Health technology assessment in the era of personalized health care

Becla, Lidia; Lunshof, Jeantine E.; Genevieve, David; Bäumen, Tobias Schulte in den; Westerhoff, Hans V.; Lange, Bodo; Brand, Angela

doi:10.1017/s026646231100002x

Cited by 28 publications

(33 citation statements)

References 21 publications

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“…Since cancer consists of molecular defects that affect biological processes at the cellular level and in turn affects the whole person (a systems biology disease), treatment should be based on the individual disease, which is personalizing medicine. Cancer treatment centers need molecular analysis systems that are fully automated with high-throughput, as well as cross-institutional electronic health records (EHRs) to fully understand the disease and family history [23]. EHRs can be used to promote multidisciplinary practice through improved informational flow and access in an organizational setting [24].…”

Section: The Integrated Practice Unit Model For Cancermentioning

confidence: 99%

“…EHRs can be used to promote multidisciplinary practice through improved informational flow and access in an organizational setting [24]. HTA can be used when implementing such systems to ensure the most effective equipment will be utilized [23].…”

Section: The Integrated Practice Unit Model For Cancermentioning

confidence: 99%

“…Multidisciplinary work can provide unity, meaning specialist communicate and collaborate to provide the best care to each patient [23,24]. In a study conducted by Oborn, Barrett, and Davidson, a multidisciplinary team utilized a health information technology (HIT) application to promote collaboration and coordination [24].…”

Section: The Integrated Practice Unit Model For Cancermentioning

confidence: 99%

See 2 more Smart Citations

Systematic Review of Emerging Models of Cancer Care: Implications for the Health Industry

Kash¹,

McKahan²,

Mack³

et al. 2017

J Integr Oncol

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Background: Cancer is now a chronic disease in the United States, with about 1.6 million new cases diagnosed annually. Emerging models of cancer care are beginning to make headway to ensure each patient is receiving the most appropriate, fully coordinated, quality, patient-centered care needed to achieve the best long-term outcomes. This paper presents five emerging models of cancer care found from a systematic literature review and discusses the implications such models have on facility design.

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Section: The Integrated Practice Unit Model For Cancermentioning

confidence: 99%

Section: The Integrated Practice Unit Model For Cancermentioning

confidence: 99%

Section: The Integrated Practice Unit Model For Cancermentioning

confidence: 99%

See 1 more Smart Citation

Systematic Review of Emerging Models of Cancer Care: Implications for the Health Industry

Kash¹,

McKahan²,

Mack³

et al. 2017

J Integr Oncol

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show abstract

“…However, it is unlikely that payers would subsidize population-based testing and treatments solely on the basis of n-of-1 studies [58]. An alternative could be the…”

Section: Review Merlinmentioning

confidence: 99%

The Use of the ‘Linked Evidence Approach’ to Guide Policy on the Reimbursement of Personalized Medicines

Merlin¹

2014

Personalized Medicine

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It is uncommon to find published clinical trials that measure the health benefits of medical testing. As a consequence, policy makers often have to decide whether access to, or public funding of, medical tests is warranted without knowing the clinical impact of testing on the patient. In the situation where a policy maker is considering a companion genetic test and tailored drug therapy, deficiencies in the evidence base are exacerbated because two technologies need to be assessed and the proposed genetic biomarker needs to be validated. The Linked Evidence Approach (LEA) is a methodology that was developed in 2005 to cope with inadequacies in the evidence supporting medical test evaluations. In 2010 the approach was adapted to the evaluation of pharmacogenetic interventions. This article describes how LEA and similar analytic frameworks are used internationally, highlights particular challenges with the approach, and proposes ways that LEA might be applied to pharmacogenomic interventions.

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“…Also, ELSI can be limited to one perspective: the industrial and not the population based perspective. Taking into account future developments such as ‘truly' personalized medicine moving from clinical utility to personal utility and the use of ‘personal-genome tests' [66], current HTA as a tool for decision-making will be challenged [67]. Current HTA evaluates a technology on the population or subpopulation, but not on an individual level, which will be the need in the era of ‘truly' personalized medicine.…”

Section: Phg Approached and Translation Into Public Healthmentioning

confidence: 99%

<b><i>Chlamydia trachomatis</i></b> Infections and Subfertility: Opportunities to Translate Host Pathogen Genomic Data into Public Health

Lal¹,

Malogajski²,

Verweij

et al. 2013

Public Health Genomics

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Chlamydia trachomatis (CT) infections in women can result in tubal pathology (TP). Worldwide 10-15% of all couples are subfertile, meaning they did not get pregnant after 1 year. Part of the routine subfertility diagnostics is the Chlamydia Antibody Test (CAT) to decide for laparoscopy or not in order to diagnose TP. The CAT positive and negative predictive value is such that many unneeded laparoscopies are done and many TP cases are missed. Addition of host genetic markers related to infection susceptibility and severity could potentially improve the clinical management of couples who suffer from subfertility. In the present study, the potential translational and clinical value of adding diagnostic host genetic marker profiles on the basis of infection and inflammation to the current clinical management of subfertility was investigated. This review provides an overview of the current state of the art of host genetic markers in relation to CT infection, proposes a new clinical diagnostic approach, and investigates how the Learning-Adapting-Leveling model (LAL, a public health genomic (PHG) model) can be of value and provide insight to see whether these host genetic markers can be translated into public health. This review shows that the preliminary basis of adding host genetic marker profiles to the current diagnostic procedures of subfertility is present but has to be further developed before implementation into health care can be achieved. CT infection is an example in the field of PHG with potential diagnostic to be taken up in the future in the field of subfertility diagnosis with a time line for integration to be dependent on enhanced participation of many stakeholders in the field of PHG which could be advanced through the LAL model.

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Health technology assessment in the era of personalized health care

Abstract: Integrative, systems biology-based approaches toward personalized medicine call for novel assessment methods. The translation of their highly innovative technologies into the practice of health care requires the development of new HTA concepts.

Cited by 28 publications

References 21 publications

Systematic Review of Emerging Models of Cancer Care: Implications for the Health Industry

Systematic Review of Emerging Models of Cancer Care: Implications for the Health Industry

The Use of the ‘Linked Evidence Approach’ to Guide Policy on the Reimbursement of Personalized Medicines

<b><i>Chlamydia trachomatis</i></b> Infections and Subfertility: Opportunities to Translate Host Pathogen Genomic Data into Public Health

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