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Implementation of innovative medical technologies in German inpatient care: patterns of utilization and evidence development

BACKGROUND: Innovative medical technologies are commonly associated with positive expectations. At the time of their introduction into care, there is often little evidence available regarding their benefits and harms. Accordingly, some innovative medical technologies with a lack of evidence are used...

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Autores principales: Dreger, Marie, Eckhardt, Helene, Felgner, Susanne, Ermann, Hanna, Lantzsch, Hendrikje, Rombey, Tanja, Busse, Reinhard, Henschke, Cornelia, Panteli, Dimitra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556925/
https://www.ncbi.nlm.nih.gov/pubmed/34717677
http://dx.doi.org/10.1186/s13012-021-01159-3
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author Dreger, Marie
Eckhardt, Helene
Felgner, Susanne
Ermann, Hanna
Lantzsch, Hendrikje
Rombey, Tanja
Busse, Reinhard
Henschke, Cornelia
Panteli, Dimitra
author_facet Dreger, Marie
Eckhardt, Helene
Felgner, Susanne
Ermann, Hanna
Lantzsch, Hendrikje
Rombey, Tanja
Busse, Reinhard
Henschke, Cornelia
Panteli, Dimitra
author_sort Dreger, Marie
collection PubMed
description BACKGROUND: Innovative medical technologies are commonly associated with positive expectations. At the time of their introduction into care, there is often little evidence available regarding their benefits and harms. Accordingly, some innovative medical technologies with a lack of evidence are used widely until or even though findings of adverse events emerge, while others with study results supporting their safety and effectiveness remain underused. This study aims at examining the diffusion patterns of innovative medical technologies in German inpatient care between 2005 and 2017 while simultaneously considering evidence development. METHODS: Based on a qualitatively derived typology and a quantitative clustering of the adoption curves, a representative sample of 21 technologies was selected for further evaluation. Published scientific evidence on efficacy/effectiveness and safety of the technologies was identified and extracted in a systematic approach. Derived from a two-dimensional classification according to the degree of utilization and availability of supportive evidence, the diffusion patterns were then assigned to the categories “Success” (widespread/positive), “Hazard” (widespread/negative), “Overadoption” (widespread/limited or none), “Underadoption” (cautious/positive), “Vigilance” (cautious/negative), and “Prudence” (cautious/limited or none). RESULTS: Overall, we found limited evidence on the examined technologies regarding both the quantity and quality of published randomized controlled trials. Thus, the categories “Prudence” and “Overadoption” together account for nearly three-quarters of the years evaluated, followed by “Success” with 17%. Even when evidence is available, the transfer of knowledge into practice appears to be inhibited. CONCLUSIONS: The successful implementation of safe and effective innovative medical technologies into practice requires substantial further efforts by policymakers to strengthen systematic knowledge generation and translation. Creating an environment that encourages the conduct of rigorous studies, promotes knowledge translation, and rewards innovative medical technologies according to their added value is a prerequisite for the diffusion of valuable health care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13012-021-01159-3.
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spelling pubmed-85569252021-11-01 Implementation of innovative medical technologies in German inpatient care: patterns of utilization and evidence development Dreger, Marie Eckhardt, Helene Felgner, Susanne Ermann, Hanna Lantzsch, Hendrikje Rombey, Tanja Busse, Reinhard Henschke, Cornelia Panteli, Dimitra Implement Sci Research BACKGROUND: Innovative medical technologies are commonly associated with positive expectations. At the time of their introduction into care, there is often little evidence available regarding their benefits and harms. Accordingly, some innovative medical technologies with a lack of evidence are used widely until or even though findings of adverse events emerge, while others with study results supporting their safety and effectiveness remain underused. This study aims at examining the diffusion patterns of innovative medical technologies in German inpatient care between 2005 and 2017 while simultaneously considering evidence development. METHODS: Based on a qualitatively derived typology and a quantitative clustering of the adoption curves, a representative sample of 21 technologies was selected for further evaluation. Published scientific evidence on efficacy/effectiveness and safety of the technologies was identified and extracted in a systematic approach. Derived from a two-dimensional classification according to the degree of utilization and availability of supportive evidence, the diffusion patterns were then assigned to the categories “Success” (widespread/positive), “Hazard” (widespread/negative), “Overadoption” (widespread/limited or none), “Underadoption” (cautious/positive), “Vigilance” (cautious/negative), and “Prudence” (cautious/limited or none). RESULTS: Overall, we found limited evidence on the examined technologies regarding both the quantity and quality of published randomized controlled trials. Thus, the categories “Prudence” and “Overadoption” together account for nearly three-quarters of the years evaluated, followed by “Success” with 17%. Even when evidence is available, the transfer of knowledge into practice appears to be inhibited. CONCLUSIONS: The successful implementation of safe and effective innovative medical technologies into practice requires substantial further efforts by policymakers to strengthen systematic knowledge generation and translation. Creating an environment that encourages the conduct of rigorous studies, promotes knowledge translation, and rewards innovative medical technologies according to their added value is a prerequisite for the diffusion of valuable health care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13012-021-01159-3. BioMed Central 2021-10-30 /pmc/articles/PMC8556925/ /pubmed/34717677 http://dx.doi.org/10.1186/s13012-021-01159-3 Text en © The Author(s) 2021, corrected publication 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Dreger, Marie
Eckhardt, Helene
Felgner, Susanne
Ermann, Hanna
Lantzsch, Hendrikje
Rombey, Tanja
Busse, Reinhard
Henschke, Cornelia
Panteli, Dimitra
Implementation of innovative medical technologies in German inpatient care: patterns of utilization and evidence development
title Implementation of innovative medical technologies in German inpatient care: patterns of utilization and evidence development
title_full Implementation of innovative medical technologies in German inpatient care: patterns of utilization and evidence development
title_fullStr Implementation of innovative medical technologies in German inpatient care: patterns of utilization and evidence development
title_full_unstemmed Implementation of innovative medical technologies in German inpatient care: patterns of utilization and evidence development
title_short Implementation of innovative medical technologies in German inpatient care: patterns of utilization and evidence development
title_sort implementation of innovative medical technologies in german inpatient care: patterns of utilization and evidence development
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556925/
https://www.ncbi.nlm.nih.gov/pubmed/34717677
http://dx.doi.org/10.1186/s13012-021-01159-3
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