Economic impact of limb-salvage strategies in chronic limb-threatening ischaemia: modelling and budget impact study based on national registry data.

Background: Missed opportunities to reduce numbers of primary major lower-limb amputation and increase limb-salvage procedures when treating chronic limb-threatening ischaemia have previously been identified in the literature. However, the potential economic savings for healthcare providers when salvaging a chronic limb-threatening ischaemia-affected limb have not been well documented.

Methods: A model using National Health Service healthcare usage and cost data for 1.

On the integration of early health technology assessment in the innovation process: reflections from five stakeholders.

Early health technology assessment (HTA), which includes all methods used to inform industry and other stakeholders about the potential value of new medical products in development, including methods to quantify and manage uncertainty, has seen many applications in recent years. However, it is still unclear how such early value assessments can be integrated into the technology innovation process. This commentary contributes to the discussion on the purposes early HTA can serve.

Applying health economics for policy decision making: do devices differ from drugs?

Medical devices pose unique challenges for economic evaluation and associated decision-making processes that differ from pharmaceuticals. We highlight and discuss these challenges in the context of cardiac device therapy, based on a systematic review of relevant economic evaluations. Key challenges include practical difficulties in conducting randomized clinical trials, allowing for a 'learning curve' and user characteristics, accounting for the wider organizational impacts of introducing new devices, and allowing for variations in product characteristics and prices over time.

A health economic evaluation of concomitant surgical ablation for atrial fibrillation.

Objective: Current drug treatment for atrial fibrillation is suboptimal and percutaneous catheter-based ablation techniques may be associated with complications. The aim of this study is to assess the cost-effectiveness of (1) high-intensity focused ultrasound (HIFU)-assisted surgical ablation, (2) the classic 'cut and sew' maze procedure and (3) percutaneous ablation, all concomitant to cardiac surgery (e.g.

Influence of adducting and abducting muscle forces on the subacromial space width.

Purpose: Strengthening of the shoulder depressors is an important component in the treatment of impingement syndrome. However, the quantitative effect of various muscle forces on the width of the subacromial space has never been demonstrated in vivo. Therefore, the purpose of this study was to analyze the influence of adducting and abducting muscle forces on the subacromial space width in healthy volunteers in various arm positions.

Dynamic MR mammography: three-dimensional real-time visualization of contrast enhancement in virtual reality.

Rationale And Objectives: In view of the increasing use of breast magnetic resonance (MR) imaging to supplement x-ray mammography. the authors developed a method for fast and efficient analysis of dynamic MR images of the female breast.

Materials And Methods: The MR image data sets were acquired with a saturation-recovery turbo fast low-angle shot sequence to detect the kinetics of the contrast agent concentration in the whole breast at a high temporal and spatial resolution.

Health technology assessment for medical devices in Europe. What must be considered.

Objective: To inform about the specifics of medical devices and the resulting consequences for health technology assessment (HTA) and to present the European industry position on this topic.

Methods: The paper is based on an intensive debate within Eucomed, the European trade association in the field of medical devices, informed by an HTA Experts Group, comprising experts from within and outside the medical device industry.

Results: Based on the specifics of medical devices, there are a number of methodologic considerations that require a tailored HTA, differing from the approach taken for, for example, pharmaceutical products.