Our colleague Vanesa Ramos García, researcher at the Evaluation Service of the Canary Islands Health Service (SESCS), has recently defended her PhD thesis titled Shared Decision-Making in Generalized Anxiety Disorder.
We would like to congratulate her on this important achievement, the result of her dedication, effort, and commitment to mental health research.
A true source of pride for our entire team! 🎓
Our colleague Renata Linertová, researcher at the Health Technology Assessment Unit of the Canary Islands Health Service (SESCS), is currently undertaking a two-week scientific visit at the Health Economics Research Center (HECON) of Óbuda University (Budapest), as part of the European BUR-EB. project.
On June 26th, she took part in a session focused on epidermolysis bullosa (EB), together with HECON researchers (Márta Péntek, László Gulácsi, Áron Hölgyesi, and Zrubka Zsombor), the representative of the rare disease patient federation (Gábor Pogány), and dermatologist Márta Medvecz, a specialist in EB.
In the photo, she appears alongside all of them during the event.
An excellent representation of SESCS on the international stage!
Our fellow researcher from the Canary Islands Health Service Evaluation and Planning Department, Beatriz León Salas, participated in the 65th Congress of the Spanish Society of Geriatrics and Gerontology (SEGG) / 28th Congress of the Catalan Society of Geriatrics and Gerontology (SCGiG) with two important posters within the PreFRAIL project.
An excellent contribution to the understanding of frailty. 👏👏
https://geriatria2025.com/
Ellen Sterzik holds a degree in Psychology and is a specialist in Third-Generation Contextual Therapies from the Universidad de La Laguna.
What was the purpose of the visit?
A collaboration grant from the Universidad de La Laguna.
Why did you choose SESCS?
My academic tutor introduced me to the service, explaining the work and projects carried out there. I saw it as an opportunity to broaden my knowledge in evaluation and research.
Access to up-to-date reports from GuíaSalud, as well as sharing information about PyDeSalud with family and friends. In addition, the knowledge gained from systematic reviews.
Absolutely.
Comments or suggestions:
I’ve been very lucky to meet people so willing to help and support at all times. I’ve felt very comfortable since day one. It’s a great team!
Renata Linertová, Aránzazu Hernández-Yumar, Carmen Guirado-Fuentes, Benjamín Rodríguez-Díaz, Cristina Valcárcel-Nazco, Iñaki Imaz-Iglesia, Montserrat Carmona-Rodríguez, Lidia García-Pérez
ABSTRACT
Background
Cost-effectiveness analyses of health technologies have become a part of the decision-making process in healthcare policies. Nevertheless, economic results are not always presented in comprehensible formats for non-technical audiences, such as the general population, healthcare professionals or decision-makers. The purpose of this study was to observe which formats best convey the key message of an economic evaluation, and which are best received by two different audiences.
Methods
The summary of a hypothetical cost-effectiveness analysis was edited in different formats: infographic, plain language text and video-abstract for the general population; executive summary and policy brief for a specialized population, i.e. clinicians, clinical and non-clinical managers, or methodologists in health-technology assessment. Participants were randomly shown one of the formats, and data on objective and subjective comprehension, and perceived usefulness/acceptability were gathered by means of online questionnaires. Statistical differences between formats within each audience were analysed.
Results
In the general population (N = 324), objective comprehension was statistically significantly better for infographic than for video-abstract (p = 0.005), and for plain text than for video-abstract (p = 0.024). There were no differences in subjective comprehension, but video-abstract was considered statistically significantly more useful to understand the information than plain text (p = 0.011). In the specialized population (N = 100), no statistically significant differences were observed for objective and subjective comprehension, although policy brief was perceived as statistically significantly more useful than executive summary (p = 0.005).
Conclusions
A balance between effectivity of conveying the message and attractivity of the format needs to be sought, to facilitate non-technical audiences’ understanding of economic data and, consequently, perceive decision-making processes as more transparent and legitimate. The infographic and policy brief could be robust ways to present economic data to the general public and specialized audience, respectively.
You can read the full article here.
Verónica López Gousset, Aline Silveira Silva, Anke-Peggy Holtorf, Ana Toledo-Chávarri, Ann Single.
ABSTRACT
Objectives
Evaluating the impact of patient involvement in health technology assessments (HTA) may help improve practices and avoid ineffective activities. Evaluation, however, continues to be infrequent, inconsistent, and often only relates to process quantity or quality. The Patient and Citizen Involvement in HTA Interest Group (PCIG) within Health Technology Assessment International set out to contextualize this impact to support evaluation.
Methods
Given the lack of established methodology to measure impact, the team performed a qualitative analysis of first-hand accounts about perceived changes in HTA due to involvement of patient stakeholders. A questionnaire was developed, piloted, and rolled out to collect personal perspectives from stakeholders with relevant experience. The stories were analyzed in the aggregate to identify themes in the data.
Results
From January 2019 to September 2021, twenty-four responses were collected through PCIG’s network. Responses (including one joint industry-HTA body submission) came from patient representatives (12), HTA bodies (11), and industry representatives (2) from North America (5), South America (3), Europe (13), and Asia Pacific (3). Based on themes commonly reported, a three-domain framework for evaluating impact is proposed: impact on basis of HTA result or recommendation, impact on HTA body, and impact on patient participants. The framework includes components under each domain to support reporting.
Conclusions
Using the Three-Domain Impact Framework may be useful in identifying, evaluating, and communicating the value of patient involvement in HTA. Enhancing and increasing reporting practices may improve transparency and facilitate process improvements for meaningful integration of patient stakeholders into HTA appraisals across jurisdictions.
Keywords
patient involvement; health technology assessment; impact; qualitative evaluation
You can read the full article here.
Ana Toledo-Chávarri, Janet Delgado, María Padilla, Beatriz Rodríguez-Martín
ABSTRACT
This work provides a synthesis of the perceptions of people with type 1 diabetes mellitus (T1DM) and healthcare professionals regarding the acceptability, implementation, and equity of continuous subcutaneous insulin infusion (CSII). A qualitative evidence synthesis was carried out. Three online databases (Medline, Embase, and Web of Science) were searched. Qualitative articles available in Spanish or English were included. A descriptive thematic synthesis was conducted according to PRISMA and ENTREQ guidelines.
Thirty-two references met the inclusion criteria of the study and were included from an initial 345 identified references. Seven main themes were identified:
(a) acceptability,
(b) adaptation to the insulin pump,
(c) facilitators for the adequate use of the insulin pump,
(d) variability of acceptability,
(e) barriers to the use of the insulin pump,
(f) feasibility and implementation considerations, and
(g) equity.
CSII is well accepted by most people with T1DM, with some exceptions. It can relieve the burden of disease management, increase autonomy and flexibility, and improve family relationships. There were multiple perceived barriers to its continued use. Future studies should continue to analyze inequalities in access to and use of CSII.
You can read the full article here.
1) Systematic review of thyroid function in NKX2-1-related disorders: Screening and diagnosis
Beatriz Carmona Hidalgo, Carmen Martín-Gómez, Estefanía Herrera-Ramos, Rocío Rodríguez-López, Laia-Nou Fontanet, José C Moreno, Juan Antonio Blasco-Amaro, Juliane Léger, Juan Darío Ortigoza Escobar, Grupo de trabajo de directrices sobre trastornos relacionados con NKX2-1
ABSTRACT
Background: NKX2-1-related disorders (NKX2-1-RD) are rare conditions affecting lung, thyroid, and brain development, primarily caused by pathogenic variants or deletions in the NKX2-1 gene. Congenital hypothyroidism (CH) is a common endocrine manifestation, leading to irreversible intellectual disability if left untreated.
Objectives: The aim was to evaluate the current evidence for the use of screening and diagnostic techniques for endocrine alterations in patients with NKX2-1-RD.
Methods: This systematic review was reported following the PRISMA guidelines. Two separate research questions in PICO format were addressed to cover initial screening and diagnosis procedures for endocrine diseases in patients with NKX2-1-RD. Eligibility criteria focused on patients with genetic confirmation of the disease and hypothyroidism. Various databases were searched, and data were extracted and assessed independently by two reviewers.
Results: Out of 1012 potentially relevant studies, 46 were included, for a total of 113 patients. CH was the most frequent endocrine alteration (45% of patients). Neonatal screening was reported in only 21% of patients based on blood TSH measurements. TSH thresholds varied widely across studies, making hypothyroidism detection ranges difficult to establish. Diagnostic tests using serum TSH were used to diagnose hypothyroidism or confirm its presence. 35% of patients were diagnosed at neonatal age, and 42% at adult age. Other hormonal dysfunctions identified due to clinical signs, such as anterior pituitary deficiencies, were detected later in life. Thyroid scintigraphy and ultrasonography allowed for the description of the thyroid gland in 30% of cases of hypothyroidism. Phenotypic variability was observed in individuals with the same variants, making genotype-phenotype correlations challenging.
Conclusion: This review highlights the need for standardized protocols in endocrine screening for NKX2-1-RD, emphasizing the importance of consistent methodology and hormone threshold levels. Variability in NKX2-1 gene variants further complicates diagnostic efforts. Future research should concentrate on optimizing early screening protocols and diagnostic strategies.
You can read the full article here.
2) Systematic review of thyroid function in NKX2-1-related disorders: Treatment and follow-up
Beatriz Carmona Hidalgo, Estefanía Herrera-Ramos, Rocío Rodríguez-López, Laia Nou-Fontanet, José C Moreno, Juan Antonio Blasco-Amaro, Juliane Léger, Juan Darío Ortigoza Escobar, Grupo de trabajo de directrices sobre trastornos relacionados con NKX2-1
ABSTRACT
Background: NKX2-1, a crucial transcription factor in thyroid, lung, and brain development, is associated with rare disorders featuring thyroid dysfunction, neurological abnormalities, and respiratory symptoms. The primary challenge in managing NKX2-1-related disorders (NKX2-1-RD) is early diagnosis of the genetic defect and treating specific endocrine disorders. Levothyroxine (LT4) serves as the standard hypothyroidism treatment, with required dosages influenced by the severity of the individual’s disorder, which varies widely among affected individuals.
Objectives: This systematic review aims to assess the effectiveness of LT4 treatment in NKX2-1-RD and explore optimal dosing strategies. The primary focus is on the challenges associated with the prompt diagnosis of genetic defects, rather than the established treatment protocols for individual endocrine failures.
Methods: Adhering to PRISMA guidelines, the review includes 42 studies involving 110 genetically confirmed NKX2-1-RD patients with hypothyroidism. The study investigates congenital hypothyroidism as the most prevalent endocrine alteration, along with gestational and overt hypothyroidism. The administration of LT4 treatment, dosages, and patient responses are analyzed.
Results: Among the findings, congenital hypothyroidism emerges as the predominant endocrine alteration in 41% of patients. Notably, LT4 treatment is administered in only 10% of cases, with a mean dose of 52 μg/day. The variability in initiation and dosage is likely influenced by the age at diagnosis. Positive responses, characterized by TSH adjustments within normal ranges, are observed in 11 monitored patients.
Conclusions: Early detection of congenital hypothyroidism is emphasized for timely LT4 initiation. Challenges in standardization are highlighted due to the variability in clinical manifestations and diagnostic procedures across NKX2-1-RD cases. While this review provides valuable insights into thyroid and pituitary disease treatment, limited details on LT4 treatment represent a significant study limitation. Key reporting points for future case studies are proposed to enhance the understanding and management of NKX2-1-RD hypothyroidism.
You can read the full article here.
Last Friday, May 9th, our regular collaborator and family physician Miguel García Hernández successfully defended his PhD thesis at the University of La Laguna. 👨⚕️📚
His research, titled “Analysis of the relationship between complexity factors and perceptions related to management and care among family and community care professionals: a mixed-methods study from the perspective of a person-centered model,” represents a key contribution to primary care and the person-centered approach. 🔍💡
The thesis was supervised by Professor Cristobalina Rodríguez Álvarez and co-supervised by our colleague from the Canary Islands Health Service Evaluation Unit (SESCS), Mar Trujillo Martín. An exceptional team behind this academic achievement!
At SESCS, we celebrate this milestone and wish Miguel great success in his future professional and personal endeavors. The path of research is always inspiring! 🚀💙
This past Friday, April 25th, several researchers from the Health Technology Assessment Service of the Canary Islands Health Service (SESCS) participated in the I Research Conference organized by the “La Laguna – Tenerife Norte” Family and Community Care Multiprofessional Teaching Unit. An invaluable space to share science and innovation in Primary Care. 👩⚕️👨⚕️
The event, held at the Aula Magna of the Faculty of Health Sciences at the University of La Laguna (ULL), brought together residents of Medicine and Nursing, who presented their research projects, reflecting the knowledge generated throughout their Residency Final Projects.
Congratulations to all the participants for their excellent work! 🔬📚