Million UROLOGY FACILITIES AND DEVICES

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CHAPTER 19 GAPS IN MEDICAL TECHNOLOGY IN MALAYSIA

Table 19.1 Imaging Diagnostic Technologies. Gaps in Medical Technology in Malaysia Expert Opinion Rank of Importance 1. High Resolution Computed Tomography CT system for Neuroradiology and Cardiac work. Availability: Marketed. Function: Diagnostic. Existing Alternative Options: MRI, angiography Clinical Effectiveness: Capable to reduce up to 25 of interventional neuroangiography, excellent perfusion CT angiography. Life-Saving Outcomes: Improves selection criteria for interventional neuroangiography with improved outcomes. Health-Cost Implications: Will increase health cost but maybe offset by more selective neuro –angiograms. Safety Issues: Increase radiation dose. Prioritization: Required in the next 5 years. 1 2. Cone-beam Breast Computed Tomography CBBCT Availability: Experimental Function: Diagnostic. Existing Alternative Options: Mammography, ultrasonography. Clinical Effectiveness: Higher resolution hence more sensitive. Radiation dose comparable to 2-view mammography, imaging post op breast with deformity. Life-Saving Outcomes: Improves image quality with 3-D images, hence improving cancer detection rates. Health-Cost Implications: Increase true put, duration of scan less than 1 minute. Safety Issues: - Prioritization: To be introduced within the next 5 years. 2 3. Magnetic resonance spectroscopy Availability: Marketed Function: Diagnostic Existing Alternative Options: - Clinical Effectiveness: - Life-Saving Outcomes: Faster and more accurate diagnosis. Health-Cost Implications: Increased access to MRI and increased unit cost compared to alternative. Safety Issues: Quick and less radiation. Prioritization: To be introduced within the next 5 years. 3 80 Table 19. 2 Oncology Technologies. Gaps in Medical Technology in Malaysia Expert Opinion Rank of Importance 1. Helical TomoTherapy machine. Availability: Marketed. Function: Therapeutic. Existing Alternative Options: Linear accelerator. Clinical Effectiveness: Less morbidity associated with treatment, better dose escalation. Good to consider technological improvement in terms of reduction radiation exposure. Life-Saving Outcomes: Better with more precise treatment. Health-Cost Implications: Very expensive machine, treatment cost per patient is very much higher Safety Issues: Increased risk if used by inexperienced doctors Prioritization: To be introduced within the next 5 years. 1