Evidence map›Paper›PMID 29382312›Full record

ArticleBMC endocrine disorders2018

Stem cells and beta cell replacement therapy: a prospective health technology assessment study.

Klemens Wallner, Rene G Pedroza, Isaac Awotwe, James M Piret, Peter A Senior, A M James Shapiro, Christopher McCabe

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC endocrine disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
  2. Review
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  8. Review
  9. Economics of Beta-Cell Replacement Therapy.Current diabetes reports · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Klemens WallnerDepartment of Emergency Medicine Research Group, Department of Emergency Medicine, University of Alberta, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada. wallner@ualberta.ca.ORCID http://orcid.org/0000-0003-3547-3425
Rene G PedrozaMichael Smith Laboratories and Department of Chemical & Biological Engineering, University of British Columbia, 2185 East Mall, Vancouver, BC, V6T 1Z4, Canada.
Isaac AwotweDepartment of Emergency Medicine Research Group, Department of Emergency Medicine, University of Alberta, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada.
James M PiretMichael Smith Laboratories and Department of Chemical & Biological Engineering, University of British Columbia, 2185 East Mall, Vancouver, BC, V6T 1Z4, Canada.
Peter A SeniorClinical Islet Transplant Program, Alberta Diabetes Institute, University of Alberta, 2000 College Plaza, 8215 - 112 Street, Edmonton, AB, T6G 2C8, Canada.
A M James ShapiroClinical Islet Transplant Program, Alberta Diabetes Institute, University of Alberta, 2000 College Plaza, 8215 - 112 Street, Edmonton, AB, T6G 2C8, Canada.
Christopher McCabeDepartment of Emergency Medicine Research Group, Department of Emergency Medicine, University of Alberta, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada.
University of Alberta · CAUniversity of British Columbia · CA

Funding

Alberta Innovates - Health Solutions 201201154Stem Cell Network (9/5261(PP5))Stem Cell Network NCESCN CTRA FY17/CT5
6 · The paper itself

Abstract

backgroundAlthough current beta cell replacement therapy is effective in stabilizing glycemic control in highly selected patients with refractory type 1 diabetes, many hurdles are inherent to this and other donor-based transplantation methods. One solution could be moving to stem cell-derived transplant tissue. This study investigates a novel stem cell-derived graft and implant technology and explores the circumstances of its cost-effectiveness compared to intensive insulin therapy.

methodsWe used a manufacturing optimization model based on work by Simaria et al. to model cost of the stem cell-based transplant doses and integrated its results into a cost-effectiveness model of diabetes treatments. The disease model simulated marginal differences in clinical effects and costs between the new technology and our comparator intensive insulin therapy. The form of beta cell replacement therapy was as a series of retrievable subcutaneous implant devices which protect the enclosed pancreatic progenitors cells from the immune system. This approach was presumed to be as effective as state of the art islet transplantation, aside from immunosuppression drawbacks. We investigated two different cell culture methods and several production and delivery scenarios.

resultsWe found the likely range of treatment costs for this form of graft tissue for beta cell replacement therapy. Additionally our results show this technology could be cost-effective compared to intensive insulin therapy, at a willingness-to-pay threshold of $100,000 per quality-adjusted life year. However, results also indicate that mass production has by far the best chance of providing affordable graft tissue, while overall there seems to be considerable room for cost reductions.

conclusionsSuch a technology can improve treatment access and quality of life for patients through increased graft supply and protection. Stem cell-based implants can be a feasible way of treating a wide range of patients with type 1 diabetes.

Indexed as

Cost-Benefit AnalysisDiabetes Mellitus, Type 1HumansInsulin-Secreting CellsIslets of Langerhans TransplantationLife ExpectancyQuality-Adjusted Life YearsStem CellsStem Cell TransplantationTechnology Assessment, BiomedicalCost modelingCost optimizationDisease simulationEarly technology assessmentHealth economicsHealth technology assessmentMedical deviceStem cellsTransplantationType 1 diabetes

Identifiers

PMID29382312
PMCPMC5791348
OpenAlexW2795465898

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.