Lecture 1: Technology Assessment and Health Data Flashcards
Material Nature Groups
- Drugs
- Biologics
- Devices, equipment, and supplies
- Medical/Surgical procedures
- Support System
- Organizational and Managerial Systems
Purpose and Application Groups
- Prevention
- Screening
- Diagnosing
- Treating
- Rehabilitation
Tech Purpose - Prevention
Health interventions designed to prevent a patient from developing a disease.
Tech Purpose - Screening
A test given to members of a defined population, not necessarily at rick, to identify individuals who would benefit by further testing for diagnosis.
Tech Purpose - Diagnosing
Identification of a disease through, signs, symptoms, imaging, and various biochemical markers
Tech Purpose - Treating
Intervention to cure or reduce symptoms of a disease
Tech Purpose - Rehabilitation
Process of restoring skills lost to illness or injury
Health Technology Assessment
Is a multidisciplinary field of policy analysis. It studies the
medical, social, ethical, and economic implications of
development, diffusion, and use of health technology
Patient and Societal Outcomes
- Direct and indirect effects
- Efficacy
- Effectiveness
- Safety
- Ethical concerns
Who uses HTA?
- Health product makers
- Regulators
- Clinicians
- Patients
- Hospitals
- Managers
- Government Leaders
US Preventative Task Forces
Makes recommendations about clinical preventive services. Has Grades A-D and I Statement.
What type of data is gathered for an HTA?
- Data on the population
- Vital statistics
- Health statistics
- Statistics about helath services
Name the 2 types of Epimemiologic Studies
- Experimental (Randomized Clinical Trials)
- Observational
What is an Experimental Epidemiological Study?
– Takes two populations with similar conditions and randomly,
and blindly assigns one group a new “treatment” and the
other a placebo or standard care. Used to determine causation.
What is an Observational Epidemiological Study?
– Looks at two populations that had been previously assigned a
control vs. treatment group and assesses the differences
between the groups over time. Gives correlations or associations.
When do you use an Observational Study?
- Ethical concerns
- When study parameters may be rare, or difficult to cause
- When researches do not have a control
What can an Observational Study do?
- Provide indications of benefits and risk
- Give motivation to o controlled randomized experiments
What are the limitations of an Observational Study?
- Cannot make statements about safety, efficacy, or effectiveness
- Cannot determine causes
- Can have bias0some things end up not reported, people receiving the “treatment” is not random
Longitudinal Observational Study
Follows individuals over time to track changes with the same variable, repeated observation, can be retroactive.
Cross-sectional Observational Study
Describes feature of population such as prevalence of illness, relative risk and association
Association
Statistical dependence between two or more events
Relative Risk (RR)
Asses the strength of an association.
RR = 1 no risk,
RR > 1 means increased risk
RR < 1 means protective effect
Incidence
Number of new cases of disease in a population over a period of time
Annual Incidence Rate = # of new cases (in 1 year)/# in that population (at mid year)
Prevalence
Number of existing cases of the disease in a population at a given time
Point Prevalence = # of total cases at one time/ # in that population at same time point
Mortality Rate
Number of deaths
- Specific for disease
Mortality Rate = # of deaths in a defines population/ # in that population mid year
(can be adapted for a subset population - Infant Mortality Rate)
Morbidity
- Degree or severity of disease
- Hard to define
Disability-Adjusted Life Year (DALY)
- Years of life lost due to ill health, disability, or premature death
- Measure overall disease burden (combines mortality and morbidity)
DALY = YYL + YLD
Years of Life Lost = life expectancy - age of death
Years Lost to Disability = duration of disability x disability weight
Developed Country
Has a higher standard of living and diversified economy
Developing Country
Low per capital income and a Lower Human Development Index (Education, Health, Income)
Purchasing Power Parity
Convert currencies based upon an equivalent basket of good and services
What is the criteria for Least Developed Country (LDC)
- GDP per capita $900 to graduate
- Human resource weakness
- Economic vulnerabiltiy
Disparcity
Inequality, large differences
What are indicators of disparity?
- Avg. annual per capital health expenditure
- Low Human Development Index (HDI)
Burden of disease (DALYs) - Infant mortality rate
What are some of the health risk in an informal settlement?
- Sanitation (cholera and other diarrheal diseases)
Sensitivity (Se)
Given DISEASE, screening test is POSITIVE. Able to correctly detect disease.
Se = TP/(# with disease)
Specificity (Sp)
Given NO DISEASE, screening test is NEGATIVE. Ability to avoid calling normal things disease
Se = TN/(# without disease)
Positive Prevalence Value (PPV)
Probability that given a positive test result, you have DISEASE
PPV = TP/(TP+FP)
Negatieve Prevalence Value (NPV)
Probability that given a NEGATIVE test result, you do NOT HAVE DISEASE
NPV = TN/(TN+FN)
