WHO Medical Devices

ISRRT Who list of Priority medical devices 

for cancer management

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“WHO Priority List of Medical Devices Required for Cancer Management”, WHO Medical Device Technical Series

 Donna Newman B.A. RT (R) CNMT FASRT

 The ISRRT is asking member societies to download this document  and help disseminate it within their countries. The publication addresses medical devices that can be used for management of cancer and specifically describes medical devices for six types of cancer: breast, cervical, colorectal, leukemia, lung and prostate. The publication is the outcome of a project developed by the World Health Organization (WHO) in response to the need for a model reference list of basic and priority medical devices required for cancer management, with the goal of increasing access to these medical devices, especially in low- and middle-income countries. According to World Health assembly the   WHO resolution 60.29, Health Technology requests WHO:

 1. To provide support to Member States, where necessary in establishing mechanisms to assess national needs for health technologies, and to assure their availability and safe use.

 2. To provide technical guidance and support to Member States in analyzing their needs and health systems prerequisites for health technologies, and medical devices.

 3.  To work jointly with other organizations of the United Nations system, international organizations, academic institutions and professional bodies to provide support to Member States in the prioritization, selection, and use of health technologies, in medical devices.

4. To establish and regularly update an evidence- and web-based health technologies database to serve as a clearing house which will provide guidance on appropriate medical devices according to levels of care, setting, environment, and intended health intervention, tailored to the specific needs of countries or regions.

 5. To provide support to Member States with vulnerable health care systems to identify and put in place appropriate health technologies, in medical devices, that facilitate access to quality services in primary health care.

This project was developed to help meet the outcome of this resolution. The project was based on the list of clinical interventions selected from clinical guidelines on prevention, screening, diagnosis, treatment, palliative care, monitoring and end of life care.

 Many of you may not be aware that the ISRRT has been involved from the start on this project and have given expert content in every step of this publications development.

This consultation project with the WHO fits well in the ISRRT’s  strategic framework of collaborate to develop and promote international standards. The Strategic priority being contributes to and promotes a radiation protection safety culture. We are currently collaborating with other international stakeholders and healthcare professionals and contributing to the outcome of projects which will help ensure health care for all throughout the world.

 This project for cancer management in low and middle-income setting will contribute to protecting patients in radiation safety by having a global standard as well as ensure a safety culture.

As Director of Professional Practice, I sent out the draft document to our regional coordinator, ISRRT board, and some member societies to gather input and suggestion in consultation for this document. The ISRRT was asked several times for draft consultation over the entirety of this project with the WHO and each time as Director of professional practice we made sure to include all our committees as well as the board of directors to ensure we covered all area of expertise during the review process and as members you contributed to the expertise of the content of the final document that was produced by the WHO this past spring.

  I also had the opportunity to serve in the November–December 2015 - Experts, participants in teleconferences and document editors committee, where I represented the ISRRT on teleconferences and through the internet. Our committee reviewed the draft list of medical devices needed to start a radiology department and finally serving as one of the document editors emphasis on radiographer expertise.

The ISRRT received an invitation following from the WHO, consultation, help and implementation of the member states, and international partner and the WHO these targets will help contribute to the global target of 25% reduction in premature mortality from NCD’s by 2025.

 The terms of reference were established and endorsed by the World Health Assembly in May of 2014 and in Sept 2014 the WHO Global coordination mechanism working group was established enhance the coordination of activities, multiple stakeholder engagement and actions across sectors in order to contribute to the implementation of the action plan 2013-2020.

The project objective was to define a comprehensive tool to guide policymakers and healthcare managers in the selection of medical devices for achieving the most appropriate cancer management. The hope is that this document will have global impact on cancer management and in the continuum of care including prevention, diagnosis, treatment and follow-up and palliation.

 The overall project included the common medical devices needed for various types of cancer in the following specialties: Primary clinical assessment, surgery, radiotherapy, laboratory, diagnostic imaging, and pathology. The third was to discuss the input from specialists and expert groups’ preliminary review of the list of medical devices and health interventions previous to the consultation. The fourth was to agree on the medical devices required for each intervention, specialty area, type of cancer and healthcare facility in different resource setting Finally the fifth was to propose country implementation strategies and define an action plan, activities, responsible organizations and timeline required consolidate a list of medical devices for cancer management by health care level and type of health care.

The ISRRT was asked several times for draft consultation on this cancer draft was sent out to Director of professional practice we sent this to our committees as well as the board of directors for input and asked the ISRRT members for expert review and input to the contact of the draft revisions each time we received a letter for consultation over the past two years. As Director of Professional Practice, I also had the opportunity to serve on the November–December 2015 - Experts, participants in teleconferences and document editors committee, where I represented the ISRRT on teleconferences and through the internet.

 Our committee reviewed the draft list of medical devices needed to start a radiology department and finally serving as one of the document editors emphasis on radiographer expertise.  The expert group of imaging and nuclear medicine was comprised of 16 experts from around the world including radiologists, Industry, technologists, and staff from both the IAEA and WHO.  The goal of the project was to take the information gathered from part one of the project and further develop the list of priority medical devices required for basic health interventions to manage cancer which will allow member states to use as a reference according to the local needs and local infrastructure and specialized human resources available.

  The group reviewed documents gathered and I gave the technologists input on the list of medical devices required for cancer management and to determine the basic list of health conditions and services needed to provide cancer care for the five cancer both mean and woman worldwide.

 The most current guidelines were systematically reviewed and a list procedure from the guidelines along with list of medical devices needed to perform these procedures also listed of recommended interventions and procedures for these types of health conditions and medical devices and technologies needed. The project also included determining what medical devices would need to be allocated for each level of care and what medical devices and services should be provided at the three levels of Healthcare facilities, level one being Health Post or Health Center for basic needs, level two would be considered a District hospital with surgery and pathology and some outpatient radiation therapy and finally level three was considered a specialized hospital with all service available including surgery, high level radiology equipment and full radiation therapy and medical oncology department. This included review the general basic medical devices per service using working tool one, then identify the basic services, functions/Interventions and specific basic medical devise to in the WHO model list of basic medical devices of cancer management using a working tool and report back a complete document to the working group of the WHO.

The ISRRT can’t thank it members enough for taking time to contribute, review and ensure that the radiographer voice was heard and represented and the information regarding our profession was reviewed to insure accuracy during the development of this important global WHO cancer document.  We can’t express enough our gratitude to our expert professionals that took time to participate and give feedback.  The ISRRT as the global voice for our professional know we will always be asked to be the expert voice for our profession if we take the time to contribute.

  For those of you that are interested downloading the final document to use in aiding in the implementation of a cancer program within your country or elevate the cancer care if you have already established practice. A final document contents are below:

 The first section defines the global increase in cancer cases, the global goals to manage NCDs and the WHO activities related to these goals.

The second section presents the methodology used for the selection of medical devices that support clinical interventions required to screen, diagnose, treat and monitor cancer stages, as well as the provision of palliative care, based on evidence-based information.

 The third section lists the priority medical devices required to manage cancer in seven different units of health care services:

 1. Vaccination, clinical assessment, and endoscopy

 2. Medical imaging and nuclear medicine

3. Surgery

 4. Laboratory and pathology

5. Radiotherapy

6. Systemic therapy

7. Palliative and end of life care.

 

 The lists include the basic technologies required to provide general services and the specific priority medical devices to manage cancer. This section also examines other health system components such as infrastructure, human resources and quality management requirements and guidance documents by service unit. The last section proposes the activities required in a country or setting where the present guidance and lists are to be implemented.