Innovative public procurement (IPP) is a driver of innovation across sectors. IPP involves the strategic acquisition of cutting-edge technologies and solutions by public entities in collaboration with the private sector. This approach aims to leverage the potential of “omics” technologies, such as genomics and proteomics, within the public sector to advance healthcare solutions.

The IPP process comprises key phases such as needs identification, solicitation preparation, execution, evaluation and awarding, and impact and assessment. The methodology applied was based on the Rapid Assessment Tool for Omics Technologies developed by the Andalusian Agency for Health Technology Assessment, accompanied by clinical validity reports from the impact and evaluation phase of the Technical Office for IPP of Andalusia. The aim was to assess the clinical validation results of two omics technologies, that is, two diagnostic tests. A systematic review was performed to identify existing evidence. We also addressed the challenges associated with implementing the Rapid Assessment Tool in the IPP process.

Systematic reviews identifying evidence on the clinical validity and utility of omics technologies provided a foundation for the subsequent evaluation of two technologies in development, once the clinical trials had finished. An analysis of scientific evidence, together with the compilation of information provided by industry, was conducted through a questionnaire and clinical data derived from the company’s studies. The analysis of clinical and diagnostic validity was not conclusive. We delivered the final assessment report to support decision-making in the public health system of Andalusia.

Both assessed technologies presented a high degree of innovation, but different challenges and issues were identified during the application of the Rapid Assessment Tool for Omics Technologies. Further improvement in IPP procedures for innovative technologies in Andalusia, including integration of our methodological approach at the start the IPP process, could facilitate the acquisition of cutting-edge technologies in collaboration with public entities.

Personalized precision medicine (PPM) is an innovative approach to disease diagnosis, prognosis, and treatment of individual or group characteristics using diverse data sources. While omics technologies are integral to PPM, they pose challenges. Therefore, developing an appropriate methodology to assess these technologies is crucial for patient safety, resource efficiency, and clinical decision-making within the Spanish National Health System.

This health technology assessment (HTA) methodology procedure was developed by combining three different approaches: a systematic review (SR); a survey targeting experts in omics technology, ranging from basic science researchers to clinicians, and patient associations; and, finally, a consensus method (RAND Appropriateness Method [RAM]).

Through data extraction and evidence synthesis of the 38 studies included in SR, 30 existing frameworks for evaluating omics technologies were identified, as well as the elements needed to assess these technologies, leading to the first version of the framework. Two surveys were performed to integrate the perspectives of omics technology experts and patients. Subsequently, this framework version was further developed by a RAM consensus panel of experts from HTA agencies to ensure a rigorous evaluation of gathered data. The final framework was categorized into 94 elements divided into sections, categories, domains, and subdomains.

A methodological guide, including the assessment framework, was developed for the Spanish HTA network. The framework is divided into several sections addressing evidence-gathering, provision models, organizational elements, economic evaluation, and ethical and social implications. Compared to other available frameworks, our proposal included aspects such as bioinformatics, technological maturity level, and the patient perspective with the personal utility domain.

To assess whether the Mediterranean Diet (MedDiet) is associated with lower micronutrients inadequacy in a sample of Spanish preschoolers.

We conducted a cross-sectional study with 4–5-year-old children participating in the SENDO project. Information was gathered through an online questionnaire completed by parents. Dietary information was collected with a previously validated semi-quantitative FFQ. The estimated average requirements or adequate intake levels as proposed by the Institute of Medicine were used as cut-off point to define inadequate intake.

Crude and multivariable adjusted estimates were calculated with generalised estimated equations to account for intra-cluster correlation between siblings.

We used baseline information of 1153 participants enrolled in the SENDO project between January 2015 and June 2022.

OR and 95 % CI of presenting an inadequate intake of ≥ 3 micronutrients associated with the MedDiet.

The adjusted proportion of children with inadequate intake of ≥ 3 micronutrients was 27·2 %, 13·5 % and 8·1 % in the categories of low, medium and high adherence to the MedDiet, respectively. After adjusting for all potential confounders, children who had a low adherence to the MedDiet showed a significant lower odds of inadequate intake of ≥ 3 micronutrients compared to those with a high adherence (OR 9·85; 95 % CI 3·33, 29·09).

Lower adherence to the MedDiet is associated with higher odds of nutritional inadequacy.

Ultra-processed food (UPF) consumption is increasing exponentially, becoming a matter of concern for Public Health, given its adverse health effects.

To identify individual and faGmily factors predicting UPF consumption in childhood.

The SENDO project is an ongoing prospective dynamic cohort of Spanish children. In this study, we used baseline information of participants recruited between January 2015 and June 2021. Dietary information was collected with a validated semi-quantitative FFQ, and food items were classified using the NOVA classification. Individual and family factors associated with UPF consumption (P < 0·20) in univariate analyses were introduced in a model of generalised estimating equations which accounted for intra-cluster correlations between siblings.

The SENDO project (Spain), 2015–2021.

Spanish children are recruited at the age of 4–5 years and followed yearly through online questionnaires completed by parents.

In this sample of 806 participants (49 % girls; mean age 5 years (sd: 0·90)), the mean UPF consumption was 37·64 % of total energy intake (sd: 9·59). Large family size and longer exposure to screens predicted higher consumption of UPF. On the other hand, better knowledge of children’s dietary recommendations, healthy dietary attitudes towards child’s eating habits and longer breastfeeding were associated with lower consumption of UPF. All these factors accounted for approximately 16 % of the variability on the consumption of UPF in childhood.

Since most of the factors identified in this study are modifiable, they should be considered in public health strategies aimed at promoting healthy dietary habits in early life.

Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as important peripheral inflammatory biomarkers. Recent data suggest a possible role of the immune system in the pathophysiology of suicidal behavior (SB). The aim of this study is to evaluate the association among NLR, MLR, and PLR and SB in patients with major depressive disorder (MDD), and to test its validity as a biomarker for suicidality.

We evaluated 538 patients with MDD (mean age [standard deviation] = 43.87 [14.36] years; females: 68.8%). A logistic regression model was estimated to determine the independent factors associated with suicide risk in patients with and without a history of suicide attempt (SA).

Three hundred ninety-three patients (74.7%) had a personal history of SA. Patients with a previous SA were more frequently female (71.9% vs. 59.6%; p = 0.007), significantly younger (41.20 vs. 51.77 years; p < 0.001), had lower depression severity at enrolment (15.58 vs. 18.42; p < 0.000), and significantly higher mean NLR and PLR ratios (2.27 vs. 1.68, p = 0.001; 127.90 vs. 109.97, p = 0.007, respectively). In the final logistic regression model, after controlling for age, sex, and depression severity, NLR was significantly associated with SB (β = 0.489, p = 0.000; odds ratio [95% confidence intervals] = 1.631 [1.266–2.102]). We propose a cut-off value of NLR = 1.30 (sensitivity = 75% and specificity = 35%).

Our data suggest that NLR may be a valuable, reproducible, easily accessible, and cost-effective strategy to determine suicide risk in MDD.

To examine whether weight history and weight transitions over adult lifespan contribute to physical impairment among postmenopausal women.

BMI categories were calculated among postmenopausal women who reported their weight and height at age 18 years. Multiple-variable logistic regression was used to determine the association between BMI at age 18 years and BMI transitions over adulthood on severe physical impairment (SPI), defined as scoring <60 on the Physical Functioning subscale of the Rand thirty-six-item Short-Form Health Survey.

Participants were part of the Women’s Health Initiative Observational Study (WHI OS), where participants’ health was followed over time via questionnaires and clinical assessments.

Postmenopausal women (n 76 016; mean age 63·5 (sd 7·3) years).

Women with overweight (BMI=25·0–29·9 kg/m2) or obesity (BMI≥30·0 kg/m2) at 18 years had greater odds (OR (95 % CI)) of SPI (1·51 (1·35, 1·69) and 2·14 (1·72, 2·65), respectively) than normal-weight (BMI=18·5–24·9 kg/m2) counterparts. Transitions from normal weight to overweight/obese or to underweight (BMI<18·5 kg/m2) were associated with greater odds of SPI (1·97 (1·84, 2·11) and 1·35 (1·06, 1·71), respectively) compared with weight stability. Shifting from underweight to overweight/obese also had increased odds of SPI (1·52 (1·11, 2·09)). Overweight/obese to normal BMI transitions resulted in a reduced SPI odds (0·52 (0·39, 0·71)).

Higher weight history and transitions into higher weight classes were associated with higher likelihood of SPI, while transitioning into lower weight classes for those with overweight/obesity was protective among postmenopausal women.

To explore salt content in bread and to evaluate the feasibility of reducing salt contained in ‘pan francés’ bread.

The study had two phases. Phase 1, an exploratory phase, involved the estimation of salt contained in bread as well as a triangle taste test to establish the amount of salt to be reduced in ‘pan francés’ bread without detection by consumers. In Phase 2, a quasi-experimental, pre–post intervention study assessed the effects of the introduction of low-salt bread on bakery sales.

A municipal bakery in Miraflores, Lima, Peru.

Sixty-five clients of the bakery in Phase 1 of the study; sales to usual costumers in Phase 2.

On average, there was 1·25 g of salt per 100 g of bread. Sixty-five consumers were enrolled in the triangle taste test: fifty-four (83·1 %) females, mean age 58·9 (sd 13·7) years. Based on taste, bread samples prepared with salt reductions of 10 % (P=0·82) and 20 % (P=0·37) were not discernible from regular bread. The introduction of bread with 20 % of salt reduction, which contained 1 g of salt per 100 g of bread, did not change sales of ‘pan francés’ (P=0·70) or other types of bread (P=0·36). Results were consistent when using different statistical techniques.

The introduction of bread with a 20 % reduction in salt is feasible without affecting taste or bakery sales. Results suggest that these interventions are easily implementable, with the potential to contribute to larger sodium reduction strategies impacting the population’s cardiovascular health.