Anti-tumor necrosis factor drugs (anti-TNF) are the last line of treatment for psoriatic arthritis (PsA) in the guideline of Brazilian Public Health System (SUS). Data of effectiveness of these drugs are scarce in the Latin American population. This study evaluated the effectiveness of the anti-TNF on a cohort of patients with PA in the SUS.

PsA patients treated with anti-TNF, were included in an open prospective cohort study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Clinical Disease Activity Index (CDAI) were used to assess the effectiveness at six months of follow-up. The anti-TNF was considered effective when the patient achieves scores of four or less measured for BASDAI or scores of ten or less for CDAI. Frequency distributions were compiled for the sociodemographic variables and mean and standard deviation (SD) was used for clinical variables. The paired Student t-test was established to evaluate the differences between baseline and 6 months evaluated for BASDAI and CDAI.

Fifty-four patients with PsA completed six months of follow-up. The mean age of patients was 54.03 years (10.44) and the mean disease duration was 8.00 years (7.49). Furthermore, 50 percent of the patients were female, 61.1 percent white and 59.6 percent married. The most used anti-TNF was adalimumab (63.0 percent), followed by etanercept (20.4 percent) and infliximab (16.7 percent). The anti-TNF reduced disease activity measured by BASDAI and CDAI at six months of follow-up (p<.001). The percentage of patients achieving the effectiveness with anti-TNF was 61.1 percent measured by BASDAI and 53.7 percent by CDAI.

Anti-TNF drugs demonstrated to be effective in more than half of patients at six months. This result highlighted the importance of the treatment with the anti-TNF drugs in the Brazilian population. Long-term data are needed to confirm these results.

Older people with cancer are less likely to receive radical treatment for cancer. We conducted a series of systematic reviews to explore the effectiveness and tolerability of systemic anti-cancer therapy for older people with cancer. The reviews were conducted on behalf of the National Cancer Equality Initiative to establish an understanding of the current body of research and to enable the development of more personalized treatment protocols for elderly patients that take into account fitness and personal choice.

We conducted six systematic reviews that considered the effectiveness and tolerability of treatment for older people with cancer (breast, colorectal, lung, renal cell, chronic myeloid leukaemia and non-Hodgkin's lymphoma). Four electronic databases were searched from 2010 to 2013. Data were extracted on a range of outcomes from published studies (randomised controlled trials, subgroup analyses, pooled analyses, cohort studies and retrospective studies).

We found a large quantity of published research from a wide range of study types. We included a total of 490 studies (64 randomized controlled trials, 30 subgroup analyses, 24 pooled analyses, 255 cohort studies, and 117 retrospective studies).

Most of the randomized controlled trials enrolled fitter and healthier patients than those seen in routine clinical practice. The evidence indicates that older patients with good performance status can, and do, respond well to chemotherapy, frequently achieving similar survival benefit to younger patients.

We found no consistent definitions of ‘old’ or ‘elderly’ and these varied from 50 years to 85 years across studies.

The study results demonstrate that comprehensive geriatric assessment has not been routinely conducted in clinical cancer studies and that readily available assessment tools were not used by study investigators.

Age should not be a barrier to treatment for the older population. Research is needed to determine which treatment regimens offer the appropriate balance of clinical effect and likelihood of adverse events within older populations. Future randomized controlled trials could be designed to include either higher proportions of older people, or only older people.

Drug prices are mainly determined by production costs, commercial circulation and use in medical institutions. In 2015, total sales of the Chinese drug distribution industry was CNY1,613.3 billion (USD248.6 billion at 31 December 2015 exchange rate), with CNY28.3 billion (USD4.4 billion) profit and an average cost rate of 5.4 percent due to high logistics costs (1). Under Multi-invoice Systems in China, drugs are delivered through national, provincial, local agents, with invoiced and prices going up each time (2). The Two-invoice System, which comes up in April 2016, is China's first drug distribution policy aiming to compress circulation, and reduce unrealistically high prices. There will be only two invoices, one from production enterprises to distributors, the other from distributors to medical institutions. The objective of this study is to evaluate the effect of the Two-invoice System on drug distribution and price in China.

We conducted a literature review of relevant articles and policies in five provinces on China National Knowledge Infrastructure (CNKI), Wanfang, PubMed and government websites. We conducted in-depth individual interviews for qualitative research on policy mechanisms with two government officials and four drug production and distribution enterprise managers. The quantitative study on policy effect measured indicators, namely, number of distributors, concentration ratio index (CR), net sales ratio, and ex-factory price. We compared the pilot province before and after the policy, with national level and other provinces. We considered related drug policies to eliminate confounding. Focus group discussion on conclusions and suggestions will be conducted.

There are no peer review articles, only news media on this topic. In Fujian Province, the number of distributors droped from 246 to 62. In 2015, the Top 3 drug wholesalers reached a market share of 36 percent (CR3), and Top 10 for 86 percent (CR10). Compared to the whole country, CR3 is 26 percent and CR100 is 86 percent. Net sales in the drug wholesale market in Fujian accounted for 75.6 percent, with an increase of 4.3 percent. While at the national level, it is only 57.2 percent with an increase of 0.3 percent (3).

The Two-invoice System in China reduces intermediate circulation, and increases industrial concentration. Net sales directly to hospitals are encouraged, whichaffects distribution and production areas. Production enterprises tend to invoice with higher prices instead of offering reserve prices to agents.

Health Technology Assessment (HTA) processes have become a fundamental part in the lifecycle of new medicines. However, their deep relation with national legislation creates ambiguous and controversial results between the European countries. Can they be standardized across Europe?

Sources of national differences have been identified in timelines, documents, methods, data interpretation, and conclusions. In order to harmonize and standardize HTA cooperation across Europe the European Network for HTA (EUnetHTA) was established. We analyzed guidelines, requirements, and output of EUnetHTA and noted the differences between those guidelines and the German G-BA (Federal Joint Committee, Gemeinsamer Bundesausschuss) standard and IQWiG (Institute for Quality and Efficiency in Health Care, Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen) methods.

The comparison between German and European HTAs highlights that although both procedures follow the rules of Evidence-Based Medicine, differences in Body of Evidence, Comparator, Surrogate Endpoints, Subgroups, and Evidence Synthesis may lead to diverging HTA outcomes. The European HTA framework facilitates the appropriate depiction of clinical reality through comprehensive inclusion of the existing evidence with context specific statistical methods. It might become a worldwide platform for HTA evaluation and discussion.

Only the involvement of both, pharmaceutical companies and HTA bodies within a unified European framework can lead to a mature and transparent procedure with a reliable outcome independent of legal requirements.

There has been a growing interest in international collaboration among Health Technology Assessment (HTA) organizations on macro, meso, and micro policy-making levels. Global member-driven professional HTA societies make contributions to scientific improvement and enhance interactions in the HTA ecosystem. However, little is known about collaboration between HTA organizations at the global level. This study intends to examine the main drivers of network relationships of HTA organizations.

Social network analysis was used to ascertain the relationships between HTA organizations and to visualize the main drivers of collaboration. The total number of memberships of the HTA organizations of the International Society For Pharmacoeconomics and Outcomes Research (ISPOR), Health Technology Assessment International (HTAi), International Netowork of Agencies for HTA (INAHTA), EuroScan, European Network for HTA (EUnetHTA), HTAsiaLink, Red de Evaluación de Tecnologías en Salud de las Américas (RedETSA) were considered to create the network. Ten different types of HTA organizations were considered in the analysis including the Ministry of Health (MoH), university, for-profit, and hospitals. The Fruchterman-Reingold algorithm was used to perform network analysis; average clustering coefficient and average path length were examined to measure collaborative performance.

A network graph of the HTA ecosystem shows the highest collaborative frequency in terms of HTA organizations, occurred with members of the Ministry of Health, government agencies, universities, and non-profit organizations. The average path length was 2.21 and the average clustering coefficient was 36.576 which indicates an obvious clustering effect.

These study results highlight that the network throughout the HTA ecosystem is driven by government organizations. Integrating the private sector into the system, creating common information and data sharing strategies, and improving the number of internationally experienced HTA professionals are essential strategies to foster collaboration in HTA organizations. As HTA is shaped by local dynamics and there is no gold standard for HTA implementation, encouragement of collaborative efforts is the only way to prevent duplication of effort and to make health technologies available for everyone.

A novel, sensor-based, factory-calibrated Flash Monitoring System (FMS) has recently proved to be an effective alternative to conventional self-monitoring of blood glucose (SMBG) in patients affected by type 1 and type 2 diabetes. The 14-days adhesive sensor, that continuously measures glucose levels in the interstitial fluid, can transfer glucose levels data to a handheld reader or a smartphone equipped with a specific medical app. The uptake of the new technology has been limited so far, because of its high costs. A cost analysis has been conducted to identify the optimal target population of introducing FSM in Veneto.

The model was designed with a 1-year time horizon for patients with diabetes using intensive insulin in Veneto region. The costs of the new technology was estimated using inputs from the two main randomized controlled trials (the IMPACT study and the REPLACE study) published in the international literature, Regional evidence-based guidelines and administrative database. Resource utilization included strips, lancets, needles, sensors, distribution and patients training. Regional unit costs were adopted.

FSM has not shown so far relevant and statically significant benefits in terms of severe adverse events’ reduction. Estimated yearly costs for a FSM user included glucose monitoring, technology training and distribution costs, for a total of EUR1277 per patient. The new technology has been shown to be affordable in diabetic patients with i) 4years<age<18years, ii) continuous subcutaneous insulin infusion and iii) ≥5 blood glucose monitoring per day.

The Veneto Region should carefully consider prescribing extension to other diabetic patients categories, since the high cost of the new technology. A strict prescribing monitoring is strongly recommended with the aim of ensuring appropriateness and avoiding overspending.

Following a first field evaluation conducted in 2013, we found that hemolysis can be induced by infusion pumps during blood transfusion. Actually, limited data is available on the risk of hemolysis associated with the most used infusion pumps in Quebec hospitals: InfusomatSpace (peristaltic), Plum A+TM (piston) and ColleagueCXE (shuttle).

Staff from the blood bank and the Health Technology Assessment (HTA) unit in our hospital collaborated in 2016 to assess the hemolysis and potassium level (that is, a blood test sensitive to hemolysis) induced by the use of the three infusion pumps mentioned above. Measurements were taken for each pump at five flow rates, from 30 to 450 ml/hour, and were compared with measurements taken before using the pumps. Tests were conducted with 135 red blood cell (RBC) units. RBC units were aged from 10 to 28 days.

The shuttle- and piston-type pumps resulted in low hemolysis levels. The peristaltic-type pump produced significantly more hemolysis. However, the absolute value of hemolysis remained within the range recommended by the regulatory agencies in North America and Europe. Potassium levels did not increase with the use of the pumps.

The collaboration between the blood bank and the HTA unit led to the conclusion that modern infusion pumps widely used in Quebec hospitals produce non-threatening levels of hemolysis during blood transfusion. This finding is important to ensure safe practices.

In order to support service planning of the youth program of the East of Montreal Health and Social Services Board, and potentially of the other twenty-five programs across the Quebec province, our hospital-based Health Technology Assessment (HTA) unit was asked to bring evidence of the effective interventions for five most common mental disorders in children and young populations, namely anxio-depressive disorders, attention deficit and hyperactivity disorder, oppositional and conduct disorders, substance abuse disorders, and suicide attempts.

A review of reviews was conducted for the five disorders in young populations aged 6 to 25 years. This was based exclusively on systematic reviews and meta-analysis of a minimum two randomized-controlled trials. The review was completed with examples of Quebec's good practices in youth mental health gathered from personal research experience of clinical researchers involved in the project. The project involved collaboration with three other hospital units and provincial HTA agencies.

No review supporting screening and early detection for the five disorders was identified. Prevention, however, was better covered in the literature, and a clear distinction was made between universal, targeted and indicated interventions. In general, targeted and indicated prevention interventions were effective in the case of anxio-depressive (1) and substance use disorders, while universal prevention strategies seemed to reduce suicide attempts and suicide ideation (2). Effective treatments also exist for these mental disorders. In general, psychotherapies dominated for anxio-depressive and substance use disorders; parental skills dominated in oppositional disorders, whilst pharmacological treatment dominated in attention deficit and hyperactivity disorder (3). Evidence was limited for suicide attempts. The overview of Quebec's good practices allowed identification of interventions or practices already in use in the province.

The review summarized effective interventions for five most common mental disorders in young populations. It also permitted to identify several research gaps, and therefore research recommendations were formulated for the province's health research agency.

Despite numerous medical, pharmacological and surgical approaches for chronic low back pain (LBP), many patients continue to complain of severe disabling pain. Peripheral nerve field stimulation (PNfS), alone or combined with spinal cord stimulation, is a neuromodulation procedure that have been recently developed and implemented in our hospital. We conducted a Health Technology Assessment (HTA) to determine if PNfS may be considered as a standard of practice in the management of intractable LBP and failed back surgery syndrome (FBSS).

An interdisciplinary group of experts was involved in the project. A systematic review (SR) was performed in several databases and grey literature to identify clinical practice guidelines, SR and observational studies published through September 2016. A survey was conducted among other chronic pain centers in Canada to document PNfS use in LBP and FBSS treatment.

Data on effectiveness and safety of PNfS in chronic LBP treatment were scarce. Short-term results (3-12 months) from small sample and low quality studies suggest that PNfS, alone or combined with spinal cord stimulation, is associated with pain intensity and opioid use reductions. Effects on functional status and quality of life remain undetermined. Most frequent adverse events reported with PNfS devices are lead migrations, discomfort or pain and surgical site infections. No other Canadian pain centers were found to use PNfS in chronic LBP or FBSS.

PNfS is potentially a beneficial treatment option for patients with chronic low back pain or FBSS. However, the value of this innovative treatment remains unknown. Among factors to be clarified are target population (any chronic low back pain or FBSS), use of PNfS alone or combined with spinal cord stimulation, long-term effects, and comparison with conventional medical management. PNfS use in chronic LBP has to be assessed through a rigorous framework before its introduction as a standard medical practice.

Available data in the scientific literature is not always sufficient to make a clear Health Technology Assessment (HTA) recommendation without any other source of data. Contextual data and local expertize are an important source of data that cannot be ignored in HTA process. Despite a lack of evidence in the scientific literature, a technology can be recommended in a given context. We illustrate this by a case study about biplane angiography for vascular neurointervention.

A systematic review was conducted. The level of evidence was assessed by the grid of Downs and Black. An analysis of the context in our setting was also conducted. The main outcomes were: radiation doses, clinical complications, procedure times, purchase cost, impact on teaching programs, confidence of clinicians in the technology, quality of care, and volume of activity. A committee constituted of managers, clinical experts, physicians, physicists and HTA experts was created to produce a recommendation about biplane technology acquisition.

A list of 257 citations was obtained yielding 9 eligible articles for analysis. Despite the lack of evidence found in the literature (median of Downs and Black: 3/32), the biplane system appears to reduce ionizing radiation and medical complications as well as shorten procedure time. Contextual data indicated that biplane system could improve operator's confidence, which could translate into reduced risk, especially for complex procedures. We estimate that a minimum of 50 cases can be done in our context (University hospital center covering a population of 306,322 people) with a higher level of patient safety. In addition, the biplane system can support our institution in advanced procedures teaching program.

Given on the advantages provided by the biplane technology in our setting, the committee has recommended its acquisition. However, this technology should be implemented with a responsibility in collecting outcome data to optimize clinical protocol in doses of ionizing delivered.

Health Technology Assessment (HTA) methods are usually applied to the evaluation of drugs, devices, and procedures. We have used HTA to promote evidence-based decision-making on topics relating to staffing and career development for healthcare professionals. Interventions to reduce the stress associated with caring for patients who need repeated hospitalization such as patients with sickle cell disease are thought to improve job satisfaction and nurse retention, but is there scientific evidence to support them?

We systematically searched Medline, CINAHL, PsycINFO, Cochrane, and Joanna Briggs Institute databases for published studies evaluating interventions targeting healthcare personnel. Searches combined tems for sickle cell disease with terms for job stress, turnover, and other career-related outcomes. We evaluated the quality of individual studies using standardized checklists and constructed evidence tables.

We found one randomized trial (RCT) of an education program for nurses and physicians, a pre-post analysis of a communication skills and cultural awareness program, and a case study of a nurse support group. The RCT found that an education program significantly improved participants attitude towards patients but did not measure any outcomes relating to caregiver stress or job satisfaction. The pre-post study found that a communication skills program significantly improved nurses confidence in their ability to communicate with patients. The case study reported that nurses found the support group useful and felt their attitudes were improved, but there was no control group to compare their responses to. The education program was graded as moderate-strength evidence and the other programs had low-strength evidence. There was no meta-analysis or other data synthesis of the results because of the differing interventions and outcome measures.

There have been few quantitative scientific evaluations of the effectiveness of interventions to reduce the stress nurses feel when caring for sickle cell disease patient. The studies that have been published have favorable conclusions towards these interventions, but the strength of evidence is not high.

Information specialists and others searching for Health Technology Assessments (HTAs) can use the ISSG Search Filter resource (SFR) to identify filters to incorporate into search strategies. This can save time and effort when designing searches and create more efficient searches that retrieve fewer and possibly more relevant database records (link available here: https://sites.google.com/a/york.ac.uk/issg-search-filters-resource/home).

What are search filters? Search filters are collections of search terms designed to retrieve selections of records from bibliographic databases. Some filters are designed to retrieve records of specific study designs such as randomized controlled trials (RCTs) or systematic reviews; others aim to retrieve records relating to other features or topics such as the age or gender of study participants.

Search filters may be designed to be sensitive, precise or balanced between sensitivity and precision.

When would you use a search filter in HTA? Search filters can be added to search strategies to limit to specific study types, for example, RCTs, mixed methods studies, systematic reviews. They can also be used when searching for other aspects of HTA such as patient views or specific age groups.

The ISSG SFR includes sections listing search filters to help identify adverse effects, aetiology, economic evaluations, health state utility values, public views, and quality of life.

How are filters used? A search filter is often used in combination with a topic search to restrict the search results to a specific type of record, for example, records reporting health state utility values or records of randomized controlled trials.

Further guidance on the use of search filters can be found in the SuRe Info Search Filters chapter.

In contrast to bibliographic databases, trial registries do not offer the option of formulating complex search queries, thus making targeted searches more difficult. However, ClinicalTrials.gov (CT.gov) and the International Clinical Trials Registry Platform (ICTRP) offer different search features that may help compensate this limitation. Our aim was to determine the importance of search features (for example, searches using synonyms or, additionally in CT.gov, automatic inclusion of further search fields) for trial registry searches.

We conducted a project called “Trial registry searches for studies of newly approved drugs” (1). One analysis investigated the question as to whether searches for different health conditions and interventions (new drugs) directly identified registry entries with the search terms entered or whether certain search features were responsible for this. We searched CT.gov and ICTRP for different conditions and interventions using the advanced search interface. For each search, we documented the synonyms listed in the two registries. We imported the registry entries into EndNote and evaluated whether the search terms used were available in the corresponding search fields (condition; intervention).

For CT.gov, 96 registry entries on 18 interventions and 190 entries on 12 conditions were analysed. Of these, twenty-three (24 percent) entries for interventions and thirty-eight (20 percent) for conditions were identified by search features, not by search terms. For ICTRP, 32 entries on 10 interventions and 100 entries on 9 conditions were analysed. Of these, five (16 percent) entries for interventions and eight (8 percent) for conditions were identified by search features.

Trial registry search features have an important impact on the sensitivity of searches. Many studies are not identified by the search terms entered, but by searches using synonyms and, additionally in CT.gov, by automatic inclusion of further search fields. Moreover, search features in CT.gov are more effective than in ICTRP – even though the same search terms are used, they consistently yield higher sensitivities.

With increasing resource pressures on health systems, rapid developments in innovative technologies and limited numbers of skilled assessors, there is a need to establish sustainable methods to provide advice on healthcare technologies for decision makers. The European Network for Health Technology Assessment (EUnetHTA) has been testing an approach of collaborative production of rapid Health Technology Assessments (HTAs) and adaptation of these locally. The Scottish Health Technologies Group (SHTG) participated in two collaborative and adaptation projects to test whether this could save time and resource, whilst providing a product as robust and relevant as if developed locally. Concurrently the Scottish Intercollegiate Guidelines Network (SIGN) has been exploring ways to develop clinical guidelines more efficiently, including the use of rapid HTAs to inform recommendations.

Having established the relevance of the topics to NHS Scotland, SHTG participated as peer reviewers for EUnetHTA reviews on mitral valve repair and mechanical thrombectomy. On completion, SHTG summarized their content to fit with the well-accepted rapid review report format used in Scotland. Content was supplemented with a review of economic evidence, currently not included in the European reports, local epidemiological information and recently published studies. The thrombectomy report and associated Advice Statement were used by a small expert group to update a SIGN clinical guideline recommendation.

Providing advice through adaptation proved feasible and acceptable to stakeholders. Limited time was saved because of the supplementary work undertaken, and lessons have been learned about what should and should not be done in future .The guideline recommendation was updated and made available more quickly than similar previous updates.

Further such collaborations and adaptations will be pursued as this appears to be a sustainable approach for the future. The process could be aided by EUnetHTA publishing forward work plans and also by the inclusion of economic information, with details of the decision-making context provided, to allow assessment of its relevance locally.

Registration of trial protocols has become increasingly important in recent years. In the context of systematic reviews, published trial protocols facilitate the identification of studies. Data recorded in trials registers requires standardization to assist with ease of identification, and availability of the most current protocol version. Searching sources of trial protocols, for example trials registers, has issues relating to currency, coverage, functionality and indexing. An empirical study was conducted in the context of a funded systematic review, to establish; the proportion of trial protocols retrievable, the most effective retrieval methods, barriers to retrieving protocols, and whether the most easily retrieved protocol copy remains the document of record.

In a systematic review of primary care interventions for medically unexplained symptoms, seventy-four trials were identified as potential included studies. To search for the seventy-four trial protocols, multiple sources and methods were utilized to identify the the differential coverage of sources and the relative efficiency of retrieval methods. Retrieval methods included searching trials registers and bibliographic databases, internet searching, checking journal websites and contacting authors.

Results included; (i) number of trial protocols that were referenced in the corresponding study publication(s), (ii) percentage of protocols indexed in each checked source, including MEDLINE and various trials registers, (iii) number of authors that responded to email contact, (iv) number of authors that provided a reference to, or copy of, the protocol. Information on when the trial protocol was published, funding sources, and trial registration, was also recorded.

Conclusions are made regarding the coverage of different sources of trial protocols. This will enable Information Specialists to prioritize retrieval methods for identifying trial protocols to inform future search methods guidance. The main barriers to retrieving protocols are discussed together with recommendations for future empirical studies.

A high-level, rapid review (1) was conducted on oxygen therapy issues studied in the past 10 years in acute care settings. The main objective was to determine the appropriateness/inappropriateness of use, safety issues, and quality of care associated with oxygen prescription, administration, and monitoring. The results from this review were used to inform an upcoming provincial oxygen summit.

The Health Technology Assessment review (1) used a standardized rapid review approach: a comprehensive search of literature (published in English from 2005 to 2016), study selection using a priori developed criteria, and a qualitative synthesis of the results. Iterative interactions with the requester were necessary to clarify and refine the research questions, scope, and inclusion criteria.

Twenty-four audit studies were reviewed, the majority published after 2011, in the United Kingdom, and also in single institutions. Twelve studies reported effects after implementing interventions for improvement of oxygen prescription. Many studies had caveats on design, data reporting, and outcomes, or they lacked an explanation of the methods of analysis. Studies conducted in rural settings, and on infants and children were unavailable. The reported issues with oxygen therapy included: a lack or an inconsistency of compliance with guidelines, local policies, and standards; inappropriate prescription and administration; variability in practice among healthcare providers; and suboptimal monitoring, including poor standards of medical chart documentation for patients receiving oxygen therapy, such as incomplete details on flow rate and oxygen concentration.

Possibly due to the general tendency to publish research findings that have statistically significant results, relatively few publications were found in the literature search. The universal use of oxygen therapy and the enrolment of consecutive patients in some of the studies increase the applicability of the findings to other institutions. The rapid review provided a timely synthesis of the available, credible research for use by local stakeholders for further discussions and planning.

Thorough documentation and clear reporting are essential when conducting a comprehensive literature search for a health technology assessment (HTA) or systematic review. The ultimate goal of this process is transparency and reproducibility with the added benefit of increasing the reader's confidence in the research. Thorough documentation of the search also allows for critical appraisal of the methodology used and facilitates future updating of a review (1,2).

It has been found that large numbers of systematic review searches are inadequately documented and there is little consensus on best practices for reporting standards (3).

As part of the SuRe Info Project, we conducted a review of all current reporting standards relevant to HTAs and systematic reviews in addition to looking at the published literature on this topic in order to synthesize the evidence in this area and create a standard set of agreed upon recommendations.

We conducted a comprehensive search of Medline, Embase, and LISA (Library & Info Studies Abstracts) databases. We also examined the Equator Network (http://www.equator-network.org/) website. Reference lists of included studies and reporting guidelines were also consulted. Eleven reporting guidelines and eight studies were included in the review by two independent reviewers. Anything published before 2006, that was not a research article (other than the guidelines), and/or that did not provide new recommendations (that is, a review of another set of recommendations) was excluded.

After collecting data on the suggested reporting elements described in the literature, we pooled our results to create an overarching list of the most commonly recommended elements to describe and the most commonly recommended methods to use when documenting a comprehensive search. Not only did these elements pertain to documenting the search strategy for the final report, but they also pertained to the protocol and the abstract of a review.

It is hoped that this overview of the literature and compilation of the evidence will clarify some of the confusion that seems to exist when documenting and reporting searches and perhaps it will even help to reduce the existence of poorly described strategies in the research literature.

In both health care and social services it is important to continuously summarize and analyze existing research in the form of systematic reviews. At the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) (www.SBU.se) we collect the evidence gaps identified by systematic reviews in a database. These evidence gaps are methods used in health care/social services for which there is not enough good quality research available. By analyzing this database we can highlight populations or methods where evidence gaps are more frequent. This knowledge can be used to find areas that might need assistance in developing research structure and also when arranging research prioritization processes involving patients, consumers and clinicians.

Systematic reviews and evidence maps (methodical collections of systematic reviews) are used by SBU to identify evidence gaps. SBU has adapted the James Lindh alliance approach to give patients, consumers, relatives and clinicians the opportunity to give their view of what research they find most important to execute. SBU also collaborates with governmental research funders to communicate the content of the SBU database.

A prioritizing process regarding evidence gaps within Attention Deficit Hyperactivity Disorder (ADHD)-treatment has been finalized (1). This was accomplished by people with ADHD and caretakers, as well as clinicians and staff. Another prioritization process on the topic of treatments for injuries after vaginal birth is ongoing. In November 2016 the Swedish government presented the research policy bill where they, based on analyses of the SBU database, pointed out areas of specific importance in future research.

It is of great importance that evidence gaps get addressed and that new research is promoted in order to fill these gaps. In areas where there are numerous gaps, prioritizations involving different stakeholders is needed. Considering areas with large amounts of evidence gaps the primary focus might be on building infrastructure surrounding research before research calls can be directed towards these areas.

There are different devices, systems and technologies for people with disabilities. It's necessary to provide information on the effectiveness of products in the market and competitiveness in terms of price-quality, and providing an endorsement in the acquisition of technologies that improve their quality of life. The use of eye tracking devices is growing and its implementation in different areas has attracted the attention of several developers. Therefore the need to generate a product that evaluates the functionality of such devices is necessary in order to avoid unnecessary expenses when acquiring or repairing one of these devices.

An interface was created with different functionalities such as the location of the coordinates in which the pointer is located, standardized graphic interface design to provide statistical data that allow an objective result for its subsequent analysis and an endless number of design possibilities.

The tests performed were of accuracy and precision where the subject was asked to follow the instructions given and observe a sequence of points, especially the points located at the ends of the monitor as these are the critical points in which there is less coincidence between the cursor and the gaze.

The results obtained provided information on the performance of the tracking device. In this way it was possible to establish that the accuracy of the ocular tracker: it was ± 12.83 pixels on the horizontal axis and ± 10.66 pixels on the vertical axis. The precision was ± 9.8 pixels on the horizontal axis and ± 14.23 pixels on the vertical axis.

This shows the use phenomenon caused due to the limited mobility of the eyes in the vertical axis in comparison to the horizontal mobility. The precision data obtained indicate that, because the movement on the vertical axis is smaller, there is a less continuous spectrum of positions on the axis, which translates to less precision.

The data obtained can be used to compare with the results of the test with other eye tracking devices and thus this could serve as a tool to select an eye tracking device according to the user's need and his economical capabilities.

Increasingly, ambulance services offer alternatives to transfer to the emergency department (ED), when this is better for patients. The introduction of electronic health records (EHR) in ambulance services is encouraged by national policy across the United Kingdom (UK) but roll-out has been variable and complex.

Electronic Records in Ambulances (ERA) is a two-year study which aims to investigate and describe the opportunities and challenges of implementing EHR and associated technology in ambulances to support a safe and effective shift to out of hospital care, including the implications for workforce in terms of training, role and clinical decision-making skills.

Our study includes a scoping review of relevant issues and a baseline assessment of progress in all UK ambulance services in implementing EHR. These will inform four in-depth case studies of services at different stages of implementation, assessing current usage, and examining context.

The scoping review identified themes including: there are many perceived potential benefits of EHR, such as improved safety and remote diagnostics, but as yet little evidence of them; technical challenges to implementation may inhibit uptake and lead to increased workload in the short term; staff implementing EHR may do so selectively or devise workarounds; and EHR may be perceived as a tool of staff surveillance.

Our scoping review identified some complex issues around the implementation of EHR and the relevant challenges, opportunities and workforce implications. These will help to inform our fieldwork and subsequent data analysis in the case study sites, to begin early in 2017. Lessons learned from the experience of implementing EHR so far should inform future development of information technology in ambulance services, and help service providers to understand how best to maximize the opportunities offered by EHR to redesign care.