Announcements

Diabetes mellitus is a rapidly increasing disease worldwide. In the Austrian Diabetes Report 2017, the number of people with diabetes mellitus in Austria is estimated at about 7 to 11%, with an assumed 30-35% not diagnosed. The—individually adapted—treatment of diabetes mellitus therefore aims to achieve freedom from symptoms and to prevent acute complications and serious secondary diseases. This project report examines whether screening in the general population is recommended in guidelines and, if so, what methods are used to recommend screening in subpopulations.

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)
  https://eprints.aihta.at/1204
• DSD 116: Allograft for anterior and posterior cruciate ligament reconstruction
  https://eprints.aihta.at/1205
• DSD 117: Human dermal allograft for massive rotator cuff tears
  https://eprints.aihta.at//1206
• DSD 118: 177Lu-PSMA Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer
  https://eprints.aihta.at/1207

+4 Updates:

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