Aim
Technological and computational advancements offer new tools for the collection and analysis of real-world data (RWD). Considering the substantial effort and resources devoted to collecting RWD, a greater return would be achieved if real-world evidence (RWE) was effectively used to support Health Technology Assessment (HTA) and decision making on medical technologies. A useful question is: To what extent are RWD suitable for generating RWE?
Methods
We mapped existing RWD sources in Europe for three case studies: hip and knee arthroplasty, transcatheter aortic valve implantation (TAVI) and mitral valve repair (TMVR), and robotic surgery procedures. We provided a comprehensive assessment of their content and appropriateness for conducting the HTA of medical devices. The identification of RWD sources was performed combining a systematic search on PubMed with gray literature scoping, covering fifteen European countries.
Results
We identified seventy-one RWD sources on arthroplasties; ninety-five on TAVI and TMVR; and seventy-seven on robotic procedures. The number, content, and integrity of the sources varied dramatically across countries. Most sources included at least one health outcome (97.5%), with mortality and rehospitalization/reoperation the most common; 80% of sources included resource outcomes, with length of stay the most common, and comparators were available in almost 70% of sources.
Conclusions
RWD sources bear the potential for the HTA of medical devices. The main challenges are data accessibility, a lack of standardization of health and economic outcomes, and inadequate comparators. These findings are crucial to enabling the incorporation of RWD into decision making and represent a readily available tool for getting acquainted with existing information sources.
Conservation challenges occur in complex social-ecological systems that require scientists and practitioners to recognize and embrace that humans are active agents within these systems. This interdependence of the social and ecological components of systems necessitates effective leadership to address and solve conservation problems successfully. Although conservation practitioners increasingly recognize leadership as critical to achieve conservation goals, clarity about the term leadership remains elusive in terms of specific strategies and behaviours. Our objective in this review of conservation leadership scholarship was to build on prior literature to conceptualize and define the behavioural leadership strategies that lead to successful conservation outcomes. Following an initial review of more than 1,200 peer-reviewed publications, we conducted a systematic review of 59 articles utilizing an inductive analysis approach and identified a set of five leadership domains that contribute to positive conservation outcomes: (1) stakeholder engagement, (2) trust, (3) vision, (4) individual champion, and (5) excellence in internal attributes. Each domain is defined by 2–4 behaviours that we consider leadership practices. To sustain meaningful progress toward global conservation of biodiversity, conservation scientists and practitioners must embrace and invest in leadership as an integral component of solving our collective conservation challenges.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.