There is growing awareness of the impact health technologies can have on the environment and the negative consequences of these environmental impacts on human health. However, health system decision-makers may lack the expertise, data, or resources to incorporate environmental considerations when making decisions about the adoption and use of health technologies. In this article, we describe how health technology assessment (HTA) is evolving to address climate change by providing health system decision-makers with the information they can use to reduce the impact of health care systems on the environment. Our objective is to consider approaches for including the environment domain when conducting an HTA—in particular, the use of the deliberative process—and for determining when the domain should be included. We explore the challenges of gathering the relevant data necessary to assess the environmental impact of a health technology, and we describe a “triage” approach for determining when an in-depth environmental impact assessment is warranted. We also summarize related initiatives from HTA agencies around the world.

Evidence from 1 systematic review and 2 observational studies suggests that dexamethasone intravitreal implant is associated with improvement in macular edema secondary to retinal detachment surgery. The evidence primarily came from low- to moderate-quality studies. It is challenging to draw definitive conclusions about the effectiveness of this intervention because of the paucity of data, the lack of controlled clinical studies, and the retrospective nature of the current literature. No evidence was identified on the cost-effectiveness of dexamethasone intravitreal implant for the treatment of macular edema secondary to retinal detachment surgery.

An English translator and clerk at the Tower of London, William Painter (?1540–95) is best known for hisThe palace of pleasure(vol. 1, 1566; vol. 2, 1567), which contains about 100 stories from Italian, French, and classical sources – with plots centred on love, jealousy, wit, and exemplary individuals – that influenced the development of English drama and the early history of the English novel. Narratives found in Shakespeare'sRape of Lucrece, Romeo and Juliet, All's well that ends well, Timon of Athens, andEdward IIIappear in thePalace, which additionally served as a source for John Webster'sThe Duchess of Malfi, John Marston'sThe Dutch courtesan, Philip Massinger'sPicture, and other plays.

Deep brain stimulation involves the surgical insertion of electrodes to stimulate targeted areas of the brain. It is recommended to help control movement-related symptoms of Parkinson disease with certain indications and contraindications to consider. This rapid Environmental Scan describes the landscape of deep brain stimulation surgery across Canada and identifies conditions other than Parkinson disease that can benefit from the therapy. It also provides an overview of cost-effectiveness studies on deep brain stimulation for Parkinson disease. Emerging indications for deep brain stimulation include refractory obsessive-compulsive disorder, refractory epilepsy, treatment-resistant Tourette syndrome, certain types of pain, refractory major depressive disorder, tardive dyskinesia, and essential tremor. In Canada, there are deep brain stimulation surgery programs in Alberta, British Columbia, Manitoba, Nova Scotia, Ontario, Quebec, and Saskatchewan. The number of qualified neurosurgeons for deep brain stimulation surgery ranges from 1 to 5 (at least) across jurisdictions. Overall, deep brain stimulation is considered cost-effective for people living with advanced Parkinson disease. The risk of developing Parkinson disease increases with age, with onset typically occurring in late adulthood. The number of people eligible for deep brain stimulation in Canada is expected to increase with the aging population and emerging indications. Information related to existing surgery programs can help support capacity planning for deep brain stimulation surgery in Canada.

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