Cost‑of‑illness studies in nine Central and Eastern European countries

Background To date, a multi-country review evaluating the cost-of-illness (COI) studies from the Central and Eastern European (CEE) region has not yet been published. Our main objective was to provide a general description about published COI studies from CEE. Methods A systematic search was performed between 1 January 2006 and 1 June 2017 in Medline, EMBASE, The Cochrane Library, CINAHL, and Web of Science to identify all relevant COI studies from nine CEE countries. COI studies reporting costs without any restrictions by age, co-morbidities, or treatment were included. Methodology, publication standards, and cost results were analysed. Results We identifed 58 studies providing 83 country-specifc COI results: Austria (n=9), Bulgaria (n=16), Croatia (n=3), the Czech Republic (n=10), Hungary (n=24), Poland (n=11), Romania (n=3), Slovakia (n=3), and Slovenia (n=4). Endocrine, nutritional, and metabolic diseases (18%), neoplasms (12%), infections (11%), and neurological disorders (11%) were the most frequently studied clinical areas, and multiple sclerosis was the most commonly studied disease. Overall, 57 (98%) of the studies explicitly stated the source of resource use data, 45 (78%) the study perspective, 34 (64%) the costing method, and 24 (58%) reported at least one unit costs. Regardless of methodological diferences, a positive relationship was observed between costs of diseases and countries’ per capita GDP. Conclusions Cost-of-illness studies varied considerably in terms of methodology, publication practice, and clinical areas. Due to these heterogeneities, transferability of the COI results is limited across Central and Eastern European countries

Implementation of coverage with evidence development schemes for medical devices : a decision tool for late technology adopter countries

Experiences with coverage with evidence development (CED) schemes are fairly limited in Central and Eastern European (CEE) countries, which are usually late adopters of new health technologies. Our aim was to put forward recommendations on how CEE health technology assessment bodies and payer organizations can apply CED to reduce decision uncertainty on reimbursement of medical devices, with a particular focus on transferring the structure and data from CED schemes in early technology adopter countries in Western Europe. Structured interviews on the practices and feasibility of transferring CED schemes were conducted and subsequently, a draft tool for the systematic classification of decision alternatives and recommendations was developed. The decision tool was reviewed in a focus group discussion and validated within a wider group of CEE experts in a virtual workshop. Transferability assessment is needed in case of (1) joint implementation of a CED scheme; (2) transferring the structure of an existing CED scheme to a CEE country; (3) reimbursement decisions that are linked to outcomes of an ongoing CED scheme in another country and (4) real-world evidence transferred from completed CED schemes. Efficient use of available resources may be improved by adequately transferring evidence and policy tools from early technology adopter countries

Guidance on using real-world evidence from Western Europe in Central and Eastern European health policy decision making

Aim: Real-world data and real-world evidence (RWE) are becoming more important for healthcare decision making and health technology assessment. We aimed to propose solutions to overcome barriers preventing Central and Eastern European (CEE) countries from using RWE generated in Western Europe. Materials & methods: To achieve this, following a scoping review and a webinar, the most important barriers were selected through a survey. A workshop was held with CEE experts to discuss proposed solutions. Results: Based on survey results, we selected the nine most important barriers. Multiple solutions were proposed, for example, the need for a European consensus, and building trust in using RWE. Conclusion: Through collaboration with regional stakeholders, we proposed a list of solutions to overcome barriers on transferring RWE from Western Europe to CEE countries. Plain language summary: Collecting real-world data and generating real-world evidence from it is becoming more important for making better decisions in healthcare. We investigated the main barriers which prevent using real-world evidence in Central and Eastern Europe, originally generated in Western Europe. After identifying the nine most important barrier, with the help of local experts we proposed solutions to overcome those barriers. Several possible solutions were proposed, many of them highlighting the need for a European consensus on these matters and building trust in new methods. Our results can hopefully serve as a guidance document to help overcome the barriers. Tweetable abstract: Research investigating ways to overcome barriers preventing Central and Eastern European countries from using Western European real-world evidence for healthcare decision making, using a multi-methods approach to create a list of solutions in collaboration with local stakeholders

Recommendations for patient involvement in health technology assessment in Central and Eastern European countries

IntroductionMeaningful patient involvement in health technology assessment (HTA) is essential in ensuring that the interests of the affected patient population, their families, and the general public are accurately reflected in coverage and reimbursement decisions. Central and Eastern European (CEE) countries are generally at less advanced stages of implementing HTA, which is particularly true for patient involvement activities. As part of the Horizon2020 HTx project, this research aimed to form recommendations for critical barriers to patient involvement in HTA in CEE countries. MethodsBuilt on previous research findings on potential barriers, a prioritisation survey was conducted online with CEE stakeholders. Recommendations for prioritised barriers were formed through a face-to-face workshop by CEE stakeholders and HTx experts. ResultsA total of 105 stakeholders from 13 CEE countries completed the prioritisation survey and identified 12 of the 22 potential barriers as highly important. The workshop had 36 participants representing 9 CEE countries, and 5 Western European countries coming together to discuss solutions in order to form recommendations based on best practices, real-life experience, and transferability aspects. Stakeholder groups involved in both phases included HTA organisation representatives, payers, patients, caregivers, patient organisation representatives, patient experts, health care providers, academic and non-academic researchers, health care consultants and health technology manufacturers/providers. As a result, 12 recommendations were formed specified to the CEE region's context, but potentially useful for a broader geographic audience. ConclusionIn this paper, we present 12 recommendations for meaningful, systematic, and sustainable patient involvement in HTA in CEE countries. Our hope is that engaging more than a hundred CEE stakeholders in the study helped to spread awareness of the importance and potential of patient involvement and that the resulting recommendations provide tangible steps for the way forward. Future studies shall focus on country-specific case studies of the implemented recommendations

GPU Adding-Doubling Algorithm for Analysis of Optical Spectral Images

The Adding-Doubling (AD) algorithm is a general analytical solution of the radiative transfer equation (RTE). AD offers a favorable balance between accuracy and computational efficiency, surpassing other RTE solutions, such as Monte Carlo (MC) simulations, in terms of speed while outperforming approximate solutions like the Diffusion Approximation method in accuracy. While AD algorithms have traditionally been implemented on central processing units (CPUs), this study focuses on leveraging the capabilities of graphics processing units (GPUs) to achieve enhanced computational speed. In terms of processing speed, the GPU AD algorithm showed an improvement by a factor of about 5000 to 40,000 compared to the GPU MC method. The optimal number of threads for this algorithm was found to be approximately 3000. To illustrate the utility of the GPU AD algorithm, the Levenberg–Marquardt inverse solution was used to extract object parameters from optical spectral data of human skin under various hemodynamic conditions. With regards to computational efficiency, it took approximately 5 min to process a 220 × 100 × 61 image (x-axis × y-axis × spectral-axis). The development of the GPU AD algorithm presents an advancement in determining tissue properties compared to other RTE solutions. Moreover, the GPU AD method itself holds the potential to expedite machine learning techniques in the analysis of spectral images

Recommendations for patient involvement in health technology assessment in Central and Eastern European countries

Introduction: Meaningful patient involvement in health technology assessment (HTA) is essential in ensuring that the interests of the affected patient population, their families, and the general public are accurately reflected in coverage and reimbursement decisions. Central and Eastern European (CEE) countries are generally at less advanced stages of implementing HTA, which is particularly true for patient involvement activities. As part of the Horizon2020 HTx project, this research aimed to form recommendations for critical barriers to patient involvement in HTA in CEE countries. Methods: Built on previous research findings on potential barriers, a prioritisation survey was conducted online with CEE stakeholders. Recommendations for prioritised barriers were formed through a face-to-face workshop by CEE stakeholders and HTx experts. Results: A total of 105 stakeholders from 13 CEE countries completed the prioritisation survey and identified 12 of the 22 potential barriers as highly important. The workshop had 36 participants representing 9 CEE countries, and 5 Western European countries coming together to discuss solutions in order to form recommendations based on best practices, real-life experience, and transferability aspects. Stakeholder groups involved in both phases included HTA organisation representatives, payers, patients, caregivers, patient organisation representatives, patient experts, health care providers, academic and non-academic researchers, health care consultants and health technology manufacturers/providers. As a result, 12 recommendations were formed specified to the CEE region’s context, but potentially useful for a broader geographic audience. Conclusion: In this paper, we present 12 recommendations for meaningful, systematic, and sustainable patient involvement in HTA in CEE countries. Our hope is that engaging more than a hundred CEE stakeholders in the study helped to spread awareness of the importance and potential of patient involvement and that the resulting recommendations provide tangible steps for the way forward. Future studies shall focus on country-specific case studies of the implemented recommendations

Design and Validation of a Custom-Made Laboratory Hyperspectral Imaging System for Biomedical Applications Using a Broadband LED Light Source

Hyperspectral imaging (HSI) is a promising optical modality that is already being used in numerous applications. Further expansion of the capabilities of HSI depends on the modularity and versatility of the systems, which would, inter alia, incorporate profilometry, fluorescence imaging, and Raman spectroscopy while following a rigorous calibration and verification protocols, thus offering new insights into the studied samples as well as verifiable, quantitative measurement results applicable to the development of quantitative metrics. Considering these objectives, we developed a custom-made laboratory HSI system geared toward biomedical applications. In this report, we describe the design, along with calibration, characterization, and verification protocols needed to establish such systems, with the overall goal of standardization. As an additional novelty, our HSI system uses a custom-built broadband LED-based light source for reflectance imaging, which is particularly important for biomedical applications due to the elimination of sample heating. Three examples illustrating the utility and advantages of the integrated system in biomedical applications are shown. Our attempt presents both the development of a custom-based laboratory HSI system with novel LED light source as well as a framework which may improve technological standards in HSI system design

Uporaba zdravstvenih storitev s strani starejših Evropejcev: empirična analiza

Background and Purpose: Chronic diseases and associated co-morbidities are highly prevalent among elderly and are associated with an increase in health services utilization which in turn raises health care expenditures throughout industrialized societies. However, health care utilization in elderly is still inadequately understood, particularly regard­ing the differences among European jurisdictions. In our article, we use dataset of Wave 5 of SHARE survey to study the utilization of health care in older Europeans in 15 European countries. Design/Methodology/Approach: We investigate relationships between factors such as age, gender, income, educa­tion and health variables and the utilization of various types of health services. We apply regression modeling to study the determinants of health utilization (different socioeconomic and health variables) of older people. Results: We show some significant differences between determinants of health utilization in terms of probability and frequency of usage. We also explore patterns between welfare regimes, taking Eastern European jurisdictions as a reference category. Finally, we show that in a simple causal model the provision of formal and/or informal homecare serves as a complement to utilization of health care services. Conclusion: Results of our article are important for the management of health care facilities in terms of health care usage by older people, and can be of value to health care providers and policy makers in the fieldOzadje in namen: Kronične bolezni in s tem povezana obolenja so zelo razširjena med starejšimi, povezana pa so tudi z večjo uporabo zdravstvenih storitev, kar povečuje izdatke za zdravstveno varstvo v vseh sodobnih razvitih družbah. Vendar pa še vedno preslabo razumemo in poznamo dejavnike uporabe zdravstvenih storitev s strani starejših, še posebej glede razlik med evropskimi državami. V prispevku uporabimo nabor podatkov petega vala raziskave SHARE za raziskavo uporabe zdravstvenih storitev starejših v 15 evropskih državah. Metodologija: V prispevku raziskujemo razmerja med dejavniki, kot so starost, spol, dohodek, izobrazba in zdrav­stvene spremenljivke ter uporabo različnih vrst zdravstvenih storitev. Pri preučevanju determinant uporabe zdrav­stvenih storitev starejših (različnih socioekonomskih in zdravstvenih spremenljivk) uporabimo regresijsko mode­liranje. Rezultati: Pokažemo na nekaj pomembnih razlik med dejavniki uporabe zdravstvenih storitev tako glede verjet­nosti kot pogostosti uporabe. Prav tako pokažemo na razmerja med blaginjskimi sistemi, pri čemer so vzhodnoe­vropske države referenčna kategorija, s katero primerjamo vse druge. Ob koncu z uporabo preprostega vzročnega regresijskega modela pokažemo tudi, da zagotavljanje formalne in/ali neformalne dolgotrajne oskrbe starejših služi kot dopolnilo (komplement) k uporabi zdravstvenih storitev. Zaključek: Rezultati našega izdelka so pomembni za upravljanje v zdravstvenih ustanovah, posebej glede upo­rabe zdravstvenih storitev s strani starejših in so lahko velike vrednosti za izvajalce zdravstvenih storitev in obliko­valce politik na tem področju