Научно-практический журнал Медицинские технологии. Оценка и выбор
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Issue № 29 | 2017 (3)

Abstract

Original research data in MEDLINE database allows one to find the most comprehensive answer to clinical query. This entails the problem of large amounts of material that needs to be analyzed. The main study objective was to develop an algorithm for search results ranking of medical studies based on the levels of evidence. Developed search engine is based on a combination of classifiers that determine the level of evidence and subtype of medical intervention for a study abstract. As the main classification algorithms linear classifiers, as well as AdaBoost with Random Forest and SVM with RBF kernel were considered. Evaluation of the quality of classification by medical intervention subtypes was obtained using 5-folds cross validation method. Generative probabilistic LDA model was used for solving the problem of training set imbalance. The developed algorithm allows one with 92% precision to determine the study level of evidence, and to rank query results in relevance descending order.

Keywords

evidence-based medicine, algorithm, MEDLINE, searching.

For citations

Kamalov M. V., Dobrynin V. Yu., Balykina Yu. E., Kolbin A. S., Verbitskaya E. V. Ranking Algorithm for Medical Research Results Based on the Levels of Evidence at the Stage of Getting Answers to Search Queries. Medical Technologies. Assessment and Choice. 2017; 3(29): 11–21.

Issue № 28 | 2017 (2)

Abstract

Best practice recommendations for HTA system design which do not pay sufficient attention to local institutional environments may prove to be suboptimal or dysfunctional in countries newly implementing HTA. This study presents how HTA system design can be supported by taking an institutional perspective and adopting basic findings from contingency theory. A four-step rational process to HTA system is described and nine practical recommendations are formulated for Russia and the Eurasian Economic Union.

Keywords

contingency theory, HTA system design, HTA institutions, Russia, Eurasian Economic Union.

For citations

Danko D., Khachatryan G. R. Development of Health Technology Assessment Systems in the Countries at the Initial Stage of their Introduction – Recommendations for Russia and the Countries of the Eurasian Economic Union. Medical Technologies. Assessment and Choice. 2017; 2(28): 10–19.

Issue № 27 | 2017 (1)

Abstract

The article presents the Russian-language version of the questionnaire to assess the risk of systematic bias in cross-sectional studies of diagnostic tests. This version is the adapted translation of the international consensus questionnaire QUADAS. The risk of systematic bias in the original scale is not stratified, however, we propose to evaluate the overall risk of systematic bias as low, medium or high, depending on the score sum according to the criteria of the questionnaire. To assess the overall methodological quality not only the risk of systematic bias should be assessed, but also the risk of incorrect statistical analysis.

Keywords

cross-sectional study, diagnostic test, diagnostic accuracy, reference test, systematic bias, assessment, QUADAS.

For citations

Rebrova O. Yu., Fediaeva V. K. Assessment of Risk of Bias in the Cross-Sectional Studies of Diagnostic Tests: the Russian-Language Version of the Questionnaire QUADAS. Medical Technologies. Assessment and Choice. 2017; 1(27): 11–14.

Issue № 25 | 2016 (3)

Abstract

The article presents the Russian-language version of the questionnaire to assess the risk of systematic bias in case-control studies and cohort studies. These questionnaires are translations of the Newcastle-Ottawa Scale to assess the methodological quality of non-randomized studies. The risk of systematic bias in the original scale is not stratified, but in practice the Cochrane Collaboration considered trials with 5 or fewer points (of 9) to have a low methodological quality. We propose to assess the methodological quality not only by the assessing risk of systematic errors, but also the risk of incorrectness of statistical analysis.

Keywords

non-randomized trial, case-control, cohort, questionnaire, systematic bias, systematic error, assessment, methodological quality, Newcastle-Ottawa Scale.

For citations

Rebrova O. Yu., Fedyaeva V. K. The Questionnaire to Assess the Risk of Systematic Bias in Non-Randomized Comparative Studies: the Russian-Language Version of the Newcastle-Ottawa Scale. Medical Technologies. Assessment and Choice. 2016; 3(25): 14–19.

Issue № 25 | 2016 (3)

Abstract

Multicriteria decision analysis (MCDA) is the mathematical approach that allows to take into account several factors when making difficult decisions. The article presents the results of a pilot application of MCDA for rare diseases and orphan drugs. Comparison of two methods (direct weighting and swing weighting) for assessing the importance of the criteria was conducted. The advantage of the second approach was shown.

Keywords

multi-criteria decision analysis, MCDA, decision-making, rare diseases, weighting coefficients, direct weighting, swing weighting.

For citations

Fedyaeva V. K., Rebrova O. Yu., Omelyanovskiy V. V. Comparison of Methods for Assessing the Importance of the Criteria in Multi-Criteria Decision Analysis in Financing the Treatment of Rare Diseases. Medical Technologies. Assessment and Choice. 2016; 3(25): 8–13.

Issue № 24 | 2016 (2)

Abstract

We have developed an instrument to assess the methodological quality of network meta-analyzes and indirect comparisons based on International Society for Pharmacoeconomics and Outcomes Research (ISPOR) tool. This instrument includes 15 questions on five aspects (domains): the evidence base, analysis, presentation of results, interpretation, conflict of interests. For each domain the estimate is given informally then the general credibility (methodological quality) of the research is assessed.

Keywords

network meta-analysis, indirect comparison, mixed treatment comparison, credibility, methodological quality, questionnaire, assessment, ISPOR.

For citations

Rebrova O. Yu., Fedyaeva V. K. The Questionnaire for Evaluating the Credibility of the Network Meta-Analysis (Including Mixed and Indirect Comparisons). Medical Technologies. Assessment and Choice. 2016; 2(24): 9–15.

Issue № 23 | 2016 (1)

Abstract

Meta-analysis is often considered as the highest level evidence on the effectiveness and safety of drugs and other medical technologies; however, the methodological quality of meta-analyses and systematic reviews varies considerably, which leads to the differences of effect values and the levels of evidence of the results. In 2007, validated tool to assess the methodological quality of systematic reviews AMSTAR has been developed. It is based on the combination of many elements of the previous evaluation systems. We have translated AMSTAR into Russian and made some extra explanation. The current publication presents the Russian-language version of the questionnaire. We believe that the Russian version of AMSTAR questionnaire can be used for a more objective assessment of the evidence of medical technology.

Keywords

systematic review, meta-analysis, questionnaire, AMSTAR, Russian version.

For citations

Rebrova O. Yu., Fedyaeva V. K. Meta-analyses and Assessment of Their Methodological Quality. Russian Version of AMSTAR Questionnaire. Medical Technologies. Assessment and Choice. 2016; 1(23): 10–16.

Issue № 22 | 2015 (4)

Abstract

Restrictive drug lists can be considered to be one of the signs of reimbursement formation in Russia. According to the new rules developed in 2014, the basic principle for the Vital and Essential Drugs (VED) List compilation is a structured formalized expert opinion. The aim of this study was to construct a decision making model using mathematical tools for the VED List compilation. The paper describes a mathematical formalization of the problem, as well as mathematical modeling techniques used. Based on the constructed models, the conclusion data received from the expert organizations (EO), the main external specialist of the Ministry of Health (MES), and the data on the final decision made by interdisciplinary committee of the Ministry of Health (IC) were analyzed. The study showed that the linear regression models can be partly applied to solve the problems mentioned above. The VED List analysis with help of linear models showed that the constructed rules for an expert organization gave an error of 12.4%. The model for the analysis of the EO opinion influence on the MES conclusion gave an error of 10%. The model for the final decision gave an error of about 35%, i. e. it was impossible to determine the final Committee decision based on the scoring made by the previous agents. Recommendations on optimizing the formalized approach are presented.

Keywords

restrictive lists, formalized approach, mathematical modeling, scores.

For citations

Prasolov A.V., Kolbin A.S., Maksimkina E.A., Golant Z.M., Polushin Y.S., Kurylev A.A., Viilyum I.A., Balykina Y.E. Analysis of the 2014 Vital and Essential Drugs (VED) List Using Mathematical Modelling. Medical Technologies. Assessment and Choice. 2015; 4(22): 13–19.

Issue № 3 | 2015 (21)

Abstract

The best practice of new biomed technologies development assessment is based on rigorous and transparent management system and applied criteria. The paper is focused on innovative projects assessment management in the context of the Skolkovo Foundation expert panel. Results of its implementation are demonstrated, considering advantages and disadvantages as well as its future development.

Keywords

expertise, innovation, Skolkovo Foundation, project assessment.

For citations

Khodova К.А., Grechikhin P.V., Kutsakov V.N., Nikolsky Y.V., Bulatov K.A., Kaem K.V. Management of Innovative Projects Assessment: Skolkovo Foundation Perspective. Medical Technologies. Assessment and Choice. 2015; 3(21): 15–20.

Issue № 3 | 2015 (21)

Abstract

To assess the relative cost-effectiveness of the two medical technologies (cost-effectiveness analysis, CEA), the incremental cost-effectiveness ratio (ICER), net (monetary) health benefit (NHB) and the cost-effectiveness acceptability curve (CEAC) are used. The criterion «willingness to pay» is utilized in the above approaches. In this study, we simulated data of two medical interventions (effects and costs) and computed cost-effectiveness using the above three methods, and then compared the results. We revealed the proximity of the 95% CI for the ICER, calculated using different approaches (nonparametric percentile bootstrap, parametric Fieller, based on the NHB and CEAC). This allows to make reliable statistical conclusion about two compared medical technology and support decision making.

Keywords

cost-effectiveness analysis, confidence interval, incremental cost-effectiveness ratio, net (monetary) health benefit, cost-effectiveness acceptability curve.

For citations

Simonov A.N., Rebrova O.Yu. Statistical Estimates of Cost-Effectiveness of Medical Technologies. Medical Technologies. Assessment and Choice. 2015; 3(21): 8–14.