Innovative Health Technologies Research Articles

Cost-Effectiveness Evaluation of a Remote Monitoring Programme Including Lifestyle Education Software in Type 2 Diabetes: Results of the Educ@dom Study.

IntroductionTelemedicine programs using health technological innovation to remotely monitor the lifestyles of patients with type 2 diabetes (T2D) can improve glycaemic control and thus reduce the incidence of complications as well as management costs. In this context, an assessment was made of the 1-year and 2-year cost-effectiveness of the EDUC@DOM telemonitoring and tele-education program.MethodsThe EDUC@DOM study was a multicentre randomized controlled trial conducted between 2013 and 2017 that compared a telemonitoring group (TMG) to a control group (CG) merged with health insurance databases to extract economic data on resource consumption. Economic analysis was performed from the payer perspective, and direct costs and indirect costs were considered. The clinical outcome used was the intergroup change in glycated haemoglobin (HbA1c) levels from baseline. Missing economic data were imputed using multiple imputation, and fitted values from a generalized linear mixed model were used to calculate the incremental cost-effectiveness ratio (ICER). Bootstrapped 95% confidence ellipses were drawn in the cost-effectiveness plan.ResultsThe main analysis included data from 256 patients: 126 in the TMG and 130 in the CG. Incremental costs over 1 and 2 years were equal to €2129 and €5101, respectively, in favour of the TMG. Once imputed and adjusted for confounding factors, the TMG trends to a 21% cost decrease over 1 and 2 years of follow-up (0.79 [0.58; 1.08], p = 0.1452 and 0.79 [0.61; 1.03], p = 0.0879, respectively). The EDUC@DOM program led to a €1334 cost saving and a 0.17 decrease in HbA1c over 1 year and a €3144 cost saving and a 0.14 decrease in HbA1c over 2 years. According to the confidence ellipse, EDUC@DOM was a cost-effective strategy.ConclusionThis study provides additional economic information on telemonitoring and tele-education programs to enhance their acceptance and promote their use. In the light of this work, the EDUC@DOM program is a cost-saving strategy in T2D management.Trial registrationThis trial was registered in the Clinical Trials Database on 27 September 2013 under no. NCT01955031 and bears ID-RCB no. 2013-A00391-44.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-022-01207-1.

The digital transformation of hepatology: The patient is logged in.

The rise in innovative digital health technologies has led a paradigm shift in health care toward personalized, patient-centric medicine that is reaching beyond traditional brick-and-mortar facilities into patients' homes and everyday lives. Digital solutions can monitor and detect early changes in physiological data, predict disease progression and health-related outcomes based on individual risk factors, and manage disease intervention with a range of accessible telemedicine and mobile health options. In this review, we discuss the unique transformation underway in the care of patients with liver disease, specifically examining the digital transformation of diagnostics, prediction and clinical decision-making, and management. Additionally, we discuss the general considerations needed to confirm validity and oversight of new technologies, usability and acceptability of digital solutions, and equity and inclusivity of vulnerable populations.

Health technology assessment of paediatric medicines: European landscape, challenges and opportunities inside the conect4children project.

The medicine development process is complex and requires time and effort to ensure safety, efficacy and quality. In paediatrics, this process is even more challenging, as it involves a subgroup of the population that already faces a considerable gap in the clinical evaluation of medicines and devices compared to the adult population. Moreover, access to therapies is heavily influenced by national health technology assessment (HTA) recommendations, which often form the basis for pricing and reimbursement decisions that affect the availability of effective treatments within the national health systems. Yet performing an HTA to assess the relative effectiveness and cost-effectiveness of a new children's treatment has several non-trivial implications, creating a critical issue for the paediatric population. In addition, the advent of innovative health technologies for children emphasises the need to empower the role of HTAs in paediatrics. This article aims at describing the most relevant elements of the drug development process in the paediatric field by focusing on the HTA. Particular attention will be paid to the factors that influence market access for new paediatric medicines and patients' access to treatment. The article will also highlight some central methodological challenges in conducting HTA in the paediatric field. Finally, the article will provide insight into how initiatives, such as conect4children, may subsequently reinforce HTA awareness in the paediatric community and strengthen collaborations through network mechanisms.

Development, testing, and implementation of a new procedure to assess the clinical added benefit of pharmaceuticals.

The reimbursement process for innovative health technologies in Hungary lacks any formalized assessment of clinical added benefit (CAB). The aim of this research is to present the development, retrospective testing, and implementation of a local assessment framework for determining the CAB of cancer treatments at the Department of Health Technology Assessment of the National Institute of Pharmacy and Nutrition in Hungary. The assessment framework was drafted after screening existing methods and a retrospective comparison of local reimbursement dossiers to that of German and French methods. The Magnitude of Clinical Benefit Scale of the European Society for Medical Oncology was chosen to rate the extent of CAB in oncology, as part of a conclusion complemented by the assessment of endpoint relevance and the quality of evidence. Several rounds of retrospective assessments have been conducted involving all clinical assessors, iterated with semistructured discussions to consolidate divergence between assessors. External stakeholders were consulted to provide feedback on the framework. Retrospective assessments resulted in average more than 75 percent concordance between assessors on each element of the conclusion. Input from ten stakeholders was also incorporated; stakeholders were generally supportive, and they mostly commented on the concept, the elements of the framework, and its implementation. The procedure is suitable for routine use in the decision-making process to describe the CAB of antineoplastic technologies in Hungary. Further extension of the framework is required to cover more disease areas for structured and comparable conclusions on CAB of innovative health technologies.

ЗАНЯТТЯ З ФІЗИЧНОГО ВИХОВАННЯ У ПРОЦЕСІ РОЗВ’ЯЗАННЯ ПРОБЛЕМИ ДЕФІЦИТУ РУХОВОЇ АКТИВНОСТІ СТУДЕНТСЬКОЇ МОЛОДІ

This article presents a theoretical analysis of the features of modern physical training of future specialists and ways of supporting the motor activity of student youth. It is justified that the activation of students for independent physical exercises should use a variety of innovative physical culture and health technologies, modern forms and methods of learning - integrated classes, interactive forms of learning, the use of information and communication technologies, innovative approaches to assessing somatic health. It has been proven that the effectiveness of students' independent work is quite low, it is accompanied by increased time costs, both of students for its implementation, and of teachers for monitoring its implementation. Methodical support of the educational process plays an important role in increasing the productivity of students, during independent work. Currently, the process of development and introduction into pedagogical practice of a more advanced method of physical education, which covers the physiological, psychological, social and pedagogical aspects and ensures the improvement of the quality of educational work, activates the cognitive activity of students, develops their mental and physical abilities, is of particular importance. At the same time, an important role is assigned to the formation of students' abilities and skills of independent work. It has been established that it is possible to achieve a health-improving effect in the process of independent performance of physical exercises only by observing the main principles: systematicity, gradualness, adequacy and versatile orientation of training.In this way, the proposed technology of training cadets for independent classes in physical culture and health activities should be complex with the use of a large number of means and methods of influencing the personality. Involvement of cadets in independent classes in physical culture and health activities involves the application of a complex of educational influences, the development of a program of classes, the ratio of training tools, the dosage of loads and is a means of forming the need for systematic physical education classes in student youth based on the creation of ideas about a healthy lifestyle.

POSC220 Understanding Value Drivers of European Payers' Evaluation of Products That Combine Pharmaceuticals, Medical Technology and Digital Health − Is a New Approach Needed?

Innovation is increasing in integrated products combining a drug, a connected ‘smart’ administration device and an application that supports disease management. Specific evaluation frameworks for these combination products do not yet exist. We assessed how payers evaluate pricing and access potential of innovative digital health technologies that combines a drug, a ‘smart’ device and a companion application.

POSA287 Transferability of Disease-Related Costs of Chronic Immune-Mediated Diseases within Countries of the Middle East North Africa Region: The Case of Multiple Sclerosis

Financing decisions of innovative health technologies including specialty medicines or biologicals increasingly necessitate health technology assessment (HTA) in the Middle East North Africa (MENA) region. However, lack of cost data hampers health economic evaluations. Therefore, we assessed the possibility of transferring disease-related costs of multiple sclerosis (MS) within countries in the MENA region as a model for chronic-immune mediated disorders (IMIDs).

Design and Implementation of Medical Searching System Based on Microservices and Serverless Architectures

Microservices and Serverless computing are promising cloud-based architectural models in the software development industry that have many advantages over previous technology models. The benefit of adopting these more novel models, however, is dependent on the volume of the application workload and the execution behavior. ScanMedicine is a new searching system dedicated to providing health care professionals, patients and researchers with easy access to intelligence underpinning health technology innovations. We present the design and implementation of ScanMedicine’s framework using AWS lambda functions and microservices. We incorporated a layered architectural style where each layer run on separate hardware and adopt different architectural technique.

Integrative analysis from multi-center studies identities a consensus machine learning-derived lncRNA signature for stage II/III colorectal cancer.

SummaryBackgroundLong non-coding RNAs (lncRNAs) have recently emerged as essential biomarkers of cancer progression. However, studies are limited regarding lncRNAs correlated with recurrence and fluorouracil-based adjuvant chemotherapy (ACT) in stage II/III colorectal cancer (CRC).Methods1640 stage II/III CRC patients were enrolled from 15 independent datasets and a clinical in-house cohort. 10 prevalent machine learning algorithms were collected and then combined into 76 combinations. 109 published transcriptome signatures were also retrieved. qRT-PCR assay was performed to verify our model.FindingsWe comprehensively identified 27 stably recurrence-related lncRNAs from multi-center cohorts. According to these lncRNAs, a consensus machine learning-derived lncRNA signature (CMDLncS) that exhibited best power for predicting recurrence risk was determined from 76 kinds of algorithm combinations. A high CMDLncS indicated unfavorable recurrence and mortality rates. CMDLncS not only could work independently of common clinical traits (e.g., AJCC stage) and molecular features (e.g., microsatellite state, KRAS mutation), but also presented dramatically better performance than these variables. qRT-PCR results from 173 patients further verified our in-silico findings and assessed its feasible in different centers. Comparisons of CMDLncS with 109 published transcriptome signatures further demonstrated its predictive superiority. Additionally, patients with high CMDLncS benefited more from fluorouracil-based ACT and were characterized by activation of stromal and epithelial-mesenchymal transition, while patients with low CMDLncS suggested the sensitivity to bevacizumab and displayed enhanced immune activation.InterpretationCMDLncS provides an attractive platform for identifying patient at high risk of recurrence and could optimize precision treatment to improve the clinical outcomes in stage II/III CRC.FundingThis study was supported by the National Natural Science Foundation of China (81,972,663); Henan Province Young and Middle‐Aged Health Science and Technology Innovation Talent Project (YXKC2020037); and Henan Provincial Health Commission Joint Youth Project (SB201902014).

The 4 Youth By Youth mHealth Photo Verification App for HIV Self-testing in Nigeria: Qualitative Analysis of User Experiences.

BackgroundDespite the global expansion of HIV self-testing (HIVST), many research studies still rely on self-reported outcomes. New HIVST verification methods are needed, especially in resource-limited settings.ObjectiveThis study aims to evaluate the user experience of a mobile health (mHealth) app to enhance HIVST result reporting and verification.MethodsSemistructured, in-depth interviews were used to evaluate the user experience of the 4 Youth By Youth mHealth photo verification app for HIVST. We used a think-aloud approach, and participants performed usability tasks and completed a qualitative exit interview. The app included HIV educational resources, step-by-step video instructions for performing HIVST, a 20-minute timer, a guide on interpreting results with linkages to care, an offline version, and a photo verification system. Demographic characteristics were reported by using descriptive statistics. Qualitative data were analyzed by using thematic analysis.ResultsA total of 19 users—12 women and 7 men—with a mean age of 22 years, participated in the study. The users completed the usability tasks and successfully uploaded a photo of their test results by using the app without assistance. Four main themes were identified in the data. First, in terms of user-friendly design, the participants noted the user-friendly features of the offline version and the app’s low data use. However, some wanted the app to work in the background when using their mobile phone, and the font used should be more youth friendly. Second, in terms of ease of use, participants remarked that the app’s self-explanatory nature and instructions that guided them on how to use the app enhanced its use. Third, in terms of a user’s privacy, many participants reinforced the importance of privacy settings and tools that protect confidentiality among users. Finally, in terms of linkage to care, participants noted that the app’s linkage to care features were useful, particularly in relation to referrals to trained counselors upon the completion of the test. All the participants noted that the app provided a convenient and private means of verifying the HIV test results.ConclusionsOur findings demonstrated the importance of engaging end users in the development phase of health technology innovations that serve youth. Clinical trials are needed to determine the efficacy of using an mHealth app to verify HIVST results among young people.

8.H. Workshop: Policy and practice: the role Real-World Data (RWD) in Health Technology Assessment

Abstract The European Medicines Agency (EMA) has developed multiple schemes to improve access to medicines. Among them, the Conditional Marketing Authorisation (CMA), namely an approval based on less complete data followed by post-authorisation obligations, can be granted to medicines addressing unmet medical needs, debilitating or life-threatening diseases, rare diseases, or public health threats. In the post-authorisation obligations, real world data (RWD) routinely collected from different sources, such as electronic health records, administrative claims, or product and disease registries, are used for Real World Evidence (RWE) generation. In the context of the COVID-19 pandemic, this effort took the form of establishing an infrastructure and planning for the generation and synthesis of said data. Over the past few years, frameworks have emerged, and the European Union's new Pharmaceutical Strategy, adopted on November 2020, highlighted the need to systematically examine and transform current policies and practices to allow for the use of RWD/RWE to support the development, authorisation and use of medicines. Indeed, regulatory and Health Technology Assessment (HTA) bodies are opening the doors to the use of RWD/RWE in their evaluation frameworks. Nevertheless, currently there is a lack of established infrastructures to facilitate robust EU-wide data collection and transfer. Furthermore, there is a fragmented EU-wide landscape of heterogeneous policies on the acceptance and the appraisal of RWD/RWE. Given the COVID-19 pandemic, we also need to consider comparative effectiveness research and population information. This critically necessitates collaboration and mechanisms of information exchange supported by well-established research infrastructures. Additionally, several challenges need to be overcome, from methodological ones (quality and transferability of data) to governance issues and legislative challenges, including GDRP considerations in terms of data processing and transfer. During the 2019 HTA international (HTAi) Global Policy Forum, a call for actions and guidance to manage RWD/RWE to inform decision-making across the whole lifecycle of health technologies was launched. In fact, there is an urgent need for regulators and payers to make the best use of RWD/RWE also to allow a timely access to innovative health technologies and to reassess them across the lifecycle. This workshop is intended to carry forward the discussion on policies and practices on the use of RWD/RWE by regulatory and HTA bodies. Key messages Real world data (RWD) routinely collected from different sources and within different countries can be employed for rapid policy relevant research responses. HTA/Payer should agree on how collect and use data in the assessment and reassessment process of the value of health technologies.

Integrating Public Participation, Transparency and Accountability Into Governance of Marketing Authorisation for Genome Editing Products

Public participation, transparency and accountability are three of the pillars of good governance. These pillars become particularly important for innovative, personalised health technologies, because of the tendency of these technologies to raise distinct scientific, ethical, legal and social issues. Genome editing is perhaps the most personal of all innovative health technologies, involving precise modifications to an individual’s genome. This article focuses on the adequacy of current requirements for public participation, transparency and accountability in the governance of the market authorisation for genome edited products. Although clinical trials for genome edited products are only just underway, lessons can be drawn from the marketing approvals pathways for related gene therapy products. This article provides a broad overview of the regulatory pathways that have been adopted by the US Food and Drugs Administration, the European Medicines Authority, and the Australian Therapeutic Goods Administration for reviewing gene therapy products for marketing approval. This analysis focuses on the extent to which public participation processes and transparency and accountability of review pathways are incorporated into marketing approval policy and practice. Following this review, the article proposes the application of Sheila Jasanoff’s “technologies of humility” as a foundation for meaningfully incorporating these pillars of good governance into regulatory processes for the review of products of genome editing. We conclude by articulating clear mechanisms for operationalising technologies of humility in the context of public participation, transparency and accountability, providing a blueprint for future policy development.

Public Health and Online MICE Technology During the COVID-19 Pandemic: The Role of Health Beliefs and Technology Innovation.

The traditional meetings, incentives, conferences, and exhibitions (MICE) industry has been hit hard by social distancing regulations introduced to combat the COVID-19 pandemic, with concerns about pandemic risks and personal hygiene increasing the demand for online MICE technology. With the introduction of innovative new technologies to the MICE industry, it is important to study the psychology of online MICE attendees, particularly the factors affecting their behavioral intention to adopt online MICE technology during the pandemic. This study investigates the attitudes toward attending online MICE since the start of the epidemic based on the health belief model (HBM) and innovation diffusion theory (IDT). A total of 439 valid questionnaires were collected in China and used for structural equation modeling. The results show that the perceived safety threat, the comparative advantage, trialability, and outcome expectations positively impact the attendees' attitudes. Moreover, this study finds that attitude completely mediates the impact of perceived safety threat, comparative advantages, trialability, and outcome expectation on behavioral intention to attend online MICE events. These findings theoretically enrich the understanding of online MICE technology, the HBM, and the IDT and offer managerial implications for MICE organizers and exhibitors.

Innovation in unruptured intracranial aneurysm coiling: At which price or efficacy are new technologies cost-effective?

BackgroundUnruptured intracranial aneurysms (UIA) are increasingly being treated by endovascular coiling as opposed to open surgical clipping. Unfortunately, endovascular coiling imparts an approximate 25% recanalization rate, leading to additional procedures and increased rupture risk. While a new health technology innovation (HTI) that reduces this recanalization rate would benefit patients, few advancements have been made. We aim to determine whether cost-effectiveness has been a barrier to HTI.MethodsA probabilistic Markov model was constructed from the healthcare payer perspective to compare standard endovascular treatment of UIA to standard treatment plus the addition of a HTI adjunct. Costs were measured in 2018 USD and health outcomes were measured in quality-adjusted life-years (QALY). In the base case, the HTI was a theoretical mesenchymal stem cell therapy which reduced the aneurysm recanalization rate by 50% and cost $10,000 per procedure. All other model inputs were derived from the published scientific literature.ResultsBased on the model results, we found that for a given HTI price (y) and relative risk reduction of aneurysm recanalization (x), the HTI was always cost-effective if the following equation was satisfied: y ≤ 20268 ∙ x, using a willingness-to-pay threshold of $50,000 per QALY. The uncertainty surrounding whether an aneurysm would recanalize was a significant driver within the model. When the uncertainty around the risk of aneurysm recanalization was eliminated, the 10-year projected additional benefit to the United States healthcare system was calculated to be $113,336,994.ConclusionCost-effectiveness does not appear to be a barrier to innovation in reducing the recanalization rate of UIA treated by endovascular coil embolization. Our model can now be utilized by academia and industry to accentuate economically feasible HTI and by healthcare payers to calculate their maximum willingness-to-pay for a new technology. Our results also indicate that predicting a patient’s baseline risk of aneurysm recanalization is a critical area of future research.

Palliative care providers\u2019 use of digital health and perspectives on technological innovation: a national study

BackgroundWhile the need for digital health capability and technological innovation in palliative care services is growing rapidly, relatively little is known about the current uptake and views of individual palliative care practitioners. This study aims to explore palliative care practitioners’ current use of and perspectives on digital health innovation in palliative care.MethodsA descriptive cross-sectional survey with a web-based questionnaire was used. Participants were multidisciplinary palliative care practitioners in Australia.ResultsSurveys were returned by 170 medical, nursing, and allied health practitioners working in palliative care. Most respondents reported using a variety of digital health technology associated with clinical information systems, mobile devices, SMS text messaging, teleconferencing, and Wi-Fi. These technologies were used for the purpose of communicating with other health professionals, accessing web-based or mobile health palliative care resources, collecting or managing patient data, and providing information or education. However, few reported electronic access to patients’ advance care planning documentation or could update these data. Respondents were moderately confident in their ability to use digital health, held positive beliefs that palliative care could be enhanced through digital health, and were generally supportive of ongoing innovation through digitally-enable models of care. Palliative care providers would most like to see digital health innovations in the areas of client health records, telehealth, and personal health tracking.ConclusionThis is the first national study of digital health in Australian palliative care providers. It contributes new knowledge in this important area of palliative care practice to guide policy and education, whilst informing future directions for research.

Cost-effectiveness and budget impact analysis for high dose quadrivalent influenza vaccine in the Italian elderly population

Introduction. Influenza is a widespread acute respiratory disease and represents a serious Public Health problem, both from the NHS and society perspectives. The High Dose quadrivalent influenza vaccine (QIV HD) is a flu vaccine containing 4 times the antigens of a Standard Dose vaccine, resulting in demonstrated superior protection in the population aged 65 years and over. Methods. The analysis has been conducted from the perspective of the NHS. The CEA focuses on the comparison between QIV HD and the QIV SD vaccine. The BIM aims to estimate the potential economic impact for the National Health Service (NHS) resulting from the use of QIV HD in clinical practice in subjects aged 65 or over, when considering its introduction in combination with currently used vaccines, QIV SD and adjuvanted TIV. Results. In a scenario which considers hospitalizations possibly related to influenza, so including cardio-respiratory events, a dominant cost-effectiveness profile emerges in the comparison with QIV SD. In terms of budget impact, overall savings obtained by comparing the two scenarios regarding hospitalizations are equal to 92,766,429 € over the three years’ time horizon considered in the analysis. Conclusions. Nowadays, also considering the state of emergency due to the spread of the SARS-CoV-2 virus, it is crucial to implement innovative health technologies that improve the efficiency and sustainability of the health system. Also, it is essential to protect the elderly population, helping to avoid overload and healthcare systems disruption due to the many COVID-19 hospitalizations.

Policy innovation and emergence of innovative health technology: The system dynamics modelling of early COVID-19 handling in Indonesia

This article examines policy innovation, emergence of innovative health technology and its implication for a health system. The complexity of policy innovation implementation resulting from mixing public health resolution and economic interest will trigger the emergence of innovative health technology, which implies a health system improvement. The findings revealed that: First, policy innovation based on a science-mix category created the complexity of policy enforcement, affected the scale and speed of COVID-19 transmissions, and triggered the emergence of health innovative technology. Second, despite policy innovation in early COVID-19, handling was relatively less successful due to restricting factors in policy implementation but provided a new market for the emergence of innovative health technology. Third, the emergence of innovative health technology has strengthened health system preparedness during the pandemic, and provide an opportunity to re-examine the strengths and deficiencies of an entire health system for better health care.

The Sandbox Approach and its Potential for Use in Health Technology Assessment: A Literature Review

BackgroundThe concept of the regulatory sandbox—a safe space for testing new regulatory processes—was first used within the financial technologies (FinTech) sector, but has since expanded into other sectors, including healthcare.ObjectivesThis review aims to describe the extent of use of sandboxes in healthcare and assess the potential for the sandbox approach to be used to test and develop emerging health technology assessment (HTA) methods, policies and processes for innovative technologies.MethodsA systematic literature review was undertaken to identify published papers and reports that described and/or assessed the use of sandboxes in the healthcare sector. Searches were conducted in Medline, Embase, Econlit, Social Policy and Practice, and Health Management Information Consortium databases from inception to March 2020. Free-text Google search was also conducted to identify relevant grey literature. Only papers and reports discussing or evaluating the use of sandboxes in healthcare settings and published in English were included. Included studies were qualitatively summarised using a thematic analysis approach.ResultsOverall, 46 papers and reports were included. The topics covered were classified into 4 major themes: history of the regulatory sandbox, the sandbox as a testing environment, the sandbox as a regulatory approach, examples of using sandboxes in healthcare. Findings show that the use of regulatory sandboxes in healthcare is relatively new and primarily used in high-income countries to support the adoption of new technologies, particularly those related to digital health. Recommendations are made based on these findings to guide its use in HTA policy and methods development.ConclusionsSandboxes are increasingly used within healthcare regulation. Despite its potential, this approach has not been used in HTA policy and methodological developments to date. HTA agencies should consider this approach to facilitate developing policies, methods and processes for innovative and disruptive health technologies. Transferability to low- and middle-income countries’ settings, however, should be assessed.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40258-021-00665-1.

Temporal trends and forecasting of COVID-19 hospitalisations and deaths in Scotland using a national real-time patient-level data platform: a statistical modelling study

SummaryBackgroundAs the COVID-19 pandemic continues, national-level surveillance platforms with real-time individual person-level data are required to monitor and predict the epidemiological and clinical profile of COVID-19 and inform public health policy. We aimed to create a national dataset of patient-level data in Scotland to identify temporal trends and COVID-19 risk factors, and to develop a novel statistical prediction model to forecast COVID-19-related deaths and hospitalisations during the second wave.MethodsWe established a surveillance platform to monitor COVID-19 temporal trends using person-level primary care data (including age, sex, socioeconomic status, urban or rural residence, care home residence, and clinical risk factors) linked to data on SARS-CoV-2 RT-PCR tests, hospitalisations, and deaths for all individuals resident in Scotland who were registered with a general practice on Feb 23, 2020. A Cox proportional hazards model was used to estimate the association between clinical risk groups and time to hospitalisation and death. A survival prediction model derived from data from March 1 to June 23, 2020, was created to forecast hospital admissions and deaths from October to December, 2020. We fitted a generalised additive spline model to daily SARS-CoV-2 cases over the previous 10 weeks and used this to create a 28-day forecast of the number of daily cases. The age and risk group pattern of cases in the previous 3 weeks was then used to select a stratified sample of individuals from our cohort who had not previously tested positive, with future cases in each group sampled from a multinomial distribution. We then used their patient characteristics (including age, sex, comorbidities, and socioeconomic status) to predict their probability of hospitalisation or death.FindingsOur cohort included 5 384 819 people, representing 98·6% of the entire estimated population residing in Scotland during 2020. Hospitalisation and death among those testing positive for SARS-CoV-2 between March 1 and June 23, 2020, were associated with several patient characteristics, including male sex (hospitalisation hazard ratio [HR] 1·47, 95% CI 1·38–1·57; death HR 1·62, 1·49–1·76) and various comorbidities, with the highest hospitalisation HR found for transplantation (4·53, 1·87–10·98) and the highest death HR for myoneural disease (2·33, 1·46–3·71). For those testing positive, there were decreasing temporal trends in hospitalisation and death rates. The proportion of positive tests among older age groups (>40 years) and those with at-risk comorbidities increased during October, 2020. On Nov 10, 2020, the projected number of hospitalisations for Dec 8, 2020 (28 days later) was 90 per day (95% prediction interval 55–125) and the projected number of deaths was 21 per day (12–29).InterpretationThe estimated incidence of SARS-CoV-2 infection based on positive tests recorded in this unique data resource has provided forecasts of hospitalisation and death rates for the whole of Scotland. These findings were used by the Scottish Government to inform their response to reduce COVID-19-related morbidity and mortality.FundingMedical Research Council, National Institute for Health Research Health Technology Assessment Programme, UK Research and Innovation Industrial Strategy Challenge Fund, Health Data Research UK, Scottish Government Director General Health and Social Care.

Thermoplasmonics with Gold Nanoparticles: A New Weapon in Modern Optics and Biomedicine

Thermoplasmonics deals with the generation and manipulation of nanoscale heating associated with noble metallic nanoparticles. To this end, gold nanoparticles (AuNPs) are unique nanomaterials with the intrinsic capability to generate a nanoscale confined light‐triggered thermal effect. This phenomenon is produced under the excitation of a suitable light of a wavelength that matches the localized surface plasmonic resonance frequency of AuNPs. Liquid crystals (LCs) and hydrogels are temperature‐sensitive materials that can detect the host AuNPs and their photo‐induced temperature variations. In this perspective, new insight into thermoplasmonics, by describing a series of methodologies for monitoring, detecting, and exploiting the photothermal properties of AuNPs, is offered. From conventional infrared thermography to highly sophisticated temperature‐sensitive materials such as LCs and hydrogels, a new scenario in thermoplasmonic‐based, next generation, photonic components is presented and discussed. Moreover, a new road in thermoplasmonic‐driven biomedical applications, by describing compelling and innovative health technologies such as on‐demand drug‐release and smart face masks with smart nano‐assisted destruction of pathogens, is proposed. The latter represents a new weapon in the fight against COVID‐19.