Bridging health technology assessment and healthcare quality improvement using international consortium of health outcomes measurement standard sets

Objective Although health technology assessment (HTA) and healthcare quality improvement are distinct processes, a greater level of alignment in outcome measures used may increase the quality and efficiency of data collection. This study evaluates the agreement in outcome measures used in oncology for healthcare quality improvement and HTAs, and how these align to the International Consortium for Health Outcomes Measurement (ICHOM) standard sets. Methods We conducted a cross-sectional comparative analysis of ICHOM sets focusing on oncological indications and publicly available measures for healthcare quality and HTA reports published by the National Health Care Institute from the Netherlands and the National Institute for Health and Care Excellence from the United Kingdom. Results All ICHOM sets and HTAs used overall survival, whereas quality improvement used different survival estimates. Different progression estimates for cancer were used in HTAs, ICHOM sets, and quality improvement. Data on health-related quality of life (HRQoL) was recommended in all ICHOM sets and all HTAs, but selectively for quality improvement. In HTAs, generic HRQoL questionnaires were preferred, whereas, in quality improvement and ICHOM sets, disease-specific questionnaires were recommended. Unfavorable outcomes were included in all HTAs and all ICHOM sets, but not always for quality improvement. Conclusions Although HTA and quality improvement use outcome measures from the same domains, a greater level of alignment seems possible. ICHOM may provide input on standardized outcome measures to support this alignment. However, residual discrepancies will remain due to the different objectives of HTA and quality improvement.

FORMATION OF HEALTH'S SUSTAINABLE COMPETENCE AS A DIRECTION OF ACHIEVEMENT OF SUSTAINABLE DEVELOPMENT GOALS

The article reveals the urgency of the issue of health competence as a necessary condition for a healthy and safe life, which should contribute to the achievement of global goals of sustainable development of society. Emphasis is placed on the mission of education in the formation of the foundations of sustainable development, its functional purpose, content and effectiveness. Attention is drawn to the need to reorient domestic education towards sustainable development, in which the fourth component is defined as quality education. The normative-legal documents in the field of education are analyzed, which direct the educational process to the need for a holistic approach to the formation of health-preserving competence, indicate the need for a new understanding of the role of health, which will enable every citizen to live a full life. It is noted that the State Standard sets the competence approach as a system-forming factor in the development of personal qualities of students and the formation of a positive attitude to human health, pays attention to educational areas that provide health-oriented educational process. The study specifies the essence of the terms "health", "health", "competence approach", "health competence". It is noted that the established health competence of the graduate of the educational institution enriches the complex development of his personality on the basis of sustainable development of society. Emphasis is placed on innovative approaches to combining economic, social, health and environmental platforms to address pressing societal issues in a balanced way.

The Revenues: Changes in the Registration of This Accounting Item in Italy

In November 2021, the .Italian Accounting Board (OIC) issued a draft accounting standard concerning revenues accounting (draft accounting standard OIC 34 The Revenues). The standard sets out some exciting observations that can potentially apply in Italy and other countries that accept the considerations set out in the draft. In the article, the focus will be on what is imposed on medium and large-sized companies.

The NICE OECD countries’ geographic search filters: Part 2—validation of the MEDLINE and Embase (Ovid) filters

Objective: We previously developed draft MEDLINE and Embase (Ovid) geographic search filters for Organisation for Economic Co-operation and Development (OECD) countries to assess their feasibility for finding evidence about the countries. Here, we describe the validation of these search filters.Methods: We identified OECD country references from thirty National Institute for Health and Care Excellence (NICE) guidelines to generate gold standard sets for MEDLINE (n=2,065) and Embase (n=2,023). We validated the filters by calculating their recall against these sets. We then applied the filters to existing search strategies for three OECD-focused NICE guideline reviews (NG103 on flu vaccination, NG140 on abortion care, and NG146 on workplace health) to calculate the filters’ impact on the number needed to read (NNR) of the searches.Results: The filters both achieved 99.95% recall against the gold standard sets. Both filters achieved 100% recall for the three NICE guideline reviews. The MEDLINE filter reduced NNR from 256 to 232 for the NG103 review, from 38 to 27 for the NG140 review, and from 631 to 591 for the NG146 review. The Embase filter reduced NNR from 373 to 341 for the NG103 review, from 101 to 76 for the NG140 review, and from 989 to 925 for the NG146 review.Conclusion: The NICE OECD countries’ search filters are the first validated filters for the countries. They can save time for research topics about OECD countries by finding the majority of evidence about OECD countries while reducing search result volumes in comparison to no filter use.

Common patient-reported outcomes across ICHOM Standard Sets: the potential contribution of PROMIS®

Background The International Consortium for Health Outcomes Measurement (ICHOM) develops condition-specific Standard Sets of outcomes to be measured in clinical practice for value-based healthcare evaluation. Standard Sets are developed by different working groups, which is inefficient and may lead to inconsistencies in selected PROs and PROMs. We aimed to identify common PROs across ICHOM Standard Sets and examined to what extend these PROs can be measured with a generic set of PROMs: the Patient-Reported Outcomes Measurement Information System (PROMIS®). Methods We extracted all PROs and recommended PROMs from 39 ICHOM Standard Sets. Similar PROs were categorized into unique PRO concepts. We examined which of these PRO concepts can be measured with PROMIS. Results A total of 307 PROs were identified in 39 ICHOM Standard Sets and 114 unique PROMs are recommended for measuring these PROs. The 307 PROs could be categorized into 22 unique PRO concepts. More than half (17/22) of these PRO concepts (covering about 75% of the PROs and 75% of the PROMs) can be measured with a PROMIS measure. Conclusion Considerable overlap was found in PROs across ICHOM Standard Sets, and large differences in terminology used and PROMs recommended, even for the same PROs. We recommend a more universal and standardized approach to the selection of PROs and PROMs. Such an approach, focusing on a set of core PROs for all patients, measured with a system like PROMIS, may provide more opportunities for patient-centered care and facilitate the uptake of Standard Sets in clinical practice.

Major problems of microclimate indicator measurements indoors of residential and public buildings and ways to solve them

Human health and efficiency are largely determined by the microclimate conditions and the air quality in residential, public and industrial buildings in which people spend a significant amount of time. The existing methods of measuring microclimate indicators largely do not correspond to the changed regulatory framework, do not fully reflect all the stages of measurements, have contradictions and inaccuracies, which leads to errors in the measurement and evaluation of the results obtained. The purpose of this study was to develop guidelines for measuring microclimate indicators in residential and public buildings, leveling the existing contradictions in the current documents and meeting modern requirements. The analysis of the current methodological documents regulating the requirements for measuring microclimate indicators was carried out, the main problems encountered by specialists during measurements and evaluation of laboratory and instrumental studies of the microclimate were identified and systematized. To date, the only methodological document in the field of microclimate for residential and public buildings is GOST 30494-2011 "Residential and public buildings. Indoor microclimate parameters". This standard sets the requirements for the organization of control and allows to measure and evaluate the microclimate in almost any residential and public building. However, the standard presents requirements for measurement conditions that are practically unrealizable for many regions of Russia, unreasonably high requirements for measuring instruments (MI), which do not allow to take measurements by MI included in the State Register and having the appropriate scope of application, insufficient requirements for the criteria for the selection of premises and their preparation for an objective assessment of the microclimate parameters, inaccuracies in the presented formulas for calculating the resulting room temperature and inconsistencies in individual paragraphs of the document. There are also no requirements for processing and presenting measurement results. In this situation, the development of a methodology for measuring microclimate indicators in residential and public buildings is extremely relevant. This paper presents the main provisions of the developed draft methodology for measuring microclimate indicators in residential and public buildings at different stages of operation of research objects. The developed procedural guidelines determine the order, conditions for carrying out and minimum scope of instrumental control required for microclimate parameters in residential and public buildings that meet the requirements of sanitary legislation. In the process of procedural guidelines development inconsistencies and discrepancies of current procedural documents were considered as much as possible.

Leveraging supervised learning for functionally informed fine-mapping of cis-eQTLs identifies an additional 20,913 putative causal eQTLs

The large majority of variants identified by GWAS are non-coding, motivating detailed characterization of the function of non-coding variants. Experimental methods to assess variants’ effect on gene expressions in native chromatin context via direct perturbation are low-throughput. Existing high-throughput computational predictors thus have lacked large gold standard sets of regulatory variants for training and validation. Here, we leverage a set of 14,807 putative causal eQTLs in humans obtained through statistical fine-mapping, and we use 6121 features to directly train a predictor of whether a variant modifies nearby gene expression. We call the resulting prediction the expression modifier score (EMS). We validate EMS by comparing its ability to prioritize functional variants with other major scores. We then use EMS as a prior for statistical fine-mapping of eQTLs to identify an additional 20,913 putatively causal eQTLs, and we incorporate EMS into co-localization analysis to identify 310 additional candidate genes across UK Biobank phenotypes.

Content comparison and person-centeredness of standards for quality improvement in cardiovascular health care

Background Quality standards are important for improving health care by providing compelling evidence for best practice. High quality person-centered health care requires information on patients' experience of disease and of functioning in daily life. Objective To analyze and compare the content of five Swedish National Quality Registries (NQRs) and two standard sets of the International Consortium of Health Outcomes Measurement (ICHOM) related to cardiovascular diseases. Materials and methods An analysis of 2588 variables (= data items) of five NQRs—the Swedish Registry of Congenital Heart Disease, Swedish Cardiac Arrest Registry, Swedish Catheter Ablation Registry, Swedish Heart Failure Registry, SWEDEHEART (including four sub-registries) and two ICHOM standard sets–the Heart Failure Standard Set and the Coronary Artery Disease Standard Set. According to the name and definition of each variable, the variables were mapped to Donabedian’s quality criteria, whereby identifying whether they capture health care processes or structures or patients’ health outcomes. Health outcomes were further analyzed whether they were clinician- or patient-reported and whether they capture patients’ physiological functions, anatomical structures or activities and participation. Results In total, 606 variables addressed process quality criteria (31%), 58 structure quality criteria (3%) and 760 outcome quality criteria (38%). Of the outcomes reported, 85% were reported by clinicians and 15% by patients. Outcome variables addressed mainly ‘Body functions’ (n = 392, 55%) or diseases (n = 209, 29%). Two percent of all documented data captured patients’ lived experience of disease and their daily activities and participation (n = 51, 3% of all variables). Conclusions Quality standards in the cardiovascular field focus predominately on processes (e.g. treatment) and on body functions-related outcomes. Less attention is given to patients’ lived experience of disease and their daily activities and participation. The results can serve as a starting-point for harmonizing data and developing a common person-centered quality indicator set.