Correct coding for laboratory procedures during assisted reproductive technology cycles.

This document provides updated coding information for services related to assisted reproductive technology procedures. This document replaces the 2012 ASRM document of the same name.

[Discrete-event simulation models in the economic evaluation of health technologies and health products]. / Los modelos de simulación de eventos discretos en la evaluación económica de tecnologías y productos sanitarios.

The use of mathematical models to assess therapeutic alternatives is increasing in the economic evaluation of health technologies and services and these models are becoming an increasingly important aid to decision making in health care. Until now, 2 types of model have been used, depending to some extent on the disease to be studied: decision trees have been used for acute diseases and Markov models in chronic or recurrent diseases. However, both models present major limitations when addressing complex processes or diseases. Consequently, interest in, and the use of, discrete-event simulation is growing. The present article aims to describe the main characteristics of discrete-event simulation, the state of the art in this field, and the advantages of these models with respect to other kinds of models in health economics, especially in the evaluation of health technologies and product assessment.

Aplicaciones de la biotecnología en el Ministerio de Defensa / No disponible

No disponible

The development, validity and reliability of the Hospital in the Home Dependency Scale (HDS).

The aim of this study was to develop and investigate the validity and reliability of the Hospital-in-the-Home (HITH) Dependency Scale (HDS). The HDS is a new instrument designed to measure the dependency of HITH patients. It calculates an overall dependency level by rating four dimensions of the provision of HITH nursing care. Specifically, these dimensions are the complexity of assessment, complexity of treatment, time taken to provide the treatment, and the frequency of treatment. The results of testing the HDS suggest that it is valid in measuring adult medical and surgical HITH patient dependency. The scale demonstrated strong stability over time in test retest procedures over a one month period (r = 0.80, p <0.01) and internal consistency (Cronbach's alpha = 0.72). We conclude that the HDS is a valid, reliable instrument that is quick and easy to use in the HITH setting.

Technology evolution: the technology spectrum and its application to orthopedic technologies.

The evolution of clinical technologies presents potential adopters with considerations in planning for clinical program development that include the stage and the rate of a technology's evolution. This paper presents a conceptual framework for these considerations and applies the framework to orthopedic technologies. Eight orthopedic surgeons were asked to assess 14 orthopedic technologies and position each of them along a spectrum of research, clinical, and adopted technologies. The distribution of responses for each technology-year combination is presented, and estimates of central tendency, dispersion, and variances provide measures of the change in the distribution of responses over time for each technology and the change in the degree of rater consensus over time for each technology. While orthopedic trauma was chosen to illustrate the technology spectrum model, the model and assessment methodology is applicable to other medical specialties as well. Adoption of this framework in a hospital setting should enable more systematic and effective clinical program development.

Which are the best information sources for identifying emerging health care technologies? An international Delphi survey.

The purpose of this survey was to assess potential information sources for identifying new health care technologies. A three-round Delphi study was conducted, involving 38 selected experts who suggested and assessed potential sources by applying agreed criteria. Twenty-six potential information sources were considered. Timeliness, time efficiency, and sensitivity were important criteria in determining which were the most important sources. The eight recommended sources were: pharmaceutical journals, pharmaceutical and biotechnology companies, specialist medical journals, key medical journals, medical engineering companies, private health care providers, newsletters and bulletins from other health technology assessment agencies, and groups of expert health professionals. There is a need to use a combination of sources because the most useful sources will vary according to the type of technology under consideration.

European legislation of biomedical technology.

The primary objectives which the European directive proposal wants to reach are: a) to guarantee a high quality standard of the products which are put into the EC market, for the user; b) to guarantee the safety and health of the user and of all other people who come into direct contact with the said products. The directives define a precise scheme of regulation and control for all medical devices and this scheme is in force for all the member states of European Union.

Assessment of health information technology: which questions for which systems? Proposal for a taxonomy.

After a brief description of the main domains of application of medical informatics, a typology of questions to be assessed, and of the involved actors, is presented. Dimensions of technology assessment include techniques, medical and health efficacy, economics, sociology, and law and ethics. Barriers to evaluation are analysed. They include barriers related to the domain complexity, human motivation and methodological barriers. Finally categories of solutions and research areas are suggested.

How attractive does a new technology have to be to warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations.

Because economic evaluations of health care services are being published with increasing frequency it is important to (a) evaluate them rigorously and (b) compare the net benefit of the application of one technology with that of others. Four "levels of evidence" that rate economic evaluations on the basis of their methodologic rigour are proposed. They are based on the quality of the methods used to estimate clinical effectiveness, quality of life and costs. With the use of the magnitude of the incremental net benefit of a technology, therapies can also be classified into five "grades of recommendation." A grade A technology is both more effective and cheaper than the existing one, whereas a grade E technology is less or equally effective and more costly. Those of grades B through D are more effective and more costly. A grade B technology costs less than $20,000 per quality-adjusted life-year (QALY), a grade C one $20,000 to $100,000/QALY and a grade D one more than $100,000/QALY. Many issues other than cost effectiveness, such as ethical and political considerations, affect the implementation of a new technology. However, it is hoped that these guidelines will provide a framework with which to interpret economic evaluations and to identify additional information that will be useful in making sound decisions on the adoption and utilization of health care services.