Introduction: Despite common, serious, costly, and often fatal conditions affecting up to 50 % of older patients, delirium is often unrecognized and overlooked. We examine the accuracy of the 4AT for detecting older patients with delirium.Methods: We performed a systematic search of PubMed, Web of Science, PsycINFO, and EMBASE databases from inception to April 2020 and updated to January 2022. Four independently reviewers extracted study data and assessed the methodological quality using the revised quality assessment of diagnostic accuracy studies tool (QUADAS-2). Pooled estimates of sensitivity and specificity were generated using a bivariate random effects model. All statistical analyses were performed with STATA version 15.1 and Meta-DiSc version 1.4 software. Results: Eleven studies with 2789 participants were included. The pooled sensitivity and specificity were 0.87 (95 % CI: 0.81-0.91) and 0.87 (95 % CI: 0.79-0.92), respectively, and the positive and negative likelihood ratios were 6.66 (95 % CI: 4.12-10.74) and 0.15 (95 % CI: 0.10-0.23), respectively. Deeks' test indicated no significant publication bias (t = 0.83, P = 0.43). Univariable meta-regression showed that patient selection and flow and timing significantly influenced the pooled sensitivity (P < 0.05), settings significantly influenced the pooled specificity (P < 0.05).Conclusion: Our meta-analysis demonstrates that 4AT is a sensitive and specific screening tool for delirium in older patients. Its brevity and simplicity support its use in routine clinical practice, particularly in time-poor settings. Clinicians should come to a conclusion based largely on the 4AT findings in conjunction with clinical judgment.

In the past years, network meta-analysis (NMA) has been widely used among clinicians, guideline makers, and health technology assessment agencies and has played an important role in clinical decision-making and guideline development. To inform further development of NMAs, we conducted a bibliometric analysis to assess the current status of published NMA methodological studies, summarized the methodological progress of seven types of NMAs, and discussed the current challenges of NMAs.

Authors' objectives: Point of care tests (POCTs) for troponin (Tn) and D-Dimer enable rapid diagnostics near patients. Tn-POCTs are used when there is a suspicion of acute coronary syndrome (ACS) and D-Dimer-POCTs are used when there is a suspicion of venous thromboembolism (VTE). Objectives: The aim of this report, which is an update of a review conducted in 2019, is to answer the following questions: What is the clinical benefit of D-Dimer-POCT and Tn-POCT in the treatment of symptomatic adults in primary care?

Authors' objectives: Objective The aim of this health technology assessment (HTA) is to evaluate the safety, effectiveness and economic impact of folate testing in an asymptomatic general population and in patients with suspected folate deficiency due to the presence of symptoms, underlying medical disorders or external factors. In addition, ethical, legal, social and organisational issues related to folate testing are investigated.

Authors' objectives: EarlyCDT Lung (Oncimmune Holdings plc, Nottingham, UK) is a blood test to assess malignancy risk in people with solid pulmonary nodules. It measures the presence of seven lung cancer-associated autoantibodies. Elevated levels of these autoantibodies may indicate malignant disease. The results of the test might be used to modify the risk of malignancy estimated by existing risk calculators, including the Brock and Herder models. The objectives were to determine the diagnostic accuracy, clinical effectiveness and cost-effectiveness of EarlyCDT Lung; and to develop a conceptual model and identify evidence requirements for a robust cost-effectiveness analysis.

Authors' objectives: The aim of this report is to summarize the existing clinical and economic evidence on the remote monitoring of patients with CIEDs, i.e. ICDs, PMs, CRT-P, CRT-D, and ILRs and to investigate reimbursement practices in other countries in order to provide recommendations for a potential reimbursement of these technologies. The main research questions are: •What are the technical characteristics of RM systems for CIEDs and what health problems do they address? The aim of chapter 2 is to summarize the technology characteristics, mostly based on information provided by the RM systems providers. •What is the current use of RM of CIEDs in Belgium? The aim of chapter 3 is also to investigate the adoption and perception of these RMsystems by Belgian cardiology centres, mainly based on a short survey. •What are the clinical benefits and risks of remote monitoring of CIEDs? The aim of chapter 4 is to provide a clear synthesis of the evidence on the clinical effectiveness and safety based on other existing HTA reports, systematic reviews and randomized clinical trials. •What is the cost-effectiveness of remote monitoring of CIEDs? The aim of the chapter 5 is to provide a clear synthesis of the evidence on the cost-effectiveness based on other existing HTA reports, systematic reviews and economic evaluations. •Which legal aspects need to be considered? The aim of chapter 6 is to identify the changes in the legal frameworks affecting cardiac remote monitoring since the 2010 report and to discuss the current most debated issues in this sector. Therefore, the focus of this chapter is the impact of the new medical devices’ regulations and the new personal data protection rules as well as changes in the Belgian rules applicable to health care delivery •What forms of financing are available for health care professionals and for the equipment and services provided by RM systems providers in other countries? What are the quality criteria and other organizational aspects included in the reimbursement conditions? The aim of chapter 7 is to give examples of reimbursement conditions, financing mechanisms and quality criteria based on an international comparison in selected European countries. •Which models could be considered in Belgium and what may be their budget impact? The aim of chapter 8 is to discuss the impact of the financing models identified in chapter 7 for the Belgian context.

Authors' objectives: Sore throat is a common condition caused by an infection of the airway. Most cases are of a viral nature; however, a number of these infections may be caused by the group A Streptococcus bacterium. Most viral and bacterial sore throat infections resolve spontaneously within a few weeks. Point-of-care testing in primary care has been recognised as an emerging technology for aiding targeted antibiotic prescribing for sore throat in cases that do not spontaneously resolve. Systematically review the evidence for 21 point-of-care tests for detecting group A Streptococcus bacteria and develop a de novo economic model to compare the cost-effectiveness of point-of-care tests alongside clinical scoring tools with the cost-effectiveness of clinical scoring tools alone for patients managed in primary care and hospital settings.

Authors' objectives: HIQA was requested to undertake a rapid health technology assessment (HTA) of alternative diagnostic testing methods for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This work was done to inform the work of the National Public Health Emergency Team (NPHET) in their response to the COVID-19 (coronavirus disease 2019) pandemic. According to the World Health Organization (WHO), diagnostic testing for SARS-CoV-2 infection is critical to tracking the viral spread, understanding epidemiology, informing case management, and reducing transmission. At the request of NPHET, HIQA investigated the potential usefulness of alternative diagnostic tests for the detection of SARS-CoV-2, whether any of the tests that are commercially available are being used internationally, and identified when the tests could be deployed in the clinical pathway.