[Patient Care in German Outpatient Clinics for Environmental Medicine Illustrated by the Examples of Hamburg and Munich University Hospitals]. / Versorgung von Patient*innen an umweltmedizinischen Ambulanzen in Deutschland am Beispiel der Universitätskliniken in Hamburg und München.

People can be affected by various environmental factors (e. g., odor, noise) which can lead to medical complaints or illnesses. Few adequate contact points are available for patients with suspected environmental complaints in Germany. Illustrated by the outpatient clinics for environmental medicine in Hamburg and Munich, this report shows how patients with suspected environmental medical diseases are cared for in Germany. For the exemplary presentation, the data of the environmental medicine outpatient clinics of both the university hospitals from 01.01.2019 to 31.03.2021 are presented and compared. Overall, more female than male patients were treated at both facilities. Suspected exposure to "heavy metals" was most frequently mentioned by patients as the assumed reason for their complaints. Nonetheless, the suspected exposure or "intoxication" could be ruled out in the majority of cases by appropriate examination methods in accordance to current medical guidelines. The data provided by the environmental medicine outpatient clinics show that there is a continuous demand for environmental medical care. A close cooperation between the private practice sector and the outpatient clinics for environmental medicine providing medical care to patients should therefore be sought.

Practical tools and methods for health technology assessment in Europe: structures, methodologies, and tools developed by the European Network for Health Technology Assessment, EUnetHTA.

OBJECTIVES: This article presents an overview of the practical methods and tools to support transnational Health Technology Assessment (HTA) that were developed and pilot tested by the European network for HTA (EUnetHTA), which involved a total of sixty-four Partner organizations. METHODS: The methods differ according to scope and purpose of each of the tools developed. They included, for example, literature reviews, surveys, Delphi and consensus methods, workshops, pilot tests, and internal/public consultation. RESULTS: Practical results include an HTA Core Model and a Handbook on the use of the model, two pilot examples of HTA core information, an HTA Adaptation Toolkit for taking existing reports into new settings, a book about HTA and health policy making in Europe, a newsletter providing structured information about emerging/new technologies, an interactive Web-based tool to share information about monitoring activities for emerging/new technologies, and a Handbook on HTA capacity building for Member States with limited institutionalization of HTA. CONCLUSIONS: The tools provide high-quality information and methodological frameworks for HTA that facilitate preparation of HTA documentation, and sharing of information in and across national or regional systems. The tools will be used and further tested by partners in the EUnetHTA Collaboration aiming to (i) help reduce unnecessary duplication of HTA activities, (ii) develop and promote good practice in HTA methods and processes, (iii) share what can be shared, (iv) facilitate local adaptation of HTA information, (v) improve the links between health policy and HTA.

The HTA core model: a novel method for producing and reporting health technology assessments.

OBJECTIVES: The aim of this study was to develop and test a generic framework to enable international collaboration for producing and sharing results of health technology assessments (HTAs). METHODS: Ten international teams constructed the HTA Core Model, dividing information contained in a comprehensive HTA into standardized pieces, the assessment elements. Each element contains a generic issue that is translated into practical research questions while performing an assessment. Elements were described in detail in element cards. Two pilot assessments, designated as Core HTAs were also produced. The Model and Core HTAs were both validated. Guidance on the use of the HTA Core Model was compiled into a Handbook. RESULTS: The HTA Core Model considers health technologies through nine domains. Two applications of the Model were developed, one for medical and surgical interventions and another for diagnostic technologies. Two Core HTAs were produced in parallel with developing the model, providing the first real-life testing of the Model and input for further development. The results of formal validation and public feedback were primarily positive. Development needs were also identified and considered. An online Handbook is available. CONCLUSIONS: The HTA Core Model is a novel approach to HTA. It enables effective international production and sharing of HTA results in a structured format. The face validity of the Model was confirmed during the project, but further testing and refining are needed to ensure optimal usefulness and user-friendliness. Core HTAs are intended to serve as a basis for local HTA reports. Core HTAs do not contain recommendations on technology use.