The Role of decision-analytic modelling in German health technology assessments

BACKGROUND: Decision-analytic modelling (DAM) has become a widespread method in health technology assessments (HTA), but the extent to which modelling is used differs among international HTA institutions. In Germany, the use of DAM is optional within HTAs of the German Institute of Medical Documentation and Information (DIMDI). Our study examines the use of DAM in DIMDI HTA reports and its effect on the quality of information provided for health policies. METHODS: A review of all DIMDI HTA reports (from 1998 to September 2012) incorporating an economic assessment was performed. All included reports were divided into two groups: HTAs with DAM and HTAs without DAM. In both groups, reports were categorized according to the quality of information provided for healthcare decision making. RESULTS: Of the sample of 107 DIMDI HTA reports, 17 (15.9%) used DAM for economic assessment. In the group without DAM, conclusions were limited by the quality of economic information in 51.1% of the reports, whereas we did not find limited conclusions in the group with DAM. Furthermore, 24 reports without DAM (26.7%) stated that using DAM would likely improve the quality of information of the economic assessment. CONCLUSION: The use of DAM techniques can improve the quality of HTAs in Germany. When, after a systematic review of existing literature within a HTA, it is clear that DAM is likely to positively affect the quality of the economic assessment DAM should be used.

Spectral self-action of THz emission from ionizing two-color laser pulses in gases

The spectrum of terahertz (THz) emission in gases via ionizing two-color femtosecond pulses is analyzed by means of a semi-analytic model and numerical simulations in 1D, 2D and 3D geometries taking into account propagation effects of both pump and THz fields. We show that produced THz signals interact with free electron trajectories and thus significantly influence further THz generation upon propagation, i.e., make the process inherently nonlocal. This self-action contributes to the observed strong spectral broadening of the generated THz field. Weshow that diffraction of the generated THz radiation is the limiting factor for the co-propagating low frequency amplitudes and thus for the self-action mechanism in 2D and 3D geometries.