Announcements

Registries are systems for collecting observational data on patients in a database. They can be used by decision-makers to improve healthcare. However, the number and type of existing registries in Austria are unknown. Therefore, the aim of this report was to provide an overview of the Austrian registry landscape and to present the quality and characteristics of selected registries. Furthermore, it was a goal to examine the utilisation of Austrian registries and whether some areas need further development.

Publication: HTA Project Report No. 157: https://eprints.aihta.at/1489/
Contact: Christoph Strohmaier

For children, adolescents and adults with overweight or grade 1 obesity, group programmes are offered which include content on nutrition, exercise and behaviour. However, it is a challenge to reach the respective target groups and to retain the participants in the programme for the entire duration. Based on the reviewed literature, numerous strategies for recruiting target groups and improving programme adherence were identified. In addition, an overview of existing programmes in German-speaking countries was provided.

Since 2017, three therapies have been approved by the FDA and EMA for the treatment of SMA patients: The results show clinically relevant improvements in motor skills in SMA type 1 patients, especially in patients with early treatment initiation and >=2 SMN2 copies, as well as stabilisation of health status in SMA type 2 to 4 patients. In all studies reporting these outcomes, no significant improvements in respiratory and nutritional function were recorded regardless of SMA type and therapy used, with most studies reporting no change or an increase in the need for ventilation and nutritional support.

20 observational studies and 1 RCT were included in the synthesis, reporting on a total of 1,374 patients. 15 studies investigated nusinersen in 948 patients, one study was identified on onasmenogene abeparvovec and investigated 12 patients, and two studies investigated risdiplam in 221 patients. 193 patients received combination therapy.

We performed a guideline synopsis to identify indications for the use of image-guided interventions and summarise the subsequent recommendations. We also considered potential organisational or social aspects.

Ten clinical guidelines fulfilled our eligibility criteria. Seven were related to epidural injections in four indications (axial discogenic pain, disc herniation, spinal stenosis, post-surgery syndrome) and five clinical guidelines on facet joint injections in one indication (axial facet joint pain). The majority are related to the lumbar spine. Only three guidelines on epidural injections and four on facet joint injections provided recommendations on imaging modalities.The synopsis of recommendation for epidural injections is inconsistent in two clinical indications, axial discogenic pain and spinal stenosis, with con-flicting recommendations across CGs. The same is true for facet joint injections, for both nerve block and intraarticular injections. The other two clinical indications for epidural injections, disc herniation and post-surgery syndrome, included both strong and weak recommendations for using epidural injections.

Community Nursing is a new model of care in Austria to strengthen the health of the elderly population. The literature review examines the cost-effectiveness of the concept and methods for presenting it. The results are inconclusive. The use of community nursing tends not to be cost-effective in the eleven identified studies, but methodological limitations may have biased the results. The studies are also older and largely not from Europe. Further research using more recent methodological findings from research on complex interventions and evaluation of public health interventions is needed.

Publication: HTA Project Report No. 153: https://eprints.aihta.at/1470/
Contact: Ingrid Zechmeister-Koss

Robotic-assisted surgery represents a technically advanced form of a minimally invasive procedure that claims to improve clinical outcomes as well as healthcare resource utilization. This report is an update of a systematic review from 2019, which examined the effectiveness and safety of robotic-assisted surgery in thoracic and visceral indications, compared to open surgery and conventional laparoscopy. In total, 14 indications were investigated, with no evidence identified for five indications. Due to the heterogeneous results and lack of evidence for some study endpoints, a general statement on the effectiveness and safety of robotic-assisted surgery is not possible.

Publication: HTA Project Report No. 108: https://eprints.aihta.at/1461
Contact : Nicole Grössmann-Waniek