Shaoma Zhijing granule for children with tic disorders: A rapid health technology assessment

Objective:To rapidly assess the effectiveness,safety,economy,and applicability of Shaoma Zhijing granule(SZG)for the treatment of children with tic disorders(TD),and provide currently available best evidence for decision-makers of health policies.Methods:We conducted a rapid health technology assessment(RHTA)to explore the value of SZG.A systematic literature search in eight literature databases and on three clinical trial registration platforms was performed.The literature was screened according to eligibility criteria.The screening process and data extraction were conducted by two reviewers,and the quality of the literature was also assessed.The results were summarized,analyzed,and presented in tables or figures.Results:A total of five randomized controlled trials(RCTs)were included in this study,of which one was published in English(in the Journal of Child Psychology and Psychiatry)and four in Chinese journals.The overall risk of bias for the five RCTs was evaluated as“some concerns.”SZG monotherapy or in combi-nation with tiapride was better than tiapride alone in improving traditional Chinese medicine(TCM)syndromes and tic symptoms,with a daily cost of¥67.50e107.22.Adverse events were mainly related to the digestive,respiratory,and neurological systems,but all were mild.Conclusion:Overall,the current RHTA of published,peer-reviewed literature has located a small body of evidence evaluating the use of SZG for the treatment of TD in children.SZG has effects on improving TCM syndromes and tic symptoms;the daily cost is¥67.50e107.22;and all adverse events are mild.High-quality studies with long-term follow-up should be conducted,so as to provide local evidence and consistently guide and improve scientific decision-making.

Can health technology assessments assist the global campaign against poverty?

Although a key tenant of the Sustainable Development Goals is to achieve universal health coverage,the global drug gap persists-cver a third of the global population lack access to essential medicines.Without access to affordable drugs,people have worse health outcomes,higher medical expenses,and productivity loss,pushing them into poverty.Health technology assessments(HTAs)offer an opportunity to decrease the global drug gap and increase access to essential medicines by overcoming barriers to medicine access.These barriers include drug procurement,drug affordability for payers and patients,a patienfs ability to obtain essential medicines,and health system capacity.Using HTAs can therefore close the global drug gap by increasing access to affordable essential medicines.In turn,people have better health outcomes,spend less money on medical care,and can have better productivity.Ultimately,use of HTAs can lift the population out of poverty and force fewer people into poverty by creating better health outcomes at affordable prices.

三级医疗机构医院卫生技术评估实施现况

目的分析三级医疗机构医院卫生技术(hospital-based health technology assessment,HB-HTA)评估开展现状,为完善医疗机构HB-HTA的应用提供参考和依据。方法运用便利抽样方法,对国家卫生健康委员会医疗管理服务指导中心HB-HTA工作试点医院和已开展HB-HTA的其他医院进行问卷调查和关键知情人访谈。结果共调查19家三级医疗机构,开展HB-HTA有利于促进医疗机构科学管理决策、保障医疗质量和安全、节约医院预算、提高HB-HTA认知水平。但目前HB-HTA还存在缺乏长期持续开展的激励机制、缺乏HB-HTA相关专业人才和部门、HB-HTA流程过于繁杂、卫生技术评估时效性较差、决策支持效率较低、研究结果推广率低等问题。结论建议加强政策、资金支持,注重加强医院内部卫生技术评估人才的引进和能力培训,积极鼓励和引导医院内部建立具体HB-HTA小组或者部门,探索开发HB-HTA支持决策流程的智能化工具或软件,通过多种方式促进评估成果和评估报告的传播共享,不断完善HB-HTA的开展。

含抗菌剂缝线卫生技术评估

目的通过卫生技术评估过程系统评估含抗菌剂缝线的价值,为医疗机构科学采购提供决策依据,为医用耗材科学评估提供参考及建议。方法参考欧洲卫生技术评估网络核心模型及欧洲联盟医院卫生技术评估手册推荐框架,通过文献研究、meta分析、卫生经济学模型测算等方法全面评估含抗菌剂缝线的安全性、有效性、经济性及社会性。结果相比不含抗菌剂缝线,含抗菌剂缝线可在一定程度上降低发生手术部位感染的风险,节省因手术部位感染产生的费用。结合现有证据,含抗菌剂缝线不会产生耐药性,且不会对操作者学习曲线造成影响。结论含抗菌剂缝线能够降低发生手术部位感染的风险,对降低医疗机构整体成本支出有积极影响。手术部位感染控制属于集束化管理,医院感染管控仍需多措并举。医用耗材卫生技术评估存在较大挑战,需开展进一步探索。

生产率损失测量工具的比较研究

目的 比较可用于卫生技术评估中的生产率损失测量工具,厘清可用于卫生技术评估中的生产率损失测量工具的应用条件,以期为相关研究者在选择生产率损失的测量工具时提供参考。方法 检索PubMed、Web of Science、中国知网、万方、维普等中外数据库,检索时间从数据库建库至2021年11月,由2名研究者按照纳入与排除标准独立筛选文献、识别生产率损失测量工具、提取资料。结果 共识别出5种可用于卫生技术评估领域中的生产率损失测量工具,包括工作能力和活动受损量表(work productivity activity and impairment,WPAI)、工作能力局限调查问卷(work limitations questionnaire,WLQ)、健康与工作绩效问卷(Health and Work Performance Questionnaire,HPQ)、损失产能的估值(Valuation of Lost Productivity Questionnaire,VOLP)和医疗技术评估研究院(Institute for Medical Technology Assessment,IMTA)的生产力成本问卷(IMTA Productivity Questionnaire,IPCQ)。其中WPAI和WLQ是测量属性证据最为充足的工具;VOLP是成本涵盖最全的工具;WLQ是数据敏感性最强的工具;IPCQ是货币转化方法最多的工具;WPAI是获取使用最方便的工具。结论 对于卫生技术评估中的生产率损失测量的标准工具尚未存在统一共识,研究者可根据自身研究选取生产率损失测量工具。