The Role of HTA for Innovativeand Emerging Technologies
Prof Brendon KearneyVice Chairman of EuroScan
Chair HPACT Australia
9-11 September 2010 Bangkok Thailand
First Global Forum on Medical DevicesWorld Health Organization
A bit of history (I)
�Early warning systems part of the regular approval processes in European countries
� In January 1995, the Danish Hospital Institute organised a meeting entitled.� "International Collaboration Concerning Monitoring of Emerging Medical Technologies (MEMT)".
� Fourteen participants attended and discussed national experiences concerning MEMT and the possibility for a European collaboration.
A bit of history (II)
� A survey in 1998 among INAHTA members showed that 30% of agencies had continuing and structured early warning activities
� An international workshop "Scanning the Horizon for Emerging Health Technology" in Copenhagen in 1997
� A small working group was established with representatives from Denmark, the Netherlands, Spain, Sweden and the United Kingdom plus associated representatives from Canada and Switzerland
EuroScan Framework
� EuroScan – the international information network on new and emerging health technologies - is a collaborative network of member agencies for the exchange of information on important new and emerging health technologies.
� Each member agency is unique in the way it approaches its work but all have a common goal of informing their customers about new and emerging health technologies that may have a significant impact on their health system.
Avoid duplication and share
“The drug itself has no side effects, but the number of HTA agencies needed to prove its value may cause dizziness and nausea”
The international information network on new
and emerging health technologies
“A collaborative network of member agencies for the exchange
of information on important emerging new drugs, devices,
procedures, processes, and settings in health care”
Members
� 20 members
� AETS - Agencia de Evaluación de Tecnologías Sanitarias. Instituto de Salud Carlos III, Spain� AETSA - Agencia de Evaluación de Tecnologías Sanitarias de Andalucía, Spain� AGE.NA.S – Agenzia nationale per I servizi Sanitari Regionali, Italy� AHTA - Adelaide Health Technology Assessment, Australia� ANZHSN - Australia and New Zealand Horizon Scanning Network, Australia and New Zealand� CADTH - Canadian Agency for Drugs and Technologies in Health, Canada� CEDIT - Committee for Evaluation & Diffusion of Innovative Technologies, France� DACEHTA - Danish Centre for Evaluation and Health Technology Assessment, Denmark� DIMDI - German Institute for Medical Documentation and Information, Germany� DMTP - Division of Medical Technology Policy, Ministry of Health, Israel� FINOHTA (MUMM) - Managed Uptake of Medical Methods programme, Finnish Office for Health
Technology Assessment, Finland� GR - Health Council of the Netherlands, Netherlands� HAS - Haute Autorité de Santé, France� HIQA - Health Information & Quality Authority, Ireland� IHSP - Italian Horizon Scanning Project, Servizio Farmaceutico Territoriale, Italy� LBI–HTA - Ludwig Boltzmann Institut für Health Technology Assessment, Austria� NHSC - National Horizon Scanning Centre, England� NOKC - The Norwegian Knowledge Centre for the Health Services, Norway� OSTEBA - Basque Office for Health Technology Assessment, Basque Country� SBU - The Swedish Council on Technology Assessment in Health Care, Sweden� SFOPH - Swiss Federal Office of Public Health, Switzerland
Organization
� Executive committee� Made up of
representatives of member agencies
� Workgroups� By-laws� Strategy� Difussion
Present committee (2007-2009)Chair Iñaki Gutiérrez-Ibarluzea
(Osteba)Vice Chair Brendon Kearney
(ANZHSN)Registrar Kees Groeneveld (GR)Treasurer Christoph Kuenzli
(SFOPH)Head of Secretariat Claire Packer (NHSC)
Past committee members (2005-2007)Chair Jill Sanders (CCOHTA)Vice Chair Iñaki Gutiérrez (Osteba)Registrar Inger Norderhaug (SMM)Treasurer Anne-Florence Fay (CEDIT)Head of Secretariat Claire Packer (NHSC)
Organization
� Permanent secretariat� Based at NHSC (Birmingham)
� Head of the Secretariat
� 1 partly time researcher
� 1 partly time administrative
Joint research initiatives
� The influence of early warning activities on health care decision making and the diffusion of new technologies (current)
�Newsletter to inform on new and emerging technologies for the EUnetHTAproject (commissioned research 2007)
�Use of the Internet in identifying new technologies (2004)
�Comparative analysis of member agency systems (2002-2005) and 2007-2010.
Stockholm meeting
� To report theachievements and progress of theEuroScan collaboration
� To share informationon the methods and results
� To consider challengesto the collaboration
� To discuss its possiblefuture direction.
Actions
1. Improve the collaboration with other organizations
2. Diffuse the activities of the network
3. Create discussion groups and workgroups within the organization
4. Promote a newsletter on new and emerging health technologies (newsletter)
5. Make publicly available the methods and joint actions (methods toolkit)
1. Improve the collaboration with other organizations
� Collaborating partners of EUnetHTA
� Building bridges with HTAi
� EUSANH, IPTS, PHGEN
�MoU with INAHTA
� Final approval of INAHTA and EuroScanpartners
�MoU with WHO
� Preliminary draft sent to approval to WHO
�Shared actions
2. Diffuse the activities of the network
�Webpage
�Workshops
� Panel sessions
� Journal Articles
�Newsletter (6 monthly)
�Web 2.0, blogs
Statistics
Usage Statistics for October 2009
Public Sessions Member Sessions Total Sessions
13426 151 13577
Event Totals
Public Follow Technology Report link 8085
Technology Search (Member Section) 4477
Public Technology Search 3859
View Report (Member Section) 1998
Land on home page 1084
Log In (Member Section) 177
Technology Update (Member Section) 72
Technology Created (Member Section) 14
3. Create discussion groups and workgroups
within the organization
� Internal work� By-laws
�External work� Strategy
�Special interest work groups� Research
� Disinvestment
Disinvestment
�Approval of an interest subgroup in the HTAi on disinvestment promoted by members of EuroScanand other allies
4. Promote a newsletter on new and
emerging health technologies (public)
� Six monthly
� News from members
� News on new and emerging technologies
� Space for otherinitiatives
� Statistics of ourwebpage
5. Make publicly available the methods and
joint actions (methods toolkit)
Aim:
� to outline the various methods that members of EuroScan employ to:� Find � Select� Evaluate important new and emerging health technologies
� to provide valuable information to those interested in establishing, or improving an existing, early awareness and alert system
Methods
� ANZHSN prepare a draft
� The draft was circulated by the Secretariat to all the members in groups of three
� Improved drafts were subsequently circulated to next group
� Final draft open to discussion in a meeting in Helsinki
� Editing and improving was done by Secretariat and Osteba
Results
� Final document with 9 sections� Identify your customers
� Determine your time horizon
� Horizon scanning and early identification
� Filtration
� Prioritisation
� Assessment or prediction of impact
� Peer review
� Dissemination
� Updating information
Final document
� Includes a final checklist� Help those promoting EAAS
� It will be self-printable in the webpage
� The scheme contains hyperlinks to sections
� Electronically available in EuroScan’swebpage and printed version available in INAHTA’s booth
3. Topic identification, filtration and
investigation
The NHSC’s identification process uses three principal approaches:
(i) Focussed routine scanning – an ongoing ‘horizontal scan’designed to identify significant and urgent advances regardless of clinical specialty,
(ii) Specialty-based scanning – a ‘vertical scan’ to ensure that each clinical specialty is allocated time for an investigation of newdevelopments in the field, and
(iii) In-depth vertical scanning – work in specific clinical or technologies areas of interest to individual customers
Team members routinely scan sources for new and emerging health
technologies and for information on technologies that we are
monitoring. Sources include:
� Commercial sources e.g. Script, Clinic, pharmaceutical company pipelines
� Health-related media and journal e.g. NeLM daily news alert
� Specialist trade publications, societies and journals e.g. IVT Technology, MEDICA
� General medical journals e.g. BMJ, The Lancet, NEJM, JAMA
� Licensing sites e.g. EMEA for orphan drug opinions
� Reports from specialist groups e.g. Gene Therapy Advisory Group
� Other horizon scanning units e.g. EuroScan database, ECRI, newsletter, CADTH (Canada), ANZHSN (Australia & New Zealand)
Identification of Sources by Technology Type
Devices and
Diagnostics – sources
Early Assessment & Alert Systems
Health Organisations
HTA Organisations
Journals & Trade Publications
Examples of Sources
Australia and New Zealand Horizon Scanning Network
National Horizon Scanning Centre
EuroScan
NHS
NHS National Library for Health
Canadian Agency for Drugs and Technologies in Health
National Institute for Health & Clinical Excellence (NICE)
The Cochrane Collaboration (only devices)
International Network of Agencies for HTA (INAHTA)
Centre for Reviews & Dissemination (CRD)
British Medical Journal
JAMA
Lancet
Archives of Surgery (only devices)
New Scientist
Clinica
Identification of Sources by Technology Type
Devices and
Diagnostics – sources
Marketing Authorisation Agencies
News sites
Related organisations
Societies
Examples of sources
U.S. Food and Drug Administration (FDA)
Medscape
Science Daily
Clinica
Clinica Diagnostics
Medgadget
ECRI Institute
HAYES
American Cancer Society
Drugs – sources
Early Assessment & Alert Systems
Health Organisation
HTA Organisations
Journals & Trade Publications
Marketing Authorisation Agencies
Examples of sources
National Horizon Scanning Centre
Euroscan
NHS
Canadian Agency for Drugs and Technologies in Health
National Institute for Health & Clinical Excellence (NICE)
The Cochrane Collaboration
British Medical Journal
JAMA
Lancet
Scrip
U.S. Food and Drug Administration (FDA)
European Medicines Agency (EMEA)
Drugs – sources
News sites
Societies
Examples of sources
National Electronic Library of Medicines (NeLM)
Pharmalive
Doctors Guide
American Cancer Society
Procedures – sources
Early Assessment & Alert Systems
Health Organisations
HTA Organisations
Journals
Examples of sources
Australian and New Zealand Horizon Scanning Network
National Horizon Scanning Centre
EuroScan
NHS
NHS National Library for Health
Canadian Agency for Drugs and Technologies in Health
National Institute for Health & Clinical Excellence (NICE)
Interventional Procedures Programme (IPP)
The Cochrane Collaboration
INAHTA
Centre for Reviews & Dissemination (CRD)
ASERNIP-S
British Medical Journal
JAMA
Lancet
Archives of Surgery
Procedures – sources
News sites
Related organisations
Societies
Examples of sources
Medscape
Doctor’s guide
ECRI Institute
HAYES
American Cancer Society
Programs – sources
Early Assessment & Alert Systems
Health Organisations
HTA Organisations
Journals
News sites
Related organisations
Societies
Examples of sources
Australia and New Zealand Horizon Scanning Network
Euroscan
NHS
Canadian Agency for Drugs and Technologies in Health
National Institute for Health & Clinical Excellence (NICE)
The Cochrane Collaboration
Centre for Reviews & Dissemination (CRD)
British Medical Journal
JAMA
Lancet
Medscape
Doctor’s guide
ECRI Institute
HAYES
American Cancer Society
Settings – sources
Early Assessment & Alert Systems
Health Organisations
HTA Organisations
Journals
News sites
Related organisations
Societies
Examples of sources
Australia and New Zealand Horizon Scanning Network
Euroscan
NHS
National Institute for Health & Clinical Excellence (NICE)
Canadian Agency for Drugs & Technologies in Health
The Cochrane Collaboration
British Medical Journal
JAMA
Lancet
New Scientist
Medcape
http://medgadget.com
ECRI Institute
HAYES
American Cancer Society
HEALTH PACT
� Horizon Scan Technology Classification
- Experimental
- Investigational
- Nearly established
- Established
- Established but changed indication or modification of technique
- Should be taken out of use
HEALTH PACT
� Once identified technologies prioritised according to pre-defined criteria
- Clinical need
- Rate and pattern of diffusion
- Estimated clinical impact
- Estimated cost impact
- Efficacy and safety issues
- Ethical issues
- Cultural or religious issues
- Other
HEALTH PACT
� A technology prioritised for Health PACT review if it reaches one or more of the following threshold criteria:
- associated with obvious safety or ethical issues or controversies
- it has not been assessed and is rapidly diffusing throughout the Australian health system
- it is applicable to a large proportion of the Australian population and may have considerable clinical or cost impact
- it is applicable to a small proportion of the population but has obvious and far-reaching benefits
� Those that do not reach the priority threshold marked for monitoring/periodic review or archived
HEALTH PACT
� Prioritising Summary
� Impact Summary:
� <Name of Industry> provides <Name of Technology> with the aim of <Purpose>. The technology is available through <Health Providers> for <Target group>
- Clinical Need and Burden of Disease
- Estimated speed and geographic and practitioner use
- Existing comparators
- Estimated clinical impact of the introduction of the technology
- Estimated cost impact
- Efficacy and safety issues
- Ethical issues
- Cultural or religious considerations
- Others issues
HEALTH PACT
� Outcomes of Prioritising Summary
- Horizon Scanning Brief
- Full Health Technology Assessment
- Monitor: 6-12 monthly
- Do not progress
HEALTH PACT
� Horizon Scanning Brief
- Introduction
- Background
- Description of the Technology: the procedure, intended purpose, clinical need and burden of disease, stage of development
- Treatment Alternatives: existing comparators
- Clinical Outcomes: safety, effectiveness
- Potential Cost Impact
- Ethical Considerations: informed consent, access issues
- Training and Accreditation: training, clinical guidelines
- Limitations of the Assessment: search strategy, availability and level of evidence, sources of further information
- Impact Summary
- Conclusions
- References
Conclusions
� Build on the basis that one doesn’t fit all
� It has been based on the heterogeneity of the members
� It gives suggestions and solutions
� It has been conceived as a live tool that should be enriched with new information
� The document is opened to suggestions
Other products and actions
�Status reports
�Database
�External collaborations and partnership
�Joint actions
Status report 2005
�Diffusion� Members
� INAHTA members
� Related organization
� Decision makers
� Copies available in HTAi
�Newsletter
External collaboration and partnership
�INAHTA (almost all members)
�HTAi (active)
�ECHTA-ECAHI (steering committee)
�OECD (advisors)
�EUNetHTA�Associate and collaborating partners
�WP 7, 8 and 9
Joint actions (comparison of systems)
� Packer C, Simpson S, Stevens, A. International diffusion of newhealth technologies: a ten-country analysis of six healthtechnologies. International Journal of TechnologyAssessment in Health Care 2006; 22(4): 419-428
� Ibargoyen-Roteta N, Gutierrez-Ibarluzea I, Benguria-Arrate G, Galnares-Cordero L, Asua J. Differences in the identificationprocess for new and emerginghealth technologies. Analysis of the EuroScan database. Int J Technol Assess Health Care 2009;25(3): 367-373.
Joint actions (comparison of systems)
0,0
10,0
20,0
30,0
40,0
50,0
60,0
70,0
Device Diagnostics Drug Procedure Programme
Experimental phase II
Investigational phase III
Nearly established
Established
Other
Information not available
Missing
STAGE OF DIFFUSSION
Experimental-phase I-II Investigational- phase III Nearly established Established Other Total
n (%) n (%) n (%) n (%) n (%) n (%)
Agency 1 11 (3.0%) 255 (69.7%) 51 (13.9%) 16 (4.4%) 33 (9%) 366 (100%)
Agency 2 1 (0.4%) 16 (6,6%) 78 (32.2%) 142 (58.7%) 5 (2.1%) 242 (100%)
Agency 3 25 (15.3%) 26 (15.9%) 28 (17.9%) 22 (13.5%) 62 (38%) 163 (100%)
Agency 4 18 (17.1%) 33 (31.4%) 31 (29.5%) 17 (16.2%) 6 (5.7%) 105 (100%)
Agency 5 6 (11.1%) 9 (16.7%) 4 (7.4%) 30 (55.6%) 5 (9.3%) 54 (100%)
Agency 6 - 2 (11.8%) 7 (41.2%) 8 (47.1%) - 17 (100%)
Agency 7 2 (5.9%) 7 (20.6%) 7 (20.6%) 18 (52.9%) - 34 (100%(
Agency 8 2 (10%) 2 (10%) 2 (10%) 14 (70%) - 20 (100%)
Agency 9 4 (21.0%) 8 (42.1%) 6 (31.6%) 1 (5.3%) - 19 (100%)
Agency 10 2 (13.3%) - 10 (66.7%) 2 (13.3%) 1 (6.7%) 15 (100%)
Agency 11 1 (8.3%) 3 (25%) 3 (25%) 2 (16.7%) 3 (25%) 12 (100%)
Agency 12 - 2 (20%) 2 (20%) 5 (50%) 1 (10%) 10 (100%)
Agency 13 2 (25%) 6 (75%) - - - 8 (100%)
Agency 14 - - 2 (100%) - - 2 (100%)
Differences among agencies depending on the stage of diffusion?
TYPE OF TECHNOLOGY
Device Diagnostics Drug Procedure Programme Setting Other Total
n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%)
Agency 1 34 (9.3%) 28 (7.6%) 284 (77.4%) 11 (3%) 1 (0.3%) - 9 (2.45%) 367 (100%)
Agency 2 58 (22.5%) 18 (7%) 137 (53.1%) 24 (9.3%) - - 21 (8.14%) 258 (100%)
Agency 3 73 (44.8%) 34 (20.9%) 1 (0.6%) 23 (14.1%) 10 (5.5%) 1 (0.61%) 22 (13.50%) 163 (100%)
Agency 4 15 (14.3%) 7 (6.7%) 24 (22.9%) 34 (32.4%) 14 (13.3%) - 11 (10.48%) 105 (100%)
Agency 5 5 (9.3%) 3 (5.6%) 38 (70.4%) 3 (5.6%) - - 5 (9.26%) 54 (100%)
Agency 6 12 (60%) 3 (15%) 1 (5%) 4 (20%) - - - 20 (100%)
Agency 7 17 (50%) 2 (5.9%) - 7 (20.6%) - - 8 (23.53%) 34 (100%)
Agency 8 2 (10%) 5 (25%) 5 (25%) 6 (30%) - - 2 (10%) 20 (100%)
Agency 9 3 (15.8%) 1 (5.3%) 6 (31.6%) 7 (36.8%) 1 (5.3%) - 1 (5.26%) 19 (100%)
Agency 10 7 (46.7%) 1 (5.3%) - 7 (46.7%) - - - 15 (100%)
Agency 11 2 (15.4%) 1 (6.7%) 6 (46.2%) 1 (7.7%) - - 3 (23.08%) 13 (100%)
Agency 12 1 (9.1%) - 2 (18.2%) 5 (45.5%) 2 (18.2%) - 1 (0.91%) 11 (100%)
Agency 13 2 (25%) 2 (25%) - - 1 (12.5%) - 3 (37.5%) 8 (100%)
Agency 14 - - - 2 (100%) - - - 2 (100%)
Differences among agencies depending on
the type of technology?
What can we offer?
�Network experience working together
�Experience in the identification of new and emerging technologies
�Different approaches and agreed methodology in HTA of new and emerging technologies
�Experience in network productive research
What can we offer?
�Database with more than 1.000 identified technologies
�Clearing-house experience
�A newsletter or digest for non-members
�A formalised, centralised early warning activity
�An open-mind to new initiatives and collaboration networks
WHO call on innovative
technologies
�Invitation to participate
�Agreed joint action by members if more than 7 members agreed to participate
�14 members out of 20 agreed and volunteered�No experience assessing devices
�Lack of time or dedicated staff
EuroScan involvement
Agency Evaluators
Agencia de Evaluación de Technologías Sanitarias de Andalucía (DETECTA), Seville, Spain Dr Aurora Llanos
Agenzia Nazionale per I Servizi sanitari Regionali (Age.na.s), Rome , Italy Dr Maria Rosaria Perrini
Assistance Publique-Hôpitaux de Paris, Committee for Evaluation and Diffusion of Innovative
Technologies, France (CEDIT)
Ms Anne-Florence Fay
Australia and New Zealand Horizon Scanning Network (ANZHSN)/HPACT Prof Brendon Kearney
Australian Health Technology Assessment (AHTA) Prof Janet Hiller
Linda Mundy
Australian Safety and Efficacy Register of New Interventional Procedures – Surgical
(ASERNIPS)
Irving Lee
Alun Cameron
Basque Office for Health Technology Assessment (Osteba), Spain Dr. Iñaki Gutiérrez Ibarluzea
Canadian Agency for Drugs and Technologies in Health (CADTH) Andra Morrison
Deutsches Institut furMedizinisches Dokumentation und Information (DIMDI) Dr Hans-Peter Dauben
Health Council of the Netherlands (GR) Dr Kees Groeneveld
Cees Postema
Health Information and Quality Authority (HIQA), Ireland Martin Flattery
HTA Reviews and Dissemination Department, Norwegian Centre for Health Services
Research (NOKC)
Dr Inger Norderhaug
Helene Arentz-Hansen
Integrated Care & Aged. Department of Health, Victoria, Australia Dr Paul Fennessy
National Horizon Scanning Centre (NHSC), England and Wales Dr Claire Packer
Distribution of tasks
�14 members�Each technology evaluated by 2 members
�10 technologies per member
�Timeframe 3 weeks
�Secretariat pooled the results
Results
�The deadline was met in all cases, the majority, some days before
�The degree of agreement was high
�The assessment process was coherent
�The process was accountable
�Members who participated were happy to have taken part in this call
Selected innovative technologies
Call for innovative technologies that address global
health concerns
Applications have been evaluated by a team of international experts appointed by WHO. The
lists of selected innovative technologies include the technologies that the team of experts has
found to meet the selection criteria defined in the call for innovative technologies that meet
global health concerns.
CATEGORY 1
Category 1 is for commercialised products or products which are commercialisable. This includes
new products; products which have been commercialised for less than five years in high-income
countries and which are not (yet) widely used in low- and middle-income countries; recent
adaptation of existing non-health products for a health purpose; and/or recent adaptation of an
existing medical device for low- and middle-income settings.
CATEGORY 2
Category 2 is for products in a non-commercialised or a non-commercialised stage. This includes
products which are under development or otherwise in a conceptual stage.
1.1 The Global Initiative on Health Technologies (GIHT)
The goal of the GIHT is to help make available the benefits of
core technologies at an affordable price, particularly to
communities in resource-limited settings, in order to
effectively control important health problems. The GIHT
includes the formulation of Health technology policies,
guidance and management tools, as well as the ‘Call for
innovative technologies that address global health concerns’
STEP 1 Screening
WHO internal experts will screen all applications. The
ones which are incomplete or non medical devices will,
in principle, not be processed further. An identifier
code will be assigned to the application and all
information about the application will be removed to
maintain confidentiality
Step 2 Evaluation
After screening, eligible submissions are passed on to external
independent experts as well as to WHO designated staff for
evaluation. Evaluation will occur concurrently and independently.
Applications will have been made anonymous before the evaluation
procedure starts.
The WHO internal evaluators will, based on provided selection
methodology (Table 1), analyse and grade the submitted
applications. A total score for each submission will be used for the
selection of technologies to be presented to the meeting participants
in the Advisory Group on Innovative Technologies meeting. The five
submissions that have obtained the highest scores in each category
will be shortlisted and presented to the AGIT meeting on 27-29 April
2010.
Step 3 AGIT final selection
The AGIT will make a recommendation for a final selection of
a set of technologies for the two categories “commercialised”
and “non-commercialised” products. The AGIT will also
analyse the challenges that may face selected medical
devices when trying to successfully reach the intended
markets in low and middle-income countries with the aim to
present a way forward on how to overcome those challenges.
Selection Criteria
1. What is the level of safety for user, patient and the
environment
2. How effectively does the technology address the health concern(s) in question.
3. How well is the technology adapted to local infrastructures in resource-limited setting.
4. What is the ease of use level. What is the ease of maintenance.
5. How high are cost-effectiveness and affordability.
6. How high are cultural and social acceptability of the technology
7. Is the product innovative.
Innovation e.g.
� a product from a significant new drug class
� a product with potentially greater efficacy or reduced adverse effects than current options
� a new formulation of a licensed product that may have additional patient or service benefits
1.1 Stool sample collection and preparation kit
The intended purpose* of the stool sample collection and preparationkit is to simplify faecal examination by reducing the number ofconsumables and steps required for the procedure. The kit could therefore facilitate the diagnosis of parasitological diseases. Additionally, the kit does not appear to require water or electricity and is claimed to prevent recontamination of the environment.
1.2 LED phototherapy unit
The intended purpose* of the LED phototherapy unit is to treat hyperbilirubinaemia in newborn infants by phototherapy. The unit could increase the safety of the procedure by using a radiation source that producesblue light and minimizes the exposure to harmful ultraviolet radiation.Further potential advantages are that the unit measures the actual output of light at useful wavelengths and is claimed to have lower energy consumption than previous designs.
1.3 System for on-site production of wound irrigation solution
The intended purpose* of the system for on-site production of wound irrigation
solution is to produce aqueous solutions for the topical treatment of wounds
and infections using a power source, demineralised water and salt. Solutions
produced by the system could be used to treat a host of conditions including
traumatic injuries, post-natal infections and neglected tropical diseases that
cause ulcerations and infections.
1.4 SMS smoking cessation system
The intended purpose* of the SMS (short message service) smoking cessation
system is to provide tailored SMS-based smoking cessation support to its
users. According to preliminary research submitted, the system facilitates self-
management of smoking cessation and increases the likelihood of user
adherence to smoking cessation programs. The interactive system claims to be
capable of answering messages about cravings to support the user.
1.5 Reusable neonatal suction system
The intended purpose* of the reusable neonatal suction system is to remove
obstructive mucus from the air passages in newborn infants to reduce the risk
of asphyxia and to support neonatal resuscitation. The device is claimed to be
reusable and capable of being cleaned and boiled between uses. The device is
claimed to be made of durable silicone and not to require electric power.
1.6 Fluorescence visualisation system for cancer screening
The intended purpose* of the fluorescence visualisation system for cancer
screening is to use the natural fluorescence of mucosal tissues when excited by
a voilet/blue light to inform clinicians about the presence of abnormalities in
the mucosa in the oral cavity. This system could aid in the early detection of
oral/oropharyngeal cancers and thereby reduce morbidity and mortality
associated with these diseases.
1.7 Transcutaneous bilirubin measurement system
The intended purpose* of the transcutaneous bilirubin measurement system is
to provide an alternative to blood sample analysis for the diagnosis of
hyperbilirubinaemia in newborn infants. The system uses spectral analysis of
light reflected from the patient’s vascular bed to determine levels of bilirubin in
the blood. The device is claimed to be non-invasive and to rapidly give a read-
out.
1.8 Isotherma nucleic acid amplification system for tuberculosisdiagnosis
The intended purpose* of the isothermal nucleic acid amplification system for
tuberculosis diagnosis is to offer a point-of-care alternative to sputum smear
microscopy. The technology is claimed not to require any additional
equipment and to yield a rapid visual read-out of the diagnostic result.
2.1 Simplified anaesthesia unit
The intended purpose* of the simplified anaesthesia unit is to function as an
anaesthesia machine for surgical use in low-resource settings. The device
features an innovative valve system with reduced technical complexity
compared to traditional devices. The device is claimed to function with oxygen
from different sources including ambient air and therefore would not require
compressed oxygen.
2.2 Single use assistive vaginal delivery system
The intended purpose* of the single use assistive vaginal delivery system is to
assist foetus extraction in cases of prolonged second stages of labour without
having to use forceps, to use a vacuum extractor or to resort to caesarean
sectioning. The lack of rigid instruments in the system is claimed to reduce
the risk of injury to both mother and child.
2.3 Portable on site cell sorter and coutner for HIV and malaria diagnosis
The intended purpose* of the portable on site cell sorter and counter for HIV
and malaria diagnosis, a lab-on-a-chip, is to monitor AIDS in HIV-infected
people as well as blood cell alterations indicating malaria. The system appears
to be a small and portable device that would allow for rapid automated
screening of a blood sample for indicator of AIDS and/or malaria.
2.4 Decision support system for paediatrics HIV
The intended purpose* of the decision support system for paediatrics HIV is to
move away from paper-based medical records while ensuring easy and reliable
access to patient-centred information. This electronic health records system is
targeted at paediatric HIV cases and is intended to aid clinical decision-making
processes such as weight-based dosing support for antiretroviral drugs.
2.5 Transcutaneous anaemia monitoring system
The intended purpose* of the transcutaneous anaemia monitoring system is to screen populations
for insufficient levels of haemoglobin in the blood and to carry out diagnosis of severe anaemia. The
system is claimed to be based on spectrophotometric analysis. The device appears to be portable,
non-invasive and is claimed to give a read-out in less than a minute.
2.6 Solar-powered autoclave
The intended purpose* of the solar-powered autoclave is to sterilise medical instruments. It is
claimed to run solely on solar power. This technology could allow sterilisation of medical instruments
in remote rural areas with no access to electricity and hence reduce the risk of infections associated
with carrying out medical interventions with dirty equipment.
2.7 Portable infant warmer
The intended purpose* of the portable infant warmer is to improve the care of premature and low-
birth-weight babies by providing heat at a constant temperature in order to prevent hypothermia.
This portable device is claimed not to require electricity and would allow for close mother-to-baby
contact. The product is targeted fro use in urban and rural healthcare settings, and in home
settings.
Issues to think about
�Technical issues�Difficulties to fulfill the evaluation sheets
�Submission and evaluation processes�Definition of innovative technology
�Low quality of submissions
�Lack of information
�Same weight of criteria
Ways of improvement
�Technical issues� Centralised web platforms for submission and evaluation
�Submission and evaluation processes�Definition of innovation
�Workshop on how to submit proposals
� Scoring system. Previous work on weighting criteria, defining cut-off points for each criterion or groups of criteria
Acknowledgements
� All members of EuroScan
� Participating organizations
� Dr Aurora Llanos; Dr Maria Rosaria Perrini; Ms Anne-Florence Fay; Prof Brendon Kearney; Prof Janet Hiller; Linda Mundy; Irving Lee; Alun Cameron; Dr. Iñaki Gutiérrez Ibarluzea; Andra Morrison; Dr Hans-Peter Dauben; Dr Kees Groeneveld; Cees Postema; Martin Flattery; Dr Inger Norderhaug; Helene Arentz-Hansen; Dr Paul Fennessy; Dr Claire Packer
Suggestions
� EuroScan Secretariat, Department of Public Health, Epidemiology & Biostatistics, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK Tel: +44 (0)121 414 7496
� http://www.euroscan.org.uk