WWW.DISSERTATION.XLIBX.INFO
FREE ELECTRONIC LIBRARY - Dissertations, online materials
 
<< HOME
CONTACTS



Pages:   || 2 | 3 | 4 | 5 |   ...   | 9 |

«AHRQ Healthcare Horizon Scanning System – Potential High-Impact Interventions Report Priority Area 07: Diabetes Mellitus Prepared for: Agency for ...»

-- [ Page 1 ] --

AHRQ Healthcare Horizon Scanning System – Potential

High-Impact Interventions Report

Priority Area 07: Diabetes Mellitus

Prepared for:

Agency for Healthcare Research and Quality

U.S. Department of Health and Human Services

540 Gaither Road

Rockville, MD 20850

www.ahrq.gov

Contract No. HHSA290201000006C

Prepared by:

ECRI Institute

5200 Butler Pike

Plymouth Meeting, PA 19462

June 2014

Statement of Funding and Purpose This report incorporates data collected during implementation of the Agency for Healthcare Research and Quality (AHRQ) Healthcare Horizon Scanning System by ECRI Institute under contract to AHRQ, Rockville, MD (Contract No. HHSA290201000006C). The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

This report’s content should not be construed as either endorsements or rejections of specific interventions. As topics are entered into the System, individual topic profiles are developed for technologies and programs that appear to be close to diffusion into practice in the United States.

Those reports are sent to various experts with clinical, health systems, health administration, and/or research backgrounds for comment and opinions about potential for impact. The comments and opinions received are then considered and synthesized by ECRI Institute to identify interventions that experts deemed, through the comment process, to have potential for high impact. Please see the methods section for more details about this process. This report is produced twice annually and topics included may change depending on expert comments received on interventions issued for comment during the preceding 6 months.

A representative from AHRQ served as a Contracting Officer’s Technical Representative and provided input during the implementation of the horizon scanning system. AHRQ did not directly participate in horizon scanning, assessing the leads for topics, or providing opinions regarding potential impact of interventions.

Disclaimer Regarding 508-Compliance Individuals using assistive technology may not be able to fully access information in this report. For assistance contact info@ahrq.gov.

Financial Disclosure Statement None of the individuals compiling this information has any affiliations or financial involvement that conflicts with the material presented in this report.

Public Domain Notice This document is in the public domain and may be used and reprinted without special permission.

Citation of the source is appreciated.

Suggested citation: ECRI Institute. AHRQ Healthcare Horizon Scanning System Potential HighImpact Interventions: Priority Area 07: Diabetes Mellitus. (Prepared by ECRI Institute under Contract No. HHSA290201000006C.) Rockville, MD: Agency for Healthcare Research and Quality. June 2014. http://effectivehealthcare.ahrq.gov/index.cfm/ ii Preface The purpose of the AHRQ Healthcare Horizon Scanning System is to conduct horizon scanning of emerging health care technologies and innovations to better inform patient-centered outcomes research investments at AHRQ through the Effective Health Care Program. The Healthcare Horizon Scanning System provides AHRQ a systematic process to identify and monitor emerging technologies and innovations in health care and to create an inventory of interventions that have the highest potential for impact on clinical care, the health care system, patient outcomes, and costs. It will also be a tool for the public to identify and find information on new health care technologies and interventions. Any investigator or funder of research will be able to use the AHRQ Healthcare Horizon Scanning System to select potential topics for research.

The health care technologies and innovations of interest for horizon scanning are those that have yet to diffuse into or become part of established health care practice. These health care interventions are still in the early stages of development or adoption, except in the case of new applications of already-diffused technologies. Consistent with the definitions of health care interventions provided by the Institute of Medicine and the Federal Coordinating Council for Comparative Effectiveness Research, AHRQ is interested in innovations in drugs and biologics, medical devices, screening and diagnostic tests, procedures, services and programs, and care delivery.

Horizon scanning involves two processes. The first is identifying and monitoring new and evolving health care interventions that are purported to or may hold potential to diagnose, treat, or otherwise manage a particular condition or to improve care delivery for a variety of conditions. The second is analyzing the relevant health care context in which these new and evolving interventions exist to understand their potential impact on clinical care, the health care system, patient outcomes, and costs. It is NOT the goal of the AHRQ Healthcare Horizon Scanning System to make predictions on the future use and costs of any health care technology. Rather, the reports will help to inform and guide the planning and prioritization of research resources.





We welcome comments on this Potential High-Impact Interventions report. Send comments by mail to the Task Order Officer named in this report to: Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, or by email to: effectivehealthcare@ahrq.hhs.gov.

–  –  –

iii Contents Executive Summary

Background

Methods

Results

Discussion

Diabetes Mellitus Interventions

Artificial Pancreas Device Systems for Treatment of Diabetes (MiniMed 530G with Enlite Low-Glucose Suspend System)

Degludec Ultra-Long-Acting Insulin (Tresiba) and Degludec Plus Aspart (Ryzodeg) for Treatment of Type 1 or 2 Diabetes

ITCA 650 (Exenatide Continuous Subcutaneous Delivery) for Treatment of Type 2 Diabetes

Metabolic (Bariatric) Surgery for Resolution of Type 2 Diabetes in Mildly Obese and Nonobese Patients

Diabetic Macular Edema Intervention

Fluocinolone Acetonide Implant (Iluvien) for Treatment of Diabetic Macular Edema............... 23 References

Figures Figure 1. Overall high-impact potential: artificial pancreas device system (MiniMed 350G Low Glucose Suspend System) for treatment of diabetes requiring exogenous insulin..... 7 Figure 2. Overall high-impact potential: degludec ultra-long-acting insulin (Tresiba) and degludec plus aspart (Ryzodeg) for treatment of type 1 or 2 diabetes

Figure 3. Overall high-impact potential: ITCA 650 (exenatide continuous subcutaneous delivery) for treatment of type 2 diabetes

Figure 4. Overall high-impact potential: metabolic (bariatric) surgery for resolution of type 2 diabetes in mildly obese and nonobese patients

Figure 5. Overall high-impact potential: fluocinolone acetonide implant (Iluvien) for treatment of diabetic macular edema

iv Executive Summary Background Horizon scanning is an activity undertaken to identify technological and system innovations that could have important impacts or bring about paradigm shifts. In the health care sector, horizon scanning pertains to identification of new (and new uses of existing) pharmaceuticals, medical devices, diagnostic tests and procedures, therapeutic interventions, rehabilitative interventions, behavioral health interventions, and public health and health promotion activities. In early 2010, the Agency for Healthcare Research and Quality (AHRQ) identified the need to establish a national Healthcare Horizon Scanning System to generate information to inform comparative-effectiveness research investments by AHRQ and other interested entities. AHRQ makes those investments in 14 priority areas. For purposes of horizon scanning, AHRQ’s interests are broad and encompass drugs, devices, procedures, treatments, screening and diagnostics, therapeutics, surgery, programs, and care delivery innovations that address unmet needs. Thus, we refer to topics identified and tracked in the AHRQ Healthcare Horizon Scanning System generically as “interventions.” The AHRQ Healthcare Horizon Scanning System implementation of a systematic horizon scanning protocol (developed between September 1 and November 30, 2010) began on December 1, 2010. The system is intended to identify interventions that purport to address an unmet need and are up to 3 years out on the horizon and then to follow them up to 2 years after initial entry into the health care system.

Since that implementation, review of more than 18,000 leads about potential topics has resulted in identification and tracking of about 2,000 topics across the 14 AHRQ priority areas and 1 crosscutting area; about 550 topics are being actively tracked in the system.

Methods As part of the Healthcare Horizon Scanning System activity, a report on interventions deemed as having potential for high impact on some aspect of health care or the health care system (e.g., patient outcomes, utilization, infrastructure, costs) is aggregated twice a year. Topics eligible for inclusion are those interventions expected to be within 0–3 years of potential diffusion (e.g., in phase III trials or for which some preliminary efficacy data in the target population are available) in the United States or that have just begun diffusing and that have completed an expert feedback loop.

The determination of impact is made using a systematic process that involves compiling information on topics and issuing topic drafts to a small group of various experts (selected topic by topic) to gather their opinions and impressions about potential impact. Those impressions are used to determine potential impact. Information is compiled for expert comment on topics at a granular level (i.e., similar drugs in the same class are read separately), and then topics in the same class of a device, drug, or biologic are aggregated for discussion and impact assessment at a class level for this report. The process uses a topic-specific structured form with text boxes for comments and a scoring system (1 minimal to 4 high) for potential impact in seven parameters. Participants are required to respond to all parameters.

The scores and opinions are then synthesized to discern those topics deemed by experts to have potential for high impact in one or more of the parameters. Experts are drawn from an expanding database ECRI Institute maintains of approximately 150 experts nationwide who were invited and agreed to participate. The experts comprise a range of generalists and specialists in the health care sector whose experience reflects clinical practice, clinical research, health care delivery, health business, health technology assessment, or health facility administration perspectives. Each expert uses the structured form to also disclose any potential intellectual or financial conflicts of interest ES-1 (COIs). Perspectives of an expert with a COI are balanced by perspectives of experts without COIs.

No more than two experts with a possible COI are considered out of a total of the five to eight experts who are sought to provide comment for each topic. Experts are identified in the system by the perspective they bring (e.g., clinical, research, health systems, health business, health administration, health policy).

The topics included in this report had scores and/or supporting rationales at or above the overall average for all topics in this priority area that received comments by experts. Of key importance is that topic scores alone are not the sole criterion for inclusion—experts’ rationales are the main drivers for the designation of potentially high impact. We then associated topics that emerged as having potentially high impact with a further subcategorization of “lower,” “moderate,” or “higher” within the high-impact-potential range. As the Healthcare Horizon Scanning System grows in number of topics on which expert opinions are received and as the development status of the interventions changes, the list of topics designated as having potentially high impact is expected to change over time. This report is being generated twice a year.

For additional details on methods, please refer to the full AHRQ Healthcare Horizon Scanning System Protocol and Operations Manual published on AHRQ’s Effective Health Care Web site.

Results The table below lists the six topics for which (1) preliminary phase III data for drugs, at least phase II or equivalent data for devices and procedures, or some human data for off-label uses or programs were available; (2) information was compiled by May 15, 2014, in this priority area; and (3) we received five to eight sets of comments from experts between July 1, 2013, and May 23, 2014. (Twenty-two topics in this priority area were being tracked in the system as of May 15, 2014.) For this report, we aggregated related topics for summary and discussion (e.g., individual drugs into a class). We present five summaries on topics (indicated below by an asterisk) that emerged as having higher-impact potential on the basis of experts’ comments and assessment of potential impact.

The material on interventions in this Executive Summary and report is organized alphabetically by disease state and then by intervention. Readers are encouraged to read the detailed information on each intervention that follows the Executive Summary.

–  –  –



Pages:   || 2 | 3 | 4 | 5 |   ...   | 9 |


Similar works:

«DRUG FORMULARY Updated after HEY Drug and Therapeutics Committee meeting Of September 2013 This formulary is used and maintained by Hull and East Yorkshire Hospitals NHS Trust. It is also used as a formulary by Humber Foundation NHS Trust (HFT) and City Health Care Partnership (CHCP). The formulary has been agreed with Hull Clinical Commissioning Group and East Riding of Yorkshire Clinical Commissioning Group with the expectation that providers within Hull and East Riding will prescribe and...»

«Social Cognitive and Affective Neuroscience Advance Access published May 7, 2012 The Effect of Meditation on Brain Structure: Cortical Thickness Mapping and Diffusion Tensor Imaging Running title: Meditation Effects on Brain Structure Do-Hyung Kang1, Hang Joon Jo2, Wi Hoon Jung3, Sun Hyung Kim4, Ye-Ha Jung3, Chi-Hoon Choi5, Ul Soon Lee6, Seung Chan An6, Joon Hwan Jang1, Jun Soo Kwon1,3,7,* Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea,...»

«Grief: An Overview Stephanie Eckhaus, LCSW Dr. Desai: Welcome to the Kaiser Permanente HealthCast. My name is Dr. Kavin Desai and I’ll be your host today. Today we’re going to be speaking about something that all of us have experienced at one time or another in our lives. Whether it’s the loss of a pet, a loved one, or a job, we have all experienced grief in one form or another. And today, to help us understand that topic better, we have in our studio Stephanie Eckhaus, who is a Licensed...»

«PATIENT MEALS Food Standards The Food Standards aim to reduce the prevalence of chronic disease, such as obesity, diabetes and cardiovascular disease, by improving dietary intake. This document outlines standards for foods purchased and meals and snacks served, with the goal of improving the health of all New Yorkers served by hospitals. These standards apply to regular diet patient meals.Hospitals and their contractors are expected to follow the standards described in each of the four...»

«Package leaflet: Information for the user Lisvy 60 micrograms/24 hours + 13 micrograms/24 hours transdermal patch gestodene/ethinylestradiol This medicine is subject to additional monitoring. This will allow quick identification of new safety information. You can help by reporting any side effects you may get. See the end of section 4 for how to report side effects.Important things to know about combined hormonal contraceptives (CHCs):  They are one of the most reliable reversible methods of...»

«Something to think About motivAtionS, AttitudeS, PercePtionS And SkillS in Work heAlth And SAfety SePtember 2011 Something to Think About – Motivations, Attitudes, Perceptions and Skills in Work Health and Safety A Review of the Literature on Socio-Psychological Factors and Their Influence on Organisations’ and Individuals’ Responses to Regulation Dr Liz Bluff Regulatory Institutions Network Australian National University Report prepared for Safe Work Australia August 2011 Disclaimer The...»

«The diagnosis of death by neurological criteria in infants less than two months old April 2015 Updated recommendations Implications for practice The diagnosis of death by neurological criteria in infants less than two months old © Royal College of Paediatrics and Child Health 2015 Executive summary This document considers the diagnosis of death by neurological criteria (DNC) in infants from 37 weeks corrected gestation (post menstrual) to two months (post term) of age. Previous guidance1,2 has...»

«c 2004 Council for the Central Laboratory of the Research Councils Implementation of Nudged Elastic Band in CRYSTAL C.L. Bailey a,∗, A. Wander a, B.G. Searle a, and N.M. Harrison a,b a Computational Science and Engineering Department, CCLRC Daresbury Laboratory, Warrington, Cheshire WA4 4AD, UK b Department of Chemistry, Imperial College of Science, Technology and Medicine, London SW7 2AZ, UK Abstract Locating transition states and energies is a very important problem in many areas of...»

«Support AWA Files, fill out a quick survey http://blm.bz/43B Support AWA Files, fill out a quick survey http://blm.bz/43B MUAY THAI—THE ART OF 8 LIMBS Support AWA Files, fill out a quick survey http://blm.bz/43B Support AWA Files, fill out a quick survey http://blm.bz/43B MUAY TIM—THE ART OF 8 TOOLS Support AWA Files, fill out a quick survey http://blm.bz/43B Support AWA Files, fill out a quick survey http://blm.bz/43B Support AWA Files, fill out a quick survey http://blm.bz/43B...»

«September 30, 2013 CURRICULUM VITAE Paul Muntner ADDRESS Office Address Department of Epidemiology University of Alabama at Birmingham 1665 University Boulevard, Suite 230J Birmingham, AL Mail Address Department of Epidemiology University of Alabama at Birmingham RPHB 230J Birmingham, AL 35294 Office Telephone (205) 975-8077 Fax (205) 934-8665 E-mail pmuntner@uab.edu EDUCATION Degrees B.S. (Electrical Engineering), May 1991 University of Rochester Rochester, New York Master of Health Sciences...»

«E-ALERT | Food & Drug August 9, 2010 SUMMARY OF FDA ADVERTISING AND PROMOTION ENFORCEMENT ACTIVITIES JUNE 2010 This e-alert is part of a monthly series of e-alerts summarizing publicly-available FDA enforcement letters (i.e., warning letters and untitled letters) relating to the advertising and promotion of drugs, biologics, and medical devices. In June 2010, FDA’s Division of Drug Marketing, Advertising, and Communications (DDMAC) posted the following five enforcement letters (all untitled)...»

«Public Accounts Committee Report on General Report on the Health and Social Care Sector 2012-13 and 2013-14 To g e t he r wi t h t h e Mi n u t e s o f P ro ce ed i n g s o f t h e Co mmi t t e e re l a t in g t o t he Re po rt an d th e Mi nu t e s o f E vi de n ce O rd e re d b y t he Pub l i c A ccou n t s Co mmi t t e e to be p rin t ed o n 2 5 No ve mb e r 2 01 5 This report is the property of the Public Accounts Committee. Neither the report nor its contents should be disclosed to any...»





 
<<  HOME   |    CONTACTS
2016 www.dissertation.xlibx.info - Dissertations, online materials

Materials of this site are available for review, all rights belong to their respective owners.
If you do not agree with the fact that your material is placed on this site, please, email us, we will within 1-2 business days delete him.