Identification of technologies of no or low added value

A jointly effort performed by HTAiIG on DEA, IG on ethics, EuroScannetwork and INAHTA is aiming to elaborate a toolkit that could aid organizations and individuals on the steps to be developed when considering disinvestment activities. This presentation refers to one of the chapters of that book on identification activities and disinvestment

SIMONEV: Visual Neonatal Monitoring System - A Dashboard for managing highly complex patients

In 2019, based on R&D+i work between the Universidad Nacional del Sur and the General Dr. José Penna Interzonal Hospital, a neonatal monitoring system called SIMONE was developed to help reduce the incidence of safety problems in neonatal care. In this article, we present SIMONEV, an extension of SIMONE that integrates a visualization dashboard for the control of patients and critical processes in the hospital’s Neonatal Intensive Care Units. SIMONEV is a free and open-source visualization dashboard that allows the Hospital staff to easily follow statistics and indicators from patients at the neonatal intensive care units. Through this dashboard, a visual representation of statistics, monitoring information, and instrument indicators on patients is presented to the professionals. For this, a series of visualizations were proposed, where data collected by SIMONE is monitored through visual resources and interactions. The proposed software was implemented on the web through technologies such as Angular and Firebase under an open-source policy.Sociedad Argentina de Informática e Investigación Operativ

SIMONE - Neonatal Monitoring System. An Open Source Solution in Health Care from R+D+i

In Neonatal Intensive Care Units, the proclivity to error and the occurrence of adverse events is even greater, given the greater vulnerability of newborns. From the General Dr. José Penna Interzonal Hospital, a combined strategy was developed to reduce the incidence of safety problems in neonatal care. One component in the strategy is the safety checklist (LVS). The LVS constitutes a tool that facilitates the review of critical processes in patients and facilitates the detection of safety problems. The LVS developed for the Neonatal Intensive Care Unit of Hospital Penna was complemented with the implementation of a neonatal monitoring system called SIMONE. It has the safety checklist, a system of alerts and patient management. This application provides speed and simplicity to the task of daily check-up and storage of information for future analysis and is available an open source solution in health care from R+D+i. Although the use of safety lists is not new, its implementation through an open source and free-use software system, developed by an inter-disciplinary team, positions this proposal as one of a kind.Sociedad Argentina de Informática e Investigación Operativ

COVID-19 epidemiological surveillance through pool testing focused on asymptomatic healthcare workers in the city of Bahía Blanca

INTRODUCCIÓN: Uno de los desafíos más relevantes al comienzo de la pandemia consistió en implementar estrategias dirigidas a prevenir la transmisión del virus SARS-CoV-2 y mitigar el impacto de la COVID-19. El propósito de este estudio fue contribuir a reducir la transmisión comunitaria a través de una iniciativa interinstitucional, cuyos objetivos fueron validar un método de detección de ARN del SARS-CoV-2 e implementar y evaluar la vigilancia en trabajadores de salud asintomáticos de instituciones de salud pública de Bahía Blanca. MÉTODOS: Se validó una prueba de detección del gen E del coronavirus mediante RT-PCR a partir de ARN aislado de hisopados nasofaríngeos. Para aumentar la capacidad de testeo se validó la detección del ARN viral en muestras agrupadas (pooles). Se realizó un estudio de cohorte prospectiva entre el 15/09/20 y el 15/09/21. RESULTADOS: La sensibilidad y especificidad de la prueba en muestras individuales fue del 95% (IC 95%: 85%-100%). La sensibilidad de la detección en pooles fue del 73% (IC 95%: 46%-99%) y la especificidad, del 100%. A lo largo de la vigilancia se incluyeron 855 trabajadores y 1764 hisopados, con una incidencia acumulada anual de 2,3% (IC 95%: 1,2%-3,4%). Se detectaron 20 casos asintomáticos positivos. DISCUSIÓN: El tamizaje de trabajadores de salud asintomáticos en la pandemia contribuyó a reducir el riesgo de brotes hospitalarios. Asimismo, se generó un marco de trabajo interdisciplinario aplicable a otros problemas de saludINTRODUCTION: One of the most important challenges at the beginning of the pandemic was to implement strategies to prevent SARS-CoV-2 virus transmission and reduce the impact of COVID-19. The purpose of this study was to contribute to the reduction of community transmission through an interinstitutional initiative, aimed at validating a SARS-CoV-2 RNA detection method, and at implementing and assessing the surveillance of asymptomatic infected healthcare workers (HCWs) at public health institutions in the city of Bahía Blanca. METHODS: To validate a coronavirus RNA detection method, RNA was extracted from nasopharyngeal swabs and identification of the viral E gene was done by RT-PCR. Validation of sample pooling was performed to increase the testing capacity. A prospective cohort study was conducted from 15 September 2020 to 15 September 2021. RESULTS: The sensitivity and specificity of the test in individual samples was 95% (CI 95%: 85%-100%). The sensitivity of the pooling strategy was 73% (CI 95%: 46%-99%) and the specificity was 100%. A total of the 855 HCWs were included in the surveillance and 1764 swabs were performed, with an annual cumulative incidence of 2.3% (CI 95%: 1,2%-3,4%), and 20 positive asymptomatic cases were detected. DISCUSSION: The screening of asymptomatic HCWs during the pandemic contributed to reduce the risk of outbreaks in hospital settings. Moreover, an interdisciplinary team framework applicable to other health problems was generated.Fil: Esandi, María del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: Marinovich, Joel. Hospital Municipal Doctor Leonidas Lucero.; Argentina. Universidad Nacional del Sur; ArgentinaFil: Bergé, Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: García, Nicolás. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; ArgentinaFil: German, Olga Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: Ayala Peña, Victoria Belen. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: Sierra, Fermín. Hospital Municipal Doctor Leonidas Lucero.; Argentina. Universidad Nacional del Sur; ArgentinaFil: Serralunga, María Gabriela. Universidad Nacional del Sur. Departamento de Matemática; ArgentinaFil: Esandi, Maria Eugenia. Universidad Nacional del Sur. Departamento de Economía; ArgentinaFil: del Valle, Marta. Hospital Municipal Doctor Leonidas Lucero.; Argentina. Universidad Nacional del Sur; ArgentinaFil: Bouzat, Cecilia Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentin

Calidad de vida relacionada con la salud en niños con y sin trastornos crónicos. Estudio multicéntrico

Los trastornos crónicos (TC) en etapas tempranas de la vida pueden influir en diferentes dimensiones de la calidad de vida relacionada con la salud (CVRS) de los niños/as.Objetivo. Comparar la CVRS de niños/as con TC confirmados, con TC declarados y sin TC. Población y método. Estudio transversal en el marco de una investigación mayor realizada en escuelas de Córdoba y Bahía Blanca, y en los hospitales Italiano y Garrahan de Buenos Aires, Argentina, en 2012. La presencia de TC fue establecida por diagnóstico médico en hospitales o por declaración de sus cuidadores en escolares.Los niños/as de 8 a 12 años respondieron el cuestionario KIDSCREEN-52 sobre CVRS, una escala de desarrollo puberal y una escala de recursos económicos familiares. Los cuidadores indicaron el nivel educativo materno. Se estimó la asociación entre TC y CVRS ajustada por sexo, edad, desarrollo puberal, nivel educativo materno y nivel socioeconómico. Participaron 670 duplas niños/as cuidadores, 13,3% (n= 89) con TC confirmados (muestras de hospitales), 14,5% (n= 97) escolares con trastornos declarados y el resto eran escolares sanos. La edad promedio fue 10,2 años (desvío estándar= 1,01); 54,8% fueron niñas. Tener TC confirmados se asoció a una mayor frecuencia de bajo bienestar físico (OR 2,61; IC 95%:1,43-4,76), mientras que la presencia de TC declarados se asoció con bajas puntuaciones en bienestar psicológico (OR 1,96; IC 95%: 1,06-3,63), autopercepción (OR 2,22; IC 95%: 1,28-3,87) y relación con los padres (OR 2,04; IC 95%:1,21-3,44).Conclusiones. Los niños/as con TC confirmados mostraron con mayor frecuencia malestar físico y los que tenían TC declarados manifestaron malestar en áreas psicosociales, en comparación con los niños/as sin trastorno.Fil: Rivera, Liliana Carolina. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Salud Pública; ArgentinaFil: Mamondi, Verónica Anabel. Universidad Nacional de Córdoba. Facultad de Medicina. Escuela de Salud Pública; ArgentinaFil: Lavin Fueyo, Julieta. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Jouglard, Ezequiel Francisco. Universidad Nacional del Sur. Departamento de Ciencias de la Salud; ArgentinaFil: Pogany, Lourdes. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Sánchez, María C.. Hospital Italiano; ArgentinaFil: Prina, Martina Violeta. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Roizen, Mariana. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; ArgentinaFil: Esandi, Maria Eugenia. Universidad Nacional del Sur. Departamento de Ciencias de la Salud; ArgentinaFil: Berra, Silvina del Valle. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; Argentin

Applying systems thinking to identify enablers and challenges to scale-up interventions for hypertension and diabetes in low-income and middle-income countries: protocol for a longitudinal mixed-methods study.

INTRODUCTION: There is an urgent need to reduce the burden of non-communicable diseases (NCDs), particularly in low-and middle-income countries, where the greatest burden lies. Yet, there is little research concerning the specific issues involved in scaling up NCD interventions targeting low-resource settings. We propose to examine this gap in up to 27 collaborative projects, which were funded by the Global Alliance for Chronic Diseases (GACD) 2019 Scale Up Call, reflecting a total funding investment of approximately US$50 million. These projects represent diverse countries, contexts and adopt varied approaches and study designs to scale-up complex, evidence-based interventions to improve hypertension and diabetes outcomes. A systematic inquiry of these projects will provide necessary scientific insights into the enablers and challenges in the scale up of complex NCD interventions. METHODS AND ANALYSIS: We will apply systems thinking (a holistic approach to analyse the inter-relationship between constituent parts of scaleup interventions and the context in which the interventions are implemented) and adopt a longitudinal mixed-methods study design to explore the planning and early implementation phases of scale up projects. Data will be gathered at three time periods, namely, at planning (TP), initiation of implementation (T0) and 1-year postinitiation (T1). We will extract project-related data from secondary documents at TP and conduct multistakeholder qualitative interviews to gather data at T0 and T1. We will undertake descriptive statistical analysis of TP data and analyse T0 and T1 data using inductive thematic coding. The data extraction tool and interview guides were developed based on a literature review of scale-up frameworks. ETHICS AND DISSEMINATION: The current protocol was approved by the Monash University Human Research Ethics Committee (HREC number 23482). Informed consent will be obtained from all participants. The study findings will be disseminated through peer-reviewed publications and more broadly through the GACD network

An evidence-based framework for identifying technologies of no or low-added value (NLVT)

Objective. To synthetize the state of the art of methods for identifying candidate technologies for disinvestment and propose an evidence-based framework for executing this task. Methods. An interpretative review was conducted. A systematic literature search was performed to identify secondary or tertiary research related to disinvestment initiatives and/or any type of research that specifically described one or more methods for identifying potential candidates technologies, services, or practices for disinvestment. An iterative and critical analysis of the methods described alongside the disinvestment initiatives was performed. Results. Seventeen systematic reviews on disinvestment or related terms (health technology reassessment or medical reversal) were retrieved and methods of 45 disinvestment initiatives were compared. On the basis of this evidence, we proposed a new framework for identifying these technologies based on the wide definition of evidence provided by Lomas et al. The framework comprises seven basic approaches, eleven triggers and thirteen methods for applying these triggers, which were grouped in embedded and ad hoc methods. Conclusions. Although identification methods have been described in the literature and tested in different contexts, the proliferation of terms and concepts used to describe this process creates considerable confusion. The proposed framework is a rigorous and flexible tool that could guide the implementation of strategies for identifying potential candidates for disinvestment

Searching context-tailored strategies to enhance accessibility to colorectal cancer screening through the use of different types of evidence

Although colorectal cancer (CRC) ranks second in both incidence and mortality, screening coverage in Argentina is very low, particularly among individuals with low socio- economic status and public health coverage. Screening programs are cost-effective and successful in reducing disease-specific mortality. However, their implementation by health systems is complex and sub-optimal, partly at- tributed to difficulties in strategies design. Using methods and tools from dissemination and implementation sci- ences would contribute to designing evidence-informed strategies tailored to the specific context of the program. Our work aimed to explore how different types of evi- dence, stakeholder involvement, and evidence-informed deliberation contribute to the design of implementation strategies that address accessibility barriers to CRC screening. The study objectives were: 1) to generate lo- cal evidence on accessibility barriers in a programmatic area of Bahía Blanca, 2) to produce empirical evidence on effective strategies for increasing users and health professional adoption and adherence to CRC screening, 3) to design implementation strategies through stake- holder involvement and deliberation, incorporating the- oretical, empirical, and experiential evidence, 4) to an- alyze how these stakeholder-driven strategies address the local barriers to CRC. This research was part of a broader project conducted by an interdisciplinary team from UNS, with the aim of bridging the knowledge-action gap on priority health issues. It consisted in a 4-stage sequential study, using a mixed-method design. 1: Barriers’ assessment through key stakeholders’ interviews based on the consolidated meta-framework of Implementation Research and Michie’s theoretical framework. 2: Sys- tematic review on the effectiveness of implementation strategies targeting to the uptake and adherence of CRC screening. 3: Evidence-informed deliberative dialogue involving key stakeholders aimed at designing contex- tualized implementation strategies. 4: Mapping exercise linking proposed strategies and barriers, considering Garbus’ accessibility dimensions (technical, economic, political or symbolic). Over 80% of the proposed strat- egies focused on the technical accessibility dimension (network organization), while the remaining strategies addressed symbolic barriers (knowledge gaps, fear, underappreciated health issue). However, no strate- gies targeted to barriers related to the political-econom- ic dimensions were proposed, despite being perceived among the most critical ones (limited videocolonoscopy access, no screening policy, fragmented health system). In low-resource contexts, it is crucial to include politi- cal-economic dimensions in the design of strategies in order to advance effective and sustainable guidelines for CRC prevention. While a participatory approach helped lay the groundwork for new strategies, it cannot formalize a screening policy in AP2 alone, as some barriers and accessibility dimensions remain unaddressed.Fil: Bruzzone, Ariana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: Esandi, Maria Eugenia. Universidad Nacional del Sur. Departamento de Ciencias de la Salud; Argentina. Universidad Nacional del Sur. Departamento de Economía; ArgentinaFil: Schenfeld, Yamila. Universidad Nacional del Sur. Departamento de Ciencias de la Salud; ArgentinaFil: Dopazo Danieli, Iñaki Manuel. Universidad Nacional del Sur. Departamento de Ciencias de la Salud; ArgentinaFil: Bellando, María Belén. Universidad Nacional del Sur. Departamento de Ciencias de la Salud; ArgentinaFil: Picardi, Gonzalo. Universidad Nacional del Sur. Departamento de Ciencias de la Salud; ArgentinaFil: Schernenco, Joel. Universidad Nacional del Sur. Departamento de Ciencias de la Salud; ArgentinaFil: Robles, Manuel. Universidad Nacional del Sur. Departamento de Ciencias de la Salud; ArgentinaFil: Reig, Maria Ernestina. Municipalidad de Bahía Blanca, Secretaria de Salud; ArgentinaLXVIII Reunión Anual de la Sociedad Argentina de Investigación Clínica; XXV Jornadas Anuales de la Sociedad Argentina de Biología; LV Reunión Anual de la Asociación Argentina de Farmacología Experimental y VIII Reunión Científica Regional de la Asociación Argentina de Ciencia y Tecnología de Animales de LaboratorioMar del PlataArgentinaSociedad Argentina de Investigación ClínicaSociedad Argentina de BiologíaAsociación Argentina de Farmacología ExperimentalAsociación Argentina de Ciencia y Tecnología de Animales de Laboratori

COVID-19 epidemiological surveillance through pool testing focused on asymptomatic healthcare workers in the city of Bahía Blanca

INTRODUCCIÓN: Uno de los desafíos más relevantes al comienzo de la pandemia consistió en implementar estrategias dirigidas a prevenir la transmisión del virus SARS-CoV-2 y mitigar el impacto de la COVID-19. El propósito de este estudio fue contribuir a reducir la transmisión comunitaria a través de una iniciativa interinstitucional, cuyos objetivos fueron validar un método de detección de ARN del SARS-CoV-2 e implementar y evaluar la vigilancia en trabajadores de salud asintomáticos de instituciones de salud pública de Bahía Blanca. MÉTODOS: Se validó una prueba de detección del gen E del coronavirus mediante RT-PCR a partir de ARN aislado de hisopados nasofaríngeos. Para aumentar la capacidad de testeo se validó la detección del ARN viral en muestras agrupadas (pooles). Se realizó un estudio de cohorte prospectiva entre el 15/09/20 y el 15/09/21. RESULTADOS: La sensibilidad y especificidad de la prueba en muestras individuales fue del 95% (IC 95%: 85%-100%). La sensibilidad de la detección en pooles fue del 73% (IC 95%: 46%-99%) y la especificidad, del 100%. A lo largo de la vigilancia se incluyeron 855 trabajadores y 1764 hisopados, con una incidencia acumulada anual de 2,3% (IC 95%: 1,2%-3,4%). Se detectaron 20 casos asintomáticos positivos. DISCUSIÓN: El tamizaje de trabajadores de salud asintomáticos en la pandemia contribuyó a reducir el riesgo de brotes hospitalarios. Asimismo, se generó un marco de trabajo interdisciplinario aplicable a otros problemas de saludINTRODUCTION: One of the most important challenges at the beginning of the pandemic was to implement strategies to prevent SARS-CoV-2 virus transmission and reduce the impact of COVID-19. The purpose of this study was to contribute to the reduction of community transmission through an interinstitutional initiative, aimed at validating a SARS-CoV-2 RNA detection method, and at implementing and assessing the surveillance of asymptomatic infected healthcare workers (HCWs) at public health institutions in the city of Bahía Blanca. METHODS: To validate a coronavirus RNA detection method, RNA was extracted from nasopharyngeal swabs and identification of the viral E gene was done by RT-PCR. Validation of sample pooling was performed to increase the testing capacity. A prospective cohort study was conducted from 15 September 2020 to 15 September 2021. RESULTS: The sensitivity and specificity of the test in individual samples was 95% (CI 95%: 85%-100%). The sensitivity of the pooling strategy was 73% (CI 95%: 46%-99%) and the specificity was 100%. A total of the 855 HCWs were included in the surveillance and 1764 swabs were performed, with an annual cumulative incidence of 2.3% (CI 95%: 1,2%-3,4%), and 20 positive asymptomatic cases were detected. DISCUSSION: The screening of asymptomatic HCWs during the pandemic contributed to reduce the risk of outbreaks in hospital settings. Moreover, an interdisciplinary team framework applicable to other health problems was generated.Fil: Esandi, María del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: Marinovich, Joel. Hospital Municipal Doctor Leonidas Lucero.; Argentina. Universidad Nacional del Sur; ArgentinaFil: Bergé, Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: García, Nicolás. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; ArgentinaFil: German, Olga Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: Ayala Peña, Victoria Belen. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: Sierra, Fermín. Hospital Municipal Doctor Leonidas Lucero.; Argentina. Universidad Nacional del Sur; ArgentinaFil: Serralunga, María Gabriela. Universidad Nacional del Sur. Departamento de Matemática; ArgentinaFil: Esandi, Maria Eugenia. Universidad Nacional del Sur. Departamento de Economía; ArgentinaFil: del Valle, Marta. Hospital Municipal Doctor Leonidas Lucero.; Argentina. Universidad Nacional del Sur; ArgentinaFil: Bouzat, Cecilia Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentin