Real-World Evidence in Healthcare Decision Making : Global trends and case studies from Latin America

Objectives: Real-world evidence (RWE) is increasingly used to inform health technology assessments (HTAs) for resource allocation, which are valuable tools for emerging economies such as in America. However, the characteristics and uses in South America are unknown. This study aims to identify sources, characteristics and uses of RWE in Argentina, Brazil, Colombia and Chile, and evaluate the context-specific challenges. The implications for future regulation and responsible management of RWE in the region are also considered. Methods: A systematic literature review, database mapping, and targeted grey literature search were conducted to identify the sources and characteristics of RWE. Findings were validated by key opinion leaders attending workshops in four South American countries. Results: A database mapping exercise revealed 407 unique databases. Geographic scope, database type, population and outcomes captured were reported. Characteristics of National Health Information Systems show efforts to collect interoperable data from service providers, insurers and government agencies, but that initiatives are hampered by fragmentation, lack of stewardship and resources. RWE is mainly used in South America for pharmacovigilance and as pure academic research, but less so for HTA decision-making or pricing negotiations and not at all to inform early access schemes. Conclusions: The quality of data collected in real-world in the case-study countries varies and RWE is not consistently used in healthcare decision-making. Authors recommend that future studies monitor the impact of digitalisation, and the potential effects of access to RWE on the quality of patient care

Development of a system for teaching CS1 in C/C++ with Lego NXT robots

ABSTRACT This paper describes the development of a system for teaching C/C++ using a Lego™ NXT in a CSI college course on introductory programming. The programming of the NXT robot has been implemented using a C/C++ cross-compiler, which generates code that runs on an Open Source firmware platform, nxtOSEK. The system has built in commands and objects that run the motors and receive information from the sensors that are on the robots. The cross-compiler has been embedded in an Open Source Integrated Development Environment (IDE) Code::Blocks. The programming environment for the NXT has evolved from a previous development using the Lego™ RCX and has the advantage that it utilizes a Bluetooth interface, while the RCX uses a tower based infrared communication device. The NXT is more reliable and can be programmed to pair a specific interface with a particular robot, so that there is no cross-talk when different robots are utilized in a classroom setting. The IDE and robotic software executes on a virtual machine running under the freely available software, Sun™ VirtualBox. This allows for a uniform programming platform for Windows, MacOS, and Unix/Linux. The use of robots in CS1 affords science and engineering students the opportunity to learn sensorymotor based control, to work with an IDE early in their careers, and to gain experience with development and debugging tools that can be utilized throughout the students' academic and professional careers