Management of the neonate at the limits of viability: The Dutch viewpoint

Due to ever-improving medical technology over the course of the last century, the limit of viability has been lowered from around 32 weeks of gestation, first to 28 weeks and, in recent decades, to as low as less than 24 weeks. Long-term follow-up studies (Project on Preterm and Small-for- Gestational-Age Infants, Leiden Follow-up Project on...

Lost in translation? Role of metabolomics in solving translational problems in drug discovery and development

Too few drug discovery projects generate a marketed drug product, often because preclinical studies fail to predict the clinical experience with a drug candidate. Improving the success of preclinical-to-clinical translation is of paramount importance in optimizing the pharmaceutical value chain. Here, we advance the case for a molecular systems...

Design and implementation of a Portal for the medical equipment market: MEDICOM

Background: The MEDICOM (Medical Products Electronic Commerce) Portal provides the electronic means for medical-equipment manufacturers to communicate online with their customers while supporting the Purchasing Process and Post Market Surveillance. The Portal offers a powerful Internet-based search tool for finding medical products and...

Identification and priority setting for health technology assessment in The Netherlands: Actors and activities

This article describes the actual situation at the beginning of 1999 with regard to identification and priority setting for health technology assessment (HTA) on a national level in the Netherlands. For this purpose the literature on HTA published in 1980-1998, mainly national, was thoroughly reviewed. Many policy documents and other reports...

Use of societal criteria in evaluation of medical technology assessment research proposals in the Netherlands: Development and testing of a checklist

Rising health care costs, and the recognition that medical technology is a significant contributor to these costs, have provided the stimulus to develop medical technology assessment programmes in the Netherlands. The most important programme in this field is the Investigational Medicine Programme of the Dutch Sick Funds Council. So far,...

Strategies for successful evaluation and policy-making toward health care technology on the move: The case of medical lasers

Evaluating new health care technology that is rapidly diffusing is one of the greatest challenges to researchers and policy-makers. If no evaluation is done until the technology is mature, evaluation will not influence processes of diffusion. If evaluation is done early, it may be irrelevant when it is completed because of developments in the...

Health care technology in Sweden

Health care in Sweden is a public sector responsibility and equity in access to care is quite important. The Swedish system is organized into several levels, with the Federation of County Councils at the top, and with regional, county, and local levels. In theory, the four hospital tiers developed by these different levels provide a clear...

The future and health care technology: Implications of a system for early identification

Future and emerging health care technologies are increasingly high-impact events for society in terms of the quality and costs of health care. They raise issues of efficacy, safety, resource allocation, ethics, impact on the organization and delivery of care, and broad social effects. This article describes an analysis of future and emerging...

Lessons from the eight countries

While the eight countries presented in this issue differ considerably from each other, they have important similarities. All have faced the problem of increasing health care expenditures, and all are coming to recognize problems with health care technology such as inappropriate use and poor quality of care. Health reforms appear to be...

Health care technology as a policy issue

Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions concerning technology, including benefits and costs. A...

The cost-effectiveness of 10 selected applications in minimally invasive therapy

In this article, evidence of effectiveness and cost-effectiveness of the following procedures is reviewed: (1) laser treatment of bladder tumors; (2) extracorporeal shock-wave lithotripsy and percutaneous nephrolithotomy; (3) laparoscopic treatment of endometriosis; (4) laparoscopic removal of ovarian cysts; (5) laparoscopic cholecystectomy; (6)...

Diffusion of minimally invasive therapy in Europe

This paper considers the diffusion of the 10 cases presented in this issue. Most of the cases have diffused relatively slowly. This slow diffusion can be explained by a number of factors, including budgetary restraints, financial incentives, physician conservatism, and lack of appropriate training. A consistent thread in the cases is the...