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.
Carbon ion beam radiotherapy (CIRT) for cancer treatment: a systematic review of effectiveness and safety for 12 oncologic indications.
The project aimed at elaborating possible cancer types, being an indication for carbon ion radiotherapy (CIRT). As such, clinical studies, analysing the use of CIRT for specific cancer types, were identified through a systematic literature search and were reviewed and reported in this project.
Furthermore, a systematic review on the effectiveness (mortality, morbidity) and safety of CIRT for 54 oncologic indications in 12 regions (i.e., skull base, eye, brain, ear-nose-throat, lung, gastrointestinal, bone and soft tissue, prostate, breast, kidney, nervous system, hematologic cancer) was conducted.
We are pleased to introduce our new reports.
Decison Support Documents 2018
DSD 109: Subcutaneous implantable cardioverter defibrillator (ICD)
DSD 110: Lymphovenous anastomoses in patients with primary and secondary lymphoedema
DSD 111: Allogeneic mesenchymal stem cells for Crohn’s disease-associated complex perianal fistulas
DSD 112: Meniscal allograft transplantation for post-meniscectomy syndrome
DSD 113: Baroreceptor activation therapy for treatment-resistant hypertension
+ 3 Updates
DSD 20/4. Update 2018: Endobronchial valve implantation for emphysema
DSD 37/1. Update 2018: High-intensity focused ultrasound for the treatment of prostate cancer
DSD 44/3. Update 2018: (Percutaneous) left atrial appendage closure for the prevention of thromboembolic events in patients with atrial fibrillation
Stereotactic radiotherapy, proton therapy and irreversible electroporation for the treatment of localized prostate cancer
Irreversible electroporation (IRE, NanoKnife®) is a type of focal therapy which has been suggested as an alternative to radical treatment. It typically uses 3 to 5 electrodes which deliver short repetitive electrical pulses to destroy the cancer cells. Stereotactic radiotherapy (stereotactic body radiation therapy or SBRT) is a type of external radiation in which a higher radiation dose is delivered in a reduced number of fractions as is the case with conventional or moderately fractionated radiation therapy. Proton therapy (PT) is a further type of external radiation therapy which uses high doses of ionizing rays directed at the tumour. There is at present inadequate and insufficient evidence to show that IRE, SBRT and PT have either a positive impact on survival and quality of life or the ability to prevent or delay prostatectomy.
Publication: LBI-HTA Projektbericht Nr. 107: http://eprints.hta.lbg.ac.at/1165/
Contact: Claudia Wild
We are pleased to introduce our two new HSO reports.
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 Projektbericht Nr. 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 Projektbericht Nr. 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