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1. Automated Drugs Dispensing Systems in Hospitals: a Health Technology Assessment (HTA) Study Across Six European Countries

Author

Foglia E, Asperti F, Antonacci G, Jani YH, Garagiola E, Bellavia D, and Ferrario L

Subjects
automated drug dispensing systems, hta, economic impact, drug logistic management, efficiency, Medicine (General), R5-920, Therapeutics. Pharmacology, RM1-950
Abstract

Emanuela Foglia,1 Federica Asperti,1 Grazia Antonacci,2,3 Yogini H Jani,4 Elisabetta Garagiola,1 Daniele Bellavia,1 Lucrezia Ferrario1 1LIUC - University Cattaneo, Healthcare Datascience LAB, Castellanza, Varese, 21053, Italy; 2Department of Primary Care and Public Health, Imperial College London, National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) Northwest London, London, UK; 3Business School, Centre for Health Economics and Policy Innovation (CHEPI), Imperial College London, London, UK; 4Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, UKCorrespondence: Elisabetta Garagiola, Healthcare Datascience Laboratory - HD LAB, LIUC-Università Cattaneo, Corso G. Matteotti, 22, Castellanza, VA, 21053, Italy, Tel +39.0331.572.467, Email egaragiola@liuc.itBackground: Automated Drug Dispensing (ADD) systems are considered to be strategic hospital assets used to reduce errors and enhance economic and organizational sustainability. With regards to efficacy and safety, the literature evidence demonstrates the incremental benefits of centralised or decentralised systems compared to manual dispensing. Analyses about organisational and economic sustainability are still lacking and the present study aims to perform a Health Technology Assessment (HTA), producing multidimensional evidence on the use of ADD systems within hospitals.Methods: In 2023, a comprehensive HTA draws insights from healthcare professionals across six European nations: Italy, France, Germany, the Netherlands, the United Kingdom, and Belgium. This appraisal juxtaposed four drug dispensing scenarios: manual methods, centralized ADD systems, decentralized ADD systems, and integrated solutions employing cutting-edge technologies in both central pharmacies and wards. The study deployed an Activity-Based Costing approach that was combined with a cost-effectiveness and Budget Impact Analysis to evaluate economic impacts. Qualitative questionnaires were implemented to assess ethical, legal, organizational, safety, and efficacy aspects.Results: From a multidimensional perspective, healthcare professionals acknowledged ADD manifold advantages of ADD systems. From an organizational perspective and within a 12-month timeframe, transitioning to automation may face initial challenges that are attributed to potential resistance from professionals and significant investments. However, 36 months past its adoption, automation’s superiority over manual methods was recognized. Economically, savings burgeoned from +17.9% in UK to +26.6% in Belgian hospitals that adopted integrated systems in comparison to traditional manual approaches.Conclusion: Compared to traditional methods, implementing ADD systems could improve the logistic management of drug in the hospital setting, thereby enhancing safety and efficacy, streamlining the healthcare professionals’ workflow, and bolstering financial stability.Keywords: automated drug dispensing systems, HTA, economic impact, drug logistic management, efficiency

Published
2024

2. Glycated Albumin for Glycemic Control in T2DM Population: A Multi-Dimensional Evaluation

Author

Ferrario L, Schettini F, Avogaro A, Bellia C, Bertuzzi F, Bonetti G, Ceriello A, Ciaccio M, Corsi Romanelli M, Dozio E, Falqui L, Girelli A, Nicolucci A, Perseghin G, Plebani M, Valentini U, Zaninotto M, Castaldi S, and Foglia E

Subjects
glycated albumin, type 2 diabetes mellitus, t2dm, health technology assessment, economic evaluation, multidimensional approach, Medicine (General), R5-920, Therapeutics. Pharmacology, RM1-950
Abstract

Lucrezia Ferrario,1 Fabrizio Schettini,1 Angelo Avogaro,2 Chiara Bellia,3 Federico Bertuzzi,4 Graziella Bonetti,5 Antonio Ceriello,6 Marcello Ciaccio,3,7 Massimiliano Corsi Romanelli,8,9 Elena Dozio,9 Luca Falqui,10 Angela Girelli,11 Antonio Nicolucci,12 Gianluca Perseghin,13,14 Mario Plebani,15 Umberto Valentini,11 Martina Zaninotto,15 Silvana Castaldi,9,16 Emanuela Foglia1 1Centre for Health Economics, Social and Health Care Management, Università Carlo Cattaneo - LIUC, Castellanza, Italy; 2Department of Medicine, University-Hospital of Padova, Padova, Italy; 3Section of Clinical Biochemistry and Clinical Molecular Medicine, Department of Biopathology and Medical Biotechnologies, University of Palermo, Palermo, Italy; 4Diabetology Unit, Grande Ospedale Metropolitano Niguarda Hospital, Milan, Italy; 5Department of Medicine Services, Valcamonica Hospital, Esine, Italy; 6Department of Cardiovascular and Metabolic Diseases, Multimedica Research Institute, Milan, Italy; 7Department of Laboratory Medicine, University-Hospital of Palermo, Palermo, Italy; 8Service of Laboratory Medicine 1-Clinical Pathology, Policlinico San Donato, Milan, Italy; 9Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; 10Department of Medicine, Diabetes and Endocrinology, Multimedica Research Institute, Milan, Italy; 11Diabetes Care Unit, Spedali Civili Hospital, Brescia, Italy; 12Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy; 13Department of Medicine and Surgery, Università degli Studi di Milano Bicocca, Milan, Italy; 14Department of Medicine and Rehabilitation, Unit of Metabolic Medicine, Policlinico di Monza, Monza, Italy; 15Department of Laboratory Medicine, University-Hospital of Padova, Padova, Italy; 16Fondazione Ca’ Granda Ospedale Maggiore Policlinico Research Institute of Milano, Milano, ItalyCorrespondence: Lucrezia FerrarioCentre for Health Economics, Social and Health Care Management, Università Carlo Cattaneo – LIUC, Corso Matteotti 22, Castellanza, 21053, VA, ItalyTel +39 033 1572504Fax +39 033 1572513Email lferrario@liuc.itPurpose: To investigate the glycated albumin (GA) introduction implications, as an add-on strategy to traditional glycemic control (Hb1Ac and fasting plasma glucose – FPG) instruments, considering insulin-naïve individuals with type 2 diabetes mellitus (T2DM), treated with oral therapies.Methods: A Health Technology Assessment was conducted in Italy, as a multi-dimensional approach useful to validate any innovative technology. The HTA dimensions, derived from the EUnetHTA Core Model, were deployed by means of literature evidence, health economics tools and qualitative questionnaires, filled-in by 15 professionals.Results: Literature stated that the GA introduction could lead to a higher number of individuals achieving therapeutic success after 3 months of therapy (97.0% vs 71.6% without GA). From an economic point of view, considering a projection of 1,955,447 T2DM insulin-naïve individuals, potentially treated with oral therapy, GA introduction would imply fewer individuals requiring a therapy switch (− 89.44%), with a 1.06% in costs reduction, on annual basis, thus being also the preferable solution from a cost-effectiveness perspective (cost-effectiveness value: 237.74 vs 325.53). According to experts opinions, lower perceptions on GA emerged with regard to equity aspects (0.13 vs 0.72, p-value> 0.05), whereas it would improve both individuals (2.17 vs 1.33, p-value=0.000) and caregivers quality of life (1.50 vs 0.83, p-value=0.000). Even if in the short term, GA required additional investments in training courses (− 0.80 vs 0.10, p-value = 0.036), in the long run, GA could become the preferable technology (0.30 vs 0.01, p-value=0.018) from an organisational perspective.Conclusion: Adding GA to traditional glycaemic control instruments could improve the clinical pathway of individuals with T2DM, leading to economic and organisational advantages for both hospitals and National Healthcare Systems.Keywords: glycated albumin, type 2 diabetes mellitus, T2DM, Health Technology Assessment, economic evaluation, multidimensional approach

Published
2021

3. Advanced Medical Devices for Preparation and Administration of Chemotherapeutic Agents: Results from a Multi-Dimensional Evaluation

Author

Ferrario L, Schettini F, Garagiola E, Cecchi A, Lugoboni L, Serra P, Porazzi E, and Foglia E

Subjects
closed-system medical device, chemotherapy agents, safety, economic evaluation, hta, organisational benefits, Medicine (General), R5-920, Therapeutics. Pharmacology, RM1-950
Abstract

Lucrezia Ferrario,1 Fabrizio Schettini,1 Elisabetta Garagiola,1 Adriana Cecchi,2 Lucia Lugoboni,3 Paolo Serra,4 Emanuele Porazzi,1 Emanuela Foglia1 1Carlo Cattaneo – LIUC University and LIUC Business School, Castellanza, Italy; 2ARCS – Azienda Regionale di Coordinamento per la Salute, Udine, Italy; 3Bee Care, Lugano, Switzerland; 4Brotzu Hospital, Cagliari, ItalyCorrespondence: Lucrezia FerrarioCarlo Cattaneo – LIUC University and LIUC Business School, Corso Matteotti 22, Castellanza, VA 21053, ItalyTel +39 033 1572504Fax +39 033 1572513Email lferrario@liuc.itPurpose: To evaluate the incremental benefits concerning the implementation of closed-system medical devices for the preparation and administration of chemotherapy agents (integrated or not with traceable workflow), within an Italian clinical practice, in which the use of such technologies is not standardized.Methodology: Four Scenarios, implying different levels of technologies introduction, were analyzed, based on the presence and/or absence of closed systems and traceable workflow, in the preparation and in the administration phase. A literature review was conducted, in order to retrieve efficacy and safety measures. Economic and organizational benefits, assuming a hospitals perspective, were assessed by means of health-economics tools, considering 27,660 (± 695.86) drugs on average prepared, on an annual basis, by 12 hospitals involved. The typology of medical devices and other devices/equipment used, the human resources involved, and the time spent for the preparation and administration phases were collected.Results: Literature stated that the introduction of advanced technologies (CSTDs in the preparation phase, closed-system in the administration phase, both integrated by a traceable workflow) could: i) decrease surface contamination (12.24% vs 26.39%, P< 0.001) and ii) improve the capability to identify dosage errors (7% vs 0.096%, P< 0.05). The above technologies presented the best trade-off between cost sustained and efficacy gained. Despite marginal investments (ranging from +1% to +6%) being required for their acquisition, an organizational saving equal to more than 1,000 working hours emerged, which could be spent on other hospital activities.Conclusion: The implementation of closed systems, integrated with a traceable workflow grounding on gravimetric control, may be considered a valid technological alternative within the investigated setting. The marginal incremental costs could be absorbed already in the first year after their introduction, in particular, because of the potential time saving in using closed systems in both the preparation and administration phases, demonstrating the sustainability and feasibility of such advanced technologies.Keywords: closed-system medical device, chemotherapy agents, safety, economic evaluation, HTA, organisational benefits

Published
2020

4. HTA and innovative treatments evaluation: the case of metastatic castration-resistant prostate cancer

Author

Bretoni A, Ferrario L, and Foglia E

Subjects
mCRPC, multidimensional assessment, economic evaluation, multicriteria decision analysis, hormonal therapies, MCDA, Medicine (General), R5-920, Therapeutics. Pharmacology, RM1-950
Abstract

Alberto Bretoni, Lucrezia Ferrario, Emanuela FogliaCentre for Health Economics, Social and Health Care Management, LIUC – Università Cattaneo, Castellanza, ItalyPurpose: To investigate the implications of the introduction of two hormonal therapies, abiraterone acetate + prednisone (AA+P) and enzalutamide (ENZA), for the treatment of naïve patients with metastatic castration-resistant prostate cancer (mCRPC) in the Italian setting.Methods: In 2017–2018, a Health Technology Assessment was conducted in Italy, considering the National Healthcare Service (NHS) perspective. Data were retrieved from literature evidence, economic evaluations, and qualitative questionnaires, considering the 9 EUnetHTA dimensions, and a final multi-criteria approach.Results: On the basis of mCRPC prevalence and incidence rates in Italy, the analysis considered 11,212 males eligible to either AA+P or ENZA treatments. Both drugs led to an improvement of the patients’ overall survival, with respect to the standard of care, composed of docetaxel chemotherapy. However, AA+P showed a higher rate of drug-related moderate adverse events and a monitoring activities incidence superior to ENZA (+70%, p-value=0.00), which led to a major resources absorption (€ 1,056.02 vs € 316.25, p-value=0.00), whereas ENZA showed a better cost-effectiveness average value (CEV: 54,586.12 vs 57,624.15). Economic savings ranging from 1.46% to 1.61% emerged for the NHS, as well as organizational advantages, with fewer minutes required for the mCRPC management (AA+P: 815 mins vs ENZA: 500 mins). According to experts’ perceptions, based on a 7-item Likert scale (ranging from −3 to +3), similar results emerged on ethical and social impact (ENZA: 1.35 vs AA+P: 1.48, p-value>0.05), and on legal dimension (ENZA: 0.67 vs AA+P: 0.67, p-value>0.05), since both drugs improved the patients’ quality of life and received approval for use. High-level perceptions related to ENZA adoption emerged with regard to equity (ENZA: 0.69 vs AA+P: 0.25, p-value

Published
2019

5. A comparison between WHODAS 2.0 and Modified Barthel Index: which tool is more suitable for assessing the disability and the recovery rate in orthopedic rehabilitation?

Author

Galli T, Mirata P, Foglia E, Croce D, Porazzi E, Ferrario L, Ricci E, Garagiola E, Pagani R, and Banfi G

Subjects
Disability, Modified Barthel Index, Whodas 2.0, orthopaedics, rehabilitation, Medicine (General), R5-920, Therapeutics. Pharmacology, RM1-950
Abstract

Tiziana Galli,1 Paolo Mirata,2 Emanuela Foglia,3 Davide Croce,3,4 Emanuele Porazzi,3 Lucrezia Ferrario,3 Elena Ricci,5 Elisabetta Garagiola,3 Roberta Pagani,3 Giuseppe Banfi6,7 1Department of Functional Recovery and Re-education, Hospital of Saronno, Hospital Authority “ASST Valle Olona”, Saronno, Italy; 2Department of Functional Recovery and Re-education, Hospital of Busto Arsizio, Hospital Authority “ASST Valle Olona”, Busto Arsizio, Italy; 3Centre for Research on Health Economics Social and Health Care Management (CREMS), LIUC - Università Cattaneo, Castellanza, Italy; 4School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 5Department of Infectious Diseases, Fatebenefratelli Sacco Hospital, Milan, Italy; 6Orthopaedics Institute, IRCCS Galeazzi, Milan, Italy; 7San Raffaele Scientific Institute, Milan, Italy Purpose: The aim of the present study was to compare 2 clinical assessment tools, the Modified Barthel Index (currently administered to patients admitted into inpatient rehabilitation units after elective hip or knee arthroplasty) with the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 scale, in order to identify which tool is more suitable for assessing the disability and the “recovery rate”.Patients and methods: A perspective multicenter observational study was developed, involving 2 hospital authorities in Italy. Eighty consecutive cases of inpatients were enrolled. Patient’s disability was evaluated using both of the aforementioned tools, before and after the rehabilitation program.Results: The WHODAS 2.0 score was, on average, 12.21% higher than the Modified Barthel Index, before the surgical intervention. Modified Barthel Index measures could be considered as a determinant and a predictor of length of stay.Conclusion: The Modified Barthel Index is limited, since it does not consider a patient’s perspective. The WHODAS 2.0 scale fully considers a patient’s perception of disability. Therefore, both assessment scales should be administered in clinical practice, in order to provide integration of clinical information with a patient’s reported outcome measures. Keywords: disability, Modified Barthel Index, WHODAS 2.0, orthopedics, rehabilitation

Published
2018

6. Economic and organizational sustainability of a negative-pressure portable device for the prevention of surgical-site complications

Author

Foglia E, Ferrario L, Garagiola E, Signoriello G, Pellino G, Croce D, and Canonico S

Subjects
NPWT portable device, surgical site complication, economic analysis, organisational advantage, Italy, Medicine (General), R5-920, Therapeutics. Pharmacology, RM1-950
Abstract

Emanuela Foglia,1 Lucrezia Ferrario,1 Elisabetta Garagiola,1 Giuseppe Signoriello,2 Gianluca Pellino,3 Davide Croce,1,4 Silvestro Canonico3 1Centre for Health Economics, Social and Health Care Management - LIUC University, Castellanza, Italy; 2Department of Mental Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy; 3School of Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy; 4School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Purpose: Surgical-site complications (SSCs) affect patients’ clinical pathway, prolonging their hospitalization and incrementing their management costs. The present study aimed to assess the economic and organizational implications of a portable device for negative-pressure wound therapy (NPWT) implementation, compared with the administration of pharmacological therapies alone for preventing surgical complications in patients undergoing general, cardiac, obstetrical–gynecological, or orthopedic surgical procedures.Patients and methods: A total of 8,566 hospital procedures, related to the year 2015 from one hospital, were evaluated considering infection risk index, occurrence rates of SSCs, drug therapies, and surgical, diagnostic, and specialist procedures and hematological exams. Activity-based costing and budget impact analyses were implemented for the economic assessment.Results: Patients developing an SSC absorbed i) 64.27% more economic resources considering the length of stay (€ 8,269±2,096 versus € 5,034±2,901, p

Published
2017

7. Cost of human immunodeficiency virus infection in Italy, 2007–2009: effective and expensive, are the new drugs worthwhile?

Author

Rizzardini G, Restelli U, Bonfanti P, Porazzi E, Ricci E, Foglia E, Carenzi L, and Croce D

Subjects
Medicine (General), R5-920, Therapeutics. Pharmacology, RM1-950
Abstract

Giuliano Rizzardini,1 Umberto Restelli,2 Paolo Bonfanti,3 Emanuele Porazzi,2 Elena Ricci,1 Emanuela Foglia,2 Laura Carenzi,1 Davide Croce21First Infectious Diseases Department, "Luigi Sacco" Hospital, Milan; 2Centre for Research on Health Economics, Social, and Health Care Management, Università Carlo Cattaneo, Castellanza; 3Infectious Diseases Department, "Alessandro Manzoni" Hospital, Lecco, ItalyBackground: In recent years, the increased efficacy and effectiveness of antiretroviral treatment has led to longer survival of patients infected with human immunodeficiency virus (HIV), but has also raised the question of what happens to consumption of resources. Early highly active antiretroviral treatment (HAART), management of hepatitis C virus (HCV) coinfection, and expensive newly marketed drugs may affect the economic sustainability of treatment from the point of view of the National Healthcare Services. The present study aimed to provide information on the economic burden of HIV-positive patients resident in the Lombardy region using a three-year time horizon.Methods: This was a retrospective, observational, budget impact study, based on information collected for the period 2007–2009, including hospitalizations, outpatient services, and HAART and non-HAART drug utilization. Patients with confirmed HIV infection, aged ≥ 18 years, resident in the Lombardy region, and followed at the "L Sacco" Hospital in Milan from 2007 to 2009 were eligible.Results: A total of 483 patients (mean age 44.1 years) were included in the study. The mean CD4+ cell count increased over the study period from 462 ± 242 cells/mm3 in 2007, to 513 ± 267 cells/mm3 in 2008, to 547 ± 262 cells/mm3 in 2009. In total, 162 subjects (33.5%) were coinfected with HCV. Hospitalizations and HAART costs increased from 2007 to 2009, whereas outpatient visits and non-HAART drug costs decreased slightly over time. The total cost increase was also significant when limiting the analysis to experienced patients, HCV-negative patients, and experienced HCV-negative patients.Conclusion: CD4+ cell count, a major predictor of costs, increased over the study period. However, immunological improvement was achieved by greater expense in the short term. Whether this may be compensated by a long-term decrease in opportunistic infections and in the costs of management of HIV-related events is an area still to be investigated.Keywords: health care costs, human immunodeficiency virus infection, risk factors, retrospective study

Published
2012

12. RWD101 Intravitreal Therapies and Their Patterns of Use in Lombardy Region

Author

Foglia, E., primary, Garagiola, E., additional, Bellavia, D., additional, Schettini, F., additional, Asperti, F., additional, Machiavelli, A., additional, Merlo, D., additional, Mainardi, G., additional, Lusuriello, P., additional, Franzin, M., additional, Soliveri, N., additional, Lombardo, R., additional, Ventura, L., additional, Pieri, G., additional, Punzi, C., additional, Fazio, M., additional, Di Carlo, C., additional, and Ferrario, L.B., additional

Published
2023
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14. Could fluorescence-guided surgery be an efficient and sustainable option? A SICE (Italian Society of Endoscopic Surgery) health technology assessment summary

Author

Vettoretto, N., Foglia, E., Ferrario, L., Gerardi, C., Molteni, B., Nocco, U., Lettieri, E., Molfino, S., Baiocchi, G. L., Elmore, U., Rosati, R., Currò, G., Cassinotti, E., Boni, L., Cirocchi, R., Marano, A., Petz, W. L., Arezzo, A., Bonino, M. A., Davini, F., Biondi, A., Anania, G., Agresta, F., and Silecchia, G.

Published
2020
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15. Multidimensional Results and Reflections on CAR-T: The Italian Evidence

Author

Foglia, E, Garagiola, E, Ladisa, V, Rambaldi, A, Cairoli, R, Sammassimo, S, Salè, E, Zinzani, P, Esposti, M, Alberti, L, Mulas, M, Melis, E, Onnis, S, Marcias, M, Satta, V, Croce, D, Foglia E, Garagiola E, Ladisa V, Rambaldi A, Cairoli R, Sammassimo S, Salè EO, Zinzani PL, Esposti M, Alberti L, Mulas MF, Melis E, Onnis S, Marcias M, Satta V, Croce D, Foglia, E, Garagiola, E, Ladisa, V, Rambaldi, A, Cairoli, R, Sammassimo, S, Salè, E, Zinzani, P, Esposti, M, Alberti, L, Mulas, M, Melis, E, Onnis, S, Marcias, M, Satta, V, Croce, D, Foglia E, Garagiola E, Ladisa V, Rambaldi A, Cairoli R, Sammassimo S, Salè EO, Zinzani PL, Esposti M, Alberti L, Mulas MF, Melis E, Onnis S, Marcias M, Satta V, and Croce D

Abstract

The present study aims at defining the economic and organizational impacts of the introduction of chimeric antigen receptor T-cell therapy (CAR-T) in Italy, for the management of diffuse large B-cell lymphoma (DLBCL) patients in third-line therapy, defining the overall level of sustainability for both hospitals and the National Healthcare System (NHS). The analysis focused on CAR-T and Best Salvage Care (in the following BSC), assuming the Italian hospital and NHS perspectives, over a 36-month time horizon. Process mapping and activity-based costing methodologies were applied to collect the hospital costs related to the BSC and CAR-T pathways, including adverse event management. Anonymous administrative data on services provided (diagnostic and laboratory examinations, hospitalizations, outpatient procedures, and therapies) to 47 third-line patients with lymphoma, as well as any organizational investments required, were collected, in two different Italian Hospitals. The economic results showed that the BSC clinical pathway required less resources in comparison with CAR-T (excluding the cost related to the therapy) (BSC: 29,558.41 vs. CAR-T: EUR 71,220.84, −58.5%). The budget impact analysis depicts that the introduction of CAR-T would generate an increase in costs ranging from 15% to 23%, without considering treatment costs. The assessment of the organizational impact reveals that the introduction of CAR-T therapy would require additional investments equal to a minimum of EUR 15,500 to a maximum of EUR 100,897.49, from the hospital perspective. Results show new economic evidence for healthcare decision makers, to optimize the appropriateness of resource allocation. The present analysis suggests the need to introduce a specific reimbursement tariff, both at the hospital and at NHS levels, since no consensus exists, at least in the Italian setting, concerning the proper remuneration for the hospitals who guarantee this innovative pathway, assuming high risks related t

Published
2023

18. System Integrated Digital Empowering and teleRehabilitation to promote patient Activation and well-Being in chronic disabilities: A usability and acceptability study

Author

Rossetto, F, Borgnis, F, Isernia, S, Foglia, E, Garagiola, E, Realdon, O, Baglio, F, Rossetto, Federica, Borgnis, Francesca, Isernia, Sara, Foglia, Emanuela, Garagiola, Elisabetta, Realdon, Olivia, Baglio, Francesca, Rossetto, F, Borgnis, F, Isernia, S, Foglia, E, Garagiola, E, Realdon, O, Baglio, F, Rossetto, Federica, Borgnis, Francesca, Isernia, Sara, Foglia, Emanuela, Garagiola, Elisabetta, Realdon, Olivia, and Baglio, Francesca

Abstract

Introduction: Telerehabilitation systems represent a promising way for the management of chronic disability, delivering technology-enabled rehabilitation outside the hospital setting. However, usability and acceptability assessment with users represents a critical starting point when using digital healthcare solutions. This study aims at evaluating the user experience with a Telerehabilitation system (SIDERA∧B) from the end-user side. Methods: SIDERA∧B consists of an asynchronous delivery of rehabilitation activities through multimedia digital contents and tele-monitoring of vital parameters with technological devices for individualized, home-based management of chronic conditions. Usability (with the System Usability Scale, SUS) and acceptability (using the Technology Acceptance Model, TAM - and The Service User Technology Acceptance Questionnaire, SUTAQ) data were analyzed from the dataset of the SIDERA∧B project (N = 112 patients with Chronic Heart Failure, Parkinson's Disease and Chronic Obstructive Pulmonary Disease). The possible influence of five external factors (i.e., technological expertise, education, sex, age, and level of disability) on TAM domains was tested using Spearman's Correlation analysis. Results: Results showed a satisfactory level of technological usability (SUS Median = 77.5) and good scores in usability and learnability SUS subdomains (mean scores > 2.5). Regarding technological acceptability, participants showed high scores (Median > 4) in “Behavioral Intention”, “Perceived Usefulness”, and “Perceived Ease of Use” TAM domains. Finally, results from the SUTAQ scale highlighted that the SIDERA∧B system obtained optimal scores in all domains, especially in “Increased accessibility,” “Care personnel concerns,” and “Satisfaction.” Age (rho = −0.291, p = 0.002) and disability level (WHODAS Total score: rho = −0.218, p = 0.021) were the two external factors inversely associated with the Perceived Ease of Use. Discussion: The age of digital

Published
2023

19. Embedding the Patient-Citizen Perspective into an Operational Framework for the Development and the Introduction of New Technologies in Rehabilitation Care: The Smart&Touch-ID Model

Author

Realdon, O, Adorni, R, Ginelli, D, Micucci, D, Blasi, V, Bellavia, D, Schettini, F, Carradore, R, Polsinelli, P, D’Addario, M, Gui, M, Messina, V, Foglia, E, Steca, P, Mantovani, F, Baglio, F, Realdon, Olivia, Adorni, Roberta, Ginelli, Davide, Micucci, Daniela, Blasi, Valeria, Bellavia, Daniele, Schettini, Fabrizio, Carradore, Roberto, Polsinelli, Pietro, D’Addario, Marco, Gui, Marco, Messina, Vincenzina, Foglia, Emanuela, Steca, Patrizia, Mantovani, Fabrizia, Baglio, Francesca, Realdon, O, Adorni, R, Ginelli, D, Micucci, D, Blasi, V, Bellavia, D, Schettini, F, Carradore, R, Polsinelli, P, D’Addario, M, Gui, M, Messina, V, Foglia, E, Steca, P, Mantovani, F, Baglio, F, Realdon, Olivia, Adorni, Roberta, Ginelli, Davide, Micucci, Daniela, Blasi, Valeria, Bellavia, Daniele, Schettini, Fabrizio, Carradore, Roberto, Polsinelli, Pietro, D’Addario, Marco, Gui, Marco, Messina, Vincenzina, Foglia, Emanuela, Steca, Patrizia, Mantovani, Fabrizia, and Baglio, Francesca

Abstract

To date, at least 2.41 billion people with Non-Communicable Diseases (NCDs) are in need of rehabilitation. Rehabilitation care through innovative technologies is the ideal candidate to reach all people with NCDs in need. To obtain these innovative solutions available in the public health system calls for a rigorous multidimensional evaluation that, with an articulated approach, is carried out through the Health Technology Assessment (HTA) methodology. In this context, the aim of the present paper is to illustrate how the Smart&TouchID (STID) model addresses the need to incorporate patients’ evaluations into a multidimensional technology assessment framework by presenting a feasibility study of model application with regard to the rehabilitation experiences of people living with NCDs. After sketching out the STID model’s vision and operational process, preliminary evidence on the experiences and attitudes of patients and citizens on rehabilitation care will be described and discussed, showing how they operate, enabling the co-design of technological solutions with a multi-stakeholder approach. Implications for public health are discussed including the view on the STID model as a tool to be integrated into public health governance strategies aimed at tuning the agenda-setting of innovation in rehabilitation care through a participatory methodology.

Published
2023

20. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

Author

Berg, K. M., Bray, J. E., Ng, K. -C., Liley, H. G., Greif, R., Carlson, J. N., Morley, P. T., Drennan, I. R., Smyth, M., Scholefield, B. R., Weiner, G. M., Cheng, A., Djarv, T., Abelairas-Gomez, C., Acworth, J., Andersen, L. W., Atkins, D. L., Berry, D. C., Bhanji, F., Bierens, J., Couto, T. B., Borra, V., Bottiger, B. W., Bradley, R. N., Breckwoldt, J., Cassan, P., Chang, W. -T., Charlton, N. P., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Dainty, K. N., Dassanayake, V., Davis, P. G., Dawson, J. A., de Almeida, M. F., De Caen, A. R., Deakin, C. D., Dicker, B., Douma, M. J., Eastwood, K., El-Naggar, W., Fabres, J. G., Fawke, J., Fijacko, N., Finn, J. C., Flores, G. E., Foglia, E. E., Folke, F., Gilfoyle, E., Goolsby, C. A., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hsu, C. H., Ikeyama, T., Isayama, T., Johnson, N. J., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kleinman, M. E., Kloeck, D. A., Kudenchuk, P., Kule, A., Kurosawa, H., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lee, H. C., Lin, Y., Lockey, A. S., Macneil, F., Maconochie, I. K., Madar, R. J., Hansen, C. M., Masterson, S., Matsuyama, T., Mckinlay, C. J. D., Meyran, D., Monnelly, V., Nadkarni, V., Nakwa, F. L., Nation, K. J., Nehme, Z., Nemeth, M., Neumar, R. W., Nicholson, T., Nikolaou, N., Nishiyama, C., Norii, T., Nuthall, G. A., Ohshimo, S., Olasveengen, T. M., Ong, Y. -K. G., Orkin, A. M., Parr, M. J., Patocka, C., Perkins, G. D., Perlman, J. M., Rabi, Y., Raitt, J., Ramachandran, S., Ramaswamy, V. V., Raymond, T. T., Reis, A. G., Reynolds, J. C., Ristagno, G., Rodriguez-Nunez, A., Roehr, C. C., Rudiger, M., Sakamoto, T., Sandroni, Claudio, Sawyer, T. L., Schexnayder, S. M., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Singletary, E. M., Skrifvars, M. B., Smith, C. M., Soar, J., Stassen, W., Sugiura, T., Tijssen, J. A., Topjian, A. A., Trevisanuto, D., Vaillancourt, C., Wyckoff, M. H., Wyllie, J. P., Yang, C. -W., Yeung, J., Zelop, C. M., Zideman, D. A., Nolan, J. P., Barcala-Furelos, R., Beerman, S. B., Bruckner, M., Castren, M., Chong, S., Claesson, A., Dunne, C. L., Finan, E., Fukuda, T., Ganesan, S. L., Gately, C., Gois, A., Gray, S., Halamek, L. P., Hoover, A. V., Hurst, C., Josephsen, J., Kollander, L., Kamlin, C. O., Kool, M., Li, L., Mecrow, T. S., Montgomery, W., Ristau, P., Jayashree, M., Schmidt, A., Scquizzato, T. -M., Seesink, J., Sempsrott, J., Solevag, A. L., Strand, M. L., Szpilman, D., Szyld, E., Thom, O., Tobin, J. M., Trang, J., Webber, J., Webster, H. K., Wellsford, M., Sandroni C. (ORCID:0000-0002-8878-2611), Berg, K. M., Bray, J. E., Ng, K. -C., Liley, H. G., Greif, R., Carlson, J. N., Morley, P. T., Drennan, I. R., Smyth, M., Scholefield, B. R., Weiner, G. M., Cheng, A., Djarv, T., Abelairas-Gomez, C., Acworth, J., Andersen, L. W., Atkins, D. L., Berry, D. C., Bhanji, F., Bierens, J., Couto, T. B., Borra, V., Bottiger, B. W., Bradley, R. N., Breckwoldt, J., Cassan, P., Chang, W. -T., Charlton, N. P., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Dainty, K. N., Dassanayake, V., Davis, P. G., Dawson, J. A., de Almeida, M. F., De Caen, A. R., Deakin, C. D., Dicker, B., Douma, M. J., Eastwood, K., El-Naggar, W., Fabres, J. G., Fawke, J., Fijacko, N., Finn, J. C., Flores, G. E., Foglia, E. E., Folke, F., Gilfoyle, E., Goolsby, C. A., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hsu, C. H., Ikeyama, T., Isayama, T., Johnson, N. J., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kleinman, M. E., Kloeck, D. A., Kudenchuk, P., Kule, A., Kurosawa, H., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lee, H. C., Lin, Y., Lockey, A. S., Macneil, F., Maconochie, I. K., Madar, R. J., Hansen, C. M., Masterson, S., Matsuyama, T., Mckinlay, C. J. D., Meyran, D., Monnelly, V., Nadkarni, V., Nakwa, F. L., Nation, K. J., Nehme, Z., Nemeth, M., Neumar, R. W., Nicholson, T., Nikolaou, N., Nishiyama, C., Norii, T., Nuthall, G. A., Ohshimo, S., Olasveengen, T. M., Ong, Y. -K. G., Orkin, A. M., Parr, M. J., Patocka, C., Perkins, G. D., Perlman, J. M., Rabi, Y., Raitt, J., Ramachandran, S., Ramaswamy, V. V., Raymond, T. T., Reis, A. G., Reynolds, J. C., Ristagno, G., Rodriguez-Nunez, A., Roehr, C. C., Rudiger, M., Sakamoto, T., Sandroni, Claudio, Sawyer, T. L., Schexnayder, S. M., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Singletary, E. M., Skrifvars, M. B., Smith, C. M., Soar, J., Stassen, W., Sugiura, T., Tijssen, J. A., Topjian, A. A., Trevisanuto, D., Vaillancourt, C., Wyckoff, M. H., Wyllie, J. P., Yang, C. -W., Yeung, J., Zelop, C. M., Zideman, D. A., Nolan, J. P., Barcala-Furelos, R., Beerman, S. B., Bruckner, M., Castren, M., Chong, S., Claesson, A., Dunne, C. L., Finan, E., Fukuda, T., Ganesan, S. L., Gately, C., Gois, A., Gray, S., Halamek, L. P., Hoover, A. V., Hurst, C., Josephsen, J., Kollander, L., Kamlin, C. O., Kool, M., Li, L., Mecrow, T. S., Montgomery, W., Ristau, P., Jayashree, M., Schmidt, A., Scquizzato, T. -M., Seesink, J., Sempsrott, J., Solevag, A. L., Strand, M. L., Szpilman, D., Szyld, E., Thom, O., Tobin, J. M., Trang, J., Webber, J., Webster, H. K., Wellsford, M., and Sandroni C. (ORCID:0000-0002-8878-2611)

Abstract

The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.

Published
2023

29. New Insights from CAR-T: An Economic and Organizational Perspective

Author

Foglia, E, Garagiola, E, Ferrario, L, Ladisa, V, Scorza, A, Rambaldi, A, Cairoli, R, Medaglia, M, Simona, M, Sale, E, Omodeo, E, Zinzani, P, Esposti, M, Alberti, L, Marcias, M, Mulas, M, Satta, V, Melis, E, Onnis, S, Croce, D, Foglia E., Garagiola E, Ferrario LB, Ladisa V, Scorza A, Rambaldi A, Cairoli R, Medaglia ML, Simona M, Sale EO, Omodeo E, Zinzani PL, Esposti M, Alberti L, Marcias M, Mulas MF, Satta V, Melis E, Onnis S, Croce D, Foglia, E, Garagiola, E, Ferrario, L, Ladisa, V, Scorza, A, Rambaldi, A, Cairoli, R, Medaglia, M, Simona, M, Sale, E, Omodeo, E, Zinzani, P, Esposti, M, Alberti, L, Marcias, M, Mulas, M, Satta, V, Melis, E, Onnis, S, Croce, D, Foglia E., Garagiola E, Ferrario LB, Ladisa V, Scorza A, Rambaldi A, Cairoli R, Medaglia ML, Simona M, Sale EO, Omodeo E, Zinzani PL, Esposti M, Alberti L, Marcias M, Mulas MF, Satta V, Melis E, Onnis S, and Croce D

Published
2020

30. Pazienti diabetici di tipo 2, non in terapia insulinica e albumina glicata: UNA valutazione multidimensionale [Insuline-Naive type 2 diabetic patients: a multidimensional evaluation on the role of glycated albumin]

Author

Ferrario, L, Schettini, F, Foglia, E, Avogaro, A, Bellia, C, Bertuzzi, F, Bonetti, G, Ceriello, A, Ciaccio, M, Romanelli, M, Dozio, E, Falqui, L, Girelli, A, Nicolucci, A, Perseghin, G, Plebani, M, Valentini, U, Zaninotto, M, Croce, D, Ferrario L., Schettini F., Foglia E., Avogaro A., Bellia C., Bertuzzi F., Bonetti G., Ceriello A., Ciaccio M., Romanelli M. C., Dozio E., Falqui L., Girelli A., Nicolucci A., Perseghin G., Plebani M., Valentini U., Zaninotto M., Croce D., Ferrario, L, Schettini, F, Foglia, E, Avogaro, A, Bellia, C, Bertuzzi, F, Bonetti, G, Ceriello, A, Ciaccio, M, Romanelli, M, Dozio, E, Falqui, L, Girelli, A, Nicolucci, A, Perseghin, G, Plebani, M, Valentini, U, Zaninotto, M, Croce, D, Ferrario L., Schettini F., Foglia E., Avogaro A., Bellia C., Bertuzzi F., Bonetti G., Ceriello A., Ciaccio M., Romanelli M. C., Dozio E., Falqui L., Girelli A., Nicolucci A., Perseghin G., Plebani M., Valentini U., Zaninotto M., and Croce D.

Abstract

Insuline-Naaïve type 2 diabetic patients: a multidimensional evaluation on the role of glycated albumin Introduction: glycated Albumin (GA) is an innovative glycemic marker, that could be used in the clinical practice, as an add-on strategy, to the traditional glycemic monitoring systems, such as glycated haemoglobin (Hb1Ac) and fasting plasma glucose (FPG). The study aims at presenting the results of a multidimensional analysis conducted in Italy, exploring the main clinical, economic, ethical, social and organizational implications, related to the introduction of GA. Methods: an Health Technology Assessment (HTA) approach was implemented. The analysis considered the Italian National Healthcare Service (NHS) perspective, and assumed a 12-month time horizon, focusing on type 2 diabetes patients insulin-naïve, assuming oral therapy. The 9 HTA dimensions (derived from the Core Model developed by the European Network of HTA – EUnetHTA) were deployed, considering scientific evidence, health economics tools and qualitative approaches, through the administration of specific questionnaires to 15 diabetes experts. Results: literature reported better GA safety and efficacy profiles, thus being a predictor of the relative risk for diabetes complications development, and increasing the therapeutic success after 3 months of therapy (97.0% versus 71.6%). From an economic point of view, GA introduction resulted in an economic advantage of 1.06% and in a better tradeoff between costs sustained and efficacy gained. Considering a 7-item Likert Scale (ranging from -3 to +3), negative perceptions emerged with regard to equity aspects (0.13 versus 0.72) due to GA limited accessibility, whereas it would improve both patients (2.17 versus 1.33) and care givers (1.50 versus 0.83) quality of life. In the short term, GA required training courses and equipment update, whereas, in the long term, it could be considered the preferable solution from an organizational perspective (0.30 Conclusi

Published
2020

32. 2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations: Summary from the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; And First Aid Task Forces

Author

Wyckoff, M. H., Greif, R., Morley, P. T., Ng, K. -C., Olasveengen, T. M., Singletary, E. M., Soar, J., Cheng, A., Drennan, I. R., Liley, H. G., Scholefield, B. R., Smyth, M. A., Welsford, M., Zideman, D. A., Acworth, J., Aickin, R., Andersen, L. W., Atkins, D., Berry, D. C., Bhanji, F., Bierens, J., Borra, V., Bottiger, B. W., Bradley, R. N., Bray, J. E., Breckwoldt, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Couto, T. B., Dainty, K. N., Davis, P. G., De Almeida, M. F., De Caen, A. R., Deakin, C. D., Djarv, T., Donnino, M. W., Douma, M. J., Duff, J. P., Dunne, C. L., Eastwood, K., El-Naggar, W., Fabres, J. G., Fawke, J., Finn, J., Foglia, E. E., Folke, F., Gilfoyle, E., Goolsby, C. A., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hsu, C. H., Ikeyama, T., Isayama, T., Johnson, N. J., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kleinman, M., Kloeck, D. A., Kudenchuk, P. J., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lee, H. C., Lin, Y. (., Lockey, A. S., Maconochie, I. K., Madar, R. J., Malta Hansen, C., Masterson, S., Matsuyama, T., Mckinlay, C. J. D., Meyran, D., Morgan, P., Morrison, L. J., Nadkarni, V., Nakwa, F. L., Nation, K. J., Nehme, Z., Nemeth, M., Neumar, R. W., Nicholson, T., Nikolaou, N., Nishiyama, C., Norii, T., Nuthall, G. A., O'Neill, B. J., Ong, Y. -K. G., Orkin, A. M., Paiva, E. F., Parr, M. J., Patocka, C., Pellegrino, J. L., Perkins, G. D., Perlman, J. M., Rabi, Y., Reis, A. G., Reynolds, J. C., Ristagno, G., Rodriguez-Nunez, A., Roehr, C. C., Rudiger, M., Sakamoto, T., Sandroni, Claudio, Sawyer, T. L., Schexnayder, S. M., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Skrifvars, M. B., Smith, C. M., Sugiura, T., Tijssen, J. A., Trevisanuto, D., Van De Voorde, P., Wang, T. -L., Weiner, G. M., Wyllie, J. P., Yang, C. -W., Yeung, J., Nolan, J. P., Berg, K. M., Burdick, M. C., Cartledge, S., Dawson, J. A., Elgohary, M. M., Ersdal, H. L., Finan, E., Flaatten, H. I., Flores, G. E., Fuerch, J., Garg, R., Gately, C., Goh, M., Halamek, L. P., Handley, A. J., Hatanaka, T., Hoover, A., Issa, M., Johnson, S., Kamlin, C. O., Ko, Y. -C., Kule, A., Leone, T. A., Mackenzie, E., Macneil, F., Montgomery, W., O'Dochartaigh, D., Ohshimo, S., Palazzo, F. S., Picard, C., Quek, B. H., Raitt, J., Ramaswamy, V. V., Scapigliati, Andrea, Shah, B. A., Stewart, C., Strand, M. L., Szyld, E., Thio, M., Topjian, A. A., Udaeta, E., Vaillancourt, C., Wetsch, W. A., Wigginton, J., Yamada, N. K., Yao, S., Zace, D., Zelop, C. M., Sandroni C. (ORCID:0000-0002-8878-2611), Scapigliati A. (ORCID:0000-0002-4044-2343), Wyckoff, M. H., Greif, R., Morley, P. T., Ng, K. -C., Olasveengen, T. M., Singletary, E. M., Soar, J., Cheng, A., Drennan, I. R., Liley, H. G., Scholefield, B. R., Smyth, M. A., Welsford, M., Zideman, D. A., Acworth, J., Aickin, R., Andersen, L. W., Atkins, D., Berry, D. C., Bhanji, F., Bierens, J., Borra, V., Bottiger, B. W., Bradley, R. N., Bray, J. E., Breckwoldt, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Couto, T. B., Dainty, K. N., Davis, P. G., De Almeida, M. F., De Caen, A. R., Deakin, C. D., Djarv, T., Donnino, M. W., Douma, M. J., Duff, J. P., Dunne, C. L., Eastwood, K., El-Naggar, W., Fabres, J. G., Fawke, J., Finn, J., Foglia, E. E., Folke, F., Gilfoyle, E., Goolsby, C. A., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hsu, C. H., Ikeyama, T., Isayama, T., Johnson, N. J., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kleinman, M., Kloeck, D. A., Kudenchuk, P. J., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lee, H. C., Lin, Y. (., Lockey, A. S., Maconochie, I. K., Madar, R. J., Malta Hansen, C., Masterson, S., Matsuyama, T., Mckinlay, C. J. D., Meyran, D., Morgan, P., Morrison, L. J., Nadkarni, V., Nakwa, F. L., Nation, K. J., Nehme, Z., Nemeth, M., Neumar, R. W., Nicholson, T., Nikolaou, N., Nishiyama, C., Norii, T., Nuthall, G. A., O'Neill, B. J., Ong, Y. -K. G., Orkin, A. M., Paiva, E. F., Parr, M. J., Patocka, C., Pellegrino, J. L., Perkins, G. D., Perlman, J. M., Rabi, Y., Reis, A. G., Reynolds, J. C., Ristagno, G., Rodriguez-Nunez, A., Roehr, C. C., Rudiger, M., Sakamoto, T., Sandroni, Claudio, Sawyer, T. L., Schexnayder, S. M., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Skrifvars, M. B., Smith, C. M., Sugiura, T., Tijssen, J. A., Trevisanuto, D., Van De Voorde, P., Wang, T. -L., Weiner, G. M., Wyllie, J. P., Yang, C. -W., Yeung, J., Nolan, J. P., Berg, K. M., Burdick, M. C., Cartledge, S., Dawson, J. A., Elgohary, M. M., Ersdal, H. L., Finan, E., Flaatten, H. I., Flores, G. E., Fuerch, J., Garg, R., Gately, C., Goh, M., Halamek, L. P., Handley, A. J., Hatanaka, T., Hoover, A., Issa, M., Johnson, S., Kamlin, C. O., Ko, Y. -C., Kule, A., Leone, T. A., Mackenzie, E., Macneil, F., Montgomery, W., O'Dochartaigh, D., Ohshimo, S., Palazzo, F. S., Picard, C., Quek, B. H., Raitt, J., Ramaswamy, V. V., Scapigliati, Andrea, Shah, B. A., Stewart, C., Strand, M. L., Szyld, E., Thio, M., Topjian, A. A., Udaeta, E., Vaillancourt, C., Wetsch, W. A., Wigginton, J., Yamada, N. K., Yao, S., Zace, D., Zelop, C. M., Sandroni C. (ORCID:0000-0002-8878-2611), and Scapigliati A. (ORCID:0000-0002-4044-2343)

Abstract

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport; approach to resuscitation after drowning; passive ventilation; minimizing pauses during cardiopulmonary resuscitation; temperature management after cardiac arrest; use of diagnostic point-of-care ultrasound during cardiac arrest; use of vasopressin and corticosteroids during cardiac arrest; coronary angiography after cardiac arrest; public-access defibrillation devices for children; pediatric early warning systems; maintaining normal temperature immediately after birth; suctioning of amniotic fluid at birth; tactile stimulation for resuscitation immediately after birth; use of continuous positive airway pressure for respiratory distress at term birth; respiratory and heart rate monitoring in the delivery room; supraglottic airway use in neonates; prearrest prediction of in-hospital cardiac arrest mortality; basic life support training for likely rescuers of high-risk populations; effect of resuscitation team training; blended learning for life support training; training and recertification for resuscitation instructors; and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for futu

Published
2022

43. Pazienti diabetici di tipo 2, non in terapia insulinica e albumina glicata: UNA valutazione multidimensionale [Insuline-Naive type 2 diabetic patients: a multidimensional evaluation on the role of glycated albumin]

Author

Ferrario L., Schettini F., Foglia E., Avogaro A., Bellia C., Bertuzzi F., Bonetti G., Ceriello A., Ciaccio M., Romanelli M. C., Dozio E., Falqui L., Girelli A., Nicolucci A., Perseghin G., Plebani M., Valentini U., Zaninotto M., Croce D., Ferrario, L, Schettini, F, Foglia, E, Avogaro, A, Bellia, C, Bertuzzi, F, Bonetti, G, Ceriello, A, Ciaccio, M, Romanelli, M, Dozio, E, Falqui, L, Girelli, A, Nicolucci, A, Perseghin, G, Plebani, M, Valentini, U, Zaninotto, M, and Croce, D

Subjects
Diabetes, glycated hemoglobin, insulin, MED/13 - ENDOCRINOLOGIA
Abstract

Insuline-Naaïve type 2 diabetic patients: a multidimensional evaluation on the role of glycated albumin Introduction: glycated Albumin (GA) is an innovative glycemic marker, that could be used in the clinical practice, as an add-on strategy, to the traditional glycemic monitoring systems, such as glycated haemoglobin (Hb1Ac) and fasting plasma glucose (FPG). The study aims at presenting the results of a multidimensional analysis conducted in Italy, exploring the main clinical, economic, ethical, social and organizational implications, related to the introduction of GA. Methods: an Health Technology Assessment (HTA) approach was implemented. The analysis considered the Italian National Healthcare Service (NHS) perspective, and assumed a 12-month time horizon, focusing on type 2 diabetes patients insulin-naïve, assuming oral therapy. The 9 HTA dimensions (derived from the Core Model developed by the European Network of HTA – EUnetHTA) were deployed, considering scientific evidence, health economics tools and qualitative approaches, through the administration of specific questionnaires to 15 diabetes experts. Results: literature reported better GA safety and efficacy profiles, thus being a predictor of the relative risk for diabetes complications development, and increasing the therapeutic success after 3 months of therapy (97.0% versus 71.6%). From an economic point of view, GA introduction resulted in an economic advantage of 1.06% and in a better tradeoff between costs sustained and efficacy gained. Considering a 7-item Likert Scale (ranging from -3 to +3), negative perceptions emerged with regard to equity aspects (0.13 versus 0.72) due to GA limited accessibility, whereas it would improve both patients (2.17 versus 1.33) and care givers (1.50 versus 0.83) quality of life. In the short term, GA required training courses and equipment update, whereas, in the long term, it could be considered the preferable solution from an organizational perspective (0.30 Conclusions: the results of this study demonstrated GA strategic relevance, its economic sustainability and feasibility, versus 0.01). as well as the potential clinical pathway improvement.

Published
2020

44. New Insights from CAR-T: An Economic and Organizational Perspective

Author

Foglia E., Garagiola E, Ferrario LB, Ladisa V, Scorza A, Rambaldi A, Cairoli R, Medaglia ML, Simona M, Sale EO, Omodeo E, Zinzani PL, Esposti M, Alberti L, Marcias M, Mulas MF, Satta V, Melis E, Onnis S, Croce D, Foglia, E, Garagiola, E, Ferrario, L, Ladisa, V, Scorza, A, Rambaldi, A, Cairoli, R, Medaglia, M, Simona, M, Sale, E, Omodeo, E, Zinzani, P, Esposti, M, Alberti, L, Marcias, M, Mulas, M, Satta, V, Melis, E, Onnis, S, and Croce, D

Subjects
Business Economic, Health Care Sciences Services
Published
2020

45. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group

Author

Wyckoff, M. H., Singletary, E. M., Soar, J., Olasveengen, T. M., Greif, R., Liley, H. G., Zideman, D., Bhanji, F., Andersen, L. W., Avis, S. R., Aziz, K., Bendall, J. C., Berry, D. C., Borra, V., Bottiger, B. W., Bradley, R., Bray, J. E., Breckwoldt, J., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Dainty, K. N., Davis, P. G., de Almeida, M. F., de Caen, A. R., de Paiva, E. F., Deakin, C. D., Djarv, T., Douma, M. J., Drennan, I. R., Duff, J. P., Eastwood, K. J., El-Naggar, W., Epstein, J. L., Escalante, R., Fabres, J. G., Fawke, J., Finn, J. C., Foglia, E. E., Folke, F., Freeman, K., Gilfoyle, E., Goolsby, C. A., Grove, A., Guinsburg, R., Hatanaka, T., Hazinski, M. F., Heriot, G. S., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hung, K. K. C., Hsu, C. H., Ikeyama, T., Isayama, T., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kloeck, D. A., Kudenchuk, P. J., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lockey, A. S., Malta Hansen, C., Markenson, D., Matsuyama, T., Mckinlay, C. J. D., Mehrabian, A., Merchant, R. M., Meyran, D., Morley, P. T., Morrison, L. J., Nation, K. J., Nemeth, M., Neumar, R. W., Nicholson, T., Niermeyer, S., Nikolaou, N., Nishiyama, C., O'Neil, B. J., Orkin, A. M., Osemeke, O., Parr, M. J., Patocka, C., Pellegrino, J. L., Perkins, G. D., Perlman, J. M., Rabi, Y., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, Claudio, Sawyer, T., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Skrifvars, M. B., Smith, C. M., Smyth, M. A., Soll, R. F., Sugiura, T., Taylor-Phillips, S., Trevisanuto, D., Vaillancourt, C., Wang, T. -L., Weiner, G. M., Welsford, M., Wigginton, J., Wyllie, J. P., Yeung, J., Nolan, J. P., Berg, K. M., Abelairas-Gomez, C., Barcala-Furelos, R., Beerman, S. B., Bierens, J., Cacciola, Sofia, Cellini, J., Claesson, A., Court, R., D'Arrigo, Sonia, De Brier, N., Dunne, C. L., Elsenga, H. E., Johnson, S., Kleven, G., Maconochie, I., Mecrow, T., Morgan, P., Otto, Q., Palmieri, T. L., Parnia, S., Pawar, R., Pereira, J., Rudd, S., Scapigliati, Andrea, Schmidt, A., Seesink, J., Sempsrott, J. R., Szpilman, D., Warner, D. S., Webber, J. B., West, R. L., Sandroni C. (ORCID:0000-0002-8878-2611), Cacciola S., D'Arrigo S. (ORCID:0000-0001-6740-3195), Scapigliati A. (ORCID:0000-0002-4044-2343), Wyckoff, M. H., Singletary, E. M., Soar, J., Olasveengen, T. M., Greif, R., Liley, H. G., Zideman, D., Bhanji, F., Andersen, L. W., Avis, S. R., Aziz, K., Bendall, J. C., Berry, D. C., Borra, V., Bottiger, B. W., Bradley, R., Bray, J. E., Breckwoldt, J., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Costa-Nobre, D. T., Couper, K., Dainty, K. N., Davis, P. G., de Almeida, M. F., de Caen, A. R., de Paiva, E. F., Deakin, C. D., Djarv, T., Douma, M. J., Drennan, I. R., Duff, J. P., Eastwood, K. J., El-Naggar, W., Epstein, J. L., Escalante, R., Fabres, J. G., Fawke, J., Finn, J. C., Foglia, E. E., Folke, F., Freeman, K., Gilfoyle, E., Goolsby, C. A., Grove, A., Guinsburg, R., Hatanaka, T., Hazinski, M. F., Heriot, G. S., Hirsch, K. G., Holmberg, M. J., Hosono, S., Hsieh, M. -J., Hung, K. K. C., Hsu, C. H., Ikeyama, T., Isayama, T., Kapadia, V. S., Kawakami, M. D., Kim, H. -S., Kloeck, D. A., Kudenchuk, P. J., Lagina, A. T., Lauridsen, K. G., Lavonas, E. J., Lockey, A. S., Malta Hansen, C., Markenson, D., Matsuyama, T., Mckinlay, C. J. D., Mehrabian, A., Merchant, R. M., Meyran, D., Morley, P. T., Morrison, L. J., Nation, K. J., Nemeth, M., Neumar, R. W., Nicholson, T., Niermeyer, S., Nikolaou, N., Nishiyama, C., O'Neil, B. J., Orkin, A. M., Osemeke, O., Parr, M. J., Patocka, C., Pellegrino, J. L., Perkins, G. D., Perlman, J. M., Rabi, Y., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, Claudio, Sawyer, T., Schmolzer, G. M., Schnaubelt, S., Semeraro, F., Skrifvars, M. B., Smith, C. M., Smyth, M. A., Soll, R. F., Sugiura, T., Taylor-Phillips, S., Trevisanuto, D., Vaillancourt, C., Wang, T. -L., Weiner, G. M., Welsford, M., Wigginton, J., Wyllie, J. P., Yeung, J., Nolan, J. P., Berg, K. M., Abelairas-Gomez, C., Barcala-Furelos, R., Beerman, S. B., Bierens, J., Cacciola, Sofia, Cellini, J., Claesson, A., Court, R., D'Arrigo, Sonia, De Brier, N., Dunne, C. L., Elsenga, H. E., Johnson, S., Kleven, G., Maconochie, I., Mecrow, T., Morgan, P., Otto, Q., Palmieri, T. L., Parnia, S., Pawar, R., Pereira, J., Rudd, S., Scapigliati, Andrea, Schmidt, A., Seesink, J., Sempsrott, J. R., Szpilman, D., Warner, D. S., Webber, J. B., West, R. L., Sandroni C. (ORCID:0000-0002-8878-2611), Cacciola S., D'Arrigo S. (ORCID:0000-0001-6740-3195), and Scapigliati A. (ORCID:0000-0002-4044-2343)

Abstract

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.

Published
2021

46. Glycated Albumin for Glycemic Control in T2DM Population: A Multi-Dimensional Evaluation

Author

Ferrario, L, Schettini, F, Avogaro, A, Bellia, C, Bertuzzi, F, Bonetti, G, Ceriello, A, Ciaccio, M, Corsi Romanelli, M, Dozio, E, Falqui, L, Girelli, A, Nicolucci, A, Perseghin, G, Plebani, M, Valentini, U, Zaninotto, M, Castaldi, S, Foglia, E, Ferrario, Lucrezia, Schettini, Fabrizio, Avogaro, Angelo, Bellia, Chiara, Bertuzzi, Federico, Bonetti, Graziella, Ceriello, Antonio, Ciaccio, Marcello, Corsi Romanelli, Massimiliano, Dozio, Elena, Falqui, Luca, Girelli, Angela, Nicolucci, Antonio, Perseghin, Gianluca, Plebani, Mario, Valentini, Umberto, Zaninotto, Martina, Castaldi, Silvana, Foglia, Emanuela, Ferrario, L, Schettini, F, Avogaro, A, Bellia, C, Bertuzzi, F, Bonetti, G, Ceriello, A, Ciaccio, M, Corsi Romanelli, M, Dozio, E, Falqui, L, Girelli, A, Nicolucci, A, Perseghin, G, Plebani, M, Valentini, U, Zaninotto, M, Castaldi, S, Foglia, E, Ferrario, Lucrezia, Schettini, Fabrizio, Avogaro, Angelo, Bellia, Chiara, Bertuzzi, Federico, Bonetti, Graziella, Ceriello, Antonio, Ciaccio, Marcello, Corsi Romanelli, Massimiliano, Dozio, Elena, Falqui, Luca, Girelli, Angela, Nicolucci, Antonio, Perseghin, Gianluca, Plebani, Mario, Valentini, Umberto, Zaninotto, Martina, Castaldi, Silvana, and Foglia, Emanuela

Abstract

Purpose: To investigate the glycated albumin (GA) introduction implications, as an add-on strategy to traditional glycemic control (Hb1Ac and fasting plasma glucose – FPG) instruments, considering insulin-naïve individuals with type 2 diabetes mellitus (T2DM), treated with oral therapies. Methods: A Health Technology Assessment was conducted in Italy, as a multi-dimensional approach useful to validate any innovative technology. The HTA dimensions, derived from the EUnetHTA Core Model, were deployed by means of literature evidence, health economics tools and qualitative questionnaires, filled-in by 15 professionals. Results: Literature stated that the GA introduction could lead to a higher number of individuals achieving therapeutic success after 3 months of therapy (97.0% vs 71.6% without GA). From an economic point of view, considering a projection of 1,955,447 T2DM insulin-naïve individuals, potentially treated with oral therapy, GA introduction would imply fewer individuals requiring a therapy switch (− 89.44%), with a 1.06% in costs reduction, on annual basis, thus being also the preferable solution from a cost-effectiveness perspective (cost-effectiveness value: 237.74 vs 325.53). According to experts opinions, lower perceptions on GA emerged with regard to equity aspects (0.13 vs 0.72, p-value> 0.05), whereas it would improve both individuals (2.17 vs 1.33, p-value=0.000) and caregivers quality of life (1.50 vs 0.83, p-value=0.000). Even if in the short term, GA required additional investments in training courses (− 0.80 vs 0.10, p-value = 0.036), in the long run, GA could become the preferable technology (0.30 vs 0.01, p-value=0.018) from an organisational perspective. Conclusion: Adding GA to traditional glycaemic control instruments could improve the clinical pathway of individuals with T2DM, leading to economic and organisational advantages for both hospitals and National Healthcare Systems.

Published
2021

47. PMD164 - THE MANAGEMENT OF GLYCAEMIC CONTROL IN DIABETIC PATIENTS (T2): THE ROLE OF GLYCATED ALBUMIN

Author

Ferrario, L, Foglia, E, Schettini, F, Avogaro, A, Bellia, C, Bertuzzi, F, Ceriello, A, Croce, D, Bonetti, G, Ciaccio, M, Corsi Romanelli, M, Dozio, E, Falqui, L, Girelli, A, Nicolucci, A, Perseghin, G, Plebani, M, Valentini, U, Zaninotto, M, Ferrario, L., Foglia, E., Schettini, F., Avogaro, A., Bellia, C., Bertuzzi, F., Ceriello, A., Croce, D., Bonetti, G., Ciaccio, M., Corsi Romanelli, M., Dozio, E., Falqui, L., Girelli, A., Nicolucci, A., Perseghin, G., Plebani, M., Valentini, U., Zaninotto, M., Ferrario, L, Foglia, E, Schettini, F, Avogaro, A, Bellia, C, Bertuzzi, F, Ceriello, A, Croce, D, Bonetti, G, Ciaccio, M, Corsi Romanelli, M, Dozio, E, Falqui, L, Girelli, A, Nicolucci, A, Perseghin, G, Plebani, M, Valentini, U, Zaninotto, M, Ferrario, L., Foglia, E., Schettini, F., Avogaro, A., Bellia, C., Bertuzzi, F., Ceriello, A., Croce, D., Bonetti, G., Ciaccio, M., Corsi Romanelli, M., Dozio, E., Falqui, L., Girelli, A., Nicolucci, A., Perseghin, G., Plebani, M., Valentini, U., and Zaninotto, M.

Published
2018

50. PCN52 New Insights from CAR-T: An Economic and Organizational Perspective

Author

Foglia, E., primary, Garagiola, E., additional, Ferrario, L.B., additional, Ladisa, V., additional, Scorza, A., additional, Rambaldi, A., additional, Cairoli, R., additional, Medaglia, M.L., additional, Simona, M., additional, Omodeo Salè, E., additional, Zinzani, P.L., additional, Esposti, M., additional, Alberti, L., additional, Marcias, M., additional, Mulas, M.F., additional, Satta, V., additional, Melis, E., additional, Onnis, S., additional, and Croce, D., additional

Published
2020
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