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At least 307 records · Page 17Linked to original sources
PubMed2000

Assessment of the learning curve in health technologies. A systematic review.

OBJECTIVE: We reviewed and appraised the methods by which the issue of the learning curve has been addressed during health technology assessment in the past. METHOD: We performed a systematic review of papers in clinical databases (BIOSIS, CINAHL, Cochrane Library, EMBASE, HealthSTAR, MEDLINE, Science Citation Index, and Social Science Citation Index) using the search term "learning curve." RESULTS: The clinical search retrieved 4,571 abstracts for assessment, of which 559 (12%) published articles were eligible for review. Of these, 272 were judged to have formally assessed a learning curve. The procedures assessed were minimal access (51%), other surgical (41%), and diagnostic (8%). The majority of the studies were case series (95%). Some 47% of studies addressed only individual operator performance and 52% addressed institutional performance. The data were collected prospectively in 40%, retrospectively in 26%, and the method was unclear for 31%. The statistical methods used were simple graphs (44%), splitting the data chronologically and performing a t test or chi-squared test (60%), curve fitting (12%), and other model fitting (5%). CONCLUSIONS: Learning curves are rarely considered formally in health technology assessment. Where they are, the reporting of the studies and the statistical methods used are weak. As a minimum, reporting of learning should include the number and experience of the operators and a detailed description of data collection. Improved statistical methods would enhance the assessment of health technologies that require learning.

Biomedical Technology↗
PubMed1993

Building a strategic technology management program.

Strategic technology management decisions are one of the best opportunities for healthcare providers to positively meet clinical needs, patient expectations and competitiveness goals. Technology management must not be treated as an event (annual capital budgeting) but as a well-thought-out, long-range business plan. A strategic technology management team should be formed that includes all the key strategic business areas, plus ad hoc members from the clinical and biomedical engineering areas. Current and future needs should be assessed and the performance of the plan monitored. A plan will help achieve buy-in from clinicians and reduce unwarranted expenditures on technology.

Budgets↗
PubMed2004

The precautionary principle: a dialectical reconsideration.

This essay examines an overlooked element of the precautionary principle: a prudent assessment of the long-range or remote catastrophes possibly associated with technological development must include the catastrophes that may take place because of the absence of such technologies. In short, this brief essay attempts to turn the precautionary principle on its head by arguing that, (1) if the long-term survival of any life form is precarious, and if the survival of the current human population is particularly precarious, especially given contemporary urban population densities, and (2) if technological innovation and progress are necessary in order rapidly to adapt humans to meet environmental threats that would otherwise be catastrophic on a large scale (e.g., pandemics of highly lethal diseases), then (3) the development of biomedical technologies in many forms, but in particular including human germ-line genetic engineering, may be required by the precautionary principle, given the prospect of the obliteration of humans in the absence of such enhanced biotechnology. The precautionary principle thus properly understood requires an ethos that should generally support technological innovation, at least in particular areas of biotechnology.

Bioethical Issues↗
PubMed2006

[The role of HTA in German health care. Do we need impact objectives?].

Like other health technologies, HTA should be judged on the quality and size of its effects. However, it is only in recent years that this aspect has received increased attention. A comprehensive theoretical analysis is still missing. In this article national and international studies on the influence of HTA reports are presented. On the basis of theoretical models, the thesis is developed that the potential of HTA reports is much more extensive and complex than has been generally assumed. In order to make use of this potential, a stepwise procedure is proposed, comprising the involvement of the groups concerned, the explicit inclusion of impact objectives in all HTA reports, and the subsequent evaluation of the effects produced. This procedure is illustrated by the example of one HTA topic.

Biomedical Technology↗
PubMed2003

Hyperbaric oxygen technology: an overview of its applications, efficacy, and cost-effectiveness.

OBJECTIVES: To examine the growing evidence and the consensus in the medical community concerning the efficacy and cost-effectiveness of hyperbaric oxygen therapy (HBO2T) and to suggest future research areas to ensure the appropriate use of this technology. METHODS: A literature search of articles published between 1985 and 2000 was conducted using PubMed to describe the growth of HBO2T-related articles published over the past fifteen years. In addition, articles involving the qualitative synthesis of the efficacy and cost-effectiveness of HBO2T in thirteen major application areas were identified and compared with the changing view of the medical community toward the evidence of HBO2T. RESULTS: The total number of HBO2T-related articles published annually has steadily increased over the past fifteen years. This increase has gradually contributed to a consensus in the medical community concerning the evidence of efficacy in its major application areas. However, information regarding the cost-effectiveness of HBO2T is still extremely limited. CONCLUSIONS: Although evidence concerning the efficacy of HBO2T has been growing in the past, more evidence is still needed for some of its major application areas. Moreover, there is an urgent need to shift part of the research focus on HBO2T to its cost-effectiveness to provide decision makers with relevant information to evaluate this technology objectively.

Biomedical Technology↗
PubMed2005

The burgeoning disorder of technophilia.

Andreas Laupacis and William Evans have deftly accomplished the difficult task of synthesizing the major issues at hand. Their comments are timely, reflecting society's increasing preoccupation with rapid access to diagnostic imaging. Paradoxically, the recent CIHI report on medical imaging records a steady increase in scanners, without the expected reduction in wait times. The role of private facilities is unclear, and the value of screening asymptomatic patients is unproven. There are few clear guidelines for ordering images. New intraoperative, functional and molecular imaging technologies will further strain the system. This array of challenges should be urgently tackled by a decisive panel of national experts, who would in turn supervise consultants working full-time on guideline development.

Attitude of Health Personnel↗
PubMed1999

[Research on applications of micromachine technology in medical engineering].

This paper presents the basic concept of micromachines. The development aim and Key technology of medical micromachine Research are discussed here too. Besides, this Paper introduces some typical application research of micromachines, which may have actual reference Value for the future development of medical engineering.

Artificial Organs↗
PubMed1988

Technology assessment in medicine. The role of the American Medical Association.

Public policy decisions about health care and decisions about an individual patient's care are only as sound as the data and information on which they are founded. The formal systematic evaluation of the safety, effectiveness, and cost-effectiveness of a medical technology provides such information and is essential to the appropriate application of technology in patient care. The American Medical Association (AMA) historically has recognized the need for the practicing medical community to develop and communicate accurate and balanced evaluative information to physicians and other health care professionals. In recent years, the association has established formal programs to accomplish this objective. This article describes the AMA's three major assessment programs, the Diagnostic and Therapeutic Technology Assessment program, the Council on Scientific Affairs, and AMA Drug Evaluations. The implications of these activities for patient care and public policy are discussed.

American Medical Association↗
PubMed2002

Evaluating new health information technologies: expanding the frontiers of health care delivery and health promotion.

The modern health care system is being irrevocably changed by the development and introduction of new health information technologies (such as health information systems, decision-support tools, specialized websites, and innovative communication devices). While many of these new technologies hold the promise of revolutionizing the modern health system and facilitating improvements in health care delivery, health education, and health promotion, it is imperative to carefully examine and assess the effectiveness of these technological tools to determine which products are most useful to apply in specific contexts, as well as to learn how to best utilize these products and processes. Without good evaluative information about new technologies, we are unlikely to reap the greatest benefits from these powerful new tools. This chapter examines the demand for evaluating health information technologies and suggests several strategies for conducting rigorous and relevant evaluation research.

Biomedical Technology↗
PubMedDate not supplied

A systems engineering approach to technology assessment.

This paper presents a technology assessment process based on systems engineering methodologies used in the aerospace and defense industries. Systems engineering, defined in the U.S. military manual for engineering management, is a logical sequence of activities and decisions transforming an operational need into a description of system performance parameters and a preferred system configuration. Like systems engineering, technology assessment is driven by a single, clear need. The objective of systems engineering is to design a new system configuration; technology assessment assesses existing technologies to address this need. A six-step technology assessment model based on systems engineering principles is presented, including: (1) needs assessment; (2) clinical feasibility analysis; (3) systems assessment; (4) approval; (5) implementation; and (6) follow-up/CQI.

Biomedical Engineering↗
PubMed1987

Assessing medical technology assessment: past, present, and future.

Advances in medical technology have contributed both to the quality of health care and to its costs. The marketplace doesn't produce sufficient information to anticipate either real health or economic value. Formal assessment of new technologies for safety, efficacy, effectiveness, and cost has been unimpressively dominated by government. While new agency and institutional arrangements promise greater success, they will require a balance between public and private sector roles in procedures and financial support.

Federal Government↗