the therapeutic alliance between patient and psychotherapist).
Publication: LBI-HTA Project report No. 100: http://eprints.hta.lbg.ac.at/1157/
Contact: Roman Winkler
We are pleased to introduce our two new HSO reports.
Screening for fetal trisomies 21, 18 and 13 by non-invasive prenatal testing (NIPT). EUnetHTA report
Since several years, numerous new non-invasive prenatal tests (NIPTs) have been available to identify common chromosomal anomalies. Most NIPTs are available for trisomies 21, 18 and 13 and sex chromosome aneuploidies, but many laboratories have expanded their range of analysis to include other trisomies and common microdeletions. The main advantage of NIPT compared to the conventional screening approach is the ease of implementation and non-invasiveness of the assay, as well as the potential reduction in false-positive [FP] results. An introduction of non-invasive genetic testing has ethical, social and organizational implications that need to be considered.
Publication: LBI-HTA Project report No. 103: http://eprints.hta.lbg.ac.at/1153/
Contact: Claudia Wild
We are pleased to introduce our new HSO report.
MammaPrint® Added value of using the gene expression signature test MammaPrint® for adjuvant chemotherapy decision-making in early breast cancer. EunetHTA report
MammaPrint® is a test that measures the activity of certain genes within the tumour cells to estimate the likelihood of the tumour to return and spread to other organs, where it becomes incurable. Based on the outcome of MammaPrint®, depending whether the tumour has a low or high risk of returning, and in consultation with the clinician, it can be determined whether or not additional chemotherapy is needed after surgery. This 'gene expression test' is analysing the activity of 70 genes in the breast tumour and claims to be a tumour fingerprint.
Publication: LBI-HTA Project report No.102: http://eprints.hta.lbg.ac.at/1147
Contact: Claudia Wild
Perinatal Care at the threshold of viability Part II: Decision-making at the threshold of viability and ethical challenges at Neonatal Intensive Care Units (NICUs)
Due to the medical advances in neonatal intensive care medicine, the survival rate of premature infants has increased over the last two decades with babies born after 22 weeks of gestation now having a chance of survival. Based on interviews with five heads of Austrian perinatal care centers and a clinical ethicist, this literature review outlines the current evidence on decision-making practices (guidelines, good practice models, and communication strategies) and ethical challenges at the limit of viability.
Publication: LBI-HTA Projekt report No. 97b: http://eprints.hta.lbg.ac.at/1148/
Contact: Michal Stanak
Perinatal care at the threshold of viability; Part I: Systematic Analysis of Outcomes and Resource Needs for Neonatal Intensive Care Units to inform Healthcare Planning
Due to the medical advances in neonatal intensive care medicine, the survival rate of premature infants has increased over the last two decades, with babies born after 22 weeks of gestation now having a chance of survival. In a systematic review, recent data on survival and survival without impairment for extremely preterm infants was collected, as well as literature on resource needs in neonatal intensive care units (NICUs). In addition, interviews with five heads of Austrian perinatal care centers provide insights into the current supply situation in Austrian NICUs.
Publication: LBI-HTA Project report No. 97a: http://eprints.hta.lbg.ac.at/1146/
Contact : Katharina Hawlik