Sweden

In Sweden, the Centre for Assessment of Medical Technology (CAMTÖ) leads the development of HTA cooperation in the healthcare region Uppsala-Örebro. In September 2019, CAMTÖ released a systematic review on surgical treatment of abdominal rectus diastasis one year after delivery. The literature search was performed, only one RCT was identified, but as the design of the study was associated with a high risk of bias, no conclusions could be drawn.

In Sweden, the Centre for Assessment of Medical Technology (CAMTÖ) leads the development of HTA cooperation in the healthcare region Uppsala-Örebro. In September 2019, CAMTÖ released a systematic review on SMS alerts to laypersons for cardiopulmonary resuscitation in out-of-hospital cardiac arrest (OHCA) that aimed to clarify SMS efficacy on survival after OHCA. Currently, the best available evidence does not support the use of SMS alarm to laymen as a means of improving survival after OHCA.

In September 2019, Skåne Region released a report for ultrasound in symptoms of the acute scrotum that aimed to understand whether increased ultrasound use could improve the diagnostic of the studied condition. Although no studies investigating the direct benefit of ultrasound in patients with symptoms of acute scrotum were identified, its high precision, sensitivity, and specificity were outlined.

In September 2019, Regional Methods Council of South East healthcare region released a report where compared the prostate artery embolization (PAE) for benign prostatic hyperplasia with the transurethral resection of the prostate (TURP). It was outlined that costs and the need for blood transfusions for PAE are lower than for TURP. The use of registries for follow-up of patients and registration of side effects is strongly recommended.

In Sweden, the Centre for Assessment of Medical Technology (CAMTÖ) leads the development of HTA cooperation in the healthcare region Uppsala-Örebro. In August 2019, CAMTÖ started its work on the assessment of sclerotherapy in Achilles tendinopathy. After the completion of the evaluation process, the report would be published at the web-site of Örebro County Council.

In Sweden, the Priority Council of Skåne Region prepares and presents suggestions for new methods, routines, and treatments, to be included in the healthcare system. In August 2019, the HTA report for endoscopic procedures in dysphagia was released. The analysis showed that fiberoptic endoscopic evaluation of swallowing and videofluoroscopy are clinically well-established procedures that have good and equal coherence between different assessors and in repeated assessments.

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.

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.

The test for severe combined immunodeficiencies (SCID) is part of neonatal screening since July 1, 2019, in Germany. At the beginning of July 2019, the Swedish National Board of Health and Welfare (Socialstyrelsen) has stated that health care should offer screening for the severe combined immunodeficiency (SCID) as approximately two or three children per each year can be diagnosed and treated for the fatal disease with the test available.

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 Dental and Pharmaceutical Benefits Agency (TLV) has published a completed health economic evaluation regarding the cost-effectiveness of the comprehensive genomic profiling test for all solid tumors FoundationOne CDx. TLV believes that in most cases, the use of FoundationOne CDx is more expensive in comparison to current treatment methods. However, it has greater sensitivity and accuracy in the diagnostics.