Announcements

In the process for the further development of the Austrian screening tool for pregnant women and children (“Mother-Child-Pass”), initiated by the Ministry of Health in 2014, after several reports conducted by the LBI-HTA, an interdisciplinary and multiprofessional expert working group formulated comprehensive (screening) recommendations for pregnancy, puerperium and childhood (0-6 years). The transparent and participatory process was finished in May 2018. The final report includes all protocols of the expert working group meetings as well as all submitted formal statements. Additionally, the recommendations were thematically structured by screening methods and by time.

Irreversible electroporation (IRE) is a non-thermal ablative process in which short but strong electric fields are generated using precisely placed needles and computer-controlled potential differences between these needles. In this way, pancreatic and liver tumors located near large blood vessels or other sensitive structures can be removed without damaging them.

3D printed custom-made or customisable implants and cutting guides are currently most frequently applied in knee, maxillofacial, and cranial surgery. Evidence of very low or low quality shows significant differences in precision in terms of malalignment and deviation between 3D printed technology and standard instrumentation in knee arthroplasty. Evidence of higher quality is needed to validate these significant results and draw final conclusions. No firm conclusions can be made in mandibular reconstruction and cranioplasty, since no outcomes were significant in favour of either technology. No statements regarding long-term safety outcomes can be made.

Decision Support Documents 2019:

• DSD 115: Osteochondral allograft transplantation for the knee (or other joints)
  http://eprints.hta.lbg.ac.at/1204
• DSD 116: Allograft for anterior and posterior cruciate ligament reconstruction
  http://eprints.hta.lbg.ac.at/1205
• DSD 117: Human dermal allograft for massive rotator cuff tears
  http://eprints.hta.lbg.ac.at//1206
• DSD 118: 177Lu-PSMA Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer
  http://eprints.hta.lbg.ac.at/1207

+4 Updates:

• DSD 65/1. Update 2019: Annulus Fibrosus Repair after lumbar discectomy http://eprints.hta.lbg.ac.at/1200
• DSD 98/1. Update 2019: Single-/two-step scaffold-based cartilage repair in the knee and ankle joint
  http://eprints.hta.lbg.ac.at/1201
• DSD 99/1. Update 2019: Radiofrequency denervation for lumbar and cervical facet joint pain – a systematic review
  http://eprints.hta.lbg.ac.at/1202
• DSD 100/1. Update 2019: Upper Airway Stimulation for Moderate-to-Severe Sleep Apnea
  http://eprints.hta.lbg.ac.at/1203

In robot-assisted surgery, the surgeons control the surgical instruments with a telemanipulator. The aim of our report was to investigate the efficacy and safety of robotic surgery compared to open surgery as well as conventional laparoscopy in thoracic and visceral indications. A total of 13 indications were investigated. There was insufficient evidence for the evaluation of efficacy in nine indications. Statements on effect were possible only for some of the outcomes in only four of the procedures (oesophagectomy, gastrectomy, rectal resection,cholecystectomy), for which the quality of the evidence was rated low to moderate. Since the current evidence is not sufficient to determine the added value of robot-assisted surgery compared to conventional surgical procedures, results of ongoing studies are awaited.

Advanced Therapy Medicinal Products" (ATMP) is the umbrella term for three classes of medicinal products: somatic cell therapy medicinal products, gene therapy medicinal products and biotechnologically processed tissue preparations [also known as tissue engineering products (TEP)], as well as combination products. These drugs contain or mostly consist of living cells or tissues and are therefore highly complex. The cells used are often taken from a patient, processed in the laboratory (e.g. increased or genetically modified) and then administered again to the same patient.

Vulnerable groups, such as homeless and non-insured people, have a poorer physical and mental health status than comparable populations and usually have no or difficult access to standard health care. Social organisations provide basic health and social care services for these groups of people. Against this background, we searched for evaluation methods for the benefit assessment of easily accessible, outpatient health centers and described the methods, indicators, and instruments used in evaluation studies and reports of comparable services.