Pub Date : 2019-05-22DOI: 10.17749/2070-4909.2019.12.1.34-41
N. Zhuravleva, L. C. Shubina, O. Sukhorukikh
Aim – analyze the existing systems for assessing the levels of evidence (LE-scales) and grades of recommendation (GR-scales) in the development of clinical guidelines in the Russian Federation. Materials and Methods. We analyzed the LE- and GR-scales that had been used in developing clinical guidelines up to 01.09.2017; the materials were stored in the Federal Electronic Medical Library. The study included several stages: analysis of the clinical guidelines for the presence and type of LE- and GR-scales; comparison of the LE- and GR-scales between various clinical guidelines including the internationally accepted ones; assessment of using the international scales or their combinations in the development of clinical guidelines in Russia. Results. More than 150 various LE- and GR-scales used for clinical recommendations were identified; most of them represented modifications of the international assessment systems. The original SIGN technique was found to be most commonly used. Conclusion. Based on the results of the study, we concluded that at present, there is no unified approach to the assessment of the levels of evidence and grades of recommendation in clinical guidelines developed by professional medical associations in the Russian Federation.
{"title":"The use of the level of evidence and grade of recommendations scales in developing clinical guidelines in the Russian Federation","authors":"N. Zhuravleva, L. C. Shubina, O. Sukhorukikh","doi":"10.17749/2070-4909.2019.12.1.34-41","DOIUrl":"https://doi.org/10.17749/2070-4909.2019.12.1.34-41","url":null,"abstract":"Aim – analyze the existing systems for assessing the levels of evidence (LE-scales) and grades of recommendation (GR-scales) in the development of clinical guidelines in the Russian Federation. Materials and Methods. We analyzed the LE- and GR-scales that had been used in developing clinical guidelines up to 01.09.2017; the materials were stored in the Federal Electronic Medical Library. The study included several stages: analysis of the clinical guidelines for the presence and type of LE- and GR-scales; comparison of the LE- and GR-scales between various clinical guidelines including the internationally accepted ones; assessment of using the international scales or their combinations in the development of clinical guidelines in Russia. Results. More than 150 various LE- and GR-scales used for clinical recommendations were identified; most of them represented modifications of the international assessment systems. The original SIGN technique was found to be most commonly used. Conclusion. Based on the results of the study, we concluded that at present, there is no unified approach to the assessment of the levels of evidence and grades of recommendation in clinical guidelines developed by professional medical associations in the Russian Federation.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124550725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-22DOI: 10.17749/2070-4909.2019.12.1.14-26
T. Bezdenezhnykh, D. Fedyaev, G. Khachatryan, G. Arutyunov, K. Gerasimova
The integrated Model of health care for patients with inflammatory bowel disease (IBD) is based on the creation of specialized centers where multidisciplinary teams provide patient-centered care. Recent studies showed that the introduction of such approach into the IBD treatment practice led to faster diagnosis, an increase in the proportion of patients with mild forms of IBD and, as a result, the reduction of medical costs. The present study aims to assess the economic consequences of the proposed IBD healthcare optimization in the Republic of Tatarstan. Materials and methods. A budget impact model was created to compare two scenarios: the basic case when IBD patients are treated according to the current practice based on the existing network of clinics versus the simulated scenario when IBD patients receive medical care within a specialized IBD center, organised in accordance with the integrated multidisciplinary approach. The study hypothesis implies that the proportion of patients with severe IBD is gradually decreasing due to the change in the treatment model and the improved diagnostic procedure. The direct medical costs included the cost of visits to doctors, ambulance calls, diagnostic tests, outpatient medications, and the day-time and 24-hour in-patient care. One-way sensitivity analysis of all model inputs was performed. Results. As a result of the modified practice in the Republic of Tatarstan, the cost of medical care for IBD patients will decrease by 120 million rubles over 5 years. The sensitivity analysis shows the results are robust and not sensitive to fluctuations in the variables. However, the results are shown to be most sensitive to fluctuations in the distribution of patients by IBD severity. Conclusion. The introduction of the integrated healthcare for patients with IBD will result in lower costs of this service.
{"title":"Economic consequences of healthcare optimization for IBD patients in the Republic of Tatarstan","authors":"T. Bezdenezhnykh, D. Fedyaev, G. Khachatryan, G. Arutyunov, K. Gerasimova","doi":"10.17749/2070-4909.2019.12.1.14-26","DOIUrl":"https://doi.org/10.17749/2070-4909.2019.12.1.14-26","url":null,"abstract":"The integrated Model of health care for patients with inflammatory bowel disease (IBD) is based on the creation of specialized centers where multidisciplinary teams provide patient-centered care. Recent studies showed that the introduction of such approach into the IBD treatment practice led to faster diagnosis, an increase in the proportion of patients with mild forms of IBD and, as a result, the reduction of medical costs. The present study aims to assess the economic consequences of the proposed IBD healthcare optimization in the Republic of Tatarstan. Materials and methods. A budget impact model was created to compare two scenarios: the basic case when IBD patients are treated according to the current practice based on the existing network of clinics versus the simulated scenario when IBD patients receive medical care within a specialized IBD center, organised in accordance with the integrated multidisciplinary approach. The study hypothesis implies that the proportion of patients with severe IBD is gradually decreasing due to the change in the treatment model and the improved diagnostic procedure. The direct medical costs included the cost of visits to doctors, ambulance calls, diagnostic tests, outpatient medications, and the day-time and 24-hour in-patient care. One-way sensitivity analysis of all model inputs was performed. Results. As a result of the modified practice in the Republic of Tatarstan, the cost of medical care for IBD patients will decrease by 120 million rubles over 5 years. The sensitivity analysis shows the results are robust and not sensitive to fluctuations in the variables. However, the results are shown to be most sensitive to fluctuations in the distribution of patients by IBD severity. Conclusion. The introduction of the integrated healthcare for patients with IBD will result in lower costs of this service.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"137 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133267933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-22DOI: 10.17749/2070-4909.2019.12.1.27-33
M. B. Khrustalev, A. A. Maksimova
Medicine is one of the most important and rapidly developing branches of science. Research and developments projects run by scientific organizations and universities in this field are ultimately aimed at preserving the public health; these projects are expected to be rapidly implemented and become available to consumers. Yet in the area of medicine, the process of implementation can take many years. There is a gap between the developers (scientific organization, university), investors, and manufacturers due to the difficulty in assessing the innovation potential of the scientific results in medicine. The aim of this study was to determine the inclusion criteria for research conducted in medical universities to be incorporated in the innovation process; such criteria were supposed to be based on other (indirect) indicators ranking the medical universities. Material and methods. The study included twenty medical universities in Russia, largest in terms of the scientific and teaching staff. These universities were ranked according to the number of citations in the Web of Science over the period 2013-2017. Also, using the SciVal module developed by Elsevier, the number of publications with the participation of industrial partners was estimated. The assessment of the invention activity of medical universities was found in the materials published by the Russian Analytical Center “Expert”. Results. According to the scientometric analysis, medical universities with the most promising scientific products and scientific developments, have been in low demand by Russian and foreign companies. Conclusion. Due to the low activity of medical universities in implementing their intellectual production, potential investors and manufacturers should pay more attention to those medical universities, which produce a greater number of high-quality scientific results.
{"title":"Effective search for potentially innovative scientific results in medicine","authors":"M. B. Khrustalev, A. A. Maksimova","doi":"10.17749/2070-4909.2019.12.1.27-33","DOIUrl":"https://doi.org/10.17749/2070-4909.2019.12.1.27-33","url":null,"abstract":"Medicine is one of the most important and rapidly developing branches of science. Research and developments projects run by scientific organizations and universities in this field are ultimately aimed at preserving the public health; these projects are expected to be rapidly implemented and become available to consumers. Yet in the area of medicine, the process of implementation can take many years. There is a gap between the developers (scientific organization, university), investors, and manufacturers due to the difficulty in assessing the innovation potential of the scientific results in medicine. The aim of this study was to determine the inclusion criteria for research conducted in medical universities to be incorporated in the innovation process; such criteria were supposed to be based on other (indirect) indicators ranking the medical universities. Material and methods. The study included twenty medical universities in Russia, largest in terms of the scientific and teaching staff. These universities were ranked according to the number of citations in the Web of Science over the period 2013-2017. Also, using the SciVal module developed by Elsevier, the number of publications with the participation of industrial partners was estimated. The assessment of the invention activity of medical universities was found in the materials published by the Russian Analytical Center “Expert”. Results. According to the scientometric analysis, medical universities with the most promising scientific products and scientific developments, have been in low demand by Russian and foreign companies. Conclusion. Due to the low activity of medical universities in implementing their intellectual production, potential investors and manufacturers should pay more attention to those medical universities, which produce a greater number of high-quality scientific results.","PeriodicalId":201824,"journal":{"name":"FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124860300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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