Health technology assessment

In August 2019, the Austrian HTA body, the Ludwig-Boltzmann Institute (LBI-HTA) published updated evaluations of medical procedures previously assessed. Technologies that were revised are The Barricaid® device for annulus Fibrosus Repair after lumbar discectomy, single-step scaffold-based treatment (AMIC) and two-step scaffold-based treatment (MACI), radiofrequency denervation and electrical stimulation of the hypoglossal nerve.

In July 2019, the National Institute for Health and Care Excellence (NICE) published one new diagnostics guidance for therapeutic monitoring of TNF-alpha inhibitors in rheumatoid arthritis, two new interventional procedure guidance (for transurethral laser ablation for recurrent non-muscle-invasive bladder cancer and ultrasound-guided high-intensity transcutaneous focused ultrasound for symptomatic uterine fibroids), and one new MedTech innovation briefing for HemaClear for bloodless surgical field during limb surgery.

In late July 2019, the report of the project OTJA10, titled “Stool DNA testing for early detection of colorectal cancer” was published on the website of the European Network for HTA (EUnetHTA).

In July 2019, the Health Technology Evaluation Service of the Basque County, OSTEBA, published a report titled “Indications, utility, and use of ultrasound in primary care.”

The HTA center of Swedish Västra Götaland region has published a report for the effectiveness of laminar versus turbulent airflow in operating theaters, with regard to risk for postoperative surgical infections. It was concluded that vertical laminar airflow, compared with any other type of ventilation system in operating rooms, is probably associated with a further reduction of CFU concentration in air sampled near the operation table.

In July 2019, the Norwegian Institute of Public Health (NIPH) has released a report for the effectiveness of treatment for knee osteoarthritis to summarize key findings from systematic reviews about relevant treatment options to ease the symptoms in patients with arthritis in the knee. It was outlined that self-management education program and physical aids give little or no difference in pain, whereas noncompartmental knee arthroplasty is superior to total knee arthroplasty in pain.

The HTA center of Swedish Västra Götaland region has published a report for effectiveness and safety of microsurgical testicular sperm extraction (TESE) in infertile men with non-obstructive azoospermia (NOA) and concluded that it is uncertain whether there is any difference in complication rates for micro-TESE compared with testicular sperm aspiration (TESA). There is a need for extensive high-quality studies comparing results of micro-TESE with TESA

The HTA center of Swedish Västra Götaland region has published a report for gene expression profiles to guide adjuvant chemotherapy in luminal, HER2-negative breast cancer. It was concluded that withholding adjuvant chemotherapy in breast cancer patients with intermediate clinical risk of recurrence and low/intermediate risk according to a gene expression assay, compared with providing chemotherapy, probably results in little or no difference in overall survival within nine years and can probably not exclude a small increased risk of recurrence.

In early July 2019, the network of European HTA agencies, EUnetHTA, published the report titled “Irreversible electroporation for the treatment of liver and pancreatic cancer”.

The HTA center of Swedish Västra Götaland region has published a report for the impact of postmastectomy radiotherapy (PMRT) on complications and results of immediate breast reconstruction (IBR). PMRT compared with no radiotherapy (RT) results in a clinically significant increase of implant or tissue expander loss in patients undergoing IBR with moderate certainty of evidence. Other findings (decrease in patient satisfaction, an increase of re-operations or capsular contracture rate increase) gained low certainty of evidence.

In June 2019, the National Institute for Health and Care Excellence (NICE) published six new interventional procedure guidance, one new Medical technologies guidance for Endocuff Vision for assisting visualisation during colonoscopy, and two new MedTech innovation briefings (for Danis stent for acute oesophageal variceal bleeds, and The OPTIMIZER smart system for managing heart failure).

The mini-HTA for internal emergency medicine ultrasound in patients with urgent medical conditions was released in July 2019 in Norway. The method was determined as efficient, safe, and was recommended to be introduced as part of the clinical routine in the hospital.