Abstract for: Health Technology Assessment supported by system dynamics: an endoscopic ultrasound case study in Colombia.

The use of endoscopic ultrasound (EUS) for the diagnosis and intervention of gastric and pancreatic cancer, solid and cystic lesions in the pancreas, ampullary neoplasms, small bile duct stones, biliary obstruction during pregnancy, and choledocholithiasis, etc. However, the widespread adoption of this technology in Colombia has been limited. This situation underscores the need to evaluate the technology better to understand its market penetration limitations. This research, to determine the scope, indication, alternative technologies, clinical effectiveness outcomes of EUS, and patient complications, was based on the AdHopHTA project's mini-HTA methodology [10]. Additionally, interviews were conducted with experts and specialists in technology to discuss its economic and organizational aspects. Using system dynamics modeling, 3 scenarios were simulated to predict possible outcomes. Despite ongoing technological developments in diagnostic imaging, such as computed tomography and magnetic resonance imaging, EUS plays a fundamental role in pancreaticobiliary research. The pancreatitis rate associated with EUS-FNA has been low (1.9%), as has the presence of fever, pain, infection, duodenal drilling, pancreatic fistula, abscess, and sepsis. Another limitation is the lack of sufficient samples in patients with pancreatectomy. The simulation used reference prices from the Colombian market in 2024, with two types of EUS. Future work will incorporate an optimistic increase in demand based on market analysis and incorporate the learning curve, considering that EUS is an operator-dependent technology. Funding Source: The authors acknowledge financial support from the Nueva Granada Military University under project number INV-ING-3980.