Spain

On the 9th of July 2020, the Ministry of Health of Spain released a screening guide for Hepatitis C infection as a part of the Strategic Plan for Addressing Hepatitis C in the National Health System. To improve access to screening and link to treatment monitoring, the guide proposes actions such as diagnosing the infection in a single step, training and support activities for health professionals, or a simplification of the models.

In June 2020, the Andalusian Health Technology Assessment Department (AETSA) published an update of the earlier report (2012) on assessment of effectiveness and safety of tumor treating fields (TTF) therapy in glioblastoma.

In February 2020, the Office for Health Technology Assessment (HTA) of Basque Country OSTEBA published an HTA report for efficacy and safety of mechanical thrombectomy (MT) in the treatment of patients with ischaemic stroke beyond 6 hours after onset or with an unknown time of onset. According to the report, the use of MT, together with standard medical treatment (SMT) in such patients, is justified provided that they meet the neuroimaging selection criteria applied to the studies analyzed.

In June 2020, the Agency for Health Quality and Assessment of Catalonia (AQuAS) published an assessment report on the effectiveness and safety of bilateral implantation of non-cochlear hearing implants in Spain.

The Health Institute Carlos III (ISCIII) in Spain analyzed the effectiveness and safety of the endovenous ablation of varicose saphenous veins with cyanoacrylate closure system in patients with moderate to severe chronic venous insufficiency compared to surgical procedures, as of saphenous vein stripping, and other endovenous ablation techniques. In the report, published on the website in 2020, it was outlined that despite the limitations found in selected studies, intravenous sealing with cyanoacrylates seems to be a promising alternative to existing treatments, especially in terms of less use of anesthesia and compression bandage, as well as shorter recovery time.

In 2019, the Health Institute Carlos III (ISCIII) assessed the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of fibromyalgia, peripheral vascular disease, neurological disease, and others. The report was published online in 2020. The previous assessment, performed in 2018, was related to the use of HBOT in patients with Complex Regional Pain Syndrome (CRPS).

In February 2020, the Andalusian Health Technology Assessment Department published an assessment report on the evaluation of effectiveness and safety of epicardial closure of left atrial appendage using clips by minimally invasive surgery for thromboembolism prevention in patients with atrial fibrillation. The scientific evidence about the effectiveness and safety of the left atrial appendage closure through minimally invasive epicardial clipping is inadequate and insufficient; further research is needed.

In February 2020, the Andalusian Health Technology Assessment Department published an assessment report on the evaluation of validity, clinical utility, and safety of the next-generation sequencing genomic platform FoundationOne® in non-small cell lung cancer and other solid tumors. It was observed that it is necessary to carry out new studies to confirm the diagnostic results and the clinical usefulness of the test due to the low quality of existing evidence.

At the beginning of 2020, the Galician Scientific and Technical Advice Unit released a health technology assessment on the treatment of benign thyroid nodules (TNs) by thermal laser or radiofrequency ablation that aimed to assess its safety and clinical effectiveness compared to standard treatment. The methods were considered safe and effective procedures for the treatment of benign, solid, and symptomatic TNs.

At the beginning of 2020, the Galician Scientific and Technical Advice Unit released a health technology assessment on irreversible electroporation (IRE) for the treatment of liver and pancreatic cancer that aimed to analyze its safety, effectiveness, considerations for use, and the economic, organizational, social, ethical, or legal aspects. The efficacy evidence of IRE in achieving complete ablation is insufficient. Safety evidence is also insufficient as it is unclear whether IRE is safer as the standard treatment.

In October 2019, the Agency for Health Quality and Assessment of Catalonia (AQuAS) has released an assessment report regarding the evaluation strategies to prevent urinary tract infections associated with urethral/urinary catheters in critical patients in Intensive Care Units. The evidence is not conclusive, but there is scientific evidence that aims for the introduction of review measures for the indication of indwelling urethral/urinary catheters, its use in decubitus, and without kinking.

In October 2019, the Agency for Health Quality and Assessment of Catalonia (AQuAS) has released an assessment report regarding the scientific evidence on personalized population screening for breast cancer. The current evidence does not allow to recommend any concrete models for individualized risk prediction for breast cancer but allows to recommend the development and evaluation of new models for personalized risk prediction directed to offering different strategies to the screening of population.