Hospital-based health technology assessment(HB-HTA)is highly valuable in the application of hospital medical technology,cost control,improvement of medical quality,and protection of medical safety,and its use is incre...Hospital-based health technology assessment(HB-HTA)is highly valuable in the application of hospital medical technology,cost control,improvement of medical quality,and protection of medical safety,and its use is increasing daily globally.However,in China,HB-HTA is still in its infancy,and it is yet to be adopted in traditional Chinese medicine(TCM).Therefore,this article introduces the application and development of HB-HTA,as well as discusses the current situation of TCM and related future development strategies to provide ideas and references for the development of HB-HTA in TCM.We conclude and recommend that all major stakeholders,including the state,health departments,and hospital leaders,support and promote the exploration and development of HB-HTA in TCM hospitals and integrative medicine hospitals.We also suggest the utilization of existing talents and introduction of other necessary talents to promote better and faster organizational development,as well as suggest the formation of a national and internationally recognized HB-HTA guidance manual and toolkit for TCM hospitals based on both the national HTA guidelines and the evaluation of TCM hospitals pilot projects.Moreover,we recommend that HB-HTA pilot study should be executed with Chinese patent medicine as the starting point to form the implementation process and framework in the TCM arena.展开更多
Objectives:The widespread usage of traditional Chinese medicine(TCM)and the government's emphasis on TCM in China have created a positive macro-environment and great opportunities to develop and strengthen health ...Objectives:The widespread usage of traditional Chinese medicine(TCM)and the government's emphasis on TCM in China have created a positive macro-environment and great opportunities to develop and strengthen health technology assessment(HTA)in TCM.Over the past ten years,a series of policies have been issued by the government to promote the application of HTA and the development of TCM in China.This study reviews the concepts and characteristics of TCM,summarizes the current status of HTA in TCM,and analyzes the opportunities and challenges faced by HTA development in TCM with respect to deepening of healthcare reforms.Methods:Literature review and website searches were used to acquire information regarding the basic theories of TCM and the current status,opportunities,and challenges for HTA in TCM.Results:The number of articles on HTA in TCM rose substantially,especially those published in China National Knowledge Infrastructure(CNKI).With the optimistic policy environment and huge market demand for TCM,the development of HTA in TCM is expected to flourish in China.However,HTA in TCM also faces numerous challenges such as the absence of a clinical efficacy evaluation system for TCM and insufficient basic research evidence and qualified personnel.Conclusions:TCM has unique characteristic that distinguishes it from Western medicine.Currently,it is important to take all measures to address the existing main challenges and thereby take advantage of the present opportunities to develop and improve HTA in TCM.展开更多
Objectives:Economic growth and rapid development of health technology in China have created opportunities to strengthen health technology assessment (HTA) capacity.Over the time,HTA institutions have been established ...Objectives:Economic growth and rapid development of health technology in China have created opportunities to strengthen health technology assessment (HTA) capacity.Over the time,HTA institutions have been established to conduct HTA related work.This study reviewed the current status of HTA in China and analysed the challenges of HTA development in the context of health reform under'new normal'economy.Methods:Literature review and webpage searches were used to document the development of HTA in China.An institutional survey has also been conducted to collect information on the HTA research institutions in China.Results:The number of articles and research projects on HTA were rising and are continuing to rise.HTA development has made substantial progress in China in terms of growing number of research institutions and qualified HTA workforce.However,HTA has notable weaknesses such as low capacity for conducting HTA research,limited experience in HTA researchers,and lack of knowledge translation.Conclusion:Currently,the translation of HTA findings to policy-making is limited and the integration of HTA in the policy-making processes is still in its infancy.The HTA development in China has had opportunities due to demands of health care,health insurance,and health technology as a result of health reform.Capacity building and institutionalization of HTA are urgently needed for further development of HTA in China.展开更多
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 t...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.展开更多
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 decis...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.展开更多
医疗新技术准入评估是医疗技术纳入临床应用前的重要一环,对保证医疗服务质量和医疗安全具有关键性作用。但在准入评估具体实践过程中,还存在着准入理论框架不完善、评估指标体系不健全等问题。以卫生政策及法律法规为战略支撑,借鉴医...医疗新技术准入评估是医疗技术纳入临床应用前的重要一环,对保证医疗服务质量和医疗安全具有关键性作用。但在准入评估具体实践过程中,还存在着准入理论框架不完善、评估指标体系不健全等问题。以卫生政策及法律法规为战略支撑,借鉴医院卫生技术评估(Hospital-based Health Technology Assessment,HB-HTA)的理论和方法,综合考虑评估主体、评估客体、评估内容等核心要素,从技术特性、安全性、有效性、经济性、适用性等维度进行指标体系设计,构建引进型医疗新技术准入评估框架,以期为医疗机构医疗技术准入管理提供理论框架和循证基础。展开更多
Background Health Technology Assessment(HTA)in China has recently expanded from purely academic research to include policy or decision-oriented practice,especially after HTA evidence was used to update the National Re...Background Health Technology Assessment(HTA)in China has recently expanded from purely academic research to include policy or decision-oriented practice,especially after HTA evidence was used to update the National Reim-bursement Drug List for the first time in 2017.This study aims to identify the progress and challenges of HTA develop-ment from 2016 to 2021 and inform policies and decisions to promote further HTA development in China.Methods We conducted a cross-sectional web-based survey with policy makers,researchers and industry-providers in China in 2016 and 2021 respectively.The‘Mapping of HTA Instrument’,was utilized to assess the HTA development across eight domains:Institutionalization,Identification,Priority setting,Assessment,Appraisal,Reporting,Dissemina-tion of findings and conclusions,and Implementation in policy and practice.To reduce the influence of confound-ers and compare the mapping outcomes between the 2016 and 2021 groups,we conducted 1:1 Propensity Score Matching(PSM).Univariate analysis was conducted to compare the differences between the two groups.The overall results were further compared with those of a mapping study that included ten countries.Results In total,212 and 255 respondents completed the survey in 2016 and 2021,respectively.The total score of the HTA development level in China in 2021 was higher than that in 2016 before PSM(89.38 versus 83.96).Follow-ing PSM,183 respondents from the 2016 and 2021 groups were matched.Overall,the mean scores for most indicators in the Institutionalization domain and Dissemination domain in 2021 were higher than those in 2016(P<0.05).The Appraisal domain in 2021 was more explicit,transparent and replicable than that in 2016(t=-3.279,P<0.05).How-ever,the mean scores of most indicators in the Assessment domain were higher in 2016 than those in 2021(P<0.05).Conclusions Our study suggest that the level of HTA development in China progressed significantly from 2016 to 2021.However,before engaging in HTA activities,further efforts are required to enhance the assessment process.For instance,it is important to establish a clear goal and scope for HTA;adapt standardized methodologies for evaluat-ing the performance of systematic reviews or meta-analyses;and provide comprehensive descriptions of the safety,clinical effectiveness,cost,and cost-effectiveness of the assessed technologies,thus improving the development of HTA in China.展开更多
Introduction: Blue Marble Health Company has created a digital fall risk screening tool (Health in Motion©) that can be used by means of self-report (touch/mouse) or by means of motion capture (Microsoft Kine...Introduction: Blue Marble Health Company has created a digital fall risk screening tool (Health in Motion©) that can be used by means of self-report (touch/mouse) or by means of motion capture (Microsoft Kinect Sensor). Health in Motion©consists of automated versions of the Fall Risk Question-naire, 30-Second Chair Stand Test, and the One Leg Stance Test. Methods: We compared the three methods (self-report, sensor, and clinical standard measurement) using stopwatch and observation in 15 community-dwelling older adults, aged 63 - 80 years old. Each version was completed three times each in random order, for a total of nine trials. Results: Health in Motion©falls screening tool accessible via self-report and sensor is a valid and reliable automated at-home self-assessment for falls risk. Conclusion: Results support the use of Health in Motion©falls screening tools as viable alternatives to standard falls risk assessments for use by older adults at home.展开更多
基金This study was supported by China Center for Evidence Based Traditional Chinese Medicine,CCEBTCM(2020YJSZX-2).
文摘Hospital-based health technology assessment(HB-HTA)is highly valuable in the application of hospital medical technology,cost control,improvement of medical quality,and protection of medical safety,and its use is increasing daily globally.However,in China,HB-HTA is still in its infancy,and it is yet to be adopted in traditional Chinese medicine(TCM).Therefore,this article introduces the application and development of HB-HTA,as well as discusses the current situation of TCM and related future development strategies to provide ideas and references for the development of HB-HTA in TCM.We conclude and recommend that all major stakeholders,including the state,health departments,and hospital leaders,support and promote the exploration and development of HB-HTA in TCM hospitals and integrative medicine hospitals.We also suggest the utilization of existing talents and introduction of other necessary talents to promote better and faster organizational development,as well as suggest the formation of a national and internationally recognized HB-HTA guidance manual and toolkit for TCM hospitals based on both the national HTA guidelines and the evaluation of TCM hospitals pilot projects.Moreover,we recommend that HB-HTA pilot study should be executed with Chinese patent medicine as the starting point to form the implementation process and framework in the TCM arena.
文摘Objectives:The widespread usage of traditional Chinese medicine(TCM)and the government's emphasis on TCM in China have created a positive macro-environment and great opportunities to develop and strengthen health technology assessment(HTA)in TCM.Over the past ten years,a series of policies have been issued by the government to promote the application of HTA and the development of TCM in China.This study reviews the concepts and characteristics of TCM,summarizes the current status of HTA in TCM,and analyzes the opportunities and challenges faced by HTA development in TCM with respect to deepening of healthcare reforms.Methods:Literature review and website searches were used to acquire information regarding the basic theories of TCM and the current status,opportunities,and challenges for HTA in TCM.Results:The number of articles on HTA in TCM rose substantially,especially those published in China National Knowledge Infrastructure(CNKI).With the optimistic policy environment and huge market demand for TCM,the development of HTA in TCM is expected to flourish in China.However,HTA in TCM also faces numerous challenges such as the absence of a clinical efficacy evaluation system for TCM and insufficient basic research evidence and qualified personnel.Conclusions:TCM has unique characteristic that distinguishes it from Western medicine.Currently,it is important to take all measures to address the existing main challenges and thereby take advantage of the present opportunities to develop and improve HTA in TCM.
文摘Objectives:Economic growth and rapid development of health technology in China have created opportunities to strengthen health technology assessment (HTA) capacity.Over the time,HTA institutions have been established to conduct HTA related work.This study reviewed the current status of HTA in China and analysed the challenges of HTA development in the context of health reform under'new normal'economy.Methods:Literature review and webpage searches were used to document the development of HTA in China.An institutional survey has also been conducted to collect information on the HTA research institutions in China.Results:The number of articles and research projects on HTA were rising and are continuing to rise.HTA development has made substantial progress in China in terms of growing number of research institutions and qualified HTA workforce.However,HTA has notable weaknesses such as low capacity for conducting HTA research,limited experience in HTA researchers,and lack of knowledge translation.Conclusion:Currently,the translation of HTA findings to policy-making is limited and the integration of HTA in the policy-making processes is still in its infancy.The HTA development in China has had opportunities due to demands of health care,health insurance,and health technology as a result of health reform.Capacity building and institutionalization of HTA are urgently needed for further development of HTA in China.
基金support from“A Demonstration Program on Health Technology Assessment in China”by China Medical Board(Grant 19-318).
文摘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.
基金This study was supported by the National Natural Science Foundation of China(82174239)China Academy of Chinese Med-ical Sciences Innovation Fund(CI2021A00701-3 and CI2021A05503)China Center for Evidence Based Traditional Chinese Medicine(2020YJSZX-2).
文摘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.
文摘医疗新技术准入评估是医疗技术纳入临床应用前的重要一环,对保证医疗服务质量和医疗安全具有关键性作用。但在准入评估具体实践过程中,还存在着准入理论框架不完善、评估指标体系不健全等问题。以卫生政策及法律法规为战略支撑,借鉴医院卫生技术评估(Hospital-based Health Technology Assessment,HB-HTA)的理论和方法,综合考虑评估主体、评估客体、评估内容等核心要素,从技术特性、安全性、有效性、经济性、适用性等维度进行指标体系设计,构建引进型医疗新技术准入评估框架,以期为医疗机构医疗技术准入管理提供理论框架和循证基础。
基金supported by China Medical Board(CMB)under Grant 19-318,A Demonstration Program on Health Technology Assessment in China.
文摘Background Health Technology Assessment(HTA)in China has recently expanded from purely academic research to include policy or decision-oriented practice,especially after HTA evidence was used to update the National Reim-bursement Drug List for the first time in 2017.This study aims to identify the progress and challenges of HTA develop-ment from 2016 to 2021 and inform policies and decisions to promote further HTA development in China.Methods We conducted a cross-sectional web-based survey with policy makers,researchers and industry-providers in China in 2016 and 2021 respectively.The‘Mapping of HTA Instrument’,was utilized to assess the HTA development across eight domains:Institutionalization,Identification,Priority setting,Assessment,Appraisal,Reporting,Dissemina-tion of findings and conclusions,and Implementation in policy and practice.To reduce the influence of confound-ers and compare the mapping outcomes between the 2016 and 2021 groups,we conducted 1:1 Propensity Score Matching(PSM).Univariate analysis was conducted to compare the differences between the two groups.The overall results were further compared with those of a mapping study that included ten countries.Results In total,212 and 255 respondents completed the survey in 2016 and 2021,respectively.The total score of the HTA development level in China in 2021 was higher than that in 2016 before PSM(89.38 versus 83.96).Follow-ing PSM,183 respondents from the 2016 and 2021 groups were matched.Overall,the mean scores for most indicators in the Institutionalization domain and Dissemination domain in 2021 were higher than those in 2016(P<0.05).The Appraisal domain in 2021 was more explicit,transparent and replicable than that in 2016(t=-3.279,P<0.05).How-ever,the mean scores of most indicators in the Assessment domain were higher in 2016 than those in 2021(P<0.05).Conclusions Our study suggest that the level of HTA development in China progressed significantly from 2016 to 2021.However,before engaging in HTA activities,further efforts are required to enhance the assessment process.For instance,it is important to establish a clear goal and scope for HTA;adapt standardized methodologies for evaluat-ing the performance of systematic reviews or meta-analyses;and provide comprehensive descriptions of the safety,clinical effectiveness,cost,and cost-effectiveness of the assessed technologies,thus improving the development of HTA in China.
文摘Introduction: Blue Marble Health Company has created a digital fall risk screening tool (Health in Motion©) that can be used by means of self-report (touch/mouse) or by means of motion capture (Microsoft Kinect Sensor). Health in Motion©consists of automated versions of the Fall Risk Question-naire, 30-Second Chair Stand Test, and the One Leg Stance Test. Methods: We compared the three methods (self-report, sensor, and clinical standard measurement) using stopwatch and observation in 15 community-dwelling older adults, aged 63 - 80 years old. Each version was completed three times each in random order, for a total of nine trials. Results: Health in Motion©falls screening tool accessible via self-report and sensor is a valid and reliable automated at-home self-assessment for falls risk. Conclusion: Results support the use of Health in Motion©falls screening tools as viable alternatives to standard falls risk assessments for use by older adults at home.
