This study examines European decision makers' consideration and use of quantitative preference data. Methods:The study reviewed quantitative preference data usage in 31 European countries to support marketing authorization, reimbursement, or pricing decisions. Use was defined as: agency guidance on preference data use, sponsor submission of preference data, or decision-maker collection of preference data. The data could be collected from any stakeholder using any method that generated quantitative estimates of preferences. Data were collected through: (1) documentary evidence identified through a literature and regulatory websites review, and via key opinion leader outreach; and (2) a survey of staff working for agencies that support or make healthcare technology decisions.Results: Preference data utilization was identified in 22 countries and at a European level. The most prevalent use (19 countries) was citizen preferences, collected using time-trade off or standard gamble methods to inform health state utility estimation. Preference data was also used to: (1) value other impact on patients, (2) incorporate non-health factors into reimbursement decisions, and (3) estimate opportunity cost. Pilot projects were identified (6 countries and at a European level), with a focus on multi-criteria decision analysis methods and choice-based methods to elicit patient preferences. Conclusion:While quantitative preference data support reimbursement and pricing decisions in most European countries, there was no utilization evidence in European-level marketing authorization decisions. While there are commonalities, a diversity of usage was identified between jurisdictions. Pilots suggest the potential for greater use of preference data, and for alignment between decision makers.
The emergence of an aging society is inevitable due to the continued increases in life expectancy and decreases in birth rate. These social changes require new smart healthcare services for use in daily life, and covid-19 has also led to a contactless trend necessitating more non-face-to-face health services. Due to the improvements that have been achieved in healthcare technologies, an increasing number of studies have attempted to predict and analyze certain diseases in advance. Research on stroke diseases is actively underway, particularly with the aging population. Stroke, which is fatal to the elderly, is a disease that requires continuous medical observation and monitoring, as its recurrence rate and mortality rate are very high. Most studies examining stroke disease to date have used MRI or CT images for simple classification. This clinical approach (imaging) is expensive and time-consuming while requiring bulky equipment. Recently, there has been increasing interest in using non-invasive measurable EEGs to compensate for these shortcomings. However, the prediction algorithms and processing procedures are both time-consuming because the raw data needs to be separated before the specific attributes can be obtained. Therefore, in this paper, we propose a new methodology that allows for the immediate application of deep learning models on raw EEG data without using the frequency properties of EEG. This proposed deep learning-based stroke disease prediction model was developed and trained with data collected from real-time EEG sensors. We implemented and compared different deep-learning models (LSTM, Bidirectional LSTM, CNN-LSTM, and CNN-Bidirectional LSTM) that are specialized in time series data classification and prediction. The experimental results confirmed that the raw EEG data, when wielded by the CNN-bidirectional LSTM model, can predict stroke with 94.0% accuracy with low FPR (6.0%) and FNR (5.7%), thus showing high confidence in our system. These experimental results demonstrate the feasibility of non-invasive methods that can easily measure brain waves alone to predict and monitor stroke diseases in real time during daily life. These findings are expected to lead to significant improvements for early stroke detection with reduced cost and discomfort compared to other measuring techniques.
Stroke is the third highest cause of death worldwide after cancer and heart disease, and the number of stroke diseases due to aging is set to at least triple by 2030. As the top three causes of death worldwide are all related to chronic disease, the importance of healthcare is increasing even more. Models that can predict real-time health conditions and diseases using various healthcare services are attracting increasing attention. Most diagnosis and prediction methods of stroke for the elderly involve imaging techniques such as magnetic resonance imaging (MRI). It is difficult to rapidly and accurately diagnose and predict stroke diseases due to the long testing times and high costs associated with MRI. Thus, in this paper, we design and implement a health monitoring system that can predict the precursors of stroke diseases in the elderly in real time during daily walking. First, raw electroencephalography (EEG) data from six channels were preprocessed via Fast Fourier Transform (FFT). The raw EEG power values were then extracted from the raw spectra: alpha (α), beta (β), gamma (γ), delta (δ), and theta (θ) as well as the low β, high β, and θ to β ratio, respectively. The experiments in this paper confirm that the important features of EEG biometric signals alone during walking can accurately determine stroke precursors and occurrence in the elderly with more than 90% accuracy. Further, the Random Forest algorithm with quartiles and Z-score normalization validates the clinical significance and performance of the system proposed in this paper with a 92.51% stroke prediction accuracy. The proposed system can be implemented at a low cost, and it can be applied for early disease detection and prediction using the precursor symptoms of real-time stroke. Furthermore, it is expected that it will be able to detect other diseases such as cancer and heart disease in the future.
Objective: This study aimed to overview and assess the effectiveness of the policies and regulations that have governed new drug access in Korea, and to propose policies to enhance patient access to drugs, particularly for new innovative medicines. Methods: We approached drug access issues in two perspectives: approval lag (or availability) and reimbursement lag (or affordability). The issues were identified and evaluated through the review of literature, public documents, reports published by the government agencies and private organizations, and news articles. Results: To shorten approval lag, it is recommended to hire and train more reviewers at the Ministry of Food and Drug Safety. Increasing user fees to a realistic level can facilitate this process. To reduce reimbursement lag, flexible incremental cost-effectiveness ratio threshold, alternative cost-effectiveness evaluation, and establishment of funding source other than the national health insurance are identified as the areas to be improved. Conclusion: The current policies and regulations had to be supplemented by new systems to drastically promote patient accessibility to new drugs, consequently in order to promote national public health.
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