Health tech prelim

• Health Technology Assessment is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of health technology in a systematic, transparent, unbiased, robust manner.
• The purpose of Health Technology Assessment is to inform decision makers about what is known and what is not known about a technology, with the goal of creating policies that get the right treatment to the right patient at the right time at the right cost.
• Health Technology Assessment can be described in three ways: Physical nature, Drugs, Biologics, Devices, equipment and supplies, Medical and surgical procedures, Public health programs, Support systems, Organizational and managerial systems.
• Prevention in Health Technology Assessment is to protect against disease by preventing it from occurring, reducing the risk of its occurrence, or limiting its extent or sequelae, such as immunization and hospital infection control program.
• Internal : degree of confidence that the causal relationship being tested is trustworthy and not influenced by other factors or variables External : extent to which results from a study can be applied (generalized) to other situations, groups or events.
• Operating Characteristics of Diagnostic Test Characteristics Definition Sensitivity Proportion of people with condition who test positive Specificity Proportion of people without condition who test negative Predictive positive result Proportion of people with positive test who have condition Predictive negative result Proportion of people with negative test who do not have conditionAccuracy – the degree to which a measurement represents the true value of something
• Validity – the extent to which the study measures what is intended to measure
• Lack of validity – Bias or systematic error Lack of precision – Random error
• Precision – the degree of closeness among study results, where the study to be repeated under similar circumstances
• Relatability : a measure of how dependably an observation is exactly the same when repeated
• Screening in Health Technology Assessment is to detect a disease, abnormality, or associated risk factors in asymptomatic people, such as pap smear, tuberculin test, and serum cholesterol testing.
• Diagnosis in Health Technology Assessment is to identify the cause and nature or extent of disease in a person with clinical signs or symptoms, such as serological test for typhoid and x-ray for possible broken bone.
• Technology oriented assessments in health technology assessment are intended to determine the characteristics or impacts of particular technologies.
• Project oriented assessment in health technology assessment focus on a local placement or use of a technology in a particular institution, program, or other designated project.
• Colectomy was once used to treat epilepsy, and gastric freezing was used for peptic ulcer.
• Purposes of health technology assessment include advising regulatory agencies about whether to allow the commercial use of a drug, device, or other regulated technology, advising clinicians and patients about the appropriate use of health care interventions for a particular patients clinical needs and circumstances, supporting decision by healthcare technology companies about product development and marketing, researching agencies about evidence gaps and unmet health needs, and supporting government health officials about undertaking public health programs.
• Properties and impacts assessed in health technology assessment include technical properties, safety, efficacy and/or effectiveness, economic attributes or impacts, and social, legal, ethical, and political impacts.
• Target groups of health technology assessment (HTA) include politicians and civil servants at national or regional levels, planners at county or hospital levels, administrations in hospitals or clinical departments, organizations and companies, and citizens in general.
• Problem oriented assessments in health technology assessment focus on solutions or strategies for managing a particular disease, condition, or other problem for which alternative or complementary technologies might be used.
• Health outcome variables are used to measure the safety, efficacy, and effectiveness of health care technologies.
• Treatment in Health Technology Assessment is to improve or maintain health status or avoid further deterioration, such as antiviral therapy and coronary artery bypass graft surgery.
• Rehabilitation in Health Technology Assessment is to restore, maintain or improve a physically or mentally disabled person's function and well-being, such as exercise program for stroke treatments.
• Quality of life is defined as "those aspects of life and human function considered essential for living fully", which can include components of one environment such as attributes of housing, neighborhood, community that relate to comfort, safety, absence of crime.
• QALYs are used to quantify the cost-effectiveness studies, for instance, a new medicine versus the current one.
• There are 5 distinct health concepts that belong in the domain of health status: physical health, mental health, social functioning, role functioning, and general health perceptions; some add pain as a 6th key concept.
• There are three main types of HALYs: Quality adjusted life years (QALYs), Disability-adjusted life years (DALYs), and Healthy-years equivalents (HYEs).
• A surrogate endpoint is a measure (typically a biomarker) that is used as a substitute for a clinical endpoint of interest, such as morbidity and mortality.
• QALYs are usually used to represent years of life subsequent to a health care intervention that are outweighed or adjusted for the quality of life experienced by the patient during those years.
• Main categories of health outcomes are: Mortality (death rate), Quality of life, Morbidity (disease rate), Functional status, Adverse health events (harmful side effects), Patient satisfaction, Health status, sometimes denoted health-related quality of life, constitutes a complex, multidimensional construct.
• Health Adjusted Life Years (HALYs) recognize that changes in an individual's health status or the burden of population health should reflect not only the dimension of life expectancy but a dimension of quality of life or functional status.
• Quality of life measures, or health related quality of life measures or indexes, are increasingly used along with more traditional outcome measures to assess efficacy and effectiveness, providing a more complete picture of the ways in which health care affects patients.
• An intermediate endpoint is a non-ultimate endpoint (not mortality or morbidity) that may be associated with disease status or progression toward an ultimate endpoint.
• A biomarker is an objectively measured variable or trait that is used as an indicator of a normal biological process, a disease state, or effect of a treatment.
• QALY can be calculated using the following formula which assumes a utility value (quality of life) between 1 = perfect health; 0 = dead.
• Sensitivity measures the ability of a test to detect a particular disease when it is present.
• HALYs are not specific to a particular disease or condition.
• QALYs should be maximized and DALYs should be minimized.
• Negative predictive value is the probability of patients with a negative test result who actually do not have the disease.
• Asymptomatic patients can be tested for susceptibility (presence of a risk factor for a disease), presence of hidden or occult disease.
• Symptomatic patients can be tested for diagnosis, differential diagnosis, staging, prognosis, prediction, surveillance, monitoring.