Background: Health technology assessment (HTA) is a conventional method in many countries for evaluating reasonable use of health technologies. Aims: To investigate the ethical dimension as an inseparable aspect of HTA studies in Iranian HTA reports. Methods: For quality assessment of ethical analysis, all HTA reports published by the HTA Office up to 2020 were reviewed using 2 valid assessment tools, the HTA Core Model and the Q-SEA questionnaires. Results: We evaluated 91 reports for quality of ethical analyses. In the process dimension, the research question, literature search and inclusion/exclusion criteria were included in 91.2%, 83.5% and 82.4% of the HTA reports, respectively. The perspective of the analysis was explicitly stated in only 13.2% of the reports and the ethics framework in 6.6%. Maximum compliance with completeness, bias, policy implications, other implications, conceptual clarification and conflicting values was considered in only 2.2%, 4.4%, 9.9%, 9.9%, 14.3% and 2.2% respectively of all reports. Conclusions: Iranian HTA reports require a coordinated and integrated framework acceptable to all stakeholders.

Background: Despite significant expansion, indigenous research regarding health system still faces challenges in the field of research application. They include lack of reliable evidence, late arrival of evidence by policymakers or inappropriate language of evidence related to the field of knowledge exchange and translation. The aim of this study is to investigate the status of knowledge translation in research centers of Kerman University of Medical Sciences. Methods: This was a cross-sectional study conducted in 2020 in research centers affiliated with Kerman University of Medical Sciences. Centers entered the study through census and a standard questionnaire of self-assessment regarding knowledge-producing organizations was used. It contained 50 questions in 4 areas of research question, knowledge production, knowledge transfer and promotion of using evidence. After collecting and coding, the data were entered into SPSS 25 software and analyzed using descriptive statistics and non-parametric Mann-Whitney U test. Results: 20 clinical research centers and 6 non-clinical centers participated in this study. Only 3.85 % of the centers scored more than 80 % in total. Regarding the research question, knowledge production, knowledge transfer and promotion of using evidence, the mean standard deviation of scores were 35/85 ± 9/93, 31/50 ± 7/54, 76/65 ± 16/35 and 9/31 ± 3/27, respectively. The best situation was related to knowledge production with 70 % of the score. Findings of the Mann-Whitney U test showed that the mean of all domains in the two groups were not different. Conclusion: This study demonstrated a moderate level of knowledge translation. But, factors such as creating a structure for knowledge translation committee, considering the process of exchange, translation and transfer of knowledge in the process of approving student dissertations and research projects, reviewing research policies and creation of motivational mechanisms to promote the status of researchers can play an important facilitating role in achieving the appropriate level of knowledge exchange and translation.

10.30699/jambs.28.130.265 Background & Objective: If primary angioplasty is not available, thrombolytic therapy is an appropriate option for the treatment of acute myocardial infarction (AMI) in the early hours after the beginning of the signs. This study aimed to assess the safety and effectiveness of tenecteplase (TNKase) vs. alteplase in the treatment of ST-elevation myocardial infarction (STEMI). Materials & Methods: PubMed, Cochrane Library, and Web of Science were searched for the safety and clinical effectiveness of TNKase vs. alteplase, and a manual search was performed among the American, European, and Iranian cardiovascular journals. Randomized clinical trials (RCTs) that included comparisons of TNKase with alteplase alone or with other drugs in STEMI patients published in English, Persian, and Korean languages were included. Two authors independently assessed the eligibility and quality of RCTs. Finally, the data were analyzed in Review Manager version 5.3. Results: There was no statistically significant difference between TNKase and alteplase in the risk of 30-day mortality (RR=1.01; 95% CI: 0.89-1.13; P=0.82). The risk of reinfarction, cardiogenic shock, intracranial hemorrhage (ICH), stroke, and minor bleeding was similar in AMI patients treated with both drugs. TNKase was associated with a statistically significant reduction of total bleeding (P=0.0003) and major bleeding (P=0.0003). Conclusion: In comparison with alteplase, TNKase is recommended due to its easier use and higher safety in reducing the risk of bleeding.

Background: There is no single method for health technology assessment (HTA) which can be used in all countries to meet all the needs of the health care system policy- and decision-makers. Still, some minimum criteria for performing HTA should be in place in all the HTA structures worldwide, and many HTA agencies have reached a consensus in this regard. Aim: This study aimed to assess the quality of Iranian HTA reports. Method: Were examined all the HTA research reports published by the Iranian HTA office up to 2020. The International Network of Agencies for Health Technology Assessment checklist was employed for quality assessment. Results: A total of 97 reports were examined: only 10.0% had presented complete and appropriate contact details for obtaining further information, and 5.6% clearly stated a conflict of interests. In 87.78% of the reports, the scope of assessment was clearly determined. The quality of the reports was relatively appropriate as well as the details of the sources of information and text search strategies. Legal aspects, economic analysis, ethical implications, social implications and other stakeholder perspectives were taken into account in 7.8%, 74.4%, 11.1%, 8.9%, and 4.4% of the reports, respectively. Conclusion: As Iranian HTA reports are not of suitable quality, it is recommended that minimum standard criteria be revised and modified in the HTA process so that large-scale health care policy- and decision-makers can make reliable decisions on the basis of the results.

PPS have a variety of effects on health care providers, that the most significant are cost limitation, reduction in quantity and quality of provided services.