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At least 325 records · Page 18Linked to original sources
PubMed1999

Health technology assessment and policy decisions on hyperbaric oxygen treatment.

OBJECTIVES: To provide information to health authorities and others on the effectiveness of hyperbaric oxygen treatment (HBOT) and the impact on health services should an additional HBOT facility be established in the provincial health care system. METHODS: A literature review on the clinical use of HBOT was conducted, drawing on MEDLINE, EMBASE, and HealthSTAR. For each of 13 conditions, the effectiveness of HBOT was assessed, with reference to a widely used classification of level of evidence. Cost implications were considered for each condition for which there was sufficient evidence of effectiveness. The perspective was that of the payer. RESULTS: Good evidence of effectiveness exists for HBOT for four conditions and HBOT is established as the clinical standard of care for two others. Available evidence did not support the routine use of HBOT for a further seven indications. An additional 59-87 patients per year would be eligible for HBOT if a second facility were established in the province. Improvement in quality of life could be expected for 30-60 persons per year. A new facility would result in identified additional annual expenditure of $108,000. Capital costs could exceed $600,000. CONCLUSIONS: On the basis of the available evidence on benefits and costs to routine health care, there did not seem to be a particularly strong case for establishing a second HBOT center in the province. Following the assessment, the health authority made a decision not to provide funding for this additional service.

Alberta↗
PubMed1996

Bioelectrical impedance analysis in body composition measurement: National Institutes of Health Technology Assessment Conference Statement.

The objective of this conference was to provide physicians with a responsible assessment of bioelectrical impedance analysis (BIA) technology for body composition measurement. Participants were a non-Federal, nonadvocate, 13-member panel representing the fields of nutrition, pediatrics, surgery, public health, biomedical engineering, epidemiology, and biostatistics. In addition, 20 experts in nutrition, pediatrics, metabolism, biomedical engineering, physiology, and epidemiology presented data to the panel and a conference audience of 220. The literature was searched through Medline and an extensive bibliography of references was provided to the panel and the conference audience. Experts prepared abstracts with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The panel concluded that BIA provides a reliable estimate of total body water under most conditions. It can be a useful technique for body composition analysis in healthy individuals and in those with a number of chronic conditions such as mild-to-moderate obesity, diabetes mellitus, and other medical conditions in which major disturbances of water distribution are not prominent. BIA values are affected by numerous variables including body position, hydration status, consumption of food and beverages, ambient air and skin temperature, recent physical activity, and conductance of the examining table. Reliable BIA requires standardization and control of these variables. A specific, well-defined procedure for performing routine BIA measurements is not practiced. Therefore, the panel recommends that a committee of appropriate scientific experts and instrument manufacturers be formed with the goal of setting instrument standards and procedural methods.

Body Composition↗