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The Assessment of Alternative Interventions to Manage Health Emergencies

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (1 December 2021) | Viewed by 4723

Special Issue Editors


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Guest Editor
National Centre for Health Technology Assessment, Italian National Institute of Health, 00161 Roma RM, Italy
Interests: cost effectiveness analysis; Bayesian decision modeling; experimental economics; risk and uncertainty analysis and quantitative methods in the field of Pharmacoeconomics; HTA; healthcare policy; health outcomes research and emergency management
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Guest Editor
Università Niccolò Cusano, 00166 Roma RM, Italy
Interests: statistics; mathematics; computer science; Econometrics

Special Issue Information

Dear colleagues,

The actual health emergency caused by the COVID-19 pandemic has shown how the capability of the health systems to provide a rapid response to unexpected circumstances is critical.

Moreover, the pandemic has shown how the attitude of health organizations to operate on the edge of an efficiency frontier whose bounds mainly rely on current and ordinary activities/operations needs to be revisited to account for physical and human resources to face extraordinary situations. This raises inevitable challenges on the design and implementation of cost–benefit frameworks aimed at evaluating the value for money of health interventions.

In this Special Issue, we aim to present evidence showing how cost–benefit models can be useful tools in order to inform and support the decision-making process and to lead the design and implementation of interventions aimed at preventing and controlling the consequences of health emergencies such as pandemics. More concretely, we present the economics of emergency as the approach aimed at defining how to identify which interventions would be more efficient to be implemented in order to minimize the risk of unexpected circumstances/events. The rationale of the Special Issue is that when dealing with complex decisions, potentially leading to extraordinary circumstances, the first step for a decision maker should be to minimize the sources of uncertainty by means of further research. This would inevitably entail investments and reallocation of resources.

In this Special Issue, we will host scientific contributions showing the effectiveness and efficiency of different tools, interventions, and technologies aimed at minimizing the risk of incurring health emergencies as well as to support decision making when emergencies occur. Applied and methodological contributions, as well as case studies are welcome. Papers showing the potentialities of new analytical tools such as artificial neural networks, big data, and machine learning, as well as papers highlighting the role of different health professions are particularly encouraged.

Prof. Dr. Matteo Ruggeri
Prof. Dr. Carlo Drago
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (1 paper)

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15 pages, 12936 KiB  
Systematic Review
Effectiveness of Pre-Hospital Tourniquet in Emergency Patients with Major Trauma and Uncontrolled Haemorrhage: A Systematic Review and Meta-Analysis
by Roberto Latina, Laura Iacorossi, Alice Josephine Fauci, Annalisa Biffi, Greta Castellini, Daniela Coclite, Daniela D’Angelo, Silvia Gianola, Veronica Mari, Antonello Napoletano, Gloria Porcu, Matteo Ruggeri, Primiano Iannone, Osvaldo Chiara and on behalf of INIH—Major Trauma
Int. J. Environ. Res. Public Health 2021, 18(23), 12861; https://doi.org/10.3390/ijerph182312861 - 6 Dec 2021
Cited by 9 | Viewed by 4200
Abstract
Trauma is one of the leading causes of uncontrolled haemorrhage, death, and disability. Use of a tourniquet can be considered an optimal anti-haemorrhagic resource, in pre-hospital and emergency settings, and its lifesaving effect is clinically contradictory. This review aims to assess the clinical [...] Read more.
Trauma is one of the leading causes of uncontrolled haemorrhage, death, and disability. Use of a tourniquet can be considered an optimal anti-haemorrhagic resource, in pre-hospital and emergency settings, and its lifesaving effect is clinically contradictory. This review aims to assess the clinical efficacy of the tourniquet in the emergency pre-hospital care setting for the management of haemorrhage. We conducted the systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the PRISMA statement. We searched the following electronic databases: EMBASE, MEDLINE, and Cochrane-CENTRAL. All studies included were appraised for risk of bias. Prevalent primary outcomes were mortality and use of blood products. Secondary outcomes were related to adverse effects. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE). Four studies were involved (1762 trauma patients). The adjusted odds ratio (aOR) of 0.47 (95% confidence Interval (CI) 0.19–1.16; three studies; 377 patients) for overall mortality estimates did not give a clear indication of the benefits of emergency pre-hospital tourniquets (PH-TQ) versus no pre-hospital tourniquet (NO PH-TQ) placement. The adjusted mean difference for blood product use was −3.28 (95% CI −11.22, 4.66) for packed red blood cells (pRBC) and −4.80 (95% CI −5.61, −3.99) for plasma, respectively. The certainty of evidence was downgraded to very low for all outcomes. Our results suggest an unclear effect of emergency pre-hospital tourniquet placement on overall mortality and blood product use. However, this systematic review highlights the availability of only observational studies and the absence of high quality RCTs assessing the efficacy of PH-TQs. Randomized controlled trials are needed. Full article
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