Subjects -> MEDICAL SCIENCES (Total: 8697 journals)
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MEDICAL SCIENCES (2419 journals)                  1 2 3 4 5 6 7 8 | Last

Showing 1 - 200 of 3562 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 3)
3D Printing in Medicine     Open Access   (Followers: 5)
4 open     Open Access  
AADE in Practice     Hybrid Journal   (Followers: 6)
AAS Open Research     Open Access   (Followers: 2)
ABCS Health Sciences     Open Access   (Followers: 8)
Abia State University Medical Students' Association Journal     Full-text available via subscription   (Followers: 3)
AboutOpen     Open Access  
ACIMED     Open Access   (Followers: 1)
ACS Medicinal Chemistry Letters     Hybrid Journal   (Followers: 50)
Acta Bio Medica     Full-text available via subscription   (Followers: 2)
Acta Bioethica     Open Access  
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Acta Científica Estudiantil     Open Access  
Acta Facultatis Medicae Naissensis     Open Access   (Followers: 1)
Acta Herediana     Open Access  
Acta Informatica Medica     Open Access   (Followers: 2)
Acta Medica (Hradec Králové)     Open Access  
Acta Medica Bulgarica     Open Access  
Acta Medica Colombiana     Open Access   (Followers: 1)
Acta Médica Costarricense     Open Access   (Followers: 2)
Acta Medica Indonesiana     Open Access  
Acta Medica International     Open Access  
Acta medica Lituanica     Open Access   (Followers: 1)
Acta Medica Marisiensis     Open Access   (Followers: 1)
Acta Medica Martiniana     Open Access  
Acta Medica Nagasakiensia     Open Access   (Followers: 1)
Acta Medica Peruana     Open Access   (Followers: 2)
Acta Médica Portuguesa     Open Access  
Acta Medica Saliniana     Open Access  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 3)
Acupuncture & Electro-Therapeutics Research     Full-text available via subscription   (Followers: 8)
Acupuncture and Natural Medicine     Open Access  
Addiction Science & Clinical Practice     Open Access   (Followers: 9)
Addictive Behaviors Reports     Open Access   (Followers: 9)
Adıyaman Üniversitesi Sağlık Bilimleri Dergisi / Health Sciences Journal of Adıyaman University     Open Access   (Followers: 1)
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access   (Followers: 1)
Advanced Biomedical Research     Open Access  
Advanced Health Care Technologies     Open Access   (Followers: 10)
Advanced Science, Engineering and Medicine     Partially Free   (Followers: 9)
Advanced Therapeutics     Hybrid Journal   (Followers: 1)
Advances in Bioscience and Clinical Medicine     Open Access   (Followers: 7)
Advances in Cell and Gene Therapy     Hybrid Journal   (Followers: 1)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 27)
Advances in Clinical Radiology     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 11)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Medical Education and Practice     Open Access   (Followers: 32)
Advances in Medical Ethics     Open Access   (Followers: 5)
Advances in Medical Research     Open Access   (Followers: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 10)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 6)
Advances in Medicine     Open Access   (Followers: 3)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5)
Advances in Molecular Oncology     Open Access   (Followers: 2)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7)
Advances in Parkinson's Disease     Open Access   (Followers: 2)
Advances in Phytomedicine     Full-text available via subscription   (Followers: 1)
Advances in Preventive Medicine     Open Access   (Followers: 6)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 21)
Advances in Regenerative Medicine     Open Access   (Followers: 4)
Advances in Skeletal Muscle Function Assessment     Open Access  
Advances in Therapy     Hybrid Journal   (Followers: 5)
Advances in Traditional Medicine     Hybrid Journal   (Followers: 8)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 15)
Advances in Virus Research     Full-text available via subscription   (Followers: 6)
Advances in Wound Care     Hybrid Journal   (Followers: 14)
Aerospace Medicine and Human Performance     Full-text available via subscription   (Followers: 13)
African Health Sciences     Open Access   (Followers: 5)
African Journal of Biomedical Research     Open Access   (Followers: 1)
African Journal of Clinical and Experimental Microbiology     Open Access   (Followers: 4)
African Journal of Laboratory Medicine     Open Access   (Followers: 2)
African Journal of Medical and Health Sciences     Open Access   (Followers: 3)
African Journal of Thoracic and Critical Care Medicine     Open Access  
African Journal of Trauma     Open Access   (Followers: 1)
Afrimedic Journal     Open Access   (Followers: 3)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
AIDS Research and Human Retroviruses     Hybrid Journal   (Followers: 9)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
AJSP: Reviews & Reports     Hybrid Journal   (Followers: 1)
Aktuelle Ernährungsmedizin     Hybrid Journal   (Followers: 6)
Al-Azhar Assiut Medical Journal     Open Access   (Followers: 2)
Al-Qadisiah Medical Journal     Open Access   (Followers: 1)
Alerta : Revista Científica del Instituto Nacional de Salud     Open Access  
Alexandria Journal of Medicine     Open Access   (Followers: 1)
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 3)
Alpha Omegan     Full-text available via subscription  
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 2)
Althea Medical Journal     Open Access   (Followers: 2)
American Journal of Biomedical Engineering     Open Access   (Followers: 15)
American Journal of Biomedical Research     Open Access   (Followers: 2)
American Journal of Biomedicine     Full-text available via subscription   (Followers: 7)
American Journal of Chinese Medicine, The     Hybrid Journal   (Followers: 4)
American Journal of Clinical Medicine Research     Open Access   (Followers: 8)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Law & Medicine     Full-text available via subscription   (Followers: 12)
American Journal of Lifestyle Medicine     Hybrid Journal   (Followers: 7)
American Journal of Managed Care     Full-text available via subscription   (Followers: 13)
American Journal of Medical Case Reports     Open Access   (Followers: 3)
American Journal of Medical Sciences and Medicine     Open Access   (Followers: 5)
American Journal of Medicine     Hybrid Journal   (Followers: 50)
American Journal of Medicine and Medical Sciences     Open Access   (Followers: 1)
American Journal of Medicine Studies     Open Access   (Followers: 3)
American Journal of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American Journal of the Medical Sciences     Hybrid Journal   (Followers: 12)
American Journal on Addictions     Hybrid Journal   (Followers: 11)
American medical news     Free   (Followers: 3)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 6)
Amyloid: The Journal of Protein Folding Disorders     Hybrid Journal   (Followers: 5)
Anales de la Facultad de Medicina     Open Access  
Anales de la Facultad de Medicina, Universidad de la República, Uruguay     Open Access  
Anales del Sistema Sanitario de Navarra     Open Access   (Followers: 1)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 7)
Anatolian Clinic the Journal of Medical Sciences     Open Access  
Anatomica Medical Journal     Open Access  
Anatomical Science International     Hybrid Journal   (Followers: 3)
Anatomical Sciences Education     Hybrid Journal   (Followers: 2)
Anatomy     Open Access   (Followers: 3)
Anatomy Research International     Open Access   (Followers: 4)
Androgens : Clinical Research and Therapeutics     Open Access   (Followers: 1)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3)
Ankara Medical Journal     Open Access   (Followers: 2)
Ankara Üniversitesi Tıp Fakültesi Mecmuası     Open Access  
Annales de Pathologie     Full-text available via subscription  
Annales des Sciences de la Santé     Open Access  
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale     Full-text available via subscription   (Followers: 3)
Annals of African Medicine     Open Access   (Followers: 2)
Annals of Anatomy - Anatomischer Anzeiger     Hybrid Journal   (Followers: 3)
Annals of Bioanthropology     Open Access   (Followers: 5)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 19)
Annals of Biomedical Sciences     Full-text available via subscription   (Followers: 4)
Annals of Clinical Hypertension     Open Access  
Annals of Clinical Microbiology and Antimicrobials     Open Access   (Followers: 15)
Annals of Family Medicine     Open Access   (Followers: 18)
Annals of Health Research     Open Access   (Followers: 1)
Annals of Ibadan Postgraduate Medicine     Open Access  
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Medicine     Hybrid Journal   (Followers: 12)
Annals of Medicine and Surgery     Open Access   (Followers: 7)
Annals of Medicine and Surgery Case Reports     Open Access   (Followers: 1)
Annals of Medicine and Surgery Protocols     Open Access   (Followers: 1)
Annals of Microbiology     Hybrid Journal   (Followers: 13)
Annals of Musculoskeletal Medicine     Open Access   (Followers: 2)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Rehabilitation Medicine     Open Access   (Followers: 1)
Annals of Saudi Medicine     Open Access  
Annals of the College of Medicine, Mosul     Open Access   (Followers: 1)
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5)
Annals of The Royal College of Surgeons of England     Full-text available via subscription   (Followers: 3)
Annals of the RussianAacademy of Medical Sciences     Open Access   (Followers: 1)
Annual Reports in Medicinal Chemistry     Full-text available via subscription   (Followers: 7)
Annual Reports on NMR Spectroscopy     Full-text available via subscription   (Followers: 5)
Annual Review of Medicine     Full-text available via subscription   (Followers: 18)
Anthropological Review     Open Access   (Followers: 25)
Anthropologie et santé     Open Access   (Followers: 5)
Antibiotics     Open Access   (Followers: 9)
Antibodies     Open Access   (Followers: 2)
Antibody Reports     Open Access   (Followers: 1)
Antibody Technology Journal     Open Access   (Followers: 1)
Antibody Therapeutics     Open Access   (Followers: 1)
Anuradhapura Medical Journal     Open Access  
Anwer Khan Modern Medical College Journal     Open Access   (Followers: 2)
Apmis     Hybrid Journal   (Followers: 2)
Apparence(s)     Open Access   (Followers: 1)
Applied Clinical Informatics     Hybrid Journal   (Followers: 5)
Applied Clinical Research, Clinical Trials and Regulatory Affairs     Hybrid Journal   (Followers: 2)
Applied Medical Informatics     Open Access   (Followers: 14)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arabian Journal of Scientific Research / المجلة العربية للبحث العلمي     Open Access   (Followers: 1)
Archive of Biomedical Science and Engineering     Open Access   (Followers: 1)
Archive of Clinical Medicine     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives Medical Review Journal / Arşiv Kaynak Tarama Dergisi     Open Access  
Archives of Asthma, Allergy and Immunology     Open Access  
Archives of Clinical Hypertension     Open Access   (Followers: 2)
Archives of Medical and Biomedical Research     Open Access   (Followers: 3)
Archives of Medical Laboratory Sciences     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Medicine and Surgery     Open Access   (Followers: 1)
Archives of Organ Transplantation     Open Access   (Followers: 2)
Archives of Preventive Medicine     Open Access   (Followers: 3)
Archives of Pulmonology and Respiratory Care     Open Access   (Followers: 2)
Archives of Renal Diseases and Management     Open Access   (Followers: 2)
Archives of Trauma Research     Open Access   (Followers: 4)
Archivos de Medicina (Manizales)     Open Access   (Followers: 1)
ArgoSpine News & Journal     Hybrid Journal  
Arquivos Brasileiros de Oftalmologia     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Arquivos de Medicina     Open Access   (Followers: 1)
Ars Medica : Revista de Ciencias Médicas     Open Access  
ARS Medica Tomitana     Open Access   (Followers: 1)
Art Therapy: Journal of the American Art Therapy Association     Hybrid Journal   (Followers: 19)
Arterial Hypertension     Open Access   (Followers: 1)
Artificial Intelligence in Medicine     Hybrid Journal   (Followers: 20)
Artificial Organs     Hybrid Journal   (Followers: 1)
ASHA Leader     Open Access   (Followers: 6)
Asia Pacific Family Medicine Journal     Open Access   (Followers: 4)
Asia Pacific Journal of Clinical Nutrition     Full-text available via subscription   (Followers: 13)
Asia Pacific Journal of Clinical Trials : Nervous System Diseases     Open Access   (Followers: 1)

        1 2 3 4 5 6 7 8 | Last

Similar Journals
Journal Cover
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2465-2628
Published by AboutScience Srl Homepage  [4 journals]
  • AboutOpen: research, real world evidence, points of view and the transfer
           of knowledge

    • Authors: Giulio Zuanetti
      Pages: 1 - 1
      PubDate: 2019-01-21
      Issue No: Vol. 6, No. 1 (2019)
  • Emostatic-palliative radiotherapy in vescical carcinoma: two case reports

    • Authors: Giovanni Ceccon, Stefano Andreani, Marialuisa Bergamini, Sebastiano Buti, Cristina Dell'Anna, Francesca Ghetti, Stella Gianni, Claudia Grondelli, Elisabetta Lattanzi, Pierluigi Losardo, Moana Manicone, Roberto Rossi, Francesco Salaroli, Nunziata D'Abbiero
      Pages: 2 - 4
      Abstract: Introduction: Palliative radiotherapy is very effective for symptoms control and it improves the quality of life of patients with neoplasia at any stage of the disease. The 5% of palliative radiotherapy treatments are carried out for hemostatic purposes and this approach is particularly useful in certain diseases. In fact in bladder cancer this treatment is able to control bleeding in more than 90% of cases. Case description: We report two cases of old patients with urothelial carcinoma and macrohematuria, initially treated, for the fist time, with 20 Gy on the whole bladder obtainig completely resolution of hematuria. Afterwards, for new haematuria appearance, the patients were treated again with 15 Gy targeted on the progression region, obtaining resolution of bleeding again. Conclusion: although a haemostatic approach does not give lasting results over time, a reprocessing should be considered due to the improvement in the quality of life that it may entail. (Oncology)
      PubDate: 2019-01-28
      Issue No: Vol. 6, No. 1 (2019)
  • Inflammation management in ophthalmology: new evidences for cataract
           surgery and beyond

    • Authors: Matteo Piovella, Teresio Avitabile, Roberto Bellucci, Aldo Caporossi, Giorgio Marchini, Pasquale Troiano, Pier Luigi Canonico
      Pages: 5 - 15
      Abstract: Inflammation represents the manifestation of the host's vascular and cellular response to tissue damage, hypersensitivity of the immune system or autoimmunity. As soon as the damage is detected, the mechanisms of localization and removal of foreign substances and damaged tissues are triggered. This response is amplified by the activation of inflammatory cells and by the production of chemical mediators derived from arachidonic acid, vasoactive substances and cytokines.
      At the ocular level, among the different responses implemented by various inflammation mediators, the action of prostaglandins is mainly expressed in three ways: i) change of intraocular pressure; ii) induction of miosis; iii) increase of protein concentration in the aqueous humor.
      Ocular inflammation may continue long after the cessation of the initial cause and may also lead to serious consequences, including permanent vision reduction. For this reason, it is essential to establish a correct and effective therapeutic strategy, which allows to control inflammation, the symptoms and the clinical signs associated with it.
      This article therefore deals with therapeutic strategies to control inflammation, with a particular focus on the role of nonsteroidal anti-inflammatory drugs (NSAIDs) in cataract surgery.
      PubDate: 2019-04-15
      Issue No: Vol. 6, No. 1 (2019)
  • A Budget impact analysis of adalimumab biosimilar: the Italian context

    • Authors: Roberto Ravasio, Silvio Mazzi, Maria Esposito, Gionata Fiorino, Alberto Migliore
      Pages: 16 - 23
      Abstract: Introduction: Patients’ quality of life impairment together with a heavy burden to the NHS and society are caused by chronic inflammatory diseases. Their treatment substantially improved with the advent of biological drugs (such as adalimumab), but these drugs are very expensive. At present, the patent protection of adalimumab (Humira®) has expired, and a biosimilar (Hyrimoz®) has been approved. Since the biosimilar price is expected to be lower as compared with the originator’s, the present Drug Budget Impact analysis tries to evaluate whether and how much profitable the biosimilar availability will be for the Italian NHS, in terms of cost containment (savings). Methods and results : The time horizon in the analysis model is five years. The initial overall number of patients treated with adalimumab is estimated (based on the Italian population, the disease prevalence rates, the proportion of patients under treatment and adalimumab market share) and kept constant in time. However, the model assumes that, year by year, patients in treatment with the originator will partly switch to the biosimilar (based on a prudent estimate of the uptake rate), while (due to a bolder estimate) a larger share of naïve patients will directly start with the biosimilar. Thanks to such assumptions, total number of patients treated with adalimumab (separately with the originator and with the biosimilar) is estimated, with the respective total costs. Conclusions:  According to the present analysis, the availability of the biosimilar would generate cumulated savings (in five years) as high as €260 millions for the Italian NHS.
      PubDate: 2019-05-06
      Issue No: Vol. 6, No. 1 (2019)
  • Efficacy of tablet-based applications for mental training in preserving
           cognitive abilities of older adults

    • Authors: Marcello Maria Turconi, Filomena Vella, Francesco Mosetti
      Pages: 24 - 30
      Abstract: Background and aims: Nonpathological, age-related cognitive decline is among the most feared consequences of aging. Evidence suggests that the continued use of mental abilities can slow down cognitive decline. We developed two tablet-based applications for the mental training (ElasticaMente) and social interaction/entertainment (iNonni) of older adults. The aim of this study was to evaluate their effect on cognitive performance.
      Materials and methods: This was an exploratory study of 8 months duration. Sixty healthy residents of a senior community center aged ≥60 years were recruited and divided into three groups: participants in Groups 1 and 2 received a tablet with ElasticaMente and iNonni (Group 1, n = 20) or with iNonni only (Group 2, n = 20); participants in Group 3 (n = 20) did not receive any tablet. Participants in Groups 1 and 2 were instructed to use the applications three times a week (each session ~45 minutes). Cognitive performance was assessed at baseline (T0) and after 8 months (T1) using a battery of six validated tests.
      Results: In Group 1, cognitive test scores remained consistently stable from T0 to T1, suggesting maintenance of cognitive abilities. In contrast, in Groups 2 and 3, scores worsened from T0 to T1 across all tests. Comparison of the changes from T0 to T1 revealed statistical significance for Group 1 versus Group 3, but not for Group 1 versus Group 2 and Group 2 versus Group 3.
      Conclusion: The 8 months use of the applications ElasticaMente and iNonni was associated with a significant benefit in terms of preserved cognitive performance compared with no tablet-based activity. The potential contribution of ElasticaMente to the attenuation of cognitive decline should be further investigated. (Digital Health)
      PubDate: 2019-05-29
      Issue No: Vol. 6, No. 1 (2019)
  • Key performance indicators for monitoring the integrated care pathway in
           breast cancer: the E.Pic.A. project

    • Authors: Mattia Altini, William Balzi, Roberta Maltoni, Fabio Falcini, Flavia Foca, Giovanni Messori Ioli, Andrea Ricotti, Oscar Bertetto, Marinella Mistrangelo, Gianni Amunni, Fabrizio Gemmi, Letizia Bachini, Andrea Silenzi, Roberta Pastorino, Andrea Barbara, Andrea Pierini, Ilaria Massa
      Pages: 31 - 38
      Abstract: Background: Due to its high incidence, evaluating performance of care delivered to breast cancer patients is a crucial issue. The multidisciplinary panel E.Pic.A. (Economic Appropriateness of an Integrated Care Pathway) defined a set of key performance indicators (KPIs) to evaluate economic waste in breast cancer healthcare interventions.
      Methods: The E.Pic.A. panel identified the principal KPIs that are crucial within the breast cancer care pathway to evaluate the performance of care. KPIs were defined taking into account their reliability, validity, usability and feasibility of measurement through the linkage between multiple routine healthcare data sources.
      Results: Seven KPIs were identified: three on instrumental diagnostics, two on surgery and two on treatment. The three KPIs regarding instrumental diagnostics are aimed at assessing the inappropriateness of diagnostic tests performed before and after the index surgery. The two KPIs regarding surgery measure the inappropriateness of possible repeated interventions considering the time elapsed from the index surgery. The two KPIs regarding oncologic therapy measure the inappropriateness about the administration time of adjuvant therapy and radiotherapy considering the time elapsed from the index surgery.
      Conclusion: E.Pic.A methodology could help to evaluate economic waste in healthcare interventions with the objective of redirecting resources to interventions with greater value. (HTA & Market Access)
      PubDate: 2019-06-05
      Issue No: Vol. 6, No. 1 (2019)
  • The integrated care pathway for melanoma: the Istituto Dermopatico
           dell’Immacolata experience in Rome

    • Authors: Francesco Ricci, Alessio Caggiati, Vincenzo Ziparo, Maurizio Elia, Giandomenico Russo, Stefania D'Atri, Cristina Maria Failla, Annarita Panebianco, Giorgio Annessi, Francesca Passarelli, Marie Perez, Tommaso Tartaglione, Giovanni Di Lella, Sabatino Pallotta, Cinzia Mazzanti, Maurizio Nudo, Cristina Fortes, Damiano Abeni, Federica De Galitiis, Paolo Marchetti
      Pages: 39 - 47
      Abstract: Introduction: The Integrated Care Pathway (ICP) represents a multidisciplinary outline of anticipated care, placed in an appropriate timeframe, to support patients with specific conditions or symptoms. The aim of this paper is to define the ICP for patients with melanoma referring to the “Istituto Dermopatico dell’Immacolata-IRCCS di Roma e Villa Paola” (“Center”).
      Methods and results: A multidisciplinary group (oncologists, dermatologists, surgeons, pathologists etc.) was defined as well as a facilitator to act as a link between all experts. The first step of ICP development was a review of current practice for patients with melanoma referring to the Center. This first step had the scope to define the multidisciplinary process map (a “picture” of the care plan) for patients with melanoma. The process map defined: i) the activities performed during delivery of care to the patients, ii) the responsibilities for these activities and iii) potential problem areas or opportunities for improvements. The process map formed the basis of the final ICP document.
      Conclusion: The adoption of melanoma ICP will allow the multidisciplinary group to ensure that clinical guidelines and available evidence are incorporated into everyday practice. (Oncology, HTA & Market Access)
      PubDate: 2019-06-07
      Issue No: Vol. 6, No. 1 (2019)
  • Performance indicators for monitoring the integrated care pathway of
           patients with colorectal cancer: the E.Pic.A. project

    • Authors: Andrea Ricotti, Giovanni Messori Ioli, Mattia Altini, Letizia Bachini, William Balzi, Giovanni Luca Frassineti, Fabrizio Gemmi, Ilaria Massa, Andrea Pierini, Oscar Bertetto, Patrizia Racca
      Pages: 48 - 54
      Abstract: Background: Given limitations in economic resources, achieving sustainability in healthcare is an increasingly important issue driving policy decisions. Colorectal cancer (CRC) is a frequent oncological diagnosis with an incidence that is expected to increase, making the efficient utilisation of resources a major priority for its diagnosis and treatment. To assess potentially inappropriate utilisation of services in the integrated care pathway of patients with malignant CRC, a series of key performance indicators (KPIs) have been developed by a multidisciplinary panel of the E.Pic.A. project (Economic Appropriateness of an Integrated Care Pathway).
      Methods: The KPIs identified had to comply with criteria of reliability, representativeness, accessibility and operativity. A definition is provided for each of the KPIs, along with the methodology used to calculate it and a reference target.
      Results: Eight KPIs were identified that can measure inadequacies of services provided in the diagnostic and treatment pathways for CRC: four for instrumental diagnostics, three for surgery and one for oncologic therapy.
      Conclusions: Use of the methodology described can help payors to obtain detailed information on inappropriate and wasteful use of healthcare resources, which would then permit their reallocation for interventions with higher value for patients with CRC and other pathologies. (HTA & Market Access, Oncology)
      PubDate: 2019-06-15
      Issue No: Vol. 6, No. 1 (2019)
  • Critical interpretation of pairwise and network meta-analysis of
           randomized respiratory clinical trials

    • Authors: Paola Rogliani, Luigino Calzetta
      Pages: 55 - 61
      Abstract: A meta-analysis is a statistical technique used to assess the data of   independent studies concerning the same clinical scenario, in order to  synthesize results that are reported as effect estimate. The strength of a meta-analysis lies in its potential to combine the results of   studies characterized by different size and that may have been   underpowered to answer clinically relevant questions. Furthermore, meta-analyses can be used to clarify questions for which large randomized controlled trials have not led to consensus within the scientific community. The effect estimate resulting from a meta-analysis should be interpreted both from a statistical and clinical point of view. The clinical interpretation of the effect estimate must take into consideration the minimal clinically important differences compared to the comparator, which may be placebo and/or other active treatments. In this review we consider the key points needed to correctly and critically interpret the current meta-analyses, and to assess how reliable are the results from a statistical and clinical point of view.  
      PubDate: 2019-06-27
      Issue No: Vol. 6, No. 1 (2019)
  • Lean Management: organizational innovations in hematological Day-Hospitals

    • Authors: Caterina Bianciardi, Jacopo Guercini
      Pages: 62 - 69
      Abstract: Background. Lean Thinking is a management method which, despite its industrial origins, has spread in health-care environment too. Objective. To describe the path followed and the results reached implementing Lean Thinking in four case studies.  Methods. Such case studies were conducted in as many hematological Day-Hospitals (DHs), located in Central-Italy. At the beginning of each study, the DH internal processes, activity volumes and patient flows were analyzed and satisfaction questionnaires were administered to both operators and patients. Based on the returned questionnaires, deficiencies were focused on; for each deficiency data was collected and objectives defined. Following such definitions, analysis of inefficiency causes was performed and countermeasures were identified. In the final meeting the results were assessed and monitoring/maintenance methods were defined. All these steps were supported by Lean Thinking instruments for analysis and solution.         Results. Activity organization and patient satisfaction improved everywhere. Time losses and workloads imbalances were minimized in two DHs, particularly through higher standardization in the management of clinical-administrative documents. In another DH, the output capacity of the hospital pharmacy and the workflows in DH were aligned with respect to the course of the day, so reducing delays in the delivery of therapies.  Appointment planning was improved in the fourth DH, standardizing time slots (15-minutes) necessary for each therapy, so optimizing the number of beds and chairs used. Conclusions. Poor management of health care facilities can affect efficiency, security and quality of services provided. Lean Thinking is a valid method to address such problems.    (HTA & Market Access) 
      PubDate: 2019-06-27
      Issue No: Vol. 6, No. 1 (2019)
  • Getting your devices ready for MDR compliance – a clinical approach and
           orthopaedic device manufacturers’ perspective

    • Authors: Peter Fennema, Hassan Achakri
      Pages: 70 - 75
      Abstract:  On 26 May 2017, the Medical Devices Regulation (MDR 2017/745) was published, with the aim of replacing the current Medical Devices Directive (MDD 93/43/EC). Following a transition period of 3 years, this regulation will be applied in full from 26 May 2020. This article describes and discusses the impact of MDR on the clinical evaluation and gives advice to manufacturers on the preparation, planning and implementation of processes to support compliance with the new regulation. (Market Access)
      PubDate: 2019-07-31
      Issue No: Vol. 6, No. 1 (2019)
  • Plateau Pressure during Pressure Control Ventilation

    • Authors: Simone Sosio, Giacomo Bellani
      Pages: 76 - 77
      Abstract: (intensive care)
      PubDate: 2019-10-22
      Issue No: Vol. 6, No. 1 (2019)
  • The value of obinutuzumab for untreated advanced Follicular Lymphoma: an
           assessment based on Multicriteria Decision Analysis (MCDA)

    • Authors: Claudio Jommi, Roberto Ravasio
      Pages: 78 - 85
      Abstract: Introduction: Multicriteria Decision Analysis (MCDA) provides a framework that enhances transparency and repeatability of decisions taken on a multicriteria basis. Objective: This analysis aims at assessing obinutuzumab compared to rituximab used as a first-line treatment for Follicular Lymphoma (FL) in the Italian health care system, using an MCDA approach. Materials and Methods: We used the EVIDEM V10 MCDA framework and a Delphi approach to scrutinize the views of a panel of physicians, payers and patients on value domains and their application to our research target. Results: All stakeholders attached medium-high scores to FL severity (patients at higher risk of relapsing), unmet needs, obinutuzumab clinical benefit and evidence quality, and lower scores to organizational impact and, except for payers, to costs. The comparative analysis highlighted positive scores for the domains “incremental efficacy” (2.6: range −5/+5) and “incremental patient benefit” (1.5: range −5/+5) of obinutuzumab compared to rituximab. A slight increase of severe adverse events (≥3) for obinutuzumab was estimated by the panellists. Obinutuzumab compared to rituximab received a neutral evaluation for costs and for organizational impact. Conclusion: This study reveals that MCDA could be a useful framework for evaluating a drug and it can be used to elicit the views of different stakeholder groups (as patients). The key criteria driving the value of obinutuzumab. (HTA & Market Access)
      PubDate: 2019-11-21
      Issue No: Vol. 6, No. 1 (2019)
  • How to measure respiratory mechanics during controlled mechanical

    • Authors: Marco Giani, Alfio Bronco, Giacomo Bellani; Prof.
      Pages: 86 - 89
      Abstract: Bedside measurement of respiratory mechanics allows to closely monitor the lung function in critically ill patients. The two fundamental parameters describing the respiratory system mechanics are resistance and compliance. Resistance of the respiratory system describes the opposition to gas flow during inspiration. During volume-controlled ventilation, resistance can be calculated as the ratio between the peak to plateau pressure drop and the resulting flow rate. Compliance describes the elastic property of the respiratory system, comprising the lung and the chest wall. It is the ratio between a change in volume (i.e. tidal volume) and the corresponding change in pressure, calculated as the difference between plateau pressure and total positive end-expiratory pressure, measured by end-inspiratory and end-expiratory manual occlusion, respectively. In this review, we describe how to measure respiratory mechanics at the bedside, starting from the physiological background of the equation of motion of the respiratory system.  (Intensive care)
      PubDate: 2019-11-21
      Issue No: Vol. 6, No. 1 (2019)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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