Background: The diffusion of health technologies from translational research to reimbursement depends on several factors included the results of health economic analysis. Recent research identified several flaws in health economic concepts. Additionally, the heterogeneous viewpoints of participating stakeholders are rarely systematically addressed in current decision-making. Multi-criteria Decision Analysis (MCDA) provides an opportunity to tackle these issues. The objective of this study was to review applications of MCDA methods in decisions addressing the trade-off between costs and benefits.
Methods: Using basic steps of the PRISMA guidelines, a systematic review of the healthcare literature was performed to identify original research articles from January 1990 to April 2014. Medline, PubMed, Springer Link and specific journals were searched. Using predefined categories, bibliographic records were systematically extracted regarding the type of policy applications, MCDA methodology, criteria used and their definitions.
Results: 22 studies were included in the analysis. 15 studies (68 %) used direct MCDA approaches and seven studies (32 %) used preference elicitation approaches. Four studies (19 %) focused on technologies in the early innovation process. The majority (18 studies - 81 %) examined reimbursement decisions. Decision criteria used in studies were obtained from the literature research and context-specific studies, expert opinions, and group discussions. The number of criteria ranged between three up to 15. The most frequently used criteria were health outcomes (73 %), disease impact (59 %), and implementation of the intervention (40 %). Economic criteria included cost-effectiveness criteria (14 studies, 64 %), and total costs/budget impact of an intervention (eight studies, 36 %). The process of including economic aspects is very different among studies. Some studies directly compare costs with other criteria while some include economic consideration in a second step.
Conclusions: In early innovation processes, MCDA can provide information about stakeholder preferences as well as evidence needs in further development. However, only a minority of these studies include economic features due to the limited evidence. The most important economic criterion cost-effectiveness should not be included from a technical perspective as it is already a composite of costs and benefit. There is a significant lack of consensus in methodology employed by the various studies which highlights the need for guidance on application of MCDA at specific phases of an innovation.
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http://dx.doi.org/10.1186/s12913-015-0930-0 | DOI Listing |
Chemistry
December 2024
Harbin Institute of Technology - Weihai, School of Marine Science and Technoogy, No. 2 West Road, 264209, Weihai, CHINA.
Disulfide bonds (S-S) play a critical role in modern biochemistry, organic synthesis and prebiotic chemistry. Traditional methods for synthesizing disulfide bonds often rely on oxygen, alkali, and metal catalysts. Herein, thiol groups involved in amino acids and peptides were spontaneously converted into symmetrical and unsymmetrical disulfide bonds within water microdroplets, without the need for catalysts or oxygen, and under room temperature.
View Article and Find Full Text PDFChemSusChem
December 2024
TCG-CREST, Research Institute for Sustainable Energy (RISE), INDIA.
Hydrogen evolution reaction (HER) is a key reaction in electrochemical water splitting for hydrogen production leading to the development of potentially sustainable energy technology. Importantly, the catalysts required for HER must be earth-abundant for their large-scale deployment; silicates representing one such class. Herein, we have synthesized a series of transition mono- and bi- metal metasilicates (with SO32- group) using facile wet-chemical method followed by calcination at a higher temperature.
View Article and Find Full Text PDFExpert Opin Drug Saf
December 2024
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Introduction: The risk of HCC is twice as high in diabetic patients compared to non-diabetic ones, suggesting that diabetes advances carcinogenesis in the liver through a variety of mechanisms. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown to improve liver outcomes, emerging as promising agents to treat hepatocellular carcinoma (HCC) in patients with type 2 diabetes mellitus (T2DM).
Methods: We searched PubMed and Scopus databases for articles presenting an association between SGLT2is and HCC to explore the putative mechanisms of action underlying the anti-proliferative activity of SGLT2is.
Elife
December 2024
Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland.
Because of high mutation rates, viruses constantly adapt to new environments. When propagated in cell lines, certain viruses acquire positively charged amino acids on their surface proteins, enabling them to utilize negatively charged heparan sulfate (HS) as an attachment receptor. In this study, we used enterovirus A71 (EV-A71) as model and demonstrated that unlike the parental MP4 variant, the cell-adapted strong HS-binder MP4-97R/167G does not require acidification for uncoating and releases its genome in the neutral or weakly acidic environment of early endosomes.
View Article and Find Full Text PDFJ Am Chem Soc
December 2024
Department of Physics and Astronomy, University of Sheffield, Hounsfield Road, Sheffield S3 7RH, U.K.
Activated intramolecular singlet fission is known to occur in the conjugated polymer polythienylene-vinylene (P3TV). Instead, efficient intersystem crossing has been observed in a short 3-alkyl(thienylene-vinylene) dimer. Here, we investigate a series of oligomers covering the conjugation length gap between the dimer and polymer.
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