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PD37 High-Dose Vitamin D For The Treatment Of COVID-19
- Heidi Stürzlinger, Richard Pentz
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 38 / Issue S1 / December 2022
- Published online by Cambridge University Press:
- 23 December 2022, p. S103
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Introduction
The aim of this EUnetHTA (European Network for Health Technology Assessment) Rolling Collaborative Review on high dose vitamin D for the treatment of COVID-19 was to inform health policy at an early stage in the life cycle of therapies and to monitor ongoing studies in the format of a Living Document.
MethodsThe systematic literature search was conducted in Medline, Pubmed, medRxiv, bioRxiv, arXivso, Cochrane COVID-19 Study Register, ClinicalTrials.gov, ISRCTN Registry, EU Clinical Trials Register. The first search was done in January 2021, and the last in November 2021. English and German randomized controlled studies (RCTs) investigating treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected individuals with high dose vitamin D2, D3 or their metabolites were included if examining mortality, length of hospital stay, viral burden, clinical progression, hospitalization rates, intensive care unit (ICU) admission, mechanical ventilation, quality of life or adverse events. Two reviewers independently screened search results and assessed risk of bias and certainty of evidence. One reviewer extracted study data, checked by another.
ResultsOf the nine RCTs published to date, two investigate calcifediol, one calcitriol and six vitamin D3. All used different dosing regimens. Disease severity and proportion of vitamin D deficiency varied between studies. Calcifediol treated patients in one study required significantly less ICU admissions than untreated patients. Vitamin D3 in another study led to significantly more SARS-CoV-2 PCR-negative patients before day 21 than placebo. There were no other significant differences between groups. Twenty-five RCTs are ongoing, five of them with over 1,000 patients.
ConclusionsThe current evidence is heterogenous regarding form and dosage of vitamin D, baseline disease severity and baseline vitamin D deficiency. There is currently no standardized/recommended level of what constitutes a (beneficial) “high dose”. Most results did not show significant differences between vitamin D treated groups and no vitamin D / placebo groups. Many of the studies are very small and certainty of evidence is predominantly low or very low.
OP01 Cross Border Cooperation On High-Cost-Capital Investments In Health
- Ingrid Rosian-Schikuta, Julia Bobek, Anja Laschkolnig, Herwig Ostermann, Stephan Mildschuh, Daniela Pertl, Heidi Stürzlinger, Johannes Zsifkovits, Martin Zuba
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 33 / Issue S1 / 2017
- Published online by Cambridge University Press:
- 12 January 2018, p. 1
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INTRODUCTION:
The medical equipment sector is characterized by a large share of overall health budgets spent for the provision of capital investment goods such as medical scanners and radiotherapy units. A high variability in provision and utilization rates of medical equipment can be observed too. The objective for this study was to contribute to effective cross-border cooperation between European Union (EU)-Member States by pooling resources for high-cost medical equipment investments (1).
METHODS:Potential cost-intensive and highly specialised medical equipment, where cross-border investment resource pooling may be recommended, were identified by a combined evidence search and expert consultation. An efficiency assessment of medical equipment potential savings for EU-countries was done by a benchmark-approach and a best-practice-approach. Furthermore six examples for cross-border cooperation were investigated and two surveys have been conducted.
RESULTS:The following medical equipment can be considered as cost-intensive and highly specialized across EU-Member States: Magnetic Resonance Imaging (MRI) scanners, Computed Tomography (CT) scanners, Stereotactic systems and Surgical robots.
The efficiency assessment using the benchmark approach was performed for MRI, CT scanners, Positron Emission Tomography (PET) scanners, Angiography units, Gamma cameras and Lithotriptors. The results of the best-practice approach showed potential cost savings due to under-or overutilization per device group and EU-Member State. However, as this analysis offers a view on health systems on a very macro level it was not possible to give detailed insights at the country-level.
The six selected cross-border examples demonstrated a wide variety of options regarding the structure, extent and organization of cross-border cooperation: Five of six cross-border examples were cooperation close to the border, in four of six examples EU funds played an important role.
CONCLUSIONS:The study highlighted that cross-border cooperation in the field of cost-intensive/highly specialized medical equipment could bring economic advantages for many EU-Member States. Despite this, still only little is done by EU-Member States in terms of cooperation. Reasons are diverse and can be ascribed to lacking information, differences of national health systems, organizational and administrative hurdles, and lacking political support.