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Objectives: As there is no ranking designed for schools of Public Health, the aim of this project was to create one. Methods: To design the Public Health Academic Ranking (PHAR), we used the InCites Benchmarking and Analytics™ software and the Web Of Science™ Core Collection database. We collected bibliometric data on 26 schools of Public Health from each continent, between August and September 2022. We included 11 research indicators/scores, covering four criteria (productivity, quality, accessibility for readers, international collaboration), for the period 2017–2021. For the Swiss School of Public Health (SSPH+), a network gathering faculties across different universities, a specific methodology was used, with member-specific research queries. Results: The five top schools of the PHAR were: London School of Hygiene and Tropical Medicine, Public Health Foundation of India, Harvard T.H. Chan School of Public Health, SSPH+, Johns Hopkins Bloomberg School of Public Health. Conclusion: The PHAR allows worldwide bibliometric ordering of schools of Public Health. As this is a pilot project, the results must be taken with caution. This article aims to critically discuss its methodology and future improvements.

Background: Unconscious biases are one of the causes of health disparities. Health professionals have prejudices against patients due to their race, gender, or other factors without their conscious knowledge. This review aimed to provide an overview of research on unconscious bias among health professionals and to investigate the biases that exist in different regions of the world, the health professions that are considered, and the research gaps that still exist. Methods: We conducted a scoping review by systematically searching PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and AMED. All records were double-screened and included if they were published between 2011 and 2021. Results: A total of 5186 records were found. After removing duplicates (n = 300), screening titles and abstracts (n = 4210), and full-text screening (n = 695), 87 articles from 81 studies remained. Studies originated from North America (n = 60), Europe (n = 13), and the rest of the world (n = 6), and two studies were of global scope. Racial bias was investigated most frequently (n = 46), followed by gender bias (n = 11), weight bias (n = 10), socio-economic status bias (n = 9), and mental illness bias (n = 7). Most of the studies were conducted by physicians (n = 51) and nurses (n = 20). Other health care professionals were rarely included in these studies. Conclusions: Most studies show that health professionals have an implicit bias. Racial biases among physicians and nurses in the USA are well confirmed. Research is missing on other biases from other regions and other health professions.

In Österreich und in der Schweiz werden Pflege- und Therapieberufe an Fachhochschulen ausgebildet. Die beiden Länder machen damit positive Erfahrungen, während Deutschland mit der Akademisierung der Gesundheitsfachberufe nicht vom Fleck kommt.

Background: In Switzerland, relatively low biosimilar prescription rates have prompted the interest of the authorities. A health technology assessment (HTA) was requested to compare the available evidence of the infliximab reference product and its biosimilar for treating rheumatoid arthritis (RA). Objective: This HTA examines the efficacy, effectiveness and safety of the infliximab biosimilar compared to its reference product in RA and presents the health economic impact of a potentially increased biosimilar utilization in Switzerland. Furthermore, ethical, legal, social and organisational aspects of treatment initiation with biosimilars or switching to biosimilars are analysed. Research questions: Is it safe, efficacious and effective 1) to initiate treatment with infliximab biosimilar instead of the infliximab reference product, 2) to switch treatment from the infliximab reference product to infliximab biosimilar and 3) to switch treatment from infliximab biosimilar to the infliximab reference product in patients with RA? Methods: A systematic literature search for evidence on efficacy, effectiveness, safety and health economic outcomes of the infliximab reference product compared to biosimilars in RA was conducted. Meta-analysis was performed for outcomes with sufficient available evidence. The certainty of evidence for relevant outcomes was assessed by applying the GRADE approach. A de novo health economic model was built to assess cost differences between a RA patient treated with infliximab reference product and a patient treated with its biosimilar using a lifetime time horizon. The potential budget impact for Switzerland was estimated over the next five years. The health economic analysis focused on drug costs. Additional physician time and lab tests that may be required related to the switch were also considered. Furthermore, a targeted search for evidence on biosimilar-related ethical, legal, social and organisational aspects was conducted and findings we

Many hopes are pinned on the topic of „interprofessional collaboration”. However, a precise definition of the term is lacking, as has already been noted in some publications in the field of health sciences. Linguistic analyses dedicated to the concept of interprofessional collaboration are not yet available. The present analysis aims at narrowing this gap. Specifically, the terms „interprofessionality”, „interprofessional” and „interprofessional collaboration” were quantitatively recorded in texts from two linguistic corpora based on texts in German. In a second step, a qualitative analysis of the use of the terms was conducted. The linguistic analysis showed a considerable increase in the use of all three terms, a restriction to specialist medical publications, and a focus on interprofessional collaboration between physicians and nurses. The patient perspective was widely absent. Furthermore, the term exhibited a typical relation with development-focused keywords, indicating that the sharpening of the conceptual field of interprofessional collaboration is not yet complete. Viele Hoffnungen werden an das Thema «Interprofessionalität» geknüpft. Eine genaue Definition des Begriffs fehlt jedoch, wie in einigen gesundheitswissenschaftlichen Arbeiten bereits festgestellt wurde. Linguistische Analysen, die sich dem Begriff der Interprofessionalität und dessen Verwendung widmen, liegen bisher nicht vor. Diese Lücke geht die vorliegende Analyse an. Konkret wurden die Begriffe «Interprofessionalität», «interprofessionell» und «interprofessionelle Zusammenarbeit» in Texten aus zwei linguistischen Korpora quantitativ erfasst. In einem zweiten Arbeitsschritt wurde die Begriffsverwendung qualitativ analysiert. In einem kurzen Fazit werden die Ergebnisse reflektiert und diskutiert. Die linguistische Analyse zeigte einen erheblichen Anstieg der Verwendung aller drei Begriffe, eine Beschränkung auf fachmedizinische Publikationen, einen Fokus auf die interprofessionelle Zusammenarbe

Interprofessionelle Lehre (IPL) bedeutet, dass Studierende verschiedener Professionen mit-, von- und übereinander lernen. 2019 wurde im Kanton Zürich ein interprofessioneller Ausbildungstag (IPE-Tag) mit 68 Studierenden und acht Dozierenden über acht Lektionen durchgeführt mit dem Ziel, interprofessionelle Kompetenzen zu verbessern. Studierende aus sechs Fachbereichen des Gesundheitswesens und PhD-Studierende mit unterschiedlichem fachlichem Hintergrund mussten gemeinsam in Gruppen zwei Fälle mit Simulationspatienten/-innen bearbeiten. Zur Evaluation des IPE Tages wurde eine Prä-Post-Online-Befragung durchgeführt. Sie umfassten unter anderem eine Selbsteinschätzung mittels Items aus dem Kompetenzrahmen der Zürcher InterProfessionellen AusbildungsStation (ZIPAS®) und dem Interprofessional Collaborative Competency Attainment Survey (ICCAS) sowie offene Fragen zum IPE-Tag. Dabei wurden ZIPAS®-Kompetenzrahmen und ICCAS quantitativ, die offenen Fragen qualitativ ausgewertet. Es zeigten sich statistisch signifikante Verbesserungen in den meisten Subskalen des ZIPAS®-Kompetenzrahmens, aber nur in einem Drittel der Subskalen des ICCAS. Außerdem zeigten sich in der qualitativen Analyse der Aussagen insbesondere Verbesserungen in der Kollaboration sowie positive Aussagen zum Austausch mit Studierenden anderer Professionen, wobei viele Studierende dem Thema «Interprofessionalität» eine große Bedeutung zugeschrieben und ihren Blick bereits auf die Zukunft und ihren Alltag gerichtet haben. Der IPE-Tag könnte eine gute Methode sein, um die Zusammenarbeit und Kommunikation mit Studierenden anderer Professionen aus dem Gesundheitsbereich zu verbessern.

Viele Hoffnungen werden an das Thema «Interprofessionalität» geknüpft. Eine genaue Definition des Begriffs fehlt jedoch, wie in einigen gesundheitswissenschaftlichen Arbeiten bereits festgestellt wurde. Linguistische Analysen, die sich dem Begriff der Interprofessionalität und dessen Verwendung widmen, liegen bisher nicht vor. Diese Lücke geht die vorliegende Analyse an. Konkret wurden die Begriffe «Interprofessionalität», «interprofessionell» und «interprofessionelle Zusammenarbeit» in Texten aus zwei linguistischen Korpora quantitativ erfasst. In einem zweiten Arbeitsschritt wurde die Begriffsverwendung qualitativ analysiert. In einem kurzen Fazit werden die Ergebnisse reflektiert und diskutiert. Die linguistische Analyse zeigte einen erheblichen Anstieg der Verwendung aller drei Begriffe, eine Beschränkung auf fachmedizinische Publikationen, einen Fokus auf die interprofessionelle Zusammenarbeit zwischen Ärzten und Ärztinnen und dem Pflegepersonal, ein Fehlen der Patient/-innenperspektive sowie eine typische Relation mit entwicklungsfokussierten Schlagworten, die darauf hinweisen, dass die Schärfung des Begriffsfeldes «Interprofessionalität» noch nicht abgeschlossen ist.

Interprofessional education (IPE) means that students from different professions learn with, from and about each other. In 2019, an interprofessional education day (IPE day) was held in the canton of Zurich with 68 students and eight lecturers over eight lessons with the aim of improving interprofessional competencies. Students from six health care disciplines and PhD students with different professional backgrounds had to work together in groups on two cases with standardised patients. A pre-post online survey was conducted to evaluate the IPE day. It included self-assessment using items from the Zürcher InterProfessionelle AusbildungsStation (ZIPAS ®) competency framework and the Interprofessional Collaborative Competency Attainment Survey (ICCAS) as well as open-ended questions about the IPE day. ZIPAS ® competency framework and ICCAS were evaluated quantitatively, while the open-ended questions were evaluated qualitatively. There were statistically significant improvements in most of the subscales of the ZIPAS ® competency framework but only in one third of the ICCAS subscales. In addition, the qualitative analysis of the statements showed improvements in collaboration in particular, as well as positive statements on the exchange with students from other professions, whereby many students attributed great importance to the topic of interprofessionality and have already focused their attention on the future and their everyday lives. The IPE day could be a good method to improve the collaboration and communication with students from other professions in the health sector. Keywords - Interprofessional Education DayMixed Methods Studyinterprofessional educationInterprofessional Collaboration = Interprofessionelle Ausbildung bzw. Lehre und Zusammenarbeit gewinnen im Gesundheitswesen zunehmend an Bedeutung. Bei der interprofessionellen Lehre (IPL, engl. Interprofessional Education [IPE]) handelt es sich um das «mit-, von- und übereinander» Lernen verschiedener Profess

Der Verein zur Förderung der Wissenschaft in den Gesundheitsberufen VFWG veranstaltete zwei Online-Symposien zum Stand der Akademisierung in Deutschland, wo lediglich die Hebammen dank EU-Vorschriften seit 2020 an Fachhochschulen ausgebildet werden. Für die Pflege- und Therapieberufe gilt nach wie vor die Modellklausel, die bis 2024 verlängert wurde. In Österreich und der Schweiz sind die Ausbildungen für die Therapieberufe vollständig an den Fachhochschulen angesiedelt, für diejenigen für die Pflege und die medizinisch-technischen Berufe teilweise. Das erste Symposium erörterte, ob sog. duale Studiengänge ein Modell sein könnten für die Therapieberufe in Deutschland. Das zweite Symposium fragte, ob der Weg, den Österreich und die Schweiz eingeschlagen haben, Argumente liefern kann für eine Akademisierung der Gesundheitsberufe in Deutschland. Dieser Beitrag führt ins Thema ein; die folgenden Beiträge dokumentieren die Beiträge verschiedener Autoren zu den beiden Symposien.

As patents for first-to-market biologics expire, subsequent-entry products – biosimilars – can become available. Biosimilars are not exact copies of their reference products but highly similar with regard to efficacy and safety and available at a discount. In Switzerland, relatively low biosimilar prescription rates have prompted interest in a health technology assessment (HTA) of the infliximab reference product relative to biosimilars for treating rheumatoid arthritis (RA). This scoping report determines the feasibility of such an HTA. We conducted a systematic literature search for evidence on efficacy, effectiveness, safety, and health economic outcomes of the infliximab reference product relative to biosimilars in RA. We also conducted a targeted search for evidence on biosimilar related ethical, legal, social, and organisational aspects. We identified 15 studies reporting on randomized controlled trials (RCTs), 14 real-world evidence (RWE) studies, and 11 health economic studies. RCTs reported a range of clinical efficacy, safety, pharmacokinetic/pharmacodynamic, immunogenicity, and patient-reported outcomes. RWE studies primarily reported on effectiveness, safety, and treatment discontinuation. Health economic studies were costing studies or budget impact analyses. A substantial body of literature was identified on biosimilar regulation in different settings. For legal and ethical aspects, we developed sets of questions that we considered important for discussing reference products and biosimilars, particularly with regard to non-medical switching. The evidence base suggested that an HTA comparing the infliximab reference product with its biosimilars for treatment of RA in infliximab-naïve and switched patients would be feasible. This HTA would have to include a systematic review (and possibly a meta-analysis) of efficacy, effectiveness, and safety as well as a budget impact analysis (but not necessarily a full economic evaluation).

Hinweise zur Ausarbeitung dieser Publikation: Die SAMW hat im Auftrag der Akademien der Wissenschaften Schweiz die thematische Plattform «Chancen und Risiken der Personalisierten Gesundheit» etabliert. In diesem Rahmen hat der SAMW-Vorstand eine Arbeitsgruppe beauftragt, das Thema der Aus-, Weiter- und Fortbildung von Gesundheitsfachleuten im Bereich «Personalisierte Medizin» zu bearbeiten.

Background: Evidence-based complementary treatment options for multiple sclerosis (MS) are limited. Objective: To investigate the effect of hippotherapy plus standard care versus standard care alone in MS patients. Methods: A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12 weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12 weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity. Results: Covariance analysis of the primary endpoint resulted in a mean difference in BBS change of 2.33 (95% confidence interval (CI): 0.03–4.63, p = 0.047) between intervention (n = 32) and control (n = 38) groups. Benefit on BBS was largest for the subgroup with an Expanded Disability Status Scale (EDSS) ⩾ 5 (5.1, p = 0.001). Fatigue (−6.8, p = 0.02) and spasticity (−0.9, p = 0.03) improved in the intervention group. The mean difference in change between groups was 12.0 (p < 0.001) in physical health score and 14.4 (p < 0.001) in mental health score of Multiple Sclerosis Quality of Life-54 (MSQoL-54). Conclusion: Hippotherapy plus standard care, while below the threshold of a minimal clinically important difference, significantly improved balance and also fatigue, spasticity, and quality of life in MS patients.

Background Cost-of-illness (CoI) studies are important instruments for estimating the socioeconomic burden of specified diseases. CoI studies provide important information about the cost structure of a disease, the resulting research need, approaches to improve aspects of care and, monetary consequences from different perspectives. This information can be useful for healthcare research and health policy. Due to heterogeneity of available Cost-of-Illness studies, the working group 'Health Economics' of the German Network for Healthcare Research (DNVF) in accordance with the German Society for Health Economics (DGGO) developed an instrument for the planning, conduct and assessment of CoI studies. Methods The checklist was developed based on a systematic literature search of published national and international checklists as well as guidelines and recommendations for development and assessment of CoI studies and health economic evaluations. Structure and subject matter of the generic checklist was designed, approved and, finally, examined in a pretest by the working group. Results Based on the results of the literature search (n = 2 454), 58 articles were used for the identification of relevant criteria for the checklist. With respect to the results of the pretest, 6 dimensions were included in the checklist: (i) general aspects, (ii) identification of resources, (iii) description and quantification of resource consumption, (iv) valuation of resources (v) analysis and presentation of results and (vi) discussion and conclusion. In total, the 6 dimensions were operationalized through 37 items. Conclusion This checklist is an initial approach to improve transparency and understanding of CoI studies in terms of the extent, structure and development of the socioeconomic burden of diseases. The checklist supports the comparability of different studies and facilitates study conception.

Background: Evidence-based complementary treatment options for multiple sclerosis (MS) are limited. Objective: To investigate the effect of hippotherapy plus standard care versus standard care alone in MS patients. Methods: A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity. Results: Covariance analysis of the primary endpoint resulted in a mean difference in BBS change of 2.33 (95% confidence interval (CI): 0.03-4.63, p=0.047) between intervention (n=32) and control (n=38) groups. Benefit on BBS was largest for the subgroup with an Expanded Disability Status Scale (EDSS)5 (5.1, p=0.001). Fatigue (-6.8, p=0.02) and spasticity (-0.9, p=0.03) improved in the intervention group. The mean difference in change between groups was 12.0 (p<0.001) in physical health score and 14.4 (p<0.001) in mental health score of Multiple Sclerosis Quality of Life-54 (MSQoL-54). Conclusion: Hippotherapy plus standard care, while below the threshold of a minimal clinically important difference, significantly improved balance and also fatigue, spasticity, and quality of life in MS patients.

The efficiency-frontier approach (EFA) to health economic evaluation aims to benchmark the relative efficiency of new drugs with the incremental cost-effectiveness ratios (ICERs) of non-dominated comparators. By explicitly considering any differences in health outcomes and costs, it enhances the internal reference pricing (IRP) policy that was officially endorsed by Germany as the first country worldwide in 1989. However, the EFA has been repeatedly criticized since its official endorsement in 2009. Areas covered: This perspective aims to stimulate the debate by discussing whether the main objections to the EFA are technically valid, irrespective of national contextual factors in Germany with reservations towards using cost-per-quality-adjusted life year (QALY) thresholds. Moreover, we comparatively assessed whether the objections are truly unique to the EFA or apply equally to IRP and cost-effectiveness thresholds. Expert commentary: The plethora of objections to the EFA (n = 20) has obscured that many objections are neither technically valid nor unique to the EFA. Compared with cost-effectiveness thresholds, only two objections apply uniquely to the EFA and concern intended key properties: (1) no external thresholds are needed and (2) the EFA is sensitive to price changes of comparators. Combining these policies and developing them further are under-utilized research areas.