Equity in HTA : what doesn’t get measured, gets marginalised

When making recommendations about the public funding of new health technologies, policy makers typically pay close attention to quantitative evidence about the comparative effectiveness, cost effectiveness and budget impact of those technologies – what we might call “efficiency” criteria. Less attention is paid, however, to quantitative evidence about who gains and who loses from these public expenditure decisions, and whether those who gain are better or worse off than the rest of the population in terms of their health – what we might call “equity” criteria. Two studies recently published in this journal by Shmueli and colleagues suggest that this efficiency-oriented imbalance in the use of quantitative evidence may have unfortunate consequences – as the old adage goes: “what gets measured, gets done”. The first study, by Shmueli, Golan, Paolucci and Mentzakis, found that health policy makers in Israel think equity considerations are just as important as efficiency considerations – at least when it comes to making hypothetical technology funding decisions in a survey. By contrast, the second study – by Shmueli alone – found that efficiency rules the roost when it comes to making real decisions about health technology funding in Israel. Both studies have limitations and potential biases, and more research is needed using qualitative methods and more nuanced survey designs to determine precisely which kinds of equity consideration decision makers think are most important and why these considerations do not appear to be given much weight in decision making. However, the basic overall finding from the two studies seems plausible and important. It suggests that health technology funding bodies need to pay closer attention to equity considerations, and to start making equity a quantitative endpoint of health technology assessment using the methods of equity-informative economic evaluation that are now available

Validating a method for the estimate of gait spatio-temporal parameters with IMUs data on healthy and impaired people from two clinical centers

Instrumented gait analysis offers objective clinical outcome assessment. To this purpose, inertial measurement units (IMUs) represent nowadays a very effective solution due to their limited cost, ease of use and improved wearability. The aim of this study was to apply a well-documented IMU-based method to measure gait spatio-temporal parameters in a large number of healthy and gait-impaired subjects, and evaluate its robustness and validity across two clinical centers. Overall, the results of this work represent a robust and reliable foundation for the clinical use of the proposed IMU based method for gait parameters estimation

Constant peptidoglycan density in the sacculus of escherichia coli B/r growing at different rates

The determination and maintenance of bacterial cell shape are problems still far from being understood (reviewed [ 1,2]). Several models have been advanced during the last decade, for mechanisms governing th

A New Manuscript of Lugal-e, Tablet IV

This study edits BM 48053, a newly identified Late Babylonian manuscript of the epic poem Lugal-e in the British Museum collection. This tablet, which is likely to come from Borsippa, contributes towards the reconstruction of Tablet IV of the epic in its late bilingual form. It is also of interest for its colophon, which specifies the swift return of the tablet following a same day loan, using the phrase ina mišil ūmīšu “in half a day” or perhaps “at midday”

Lament and ritual weeping in the "negative confession" of the Babylonian Akītu festival

This study seeks to contextualise the king’s “negative confession,” which took place in the spring Akītu Festival of Babylon, within the established norms of Mesopotamian ritual practice. The king’s humiliation is situated within the contexts of status reversal, lament and ritual weeping. The study includes a comparative almanac of the Akkadian prayer and/or exclamation known as šigû