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                                Adobestock-188830004
                                ©ktdesign

                                FoundationOne®CDx: genetic profiling of solid tumours

                                Biomarkers have become enormously important in oncology in recent years. As so-called “personalised medicine,” they support clinical decisions to assess patients, i.e., their tumours, with regard to response to therapies. Multi-gene panels (such as FoundationOne®Cdx) are just starting to be offered for comprehensive molecular-genetic tumour profiling, enabling the simultaneous analysis of a few to several hundred genetic alterations in disease genes. The health policy issue is whether multi-gene diagnostics using gene panels will lead to better clinical outcomes than conventional, single-biomarker stratification.

                                Publication: Rapid Assessment No. 14: https://eprints.aihta.at/1215/
                                Contact: Claudia Wild

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                                Adobestock-842151282
                                ©John Smith

                                Screening for Diabetes mellitus: guideline recommendations

                                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.

                                Publication: LBI-HTA Project report No. 118: https://eprints.aihta.at/1213/

                                Contact: Claudia Wild

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                                Adobestock-287366133
                                ©Robert Kneschke

                                Screening and prevention programmes for children and adolescents from 6 to 14 years

                                Part I: Overview of screening and prevention programmes in other countries
                                Part II: Recommendations from evidence-based guidelines (guideline synopsis)

                                In Austria, the "Mutter-Kind-Pass” (the “mother-child pass") is a screening instrument for children up to the age of 5 years. There are currently no (universal) routine screenings in Austria for children and adolescents older than 6 years. In the present two-part report we researched and presented screening programmes in 9 countries and we identified evidence-based guidelines in guideline databases and via websites of relevant institutions and summarised their recommendations.

                                Publication: LBI-HTA Project report No. 106: https://eprints.aihta.at/1212/

                                Contact: Roman Winkler, Inanna Reinsperger

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                                Fotolia-14918338-xl13
                                ©JWPhoto

                                Re-orientation of the Austrian parent-child preventive care programme. Part XI: Further development of the mother-child-pass: Screening recommendations of the expert working group for pregnancy, puerperium and early childhood (0-6 years)

                                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.

                                Publication: LBI-HTA Project report No. 92: https://eprints.aihta.at/1163/

                                Contact: Inanna Reinsperger

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                                Adobestock-561035461
                                ©abhijith3747

                                Irreversible electroporation for the treatment of liver and pancreatic cancer

                                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.

                                There is insufficient evidence that IRE is more effective/safe or at least as effective/safe as the conventional standard of care (chemotherapy, chemoradiotherapy or palliative therapy) in the treatment of inoperable LAPC or that IRE is more effective/safe or at least as effective/safe as the conventional standard of care (TACE, sorafenib or palliative therapy) in the treatment of primary or secondary inoperable liver cancer that is not suitable for thermal ablation.

                                Publication: LBI-HTA Project report No. 119: https://eprints.aihta.at/1211/)

                                Contact: Eva Fuchs

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                                2140
                                ©Juan Gärtner

                                Horizon Scanning in Oncology - Reports

                                We are pleased to introduce our new HSO report.

                                DSD HSO No. 89
                                Brentuximab vedotin (Adcetris®) in combination with chemotherapy for CD30-positive peripheral T-cell lymphoma (PTCLs)

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                                Adobestock-137317687
                                ©jean song

                                Custom-made or customisable 3D printed implants and cutting guides versus non- 3D printed standard implants and cutting guides for improving outcome in patients undergoing knee, maxillofacial, or cranial surgery

                                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.

                                Publication: LBI-HTA Projektbericht Nr. 117:  https://eprints.aihta.at/1209/

                                Contact: Sabine Ettinger

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                                2416
                                ©AdobeStock

                                Evaluation of individual medical procedures 2019 - Reports

                                We are pleased to introduce our new reports.

                                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

                                 

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                                2139
                                ©Juan Gärtner

                                Horizon Scanning in Oncology - Reports

                                We are pleased to introduce our new HSO report.

                                DSD HSO No. 88
                                Darolutamide for the treatment of patients with nonmetastatic castration-resistant prostate cancer (CRPC)

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                                Fotolia-76406533-m33

                                Robot-assisted surgery in thoracic and visceral indications

                                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.

                                Publication: LBI-HTA Project report No. 108: https://eprints.aihta.at/1198/

                                Contact: Louise Schmidt

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