Scanning the Horizon, May 08 - Newsletter - Service Planning and New health Intervention Assessment (SPNIA)

Scanning the Horizon: Recent Developments in Health Innovations and Technologies

May 2008

This newsletter provides information, health innovations and emerging new technologies. There is an emphasis on the ten Health Targets. It is aimed to help District Health Boards and health care providers keep up to date with information to help them improve performance around the Ministry of Health's ten Health Targets and other relevant topics.

There are links to:

recent horizon scanning reports
health technology assessments
research reports.

View other issues of this newsletter
View other Ministry of Health newsletters
View information on the National Service & Technology Review Advisory Committee

IMPROVING IMMUNISATION COVERAGE

Assessment of Immunization Status in Hospitalized Children Followed by Counseling of Parents and Primary Care Physicians Improves Vaccination Coverage
“This prospective, intervention-control study in hospitalized, underimmunized children assessed the effect of vaccination reminders to parents during hospitalization and provides postdischarge rates of catch-up immunizations. One month after hospital discharge, significantly more children in the intervention group (27%) than the controls (8%) had received catch-up immunizations (P < .001).”

Influenza vaccination in adults with asthma: safety of an inactivated trivalent influenza vaccine
“Despite recommendations in most countries for giving inactivated influenza vaccine to people with asthma, only a minority currently receive it. One reason for low vaccine coverage has been concern that vaccination may induce exacerbations of asthma. In this randomized trial, 291 patients between 18 and 65 years of age received either an inactivated influenza vaccine followed 14 days later by a saline placebo or placebo followed by the vaccine…[The authors] conclude that influenza vaccination did not increase the incidence of asthma exacerbations compared to placebo in this study and the vaccine was well tolerated. The results thus support annual influenza vaccination in patients with asthma.”

IMPROVING ORAL HEALTH

Full-mouth disinfection for the treatment of adult chronic periodontitis
“The results of this review have shown that the treatment effects of full-mouth scaling or full-mouth disinfection compared to conventional scaling and root planing are modest and the implications for periodontal care are not profound. In practice the decision to select one approach to non-surgical periodontal therapy over another needs to include patient preferences and convenience of the treatment schedule.”

REDUCING CANCER WAITING TIMES

Managing the 2-week wait for breast patients.
“Published data suggest that the 2-week wait system and triple assessment at one fast-track clinic visit is an out-dated method of capturing disease from a referral population. These studies report up to 32% of breast cancer coming from routine referrals. It has been recommended, therefore, that all breast referrals should be seen within 2 weeks. The sheer volume of referrals are likely to prevent this target being achieved. The aim of this study was to analyse the performance of our fast-track system.”

REDUCING AVOIDABLE ADMISSIONS

Avoidable hospitalizations for diabetes: comorbidity risks
“Recommendations are made for how disease management programs for diabetes could incorporate treatment for comorbid conditions to reduce hospitalization risk.”

IMPROVING DIABETES SERVICES

Systematic review update and economic evaluation for the New Zealand setting: Subcutaneous insulin pump therapy (PDF, 1.8 MB) – Produced by the New Zealand Health Services Assessment Collaboration (HSAC) “The aim of this review was to evaluate the relative effectiveness, safety, and cost-effectiveness of CSII in patients with insulin-treated diabetes, when compared with optimised multiple daily injections (MDI). The primary research question to be addressed by this review was: Is subcutaneous insulin pump therapy effective, safe, and cost-effective compared with multiple daily injections?”

Applicability of the Evidence Regarding Intensive Glycemic Control and Self-Monitored Blood Glucose to Medicare Patients with Type 2 Diabetes(PDF, 2.63 MB)
“This technology assessment report on intensive glycemic control and self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes mellitus is prepared by the Tufts-New England Medical Center Evidence-based Practice Center (Tufts-NEMC EPC) for a Medicare Evidence Development and Coverage Advisory Committee (MedCAC) meeting.”

IMPROVING MENTAL HEALTH SERVICES

The effectiveness of compulsory, residential treatment of chronic alcohol or drug addiction in non-offenders (PDF, 1.34 MB) – Produced by the New Zealand Health Services Assessment Collaboration (HSAC) “The effectiveness of compulsory, residential treatment of chronic alcohol or drug addiction in non-offenders.
The study research question was: what is the effectiveness of compulsory, residential treatment of chronic alcohol or drug addiction in non-offenders?”

IMPROVING NUTRITION, INCREASING PHYSICAL ACTIVITY, REDUCING OBESITY

The safety, effectiveness and cost effectiveness of surgical and non-surgical interventions for patients morbid obesity (PDF, 1.2 MB) – Produced by NZHTA (New Zealand Health Technology Assessment) ”This technical brief provides an update on the literature examining the safety, effectiveness and cost effectiveness of surgical and non-surgical interventions for patients with morbid obesity (BMI ≥ 40 or ≥ 35 with serious obesity-related comorbidities).”

Laparoscopic Adjustable Gastric Banding for Morbid Obesity
“This topic was reviewed by the California Technology Assessment Forum (CTAF) on 28th February, 2007. It was recommended that the use of laparoscopic adjustable silicone gastric banding for the treatment of morbid obesity does not meet CTAF technology assessment criteria 4 for safety, effectiveness, and improvement in health outcomes.”

Surgery for Obesity – A Health Technology Assessment (PDF, 158 KB)
“During recent years, weight loss surgery has been performed increasingly on obese individuals - so-called bariatric surgery. Combining an increased number of severely obese patients and a possibility of surgical intervention it seems that more and more severely obese individuals will be offered surgery and thereby make increasing demands on the organisational and surgical expertise. It is thus important to discuss the consequences of the initiated surgical intervention so far.”

REDUCING THE HARM CAUSED BY TOBACCO

Psychosocial interventions for smoking cessation in patients with coronary heart disease
“Psychosocial smoking cessation interventions are effective in promoting abstinence at 1 year, provided they are of sufficient duration. Further studies, with longer follow-up, should compare different psychosocial intervention strategies, or the addition of a psychosocial intervention strategy to pharmacological therapy (e.g. nicotine replacement therapy) compared with pharmacological treatment alone.”

HIGHLIGHTED ISSUE: TELEHEALTH

Telehealth has been and continues to be an important issue in the health sector. In consideration of this, it is not surprising that numerous Health Technology Assessments (HTAs) have been completed around this subject. In this inaugural issue of our newsletter, we highlight the recent HTAs that have been completed around this issue.

Real-Time (Synchronous) Telehealth in Primary Care: Systematic Review of Systematic Reviews

Asynchronous Telehealth: Systematic Review of Analytic Studies and Environmental Scan of Relevant Initiatives

Telehealth for Acute Stroke Management (Telestroke): Systematic Review of Analytic Studies

Telehealth for Acute Stroke Management (Telestroke): Systematic Review and Environmental Scan

Remote Cardiac Monitoring – Technology Assessment (PDF,1.31 MB)

GENERAL INTEREST

Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents
“CRD summary: This well-conducted review using individual patient data compared the long-term effects of sirolimus-eluting stents and bare-metal stents. The authors found no difference in overall long-term survival or survival free of myocardial infarction between the two stents. The need for reintervention was reduced with sirolimus-eluting stents, but the risk of thrombosis was no less. These conclusions are likely to be reliable.”

CADTH Releases Intervention Tools aimed at influencing behaviour, regarding the prescribing and use of Proton Pump Inhibitors
“The Canadian Agency for Drugs and Technologies in Health (CADTH) today [25th April, 2007] announced the release of Optimal Therapy Reports and Intervention Tools for the prescribing and use of proton pump inhibitors (PPIs) through its Canadian Optimal Medication Prescribing and Utilization Service (COMPUS).”

Acceptability, benefit and costs of early screening for hearing disability: a study of potential screening tests and models (PDF, 2.4 MB)
“Study found that a simple check for hearing problems using an audiometric screening instrument is likely to be beneficial and may be cost-effective for people aged between 55 and 74, however larger scale research is warranted.”

Overview of Subcutaneous Versus Intravenous Immunoglobulin for Primary Immunodeficiencies: Systematic Review and Economic Analysis (PDF, 450 KB)
“The use of IVIg for PIDs is well-established. SCIg is now available in Canada and offers potential advantages, such as home-based administration. Informed public policy requires an assessment of the clinical and cost-effectiveness of SCIg, relative to IVIg.”

Positron Emission Tomography (PET) Mammography: A New Diagnostic Tool
"Positron emission tomography (PET) mammography incorporates PET technology into a mammography unit that can detect lesions as small as 2 mm; this is two to three times smaller than lesions that can be detected by whole-body PET."

Nuchal Translucency Measurement in First Trimester Down Syndrome Screening (PDF, 295 KB)
"The ultrasound measurement of NT between 11 and 14 weeks’ gestation, in combination with the mother’s age and the levels of placental biochemical markers in her blood, can be used to detect approximately 84% of feotuses with Down syndrome."

Low dose spiral computerized tomography (LDCT) screening for lung cancer
"This topic was reviewed by the California Technology Assessment Forum on 28th February, 2007. It is recommended that the use of LDCT as a screening test for lung cancer does not meet CTAF criteria 2-5 because it is unclear, as of yet, if it reduces lung cancer specific mortality."

HEALTH SERVICES ASSESSMENT COLLABORATION (HSAC) - CURRENT PROJECTS

HSAC03: The effectiveness of digital hearing aids and assistive listening devices for adults with hearing loss. A systematic review.

HSAC06: Effectiveness of different interventions on ambulatory sensitive hospitalisations. A systematic review.

HSAC07: Foetal Alcohol Spectrum Disorder. A systematic review.

LINKS TO OTHER HEALTH TECHNOLOGY NEWSLETTERS

ANZHSN Bulletin - Issue 5 Dec 2007 (PDF, 1 MB)
ANZHSN Bulletin - Issue 6 Apr 2008 (PDF, 930 KB)
This newsletter highlights “new health technologies identified through the Australia and New Zealand Horizon Scanning Network (ANZHSN)”.

Health Technology Update – CADTH
“Produced by the Canadian Agency for Drugs and Technologies in Health (CADTH), the newsletter presents articles about new and emerging medical devices, procedures and health systems to support health care decisions and policy making at the local, regional, provincial and national levels.”

OTHER USEFUL LINKS

Health Services Assessment Collaboration (HSAC)

Medical Services Advisory Committee (MSAC)

Canadian Agency for Drugs and Technologies in Health (CADTH)

INAHTA (International Network of Agencies for Health Technology Assessment)

EuroScan