Subjects -> HEALTH AND SAFETY (Total: 1562 journals)
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HEALTH FACILITIES AND ADMINISTRATION (390 journals)                  1 2 | Last

Showing 1 - 200 of 397 Journals sorted alphabetically
ACI Open     Open Access  
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Administration and Policy in Mental Health and Mental Health Services Research     Partially Free   (Followers: 22)
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access   (Followers: 1)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 17)
Advances in Dual Diagnosis     Hybrid Journal   (Followers: 48)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 26)
Advances in Medical Education and Practice     Open Access   (Followers: 34)
Advances in Mental Health and Intellectual Disabilities     Hybrid Journal   (Followers: 89)
Advances in Nursing Science     Hybrid Journal   (Followers: 43)
Advances in Simulation     Open Access   (Followers: 7)
African Journal of Primary Health Care & Family Medicine     Open Access   (Followers: 6)
AIDS and Behavior     Hybrid Journal   (Followers: 18)
American Journal of Hospice and Palliative Medicine     Hybrid Journal   (Followers: 48)
American Journal of Managed Care     Full-text available via subscription   (Followers: 13)
Analytical Methods     Full-text available via subscription   (Followers: 14)
Anthropologie et santé     Open Access   (Followers: 5)
Applied Clinical Informatics     Hybrid Journal   (Followers: 5)
Applied Health Economics and Health Policy     Full-text available via subscription   (Followers: 24)
Applied Research in Quality of Life     Hybrid Journal   (Followers: 13)
Archives of Public Health     Open Access   (Followers: 13)
Asian Journal of Health     Open Access   (Followers: 4)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian and New Zealand Journal of Public Health     Hybrid Journal   (Followers: 17)
Australian Health Review     Hybrid Journal   (Followers: 7)
Australian Journal of Primary Health     Hybrid Journal  
Australian Journal of Rural Health     Hybrid Journal   (Followers: 18)
Autism     Hybrid Journal   (Followers: 350)
Avicenna     Open Access   (Followers: 3)
Balint Journal     Hybrid Journal   (Followers: 2)
Bereavement Care     Hybrid Journal   (Followers: 13)
BJR     Hybrid Journal   (Followers: 21)
BMC Medical Informatics and Decision Making     Open Access   (Followers: 25)
BMC Oral Health     Open Access   (Followers: 7)
BMJ Leader     Hybrid Journal  
BMJ Quality & Safety     Hybrid Journal   (Followers: 69)
BMJ Supportive & Palliative Care     Hybrid Journal   (Followers: 50)
British Journal of Healthcare Assistants     Full-text available via subscription   (Followers: 33)
British Journal of Healthcare Management     Full-text available via subscription   (Followers: 19)
British Journal of Hospital Medicine     Full-text available via subscription   (Followers: 18)
British Journal of Nursing     Full-text available via subscription   (Followers: 297)
British Journal of School Nursing     Full-text available via subscription   (Followers: 14)
Bruce R Hopkins' Nonprofit Counsel     Hybrid Journal   (Followers: 2)
Building Better Healthcare     Full-text available via subscription   (Followers: 1)
Canadian Nurse     Full-text available via subscription   (Followers: 8)
Cardiac Electrophysiology Clinics     Full-text available via subscription   (Followers: 1)
Children and Schools     Hybrid Journal   (Followers: 8)
Chinese Medical Record English Edition     Hybrid Journal  
CIN : Computers Informatics Nursing     Hybrid Journal   (Followers: 11)
Clinical Audit     Open Access   (Followers: 4)
Clinics and Practice     Open Access  
Cognition, Technology & Work     Hybrid Journal   (Followers: 14)
Communication & Medicine     Hybrid Journal   (Followers: 5)
Community Based Medical Journal     Open Access  
Conflict and Health     Open Access   (Followers: 8)
Contemporary Nurse : A Journal for the Australian Nursing Profession     Hybrid Journal   (Followers: 7)
Critical Public Health     Hybrid Journal   (Followers: 26)
Culture, Health & Sexuality: An International Journal for Research, Intervention and Care     Hybrid Journal   (Followers: 17)
Current Opinion in Supportive and Palliative Care     Hybrid Journal   (Followers: 28)
Das Gesundheitswesen     Hybrid Journal   (Followers: 10)
Death Studies     Hybrid Journal   (Followers: 22)
Dental Nursing     Full-text available via subscription   (Followers: 3)
Disaster Health     Hybrid Journal   (Followers: 1)
DoctorConsult - The Journal. Wissen für Klinik und Praxis     Full-text available via subscription  
Droit, Déontologie & Soin     Full-text available via subscription   (Followers: 3)
E-Health Telecommunication Systems and Networks     Open Access   (Followers: 2)
East and Central African Journal of Surgery     Open Access  
Éducation thérapeutique du patient     Full-text available via subscription   (Followers: 1)
eGEMs     Open Access  
Emergency Radiology     Hybrid Journal   (Followers: 10)
Enfermería Clínica     Full-text available via subscription   (Followers: 3)
Epidemiologic Methods     Hybrid Journal   (Followers: 4)
Ergonomics     Hybrid Journal   (Followers: 24)
Escola Anna Nery     Open Access   (Followers: 1)
Ethnicity & Health     Hybrid Journal   (Followers: 15)
European Journal of Public Health     Hybrid Journal   (Followers: 27)
European Journal of Work and Organizational Psychology     Hybrid Journal   (Followers: 35)
European Research in Telemedicine / La Recherche Européenne en Télémédecine     Full-text available via subscription   (Followers: 2)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 11)
Evidence-Based Nursing     Hybrid Journal   (Followers: 74)
Evolution, Medicine, and Public Health     Open Access   (Followers: 12)
Expert Opinion on Therapeutic Patents     Hybrid Journal   (Followers: 12)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family Practice Management     Full-text available via subscription   (Followers: 5)
Focus on Health Professional Education : A Multi-disciplinary Journal     Full-text available via subscription   (Followers: 7)
Frontiers in Public Health Services and Systems Research     Open Access   (Followers: 5)
Future Hospital Journal     Full-text available via subscription   (Followers: 2)
Gastrointestinal Nursing     Full-text available via subscription   (Followers: 5)
Geron     Full-text available via subscription  
Global & Regional Health Technology Assessment     Open Access   (Followers: 1)
Global Health Action     Open Access   (Followers: 12)
Global Health Management Journal (GHMJ)     Open Access   (Followers: 1)
Global Health Research and Policy     Open Access   (Followers: 4)
Global Journal of Hospital Administration     Open Access   (Followers: 1)
Global Public Health: An International Journal for Research, Policy and Practice     Hybrid Journal   (Followers: 21)
Globalization and Health     Open Access   (Followers: 9)
Handbook of Practice Management     Hybrid Journal   (Followers: 2)
Health     Open Access   (Followers: 5)
Health & Social Care In the Community     Hybrid Journal   (Followers: 54)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 16)
Health and Interprofessional Practice     Open Access   (Followers: 6)
Health and Technology     Hybrid Journal   (Followers: 4)
Health Care Analysis     Hybrid Journal   (Followers: 17)
Health Care Management Review     Hybrid Journal   (Followers: 16)
Health Economics     Hybrid Journal   (Followers: 59)
Health Expectations     Open Access   (Followers: 16)
Health Facilities Management     Free   (Followers: 10)
Health Informatics Journal     Hybrid Journal   (Followers: 28)
Health Information : Jurnal Penelitian     Open Access   (Followers: 5)
Health Information Science and Systems     Open Access   (Followers: 4)
Health Policy and Management     Open Access   (Followers: 7)
Health Policy and Planning     Hybrid Journal   (Followers: 27)
Health Professions Education     Open Access   (Followers: 3)
Health Promotion International     Hybrid Journal   (Followers: 28)
Health Promotion Practice     Hybrid Journal   (Followers: 18)
Health Psychology     Full-text available via subscription   (Followers: 62)
Health Psychology Review     Hybrid Journal   (Followers: 46)
Health Reform Observer : Observatoire des Réformes de Santé     Open Access   (Followers: 2)
Health Research Policy and Systems     Open Access   (Followers: 16)
Health Science Journal of Indonesia     Open Access   (Followers: 2)
Health Services Research and Managerial Epidemiology     Open Access   (Followers: 3)
Health, Risk & Society     Hybrid Journal   (Followers: 14)
Healthcare : The Journal of Delivery Science and Innovation     Full-text available via subscription   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Management Forum     Hybrid Journal   (Followers: 8)
Healthcare Policy / Politiques de Santé     Full-text available via subscription   (Followers: 5)
Healthcare Quarterly     Full-text available via subscription   (Followers: 10)
Healthcare Risk Management     Full-text available via subscription   (Followers: 5)
HealthcarePapers     Full-text available via subscription   (Followers: 2)
Hispanic Health Care International     Full-text available via subscription  
História, Ciências, Saúde - Manguinhos     Open Access   (Followers: 2)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 3)
Hospital     Open Access   (Followers: 3)
Hospital a Domicilio     Open Access  
Hospital Medicine Clinics     Full-text available via subscription   (Followers: 2)
Hospital Peer Review     Full-text available via subscription   (Followers: 1)
Hospital Pharmacy     Partially Free   (Followers: 18)
Hospital Practice     Hybrid Journal   (Followers: 2)
Hospital Practices and Research     Open Access  
Housing, Care and Support     Hybrid Journal   (Followers: 9)
Human Factors : The Journal of the Human Factors and Ergonomics Society     Full-text available via subscription   (Followers: 39)
Human Resources for Health     Open Access   (Followers: 12)
ICU Director     Hybrid Journal  
Ids Practice Papers     Hybrid Journal  
IEEE Pulse     Hybrid Journal   (Followers: 5)
IISE Transactions on Healthcare Systems Engineering     Hybrid Journal   (Followers: 2)
Independent Nurse     Full-text available via subscription   (Followers: 3)
Index de Enfermeria     Open Access   (Followers: 7)
Indian Journal of Public Health     Open Access   (Followers: 1)
Informatics for Health and Social Care     Hybrid Journal   (Followers: 10)
Innovation and Entrepreneurship in Health     Open Access   (Followers: 1)
INQUIRY : The Journal of Health Care Organization, Provision, and Financing     Open Access   (Followers: 1)
Interface - Comunicação, Saúde, Educação     Open Access   (Followers: 1)
International Archives of Health Sciences     Open Access  
International Journal for Equity in Health     Open Access   (Followers: 9)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 41)
International Journal of Care Coordination     Hybrid Journal   (Followers: 7)
International Journal of Computers in Healthcare     Hybrid Journal   (Followers: 3)
International Journal of Electronic Healthcare     Hybrid Journal   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 27)
International Journal of Health Administration and Education Congress (Sanitas Magisterium)     Open Access  
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 15)
International Journal of Health Economics and Management     Hybrid Journal   (Followers: 12)
International Journal of Health Governance     Hybrid Journal   (Followers: 27)
International Journal of Health Planning and Management     Hybrid Journal   (Followers: 6)
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services Research and Policy     Open Access   (Followers: 1)
International Journal of Health System and Disaster Management     Open Access   (Followers: 3)
International Journal of Healthcare     Open Access   (Followers: 1)
International Journal of Healthcare Technology and Management     Hybrid Journal   (Followers: 7)
International Journal of Hospital Research     Open Access  
International Journal of Human Factors and Ergonomics     Hybrid Journal   (Followers: 20)
International Journal of Human Rights in Healthcare     Hybrid Journal   (Followers: 5)
International Journal of Medicine and Public Health     Open Access   (Followers: 6)
International Journal of Migration, Health and Social Care     Hybrid Journal   (Followers: 12)
International Journal of Occupational and Environmental Medicine, The     Open Access   (Followers: 16)
International Journal of Palliative Nursing     Full-text available via subscription   (Followers: 32)
International Journal of Positive Behavioural Support     Full-text available via subscription   (Followers: 38)
International Journal of Prisoner Health     Hybrid Journal   (Followers: 14)
International Journal of Privacy and Health Information Management     Full-text available via subscription   (Followers: 3)
International Journal of Public and Private Healthcare Management and Economics     Full-text available via subscription   (Followers: 4)
International Journal of Qualitative Studies on Health and Well-Being     Open Access   (Followers: 22)
International Journal of Reliable and Quality E-Healthcare     Full-text available via subscription   (Followers: 1)
International Journal of Research in Nursing     Open Access   (Followers: 12)
International Journal of Technology Assessment in Health Care     Hybrid Journal   (Followers: 16)
International Journal of Telemedicine and Clinical Practices     Hybrid Journal   (Followers: 5)
International Journal of Telework and Telecommuting Technologies     Full-text available via subscription  
International Journal of Therapy and Rehabilitation     Full-text available via subscription   (Followers: 42)
International Journal of User-Driven Healthcare     Full-text available via subscription   (Followers: 1)
International Journal on Disability and Human Development     Hybrid Journal   (Followers: 23)
Irish Journal of Paramedicine     Open Access   (Followers: 3)
JAAPA     Hybrid Journal   (Followers: 3)
Jaffna Medical Journal     Open Access  
Joint Commission Journal on Quality and Patient Safety     Hybrid Journal   (Followers: 41)
Journal for Healthcare Quality     Hybrid Journal   (Followers: 28)
Journal of Advanced Nursing     Hybrid Journal   (Followers: 252)
Journal of Advances in Medical Education & Professionalism     Open Access   (Followers: 10)
Journal of Aging and Health     Hybrid Journal   (Followers: 27)
Journal of Ambulatory Care Management, The     Hybrid Journal   (Followers: 4)
Journal of Applied Arts and Health     Hybrid Journal   (Followers: 1)

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Similar Journals
Journal Cover
International Journal of Technology Assessment in Health Care
Journal Prestige (SJR): 0.714
Citation Impact (citeScore): 1
Number of Followers: 16  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0266-4623 - ISSN (Online) 1471-6348
Published by Cambridge University Press Homepage  [396 journals]
  • Postlaunch evidence-generation studies for medical devices in Spain: the
           RedETS approach to integrate real-world evidence into decision making
    • Authors: Pedro Serrano-Aguilar; Iñaki Gutierrez-Ibarluzea, Pilar Díaz, Iñaki Imaz-Iglesia, Jesús González-Enríquez, José Luis Castro, Mireia Espallargues, Sandra García-Armesto, Paloma Arriola-Bolado, Amado Rivero-Santana, Lilisbeth Perestelo-Pérez, Himar González-Pacheco, Yolanda Álvarez-Pérez, María José Faraldo-Vallés, Janet Puñal-Riobóo, Yolanda Ramallo-Fariña, Luis María Sánchez-Gómez, José Asua-Batarrita, Eva Reviriego-Rodrigo, Anai Moreno-Rodríguez, Celia Juárez-Rojo, Marisa Vicente-Saiz, Eugenia Orejas-Pérez, Jutta Knabe-Guerra, Isabel Prieto-Yerro, Cristina González del Yerro-Valdés
      Abstract: The Monitoring Studies (MS) program, the approach developed by RedETS to generate postlaunch real-world evidence (RWE), is intended to complement and enhance the conventional health technology assessment process to support health policy decision making in Spain, besides informing other interested stakeholders, including clinicians and patients. The MS program is focused on specific uncertainties about the real effect, safety, costs, and routine use of new and insufficiently assessed relevant medical devices carefully selected to ensure the value of the additional research needed, by means of structured, controlled, participative, and transparent procedures. However, despite a clear political commitment and economic support from national and regional health authorities, several difficulties were identified along the development and implementation of the first wave of MS, delaying its execution and final reporting. Resolution of these difficulties at the regional and national levels and a greater collaborative impulse in the European Union, given the availability of an appropriate methodological framework already provided by EUnetHTA, might provide a faster and more efficient comparative RWE of improved quality and reliability at the national and international levels.
      PubDate: 2021-05-04T00:00:00.000Z
      DOI: 10.1017/S0266462321000295
      Issue No: Vol. 37, No. 1 (2021)
  • Developing a quality management system for the European Network for Health
           Technology Assessment (EUnetHTA): toward European HTA collaboration
    • Authors: Miriam Luhnen; Sari Susanna Ormstad, Anne Willemsen, Chaienna Schreuder-Morel, Catharina Helmink, Sabine Ettinger, Judit Erdos, Reza Fathollah-Nejad, Maike Rehrmann, Krystyna Hviding, Alric Rüther, Patrice X. Chalon
      Abstract: ObjectivesThe European Network for Health Technology Assessment (EUnetHTA) was established in 2006 and comprises over eighty organizations from thirty European countries. In its fifth project phase (Joint Action 3), EUnetHTA set up a quality management system (QMS) to improve the efficiency and standardization of joint work. This article presents EUnetHTA's new QMS and outlines experiences and challenges during its implementation.MethodsSeveral working groups defined processes and methods to support assessment teams in creating high-quality assessment reports. Existing guidelines, templates, and tools were refined and missing parts were newly created and integrated into the new QMS framework. EUnetHTA has contributed to Health Technology Assessment (HTA) capacity building through training and knowledge sharing. Continuous evaluation helped to identify gaps and shortcomings in processes and structures.ResultsBased on a common quality management concept and defined development and revision procedures, twenty-seven partner organizations jointly developed and maintained around forty standard operating procedures and other components of the QMS. All outputs were incorporated into a web-based platform, the EUnetHTA Companion Guide, which was launched in May 2018. Concerted efforts of working groups were required to ensure consistency and avoid duplication.ConclusionsWith the establishment of a QMS for jointly produced assessment reports, EUnetHTA has taken a significant step toward a sustainable model for scientific and technical collaboration within European HTA. However, the definition of processes and methods meeting the numerous requirements of healthcare systems across Europe remains an ongoing and challenging task.
      PubDate: 2021-04-27T00:00:00.000Z
      DOI: 10.1017/S0266462321000313
      Issue No: Vol. 37, No. 1 (2021)
  • The cost of metastatic prostate cancer using time-driven activity-based
    • Authors: Rafael J. Vargas Alves; Ana P. Beck da Silva Etges, Katsuki Arima Tiscoski, Luciana Rodrigues de Lara, Alice de Medeiros Zelmanowicz, Carisi Anne Polanczyk
      Abstract: ObjectiveTo estimate the cost of metastatic prostate cancer (mPC) treatment using the time-driven activity-based costing (TDABC) method from the perspective of a philanthropic hospital in the Brazilian public health system (PHS) and to identify determinants of costs.MethodsWe used data from patients who received docetaxel chemotherapy in the Brazilian PHS from September 2012 to May 2017. Direct medical costs were estimated with the TDABC microcosting method, taking into account the multiple departments and services the patients interacted with during their oncological treatment.ResultsThe median overall survival of the forty-three patient sample was 1.8 years (95% CI 1.45–2.30), and the total cost of the sample was BRL 917.005 (USD 250,878). The median monthly cost per patient was BRL 20.201 (USD 5,526). The end-of-life cost per patient using the TDABC method was BRL 5.151 (USD 1,409). Patients who had received previous treatment at the center registered the lowest cost for hospitalizations and exams, suggesting an opportunity to better manage healthcare resources.ConclusionsThis is the first study on the economic burden of mPC in the Brazilian PHS using the TDABC costing evaluation method. Accurate cost information obtained with the TDABC can be helpful in guiding disease management to guarantee better use of ever-scarcer resources.
      PubDate: 2021-04-26T00:00:00.000Z
      DOI: 10.1017/S0266462321000271
      Issue No: Vol. 37, No. 1 (2021)
  • Integration of ethical considerations into HTA reports: an analysis of
           integration levels using a systematic review
    • Authors: Georges-Auguste Legault; Hubert Gagnon, Monelle Parent, Christian A. Bellemare, Jean-Pierre Béland, Suzanne Kocsis-Bédard, Louise Bernier, Pierre Dagenais, Charles-Étienne Daniel, Johane Patenaude
      Abstract: ObjectiveTo describe the type and level of ethical integration in published health technology assessment (HTA) reports and systematically identify the ethical approaches utilized.MethodsA literature search was conducted with the Google™ search engine using the keyword “ethic” between 1 January 2015 and 20 August 2019. Only HTA assessment reports with a section on ethics were retained and classified according to their level of ethical integration: no ethical analysis, ethical issues highlighted, assessments according to legal or social norms, and assessments from a moral or axiological perspective—using a qualitative methodology to distinguish such integration.ResultsThis review yielded 188 reports with a section identified as being on ethics, produced by seventeen HTA agencies in eleven countries. One hundred and thirty-six reports did not develop an ethical analysis, thirty-one highlighted ethical issues, seventeen conducted a norm-based ethical assessment using a descriptive approach grounded in social norms, and four developed an assessment grounded in a moral or axiological perspective. The bioethical “four-principles” framework was used, but mainly for presenting ethical issues and not as a moral framework.ConclusionsThe majority of reports featuring a section on ethics mention ethical considerations without ethical analysis. Ethical issues are grouped with legal, social, and organizational issues and treated as contextual considerations that decision makers should be aware of. When reports present systematic norm-based ethical assessments from a descriptive perspective or ethical assessment based on a moral or axiological perspective, there is a tendency to ground these analyses in frameworks created for the purpose and reliant on a concept of ethics supporting them.
      PubDate: 2021-04-26T00:00:00.000Z
      DOI: 10.1017/S0266462321000325
      Issue No: Vol. 37, No. 1 (2021)
  • Do existing real-world data sources generate suitable evidence for the HTA
           of medical devices in Europe' Mapping and critical appraisal
    • Authors: Benedetta Pongiglione; Aleksandra Torbica, Hedwig Blommestein, Saskia de Groot, Oriana Ciani, Sarah Walker, Florian Dams, Rudolf Blankart, Meilin Mollenkamp, Sándor Kovács, Rosanna Tarricone, Mike Drummond
      Abstract: AimTechnological and computational advancements offer new tools for the collection and analysis of real-world data (RWD). Considering the substantial effort and resources devoted to collecting RWD, a greater return would be achieved if real-world evidence (RWE) was effectively used to support Health Technology Assessment (HTA) and decision making on medical technologies. A useful question is: To what extent are RWD suitable for generating RWE'MethodsWe mapped existing RWD sources in Europe for three case studies: hip and knee arthroplasty, transcatheter aortic valve implantation (TAVI) and mitral valve repair (TMVR), and robotic surgery procedures. We provided a comprehensive assessment of their content and appropriateness for conducting the HTA of medical devices. The identification of RWD sources was performed combining a systematic search on PubMed with gray literature scoping, covering fifteen European countries.ResultsWe identified seventy-one RWD sources on arthroplasties; ninety-five on TAVI and TMVR; and seventy-seven on robotic procedures. The number, content, and integrity of the sources varied dramatically across countries. Most sources included at least one health outcome (97.5%), with mortality and rehospitalization/reoperation the most common; 80% of sources included resource outcomes, with length of stay the most common, and comparators were available in almost 70% of sources.ConclusionsRWD sources bear the potential for the HTA of medical devices. The main challenges are data accessibility, a lack of standardization of health and economic outcomes, and inadequate comparators. These findings are crucial to enabling the incorporation of RWD into decision making and represent a readily available tool for getting acquainted with existing information sources.
      PubDate: 2021-04-26T00:00:00.000Z
      DOI: 10.1017/S0266462321000301
      Issue No: Vol. 37, No. 1 (2021)
  • The thorny issue of value alignment: how development-focused health
           technology assessment can help find win–win situations for patients and
           healthcare systems and commercial investors
    • Authors: Janet Bouttell; Andrew Briggs, Neil Hawkins
      PubDate: 2021-04-20T00:00:00.000Z
      DOI: 10.1017/S026646232100026X
      Issue No: Vol. 37, No. 1 (2021)
  • A different animal but the same beast' Using development-focused
           health technology assessment to define the value proposition of medical
    • Authors: Anastasia Chalkidou
      PubDate: 2021-04-19T00:00:00.000Z
      DOI: 10.1017/S0266462321000209
      Issue No: Vol. 37, No. 1 (2021)
  • Letter of support from Professor Gillian Leng CBE, Chief Executive,
           National Institute for Health and Care Excellence
    • Authors: Gillian Leng
      PubDate: 2021-04-12T00:00:00.000Z
      DOI: 10.1017/S0266462320002287
      Issue No: Vol. 37, No. 1 (2021)
  • Evidence-based searching for health technology assessment: keeping up to
           date with SuRe Info
    • Authors: Jaana Isojärvi; Julie Glanville
      Abstract: BackgroundEvidence syntheses of all types have their foundation in literature searches. Literature searching is developing in line with the growing use of evidence synthesis and is also informed, as a field of work, by the spirit of being evidence-based. Increasing numbers of research papers about information retrieval are being published, and keeping up to date with the latest developments in this ever more wide-ranging field is demanding.MethodsSummarized Research in Information Retrieval for HTA (SuRe Info) is a Web site ( that summarizes research-based information on effective and efficient evidence identification for the different aspects of health technology assessment (HTA) and evidence synthesis. This paper describes the rationale, processes, and challenges of producing SuRe Info and insights into the pace of development in the field of evidence-based information retrieval. The paper also provides scenarios suggesting how SuRe Info can help searchers in their daily work and with specific questions.ResultsSuRe Info currently comprises seventeen chapters, falling into two categories: (i) chapters about general search methods relating to all types of research and (ii) chapters summarizing the methods to use when searching for specific aspects of HTA (as defined in the HTA Core Model® by the European Network for Health Technology Assessment (EUnetHTA)).ConclusionsSuRe Info is not a substitute for methods handbooks, but by providing an overview of current research evidence for major issues in information retrieval in HTA, it helps searchers in this field to keep abreast of the latest research.
      PubDate: 2021-04-12T00:00:00.000Z
      DOI: 10.1017/S026646232100009X
      Issue No: Vol. 37, No. 1 (2021)
  • Overview of information retrieval in a hospital-based health technology
           assessment center in a Swedish region
    • Authors: Ida Stadig; Therese Svanberg
      Abstract: ObjectivesThis article aims to provide a brief review of information retrieval and hospital-based health technology assessment (HB-HTA) and describe library experiences and working methods at a regional HB-HTA center from the center's inception to the present day.MethodsFor this brief literature review, searches in PubMed and LISTA were conducted to identify studies reporting on HB-HTA and information retrieval. The description of the library's involvement in the HTA center and its working methods is based on the authors’ experience and internal and/or unpublished documents.ResultsRegion Västra Götaland is the second largest healthcare region in Sweden and has had a regional HB-HTA center since 2007 (HTA-centrum). Assessments are performed by clinicians supported by HTA methodologists. The medical library at Sahlgrenska University Hospital works closely with HTA-centrum, with one HTA librarian responsible for coordinating the work.ConclusionIn the literature on HB-HTA, we found limited descriptions of the role librarians and information specialists play in different units. The librarians at HTA-centrum play an important role, not only in literature searching but also in abstract and full-text screening.
      PubDate: 2021-04-12T00:00:00.000Z
      DOI: 10.1017/S0266462321000106
      Issue No: Vol. 37, No. 1 (2021)
  • Lessons from the vaginal mesh scandal: enhancing the patient-centric
           approach to informed consent for medical device implantation
    • Authors: Jennifer O'Neill
      Abstract: The vaginal mesh scandal, in which thousands of women were irreversibly maimed by polypropylene mesh, revealed multilevel failures in medical device regulation and implantation, demonstrating that patient-centric care has not yet fully transcended from policy into practice. In law, informed consent is considered by a two-stage test: reasonable treatment and patient information disclosure. The standard of reasonable treatment is determined according to what is deemed acceptable in accordance with a body of medical opinion. However, such bodies of medical opinion were vulnerable to external influence from device manufactures. Vaginal mesh manufacturers were found to have had financial links to research, royal colleges, and influential clinicians, which then influenced the basis of the evidence-based practice that often guides such bodies of medical opinion. According to the Independent Medicines and Medical Device Safety Report, patients’ mesh complications were also frequently under-reported and patient-based evidence of harm disregarded. Patients were also not sufficiently informed of the material risks or reasonable alternatives to mesh, which is required of the second stage of informed consent pertaining to information disclosure. This paper makes the following recommendations: that conflict of interest disclosure be mandated, that greater value be afforded to patient-based evidence to improve evaluation of treatments, and that information disclosure for informed consent should relate to the risks, benefits, and alternatives to the surgical procedure and medical device. This will ensure that patients can evaluate whether surgeons are offering unbiased treatment options and are also informed of the potential long-term risks associated with device implantation.
      PubDate: 2021-04-12T00:00:00.000Z
      DOI: 10.1017/S0266462321000258
      Issue No: Vol. 37, No. 1 (2021)
  • Establishment and implementation of hospital-based health technology
           assessment at King Hussein Cancer Center: can our model be an example'
    • Authors: Abeer A. Al-Rabayah; Saad M. Jaddoua
      Abstract: ObjectiveTo describe the establishment of, and assess the implementation of, a hospital-based health technology assessment (HTA) program in a comprehensive cancer center in Jordan.MethodsThis is a cross-sectional assessment study of the HTA program from 2008 to 2018. We used an indicator-based assessment that included structural, process, and outcome indicators. Structural indicators measured the program's enablers. Process indicators measured activities and outputs, whereas outcome indicators measured the program impact. A data collection form was prepared to collect data related to each indicator.ResultsThe program met its core structural and process indicators. The Center for Drug Policy and Technology Assessment was established as an organizational entity to conduct assessments. A functional decision-making entity is available. There are competent pharmacists to conduct assessments, including economic evaluation and decision analytical modeling. There is a structured capacity building program that has been implemented within the last 5 years. Specific submission, assessment, and appraisal processes were established and implemented. Reference methodological guidelines for efficacy, safety, and cost-effectiveness assessments were developed and used by assessors. Thirty-one HTA reports were produced from 2012 to 2018 with a 100 percent utilization rate. Twenty-three medications were listed under restriction, and eight were rejected. The prices of twenty-one medications out of the twenty-three listed medications were reduced based on the HTA assessment results.ConclusionThe HTA program at the King Hussein Cancer Center (KHCC) in Jordan is functional, is effective with a high utilization rate of produced assessments, and is having a positive impact on price reductions.
      PubDate: 2021-04-12T00:00:00.000Z
      DOI: 10.1017/S0266462321000246
      Issue No: Vol. 37, No. 1 (2021)
  • A review of implementation frameworks to operationalize health technology
           assessment recommendations for medical technologies in the Singapore
    • Authors: Vidhya Segar; Priscilla Kailian Ang, Chris Foteff, Kwong Ng
      Abstract: BackgroundMethodologies of health technology assessment (HTA) for medical technologies are well established; yet, operational frameworks that enable appropriate uptake of HTA recommendations into routine clinical practice are lacking. This review aims to identify the key themes needed to guide the planning and implementation of HTA subsidy decisions for medical technologies such as diagnostics, medical devices, and services and to monitor their impact on a complex multipayer healthcare system like Singapore.MethodsA literature search of implementation frameworks was conducted up to 20 December 2020 and was documented in a flow diagram. A thematic analysis of the evidence base was performed using the Braun and Clark approach to identify key themes, from which an implementation framework suitable for Singapore's healthcare system could be developed.ResultsThe searches yielded forty-four articles for review, from which twenty themes were identified. The top ten themes constituted the key themes of implementation essential for local adaptation and were categorized into five domains: implementation strategy, organizational support, stakeholder engagement, information dissemination, and implementation outcomes and evaluation. These domains provide operational guidance to methodically identify gaps to facilitate sustainable implementation of HTA-informed medical technology subsidy decisions.ConclusionA robust and adaptable implementation of HTA-informed subsidy decisions is crucial to optimize its intended impact of improving patient outcomes per dollar spent. The key themes of an implementation framework should capture the important aspects of organizational feasibility to ensure successful adoption in a complex multipayer healthcare system like Singapore.
      PubDate: 2021-04-12T00:00:00.000Z
      DOI: 10.1017/S0266462321000222
      Issue No: Vol. 37, No. 1 (2021)
  • Patient and public involvement in Health Technology Assessment: a new
    • Authors: Sophie Söderholm Werkö; Sophie Staniszewska
      PubDate: 2021-04-12T00:00:00.000Z
      DOI: 10.1017/S0266462321000234
      Issue No: Vol. 37, No. 1 (2021)
  • Development of an international template to support patient submissions in
           Health Technology Assessments
    • Authors: Nigel Cook; Heidi Livingstone, Jennifer Dickson, Louise Taylor, Kate Morgan, Martin Coombes, Sally Wortley, Elisabeth Oehrlein, María José Vicente-Edo, Franz Waibel, Barry Liden
      Abstract: ObjectivesTo develop an international template to support patient submissions in Health Technology Assessments (HTAs). This was to be based on the experience and feedback from the implementation and use of the Scottish Medicines Consortium's (SMC) Summary Information for Patient Groups (SIP).MethodsTo gather feedback on the SMC experience, web-based surveys were conducted with pharmaceutical companies and patient groups familiar with the SMC SIP. Semistructured interviews with representatives from HTA bodies were undertaken, along with patient group discussions with those less familiar with the SIP, to explore issues around the approach. These qualitative data informed the development of an international SIP template.ResultsSurvey data indicated that 82 percent (18 of 22 respondents) of pharmaceutical company representatives felt that the SIP was worthwhile; 88 percent (15/17) of patient group respondents found the SIP helpful. Both groups highlighted the need for additional support and guidance around plain language summaries. Further suggestions included provision of a glossary of terms and cost-effectiveness information. Patient group interviews supported the survey findings and led to the development of a new template. HTA bodies raised potential challenges around buy-in, timing, and bias connected to the SIP approach.ConclusionsThe international SIP template is another approach to support deliberative processes in HTA. Although challenges remain around writing summaries for lay audiences, along with feasibility considerations for HTA bodies, the SIP approach should support more meaningful patient involvement in HTAs.
      PubDate: 2021-04-01T00:00:00.000Z
      DOI: 10.1017/S0266462321000167
      Issue No: Vol. 37, No. 1 (2021)
  • Mind the evidence gap: the use of patient-based evidence to create
           “complete HTA” in the twenty-first century
    • Authors: Sophie Staniszewska; Sophie Söderholm Werkö
      Abstract: The aim of this paper is to review the concept of patient-based evidence in health technology assessment (HTA), drawing on philosophical ideas of knowledge in order to judge whether current approaches to the use of evidence for HTA are complete. We draw on a number of key sources, including key papers and book chapters, discussion forums, agency reports, and conference presentations. We develop the potential dimensions of patient-based evidence, describe its key attributes, and consider its future development. Patient-based evidence has the potential to be a key concept in HTA, comprised of a series of related elements of importance to patients. We recognize that we raise more questions than can be answered, but as an emerging concept, recognition and understanding of patient-based evidence is still developing. The concepts and methods that support its application in HTA require urgent development. We conclude that clinical and economic forms of evidence are not enough for HTA. For HTA to be complete, we need to consider all relevant aspects of the phenomena, including patient-based evidence. There is now an urgent need for the global research and HTA community to work together to realize the full potential of patient-based evidence through conceptual and methodological development and wider recognition. We advocate that a task force be set up to address these urgent issues.
      PubDate: 2021-03-22T00:00:00.000Z
      DOI: 10.1017/S026646232100012X
      Issue No: Vol. 37 (2021)
  • A voice to be heard: patient and public involvement in health technology
           assessment and clinical practice guidelines in Malaysia
    • Authors: Hanin Farhana Kamaruzaman; Ku Nurhasni Ku Abd Rahim, Izzuna Mudla Mohamed Ghazali, Mohd Aminuddin Mohd Yusof
      Abstract: Patient and public involvement (PPI) in health technology assessment (HTA) is widely promoted to ensure that all health-related decisions are made after taking into consideration the viewpoints of important stakeholders. In Malaysia, patients or their representatives have been involved in the development of HTA and Clinical Practice Guidelines (CPG) since 2009 and their influences have been growing steadily over the years. This paper aimed to describe the journey, achievements, challenges, and future direction of the PPI throughout all stages of the development and implementation of HTA and CPG in Malaysia. Currently, in Malaysia, patients or their representatives are mainly involved during the initial development of HTA and CPG drafts as well as during the internal and external reviews. Additionally, they are also encouraged to be involved during the implementation of HTA and CPG recommendations. Although their involvement in this aspect has slowly increased over time, challenges remain in the form of limited representativeness of selected patients or carers, uncertainty on the level of patient involvement allowed during the HTA/CPG development processes, and limited health literacy, which affect their ability to contribute meaningfully throughout the processes. Continuous improvement in these processes is important as patients or their representatives play a pivotal role in ensuring transparency, accountability, and credibility throughout the HTA/CPG development and decision-making processes.
      PubDate: 2021-03-22T00:00:00.000Z
      DOI: 10.1017/S0266462321000118
      Issue No: Vol. 37 (2021)
  • The contribution of French patient and consumer groups to health
           technology assessments over a 2-year period: an observational
           retrospective study
    • Authors: Cedric Gesbert; Joëlle André-Vert, Marc Guerrier, Margaret Galbraith, Christine Devaud, Jean-Claude K. Dupont, Marie-France Mamzer
      Abstract: BackgroundIn 2017, The French National Authority for Health (HAS) created an open, online, systematic contribution process to enable patient and consumer groups (PCGs) to contribute to health technology assessment (HTA) carried out to aid public authorities in reimbursement and pricing decision making.ObjectivesThis retrospective study analyzes how French PCGs contributed to the HTA process within the HAS for the first 2 years of this new mechanism.MethodsPCG contributions received between 01 January 2017 and 31 December 2018 and the recording of deliberations leading to reports of the corresponding HTAs were included. Analysis grids were designed by the investigators with 5 rounds of refinement tests on 10 random PCG contributions and the reports. Systematic data extraction was then performed separately by two investigators. PCG answers to the open-question templates and the related final HTA report published by the HAS were analyzed.ResultsSeventy-nine contributions from 44 PCGs were received and analyzed by the HAS for 78 out of the 592 HTAs performed for drugs or medical devices during the 2-year period. Twenty-five percent of the HTAs performed for drugs received at least one contribution. The contributions covered quality-of-life aspects, access to care, and personal and family impact. Membership and budget of the contributing PCGs varied greatly.ConclusionsThe experience gained in the first 2 years demonstrates the feasibility of the process and the fact that PCG contribution actually provides relevant input on the patient perspective for HTAs used for reimbursement decisions. The challenges identified on the side of PCGs were time constraints and human resources.
      PubDate: 2021-03-22T00:00:00.000Z
      DOI: 10.1017/S0266462321000180
      Issue No: Vol. 37 (2021)
  • Evaluating traditional and complementary medicines: Where do we go from
    • Authors: Lydia Wenxin Lin; Aparna Ananthakrishnan, Yot Teerawattananon
      Abstract: Traditional and complementary medicines are increasingly considered possible options for prevention and symptomatic treatment of the novel coronavirus, COVID-19. With renewed attention on these therapies from researchers and policy makers alike, the well-documented challenges of evaluating their safety and efficacy are once again of global concern. Between 2005 and 2018, the World Health Organization conducted a series of surveys, in which 88 percent of responding member states confirmed that their biggest challenge in traditional medicine was the need for technical guidance on research and evaluation. As a first step in pursuing this need, our commentary summarizes thirteen international and regional guidance documents by three broad categories on evaluating safety, efficacy, and product quality for market-based approval and distribution of these treatments. We highlight the paucity of updated international recommendations on these subjects and identify gaps that could inform the current evidence base. All available guidance note the need for evidence surrounding the efficacy of these treatments and practices but are also quick to caution against methodological difficulties in the conduct of such evaluations. Evidence suggests that improved evaluation methods on efficacy and effectiveness are crucial toward expanding future research into establishing the cost-effectiveness of these therapies, in the context of shifting acceptance, interest, and integration of traditional medicines into health systems, and as another step toward Universal Health Coverage.
      PubDate: 2021-03-17T00:00:00.000Z
      DOI: 10.1017/S0266462321000179
      Issue No: Vol. 37 (2021)
  • Relevance of the newly defined Health Technology Assessment: COVID-19 and
    • Authors: Kanchan Mukherjee
      PubDate: 2021-03-10T00:00:00.000Z
      DOI: 10.1017/S0266462321000192
      Issue No: Vol. 37 (2021)
  • The broader societal impacts of COVID-19 and the growing importance of
           capturing these in health economic analyses
    • Authors: Lena Schnitzler; Luca M. M. Janssen, Silvia M. A. A. Evers, Louise J. Jackson, Aggie T. G. Paulus, Tracy E. Roberts, Irina Pokhilenko
      Abstract: The rapid spread of the current COVID-19 pandemic has affected societies worldwide, leading to excess mortality, long-lasting health consequences, strained healthcare systems, and additional strains and spillover effects on other sectors outside health (i.e., intersectoral costs and benefits). In this perspective piece, we demonstrate the broader societal impacts of COVID-19 on other sectors outside the health sector and the growing importance of capturing these in health economic analyses. These broader impacts include, for instance, the effects on the labor market and productivity, education, criminal justice, housing, consumption, and environment. The current pandemic highlights the importance of adopting a societal perspective to consider these broader impacts of public health issues and interventions and only omit these where it can be clearly justified as appropriate to do so. Furthermore, we explain how the COVID-19 pandemic exposed and exacerbated existing deep-rooted structural inequalities that contribute to the wider societal impacts of the pandemic.
      PubDate: 2021-03-09T00:00:00.000Z
      DOI: 10.1017/S0266462321000155
      Issue No: Vol. 37 (2021)
  • Real-world evidence: perspectives on challenges, value, and alignment of
           regulatory and national health technology assessment data collection
    • Authors: Hannah Sievers; Angelika Joos, Mickaël Hiligsmann
      Abstract: ObjectiveThis study aims to assess stakeholder perceptions on the challenges and value of real-world evidence (RWE) post approval, the differences in regulatory and health technology assessment (HTA) real-world data (RWD) collection requirements under the German regulation for more safety in drug supply (GSAV), and future alignment opportunities to create a complementary framework for postapproval RWE requirements.MethodsEleven semistructured interviews were conducted purposively with pharmaceutical industry experts, regulatory authorities, health technology assessment bodies (HTAbs), and academia. The interview questions focused on the role of RWE post approval, the added value and challenges of RWE, the most important requirements for RWD collection, experience with registries as a source of RWD, perceptions on the GSAV law, RWE requirements in other countries, and the differences between regulatory and HTA requirements and alignment opportunities. The interviews were recorded, transcribed, and translated for coding in Nvivo to summarize the findings.ResultsAll experts agree that RWE could close evidence gaps by showing the actual value of medicines in patients under real-world conditions. However, experts acknowledged certain challenges such as: (i) heterogeneous perspectives and differences in outcome measures for RWE generation and (ii) missing practical experience with RWD collected through mandatory registries within the German benefit assessment due to an unclear implementation of the GSAV.ConclusionsThis study revealed that all stakeholder groups recognize the added value of RWE but experience conflicting demands for RWD collection. Harmonizing requirements can be achieved through common postlicensing evidence generation (PLEG) plans and joint scientific advice to address uncertainties regarding evidence needs and to optimize drug development.
      PubDate: 2021-02-24T00:00:00.000Z
      DOI: 10.1017/S0266462321000131
      Issue No: Vol. 37 (2021)
  • Early economic evaluation to guide the development of a spectroscopic
           liquid biopsy for the detection of brain cancer
    • Authors: Ewan Gray; James M. Cameron, Holly J. Butler, Michael D. Jenkinson, Mark G. Hegarty, David S. Palmer, Paul M. Brennan, Matthew J. Baker
      Abstract: ObjectivesAn early economic evaluation to inform the translation into clinical practice of a spectroscopic liquid biopsy for the detection of brain cancer. Two specific aims are (1) to update an existing economic model with results from a prospective study of diagnostic accuracy and (2) to explore the potential of brain tumor-type predictions to affect patient outcomes and healthcare costs.MethodsA cost-effectiveness analysis from a UK NHS perspective of the use of spectroscopic liquid biopsy in primary and secondary care settings, as well as a cost–consequence analysis of the addition of tumor-type predictions was conducted. Decision tree models were constructed to represent simplified diagnostic pathways. Test diagnostic accuracy parameters were based on a prospective validation study. Four price points (GBP 50-200, EUR 57-228) for the test were considered.ResultsIn both settings, the use of liquid biopsy produced QALY gains. In primary care, at test costs below GBP 100 (EUR 114), testing was cost saving. At GBP 100 (EUR 114) per test, the ICER was GBP 13,279 (EUR 15,145), whereas at GBP 200 (EUR 228), the ICER was GBP 78,300 (EUR 89,301). In secondary care, the ICER ranged from GBP 11,360 (EUR 12,956) to GBP 43,870 (EUR 50,034) across the range of test costs.ConclusionsThe results demonstrate the potential for the technology to be cost-effective in both primary and secondary care settings. Additional studies of test use in routine primary care practice are needed to resolve the remaining issues of uncertainty—prevalence in this patient population and referral behavior.
      PubDate: 2021-02-24T00:00:00.000Z
      DOI: 10.1017/S0266462321000143
      Issue No: Vol. 37 (2021)
  • Evaluating physicians’ perspectives on the efficiency and effectiveness
           of the electronic prescribing system
    • Authors: Ahmad Raeesi; Reza Abbasi, Reza Khajouei
      Abstract: BackgroundThe implementation of the electronic prescribing system follows certain objectives, and users’ perspectives can contribute to understanding the efficiency and effectiveness of this system. This study aimed to evaluate physicians’ perspectives on the efficiency and effectiveness of the electronic prescribing system.MethodsThis study was conducted on all physicians using the electronic prescribing system in clinics and hospitals affiliated with the treatment deputy of the Social Security Organization (SSO) in Sistan and Baluchistan Province in Iran. Data were collected using a self-administered questionnaire containing three sections: (i) Six items related to demographic data and clinical experience, (ii) Specific questions based on a five-point Likert scale-related physicians’ perspectives about efficiency (19 questions) and effectiveness (13 questions), and (iii) Open-ended questions about the positive and negative aspects of using the electronic prescribing system.ResultsThe mean and standard deviation of the efficiency and effectiveness of the electronic prescribing system were 3.68 ± 0.67 and 3.84 ± 0.65, respectively. Patient safety had the highest mean score among all dimensions (4.0 ± 0.64). Most participants (n = 55, 79%) considered the efficiency and effectiveness of this system high. More than 90 percent of the physicians (n = 63) believed that the electronic prescribing system enables a better medication prescription by providing alerts and access to patients’ medication history.ConclusionThe findings showed that most physicians believed that the electronic prescribing system of Iran's SSO has high efficiency and effectiveness. In particular, physicians believed that using this system improves patient safety and reduces costs.
      PubDate: 2021-02-24T00:00:00.000Z
      DOI: 10.1017/S0266462321000052
      Issue No: Vol. 37 (2021)
  • An institutional ethnographic analysis of public and patient engagement
           activities at a national health technology assessment agency
    • Authors: Julia Bidonde; Meredith Vanstone, Lisa Schwartz, Julia Abelson
      Abstract: ObjectiveThe practice of public and patient engagement (PPE) in health technology assessment (HTA) has spread worldwide, yet gaps in knowledge remain. We carried out an institutional ethnography of the Canadian Agency for Drugs and Technologies in Health (CADTH) public and patient involvement in HTA.MethodsThe research took place over 15 months and included observational work in the institutional settings, text review, and interviews with individuals working for or involved with the agency.ResultsWe found that despite demonstrated commitment to PPE, organizational history, governance structure, and practices were impediments to a unified approach to PPE. Unclear role descriptions for committee members and differences in philosophy and priority given to PPE across the organization presented challenges to effective participation. The high degree of value given to evidence-based principles at times conflicted with meaningful integration of patient input. A lack of clear goals and processes, roles, and differential treatment of evidence in PPE served to minimize the importance of patient experiences and to displace their validity. An acknowledgment of conflicts between multiple epistemic traditions at work within HTA activities may strengthen organizational approaches to PPE.ConclusionHTA organizations can learn from this study by reflecting on the challenges described and the recommendations offered to address them. We suggest solidifying CADTH's commitment to PPE with clear agency-wide roles and direction, values, and outcomes, a comprehensive framework, and policy and procedures. An acknowledgment of diverse epistemic traditions, as well as leadership and expertise in PPE, will strengthen CADTH's PPE activities and sustain its leadership position in the HTA field.
      PubDate: 2021-02-09T00:00:00.000Z
      DOI: 10.1017/S0266462321000088
      Issue No: Vol. 37 (2021)
  • Economic impact of the use of the National Surgical Quality Improvement
    • Authors: Alvine Fansi; Angela Ly, Julie Mayrand, Maggy Wassef, Aldanie Rho, Sylvie Beauchamp
      Abstract: ObjectivesThe American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) is a validated, risk-adjusted database for improving the quality and security of surgical care. ACS NSQIP can help participating hospitals target areas that need improvement. The aim of this study was to systematically review the literature analyzing the economic impact of using NSQIP. This paper also provides an estimation of annual cost savings following the implementation of NSQIP and quality improvement (QI) activities in two hospitals in Quebec.MethodsIn June 2018, we searched in seven databases, including PubMed, Embase, and NHSEED for economic evaluations based on NSQIP data. Contextual NSQIP databases from two hospitals were collected and analyzed. A cost analysis was conducted from the hospital care perspective, comparing complication costs before and after 1 year of the implementation of NSQIP and QI activities. The number and the cost of complications are measured. Costs are presented in 2018 Canadian dollars.ResultsOut of 1,612 studies, 11 were selected. The level of overall evidence was judged to be of moderate to high quality. In general, data showed that, following the implementation of NSQIP and QI activities, a significant decrease in complications and associated costs was observed, which improved with time. In the cost analysis of contextual data, the reduction in complication costs outweighed the cost of implementing NSQIP. However, this cost analysis did not take into account the costs of QI activities.ConclusionsNSQIP improves complication rates and associated costs when QI activities are implemented.
      PubDate: 2021-02-09T00:00:00.000Z
      DOI: 10.1017/S0266462320000616
      Issue No: Vol. 37 (2021)
  • Patient and public involvement in health technology assessment: update of
           a systematic review of international experiences
    • Authors: Marie-Pierre Gagnon; Mylène Tantchou Dipankui, Thomas G. Poder, Julie Payne-Gagnon, Gisèle Mbemba, Valentina Beretta
      Abstract: ObjectiveTo summarize current evidence on patient and public involvement (PPI) in health technology assessment (HTA) in order to synthesize the barriers and facilitators, and to propose a framework to assess its impact.MethodsWe conducted an update of a systematic review published in 2011 considering the recent scientific literature (qualitative, quantitative, and mixed-methods studies). We searched papers published between March 2009 (end of the initial search) and December 2019 in five databases using specific search strategies. We identified other publications through citation tracking and contacting authors of previous related studies. Reviewers independently selected relevant studies based on prespecified inclusion and exclusion criteria. We extracted information using a pre-established grid.ResultsWe identified a total of 7872 publications from the main search strategy. Ultimately, thirty-one distinct new studies met the inclusion criteria, whereas seventeen studies were included in the previous systematic review. PPI is realized through two main strategies: (i) patients and public members participate directly in decision-making processes (participation) and (ii) patients or public perspectives are solicited to inform decisions (consultation or indirect participation). This review synthesizes the barriers and facilitators to PPI in HTA, and a framework to assess its impact is proposed.ConclusionThe number of studies on patients or public involvement in HTA has dramatically increased in recent years. Findings from this updated systematic review show that PPI is done mostly through consultation and that direct involvement is less frequent. Several barriers to PPI in HTA exist, notably the lack of information to patients and public about HTA and the lack of guidance and policies to support PPI in HTA.
      PubDate: 2021-02-05T00:00:00.000Z
      DOI: 10.1017/S0266462321000064
      Issue No: Vol. 37 (2021)
  • Information specialist collaboration in Europe: Collaborative methods,
           processes and infrastructure through EUnetHTA—CORRIGENDUM
    • Authors: Siw Waffenschmidt; Marli van Amsterdam-Lunze, Rebeca Isabel Gomez, Maike Rehrmann, Ingrid Harboe, Elke Hausner
      PubDate: 2021-02-03T00:00:00.000Z
      DOI: 10.1017/S0266462321000076
      Issue No: Vol. 37 (2021)
  • Patients’ knowledge and awareness about patient support programs: a
           cross-sectional study on Lebanese adults with chronic diseases
    • Authors: Hanine Abbas; Layal Yehya, Mazen Kurdi, Rita Karam
      Abstract: ObjectivePatient Support Programs (PSPs) have become a trend among pharmaceutical companies and a standard service offering to patients. The objective of the present study is to describe the status of PSPs in Lebanon and to assess the extent of knowledge and awareness among Lebanese patients about the PSPs.MethodsA cross-sectional study was conducted between April and July 2017. A convenient sample of patients was randomly selected from outpatient clinics at four hospitals within the Greater Beirut Area. A questionnaire was used to address the study objective. Bivariate analysis was performed using the Chi-square test. Data were analyzed by using SPSS version 23.ResultsOut of 385 patients who participated in the study, 45.45 percent were aged between 46 and 66 years. None of them indicated that they were enrolled in a PSP, and only 13 percent of the respondents were aware of the existence of such a program. In terms of adherence habits, 55.6 percent of the patients self-reported that they do not skip any dose of their medication and consume their medication as prescribed by their healthcare providers. The main reason for nonadherence reported by the majority of nonadherent participants 144 (84.2%) was simple forgetfulness.ConclusionsThere is a severe lack of awareness of PSPs in Lebanon. Given the important role that PSPs play in creating value for patients—in terms of healthcare follow-up practices, improved adherence habits, and cost savings—there should be a more substantial effort by pharmaceutical companies to expand and promote their PSPs in the Lebanese market.
      PubDate: 2021-02-02T00:00:00.000Z
      DOI: 10.1017/S0266462321000040
      Issue No: Vol. 37 (2021)
  • Determinants of Managed Entry Agreements in the context of Health
           Technology Assessment: a comparative analysis of oncology therapies in
           four countries
    • Authors: Olina Efthymiadou; Panos Kanavos
      Abstract: BackgroundManaged Entry Agreements (MEAs) are increasingly used to address uncertainties arising in the Health Technology Assessment (HTA) process due to immature evidence of new, high-cost medicines on their real-world performance and cost-effectiveness. The literature remains inconclusive on the HTA decision-making factors that influence the utilization of MEAs. We aimed to assess if the uptake of MEAs differs between countries and if so, to understand which HTA decision-making criteria play a role in determining such differences.MethodsAll oncology medicines approved since 2009 in Australia, England, Scotland, and Sweden were studied. Four categories of variables were collected from publicly available HTA reports of the above drugs: (i) Social Value Judgments (SVJs), (ii) Clinical/Economic evidence submitted, (iii) Interpretation of this evidence, and (iv) Funding decision. Conditional/restricted decisions were coded as Listed With Conditions (LWC) other than an MEA or LWC including an MEA (LWCMEA). Cohen's κ-scores measured the inter-rater agreement of countries on their LWCMEA outcomes and Pearson's chi-squared tests explored the association between HTA variables and LWCMEA outcomes.ResultsA total of 74 drug-indication pairs were found resulting in n = 296 observations; 8 percent (n = 23) were LWC and 55 percent (n = 163) were LWCMEA. A poor-to-moderate agreement existed between countries (−.29 < κ < .33) on LWCMEA decisions. Cross-country differences within the LWCMEA sample were partly driven by economic uncertainties and largely driven by SVJs considered across agencies.ConclusionsA set of HTA-related variables driving the uptake of MEAs across countries was identified. These findings can be useful in future research aimed at informing country-specific, “best-practice” guidelines for successful MEA implementation.
      PubDate: 2021-01-29T00:00:00.000Z
      DOI: 10.1017/S0266462321000039
      Issue No: Vol. 37 (2021)
  • Letter of support from Eric Low, Director, Eric Low Consulting, Edinburgh,
    • Authors: Eric Low
      PubDate: 2021-01-29T00:00:00.000Z
      DOI: 10.1017/S0266462321000027
      Issue No: Vol. 37 (2021)
  • Evaluation of the impact of patient input in health technology assessments
           at NICE
    • Authors: Heidi Livingstone; Vassilia Verdiel, Helen Crosbie, Sheela Upadhyaya, Kevin Harris, Lizzie Thomas
      Abstract: ObjectiveAccounts of patient experiences are increasingly used in health technology assessment (HTA) processes. However, we know little about their impact on the decision-making process. This study aims to assess the level and the type of impact of patient input to highly specialised technologies (HSTs) and interventional procedures (IPs) guidance at the National Institute for Health and Care Excellence (NICE).MethodsA questionnaire was developed to capture quantitative and qualitative data on the amount and type of impact of patient input into NICE HTAs. It was completed by committee members of the guidance-producing programs after a discussion of the considered topics. The data were analyzed by topic and overall, for each program, and compared across programs.ResultsPatient input was assessed on ten pieces of HST guidance published between January 2015 and November 2019, and on twenty-six pieces of IP guidance scoped between February 2016 and October 2018. A total of 96 responses were collected for HST and 440 for IP. The level of impact of patient input was higher for HST than for IP. For HST, no respondents stated that it had no impact, whereas in IP, 35 percent of respondents did. The most common types of impact found for HST and IP were that it helped interpret the other evidence and that it provided new evidence.ConclusionsThe impact of patient input is not necessarily explicit in changing recommendations, but it provides context, reassurance, and new information to the committee for the decision-making process in HTAs.
      PubDate: 2021-01-29T00:00:00.000Z
      DOI: 10.1017/S0266462320002214
      Issue No: Vol. 37 (2021)
  • Pilot approach to analyzing patient and citizen involvement in health
           technology assessment in four diverse low- and middle-income countries
    • Authors: Anke-Peggy Holtorf; Debjani Mueller, M. Sharmila A. Sousa, Lauren Pretorius, Kalman Emry Wijaya, Sylvester Adeyemi, Dipen Ankleshwaria
      Abstract: BackgroundIn low- and middle-income countries (LMICs) striving to achieve universal health coverage, the involvement of different stakeholders in formal or informal ways in health technology assessment (HTA) must be culturally and socially relevant and acceptable. Challenges may be different from those seen in high-income countries. In this article, we aimed to pilot a questionnaire for uncovering the context-related aspects of patient and citizen involvement (PCI) in LMICs, collecting experiences encountered with PCI, and identifying opportunities for patients and citizens toward contributing to local decision- and policy-making processes related to health technologies.MethodsThrough a collaborative, international multi-stakeholder initiative, a questionnaire was developed for describing each LMIC's healthcare system context and the emergence of opportunities for PCI relating to HTA. The questionnaire was piloted in the first set of countries (Brazil, Indonesia, Nigeria, and South Africa).ResultsThe questionnaire was successfully applied across four diverse LMICs, which are at different stages of using HTA to inform decision making. Only in Brazil, formal ways of PCI have been defined. In the other countries, there is informal influence that is contingent upon the engagement level of patient and citizen advocacy groups (PCAGs), usually strongest in areas such as HIV/AIDS, TB, oncology, or rare diseases.ConclusionsThe questionnaire can be used to analyze the options for patients and citizens to participate in HTA or healthcare decision making. It will be rolled out to more LMICs to describe the requirements and opportunities for PCI in the context of LMICs and to identify possible routes and methodologies for devising a more systematic and formalized PCI in LMICs.
      PubDate: 2021-01-25T00:00:00.000Z
      DOI: 10.1017/S0266462320002263
      Issue No: Vol. 37 (2021)
  • Development of a checklist to guide equity considerations in health
           technology assessment
    • Authors: Maria Benkhalti; Manuel Espinoza, Richard Cookson, Vivian Welch, Peter Tugwell, Pierre Dagenais
      Abstract: ObjectivesHealth technology assessment (HTA) can impact health inequities by informing healthcare priority-setting decisions. This paper presents a novel checklist to guide HTA practitioners looking to include equity considerations in their work: the equity checklist for HTA (ECHTA). The list is pragmatically organized according to the generic HTA phases and can be consulted at each step.MethodsA first set of items was based on the framework for equity in HTA developed by Culyer and Bombard. After rewording and reorganizing according to five HTA phases, they were complemented by elements emerging from a literature search. Consultations with method experts, decision makers, and stakeholders further refined the items. Further feedback was sought during a presentation of the tool at an international HTA conference. Lastly, the checklist was piloted through all five stages of an HTA.ResultsECHTA proposes elements to be considered at each one of the five HTA phases: Scoping, Evaluation, Recommendations and Conclusions, Knowledge Translation and Implementation, and Reassessment. More than a simple checklist, the tool provides details and examples that guide the evaluators through an analysis in each phase. A pilot test is also presented, which demonstrates the ECHTA's usability and added value.ConclusionsECHTA provides guidance for HTA evaluators wishing to ensure that their conclusions do not contribute to inequalities in health. Several points to build upon the current checklist will be addressed by a working group of experts, and further feedback is welcome from evaluators who have used the tool.
      PubDate: 2021-01-25T00:00:00.000Z
      DOI: 10.1017/S0266462320002275
      Issue No: Vol. 37 (2021)
  • On the role of cost-effectiveness thresholds in healthcare priority
    • Authors: Jonathan Siverskog; Martin Henriksson
      Abstract: In the past few years, empirical estimates of the marginal cost at which health care produces a quality-adjusted life year (QALY, k) have begun to emerge. In theory, these estimates could be used as cost-effectiveness thresholds by health-maximizing decision makers, but prioritization decisions in practice often include other considerations than just efficiency. Pharmaceutical reimbursement in Sweden is one such example, where the reimbursement authority (TLV) uses a threshold range to give priority to disease severity and rarity. In this paper, we argue that estimates of k should not be used to inform threshold ranges. Instead, they are better used directly in health technology assessment (HTA) to quantify how much health is forgone when a new technology is funded in place of other healthcare services. Using a recent decision made by TLV as a case, we show that an estimate of k for Sweden implies that reimbursement meant forgoing 8.6 QALYs for every QALY that was gained. Reporting cost-effectiveness evidence as QALYs forgone per QALY gained has several advantages: (i) it frames the decision as assigning an equity weight to QALYs gained, which is more transparent about the trade-off between equity and efficiency than determining a monetary cost per QALY threshold, (ii) it makes it less likely that decision makers neglect taking the opportunity cost of reimbursement into account by making it explicit, and (iii) it helps communicate the reason for sometimes denying reimbursement in a way that might be less objectionable to the public than current practice.
      PubDate: 2021-01-25T00:00:00.000Z
      DOI: 10.1017/S0266462321000015
      Issue No: Vol. 37 (2021)
  • Creating a patient and community advisory committee at the Canadian Agency
           for Drugs and Technologies in Health
    • Authors: Sarah Berglas; Nadine Vautour, Daryl Bell
      Abstract: In recognition of patients’ roles using, and contributing to, a publicly funded health system, the Canadian Agency for Drugs and Technologies in Health (CADTH) created a Patient and Community Advisory Committee. Twelve members bring lived experiences of chronic illness, progressive illness, mental illness, trauma, traveling long distances for treatment, and caregiving to an ill child, parent, or spouse. Members contribute their own insights and ideas but do not represent specific organizations or viewpoints. This paper explores how CADTH determined the committee's role, whether to have individuals or organizations as members, and how to recruit for diversity. The creation of this committee is changing how CADTH engages with patients.
      PubDate: 2021-01-22T00:00:00.000Z
      DOI: 10.1017/S0266462320002251
      Issue No: Vol. 37 (2021)
  • Scottish Health Technologies Group: enhancing patient engagement
    • Authors: James Angus Stewart; Edward Clifton, Karen Macpherson, Nikolina Angelova, Graeme Morrison
      Abstract: ObjectivesThe Scottish Health Technologies Group (SHTG) provides evidence support and advice to the National Health Service in Scotland on the use of new and existing health technologies, which, although not medicines, are likely to have significant implications for people's care. The purpose of this paper is to highlight the developments that have taken place in the SHTG's patient involvement processes in the years 2017 to 2019, focusing primarily on specific engagement with patient organizations and considering how the new approaches have been received by stakeholders.MethodsFeedback from patient organizations that participated in the SHTG submission process, alongside SHTG committee members’ views on patient organizations contributions, was gathered primarily via online questionnaires. The number of times that patient organizations were invited and accepted the opportunity to peer-review SHTG advice statements prior to and after the employment of a Public Involvement Advisor (PIA) was analyzed.ResultsCompleted questionnaires (n = 4) from three case study examples showed high patient organization satisfaction with their experience of the SHTG process. The feedback from SHTG committee members that was gathered indicated that patient organization participation was generally well received. The number of peer reviews from patient organizations for SHTG advice statements in 2018–2019 doubled to 86 percent of the total advice statements (n = 22), compared with 43 percent (n = 14) in 2016–2017.ConclusionsSignificant progress has been made toward improving the SHTG's patient involvement processes. A dedicated PIA post within the SHTG has allowed for a more tailored support to patient organizations and has encouraged their increased participation in SHTG processes.
      PubDate: 2021-01-20T00:00:00.000Z
      DOI: 10.1017/S026646232000224X
      Issue No: Vol. 37 (2021)
  • Patient involvement in relative effectiveness assessments in the European
           Network for Health Technology Assessment
    • Authors: Ida Kristin Ørjasæter Elvsaas; Sabine Ettinger, Anne Willemsen
      Abstract: Patient involvement in the process of producing health technology assessments has become increasingly important. In the European Network for Health Technology Assessment (EUnetHTA), several approaches to patient involvement were explored. The outcome was a document on “Patient Input in Relative Effectiveness Assessments” that is available for access and was published in 2019.The aim of this article is to analyze the experience gained by EUnetHTA in patient involvement for EUnetHTA assessment production, describe and quantify the approaches used, and outline the challenges and avenues for the improvement of current processes.Patients were involved in twenty-three of thirty-six pharmaceutical and other technology EUnetHTA assessments from June 2016 until the end of November 2019. Approaches to patient involvement included using a patient input template, one-on-one conversations, group conversations, scoping meeting with patients, and other approaches.Although it is recognized that patient involvement is important to understand the needs of the target patient population, challenges remain with timely patient involvement. Additionally, further efforts are needed to guide assessment teams on how to implement and enhance the visibility of patient input in assessments.
      PubDate: 2021-01-20T00:00:00.000Z
      DOI: 10.1017/S0266462320002226
      Issue No: Vol. 37 (2021)
  • The representation of public values in health technology assessment to
    • Authors: Hossein Haji Ali Afzali; Jackie Street, Tracy Merlin, Jonathan Karnon
      Abstract: Over the past few years, there has been an increasing recognition of the value of public involvement in health technology assessment (HTA) to ensure the legitimacy and fairness of public funding decisions [Street J, Stafinski T, Lopes E, Menon D. Defining the role of the public in Health Technology Assessment (HTA) and HTA-informed decision-making processes. Int J Technol Assess Health Care. 2020;36:87–95]. However, important challenges remain, in particular, how to reorient HTA to reflect public priorities. In a recent international survey of thirty HTA agencies conducted by the International Network of Agencies for HTA (INAHTA), public engagement in HTA was listed as one of the “Top 10” challenges for HTA agencies [O'Rourke B, Werko SS, Merlin T, Huang LY, Schuller T. The “Top 10” challenges for health technology assessment: INAHTA viewpoint. Int J Technol Assess. 2020;36:1–4].Historically, Australia has been at the forefront of the application of HTA for assessing the effectiveness and cost-effectiveness of new health technologies to inform public funding decisions. However, current HTA processes in Australia lack meaningful public inputs. Using Australia as an example, we describe this important limitation and discuss the potential impact of this gap on the health system and future directions.
      PubDate: 2021-01-18T00:00:00.000Z
      DOI: 10.1017/S0266462320002238
      Issue No: Vol. 37 (2021)
  • Strengthening patient outcome evidence in health technology assessment: a
           coproduction approach
    • Authors: Mark Rasburn; Heidi Livingstone, Sarah E. Scott
      Abstract: The National Institute for Health and Care Excellence (NICE) worked with patients and staff from six patient organizations to review existing health technology assessment (HTA) methods and coproduce proposals to improve the following: patient involvement, how patient evidence is identified and considered by committees, and the support offered to patient stakeholders. This engagement identified important factors that HTA bodies need to understand to enable meaningful patient and public involvement (PPI), such as having clearly documented processes, appropriate evidence submission processes, transparent decisions, and suitable support. This work demonstrated the benefits of HTA bodies working collaboratively with patient stakeholders to improve PPI. By doing so, HTA bodies can increase their knowledge and understanding of the barriers faced by patient stakeholders to develop appropriate solutions to remove them. The coproduction approach improved stakeholder engagement methods, provided a better analysis of data, supported the development of meaningful conclusions, and improved stakeholder relationships.
      PubDate: 2021-01-13T00:00:00.000Z
      DOI: 10.1017/S0266462320002202
      Issue No: Vol. 37 (2021)
  • Developing recommendations for the diagnosis and treatment of Lyme
           disease: the role of the patient's perspective in a controversial
    • Authors: Marie-Pascale Pomey; Paula L. Bush, Olivier Demers-Payette, Audrey L'Espérance, Louis Lochhead, Isabelle Ganache, Denis Roy
      Abstract: ContextThe Ministry of Health in Québec requested the National Institute of Excellence in Health and Social Services to produce clinical and implementation recommendations for the prophylaxis, diagnosis, and treatment of Lyme disease.Objectives(i) Describe the process of trialing different modalities of patient engagement as a means to integrate a diversity of patient perspectives and (ii) Describe the learning process of INESSS regarding the integration of the patient perspective.MethodologyAll documents were analyzed, and a survey with all advisory committee members and semi-structured interviews with stakeholders were conducted. Each interview was transcribed verbatim and imported into QDA miner software for the purposes of analysis. Data analysis was carried out concurrently with data collection to allow for an iterative approach between data collection and analysis.ResultsFive methods to integrate the perspectives of patients were used: (i) interviews with patients, (ii) inclusion of patient partners within the advisory committee, (iii) literature review, (iv) focus groups with one patient association, and (v) feedback from patient associations on recommendations intended for decision makers and other targeted stakeholders. The patient partners influenced decisions by sharing their experiential knowledge. The patient interviews and the literature review added an in-depth perspective on the disease and experience with the healthcare system. The patient association members shared their perspectives and helped disseminate the recommendation to sustain a practice change.ConclusionThe combination of methods to collect and integrate patients’ knowledge and patient associations’ perspectives helped develop a comprehensive understanding of a controversial object of evaluation.
      PubDate: 2020-12-23T00:00:00.000Z
      DOI: 10.1017/S0266462320002123
      Issue No: Vol. 37 (2020)
  • Lessons learned from the reimbursement policy for immune checkpoint
           inhibitors and real-world data collection in Taiwan
    • Authors: Li Ying Huang; Churn-Shiouh Gau
      Abstract: This paper describes the reimbursement policy for immune checkpoint inhibitors in Taiwan and provides a perspective to improve the quality, consistency, and transparency of decision making. Global trends for cancer treatment have shifted from chemotherapies to targeted therapies and immuno-oncology (IO) medicine, leading to significant increases in treatment costs. To enhance the accessibility of advanced therapy, the Taiwan National Health Insurance Administration announced two pathways for high-cost medicine: the managed entry agreement and a set of general rules of reimbursement submission for high-cost drugs. To further manage the financial burden on Taiwan's national health insurance system, the policy makers introduced novel inhibitory drugs for cancer immune checkpoints, subject to a maximum annual budget of NT$800 million (≈US$26.7 million). In April 2019, a national registry was established for patients undergoing cancer immunotherapy. Clinical characteristics, treatment duration, toxicity, and the outcome of the postcheckpoint inhibitor treatments were recorded. By analyzing real-world data, we assess the therapeutic effect of IO treatment in Taiwanese patients, thereby enabling payers to adjust payment regulations and rules for reimbursement. The Health Technology Assessment Team plays an important role in drawing upon the evidence to support policy making. Under an implemented cost-management mechanism, Taiwan's high-cost drug policy has enabled patients to access new medicines and maximized patient benefits.
      PubDate: 2020-12-21T00:00:00.000Z
      DOI: 10.1017/S0266462320002160
      Issue No: Vol. 37 (2020)
  • Creating enriched training sets of eligible studies for large systematic
           reviews: the utility of PubMed's Best Match algorithm
    • Authors: Margaret Sampson; Nassr Nama, Katharine O'Hearn, Kimmo Murto, Ahmed Nasr, Sherri L. Katz, Gail Macartney, Franco Momoli, J. Dayre McNally
      Abstract: IntroductionSolutions like crowd screening and machine learning can assist systematic reviewers with heavy screening burdens but require training sets containing a mix of eligible and ineligible studies. This study explores using PubMed's Best Match algorithm to create small training sets containing at least five relevant studies.MethodsSix systematic reviews were examined retrospectively. MEDLINE searches were converted and run in PubMed. The ranking of included studies was studied under both Best Match and Most Recent sort conditions.ResultsRetrieval sizes for the systematic reviews ranged from 151 to 5,406 records and the numbers of relevant records ranged from 8 to 763. The median ranking of relevant records was higher in Best Match for all six reviews, when compared with Most Recent sort. Best Match placed a total of thirty relevant records in the first fifty, at least one for each systematic review. Most Recent sorting placed only ten relevant records in the first fifty. Best Match sorting outperformed Most Recent in all cases and placed five or more relevant records in the first fifty in three of six cases.DiscussionUsing a predetermined set size such as fifty may not provide enough true positives for an effective systematic review training set. However, screening PubMed records ranked by Best Match and continuing until the desired number of true positives are identified is efficient and effective.ConclusionsThe Best Match sort in PubMed improves the ranking and increases the proportion of relevant records in the first fifty records relative to sorting by recency.
      PubDate: 2020-12-18T00:00:00.000Z
      DOI: 10.1017/S0266462320002159
      Issue No: Vol. 37 (2020)
  • Role of patients’ organizations in Health Technology Assessment: a
           Habermasian system and lifeworld perspective
    • Authors: Neda Milevska-Kostova; Sita Ratna Devi Duddi, Richard J. Cooper
      Abstract: Patient and public involvement in Health Technology Assessment (HTA) is gaining increased interest among research and policy communities. Patients’ organizations represent an important link between individual patients and the health system. Social theories are increasingly being used to explain doctor–patient–system interactions, expanding understanding beyond the mere clinical perspective. In this sense, patient involvement in HTA can also be considered through the Habermas’s theory of communicative action. From a Habermasian perspective, HTA as part of the instrumental rationality contributes to an increased efficiency of resource use within the system; however, such rationalization threatens to colonize the lifeworld by making it “increasingly state administered with attenuated possibilities for communicative action as a result of the commercialization and rationalization in terms of immediate returns.” Using Habermasian system/lifeworld framework, this paper explores opportunities and obstacles to patient involvement in HTA, whereby trying to understand current and possible roles of patients’ organizations as a mediating force between HTA as a function of the system and the lifeworld represented by patients.
      PubDate: 2020-12-15T00:00:00.000Z
      DOI: 10.1017/S0266462320002147
      Issue No: Vol. 37 (2020)
  • Patient and caregiver engagement in the Patient-Centered Outcomes Research
           Institute (PCORI) Health Care Horizon Scanning System (HCHSS) process
    • Authors: Kelley Tipton; Jennifer De Lurio, Eileen Erinoff, Randy Hulshizer, Diane Robertson, Donna Beales, Damian Carlson, Christian Cuevas, Eloise DeHaan, Andrea Druga, Marcus Lynch, Misha Mehta, Maria Middleton, Brian Wilkinson, Karen Schoelles
      Abstract: ObjectiveThe Patient-Centered Outcomes Research Institute (PCORI) horizon scanning system is an early warning system for healthcare interventions in development that could disrupt standard care. We report preliminary findings from the patient engagement process.MethodsThe system involves broadly scanning many resources to identify and monitor interventions up to 3 years before anticipated entry into U.S. health care. Topic profiles are written on included interventions with late-phase trial data and circulated with a structured review form for stakeholder comment to determine disruption potential. Stakeholders include patients and caregivers recruited from credible community sources. They view an orientation video, comment on topic profiles, and take a survey about their experience.ResultsAs of March 2020, 312 monitored topics (some of which were archived) were derived from 3,500 information leads; 121 met the criteria for topic profile development and stakeholder comment. We invited fifty-four patients and caregivers to participate; thirty-nine reviewed at least one report. Their perspectives informed analyst nominations for fourteen topics in two 2019 High Potential Disruption Reports. Thirty-four patient stakeholders completed the user-experience survey. Most agreed (68 percent) or somewhat agreed (26 percent) that they were confident they could provide useful comments. Ninety-four percent would recommend others to participate.ConclusionsThe system has successfully engaged patients and caregivers, who contributed unique and important perspectives that informed the selection of topics deemed to have high potential to disrupt clinical care. Most participants would recommend others to participate in this process. More research is needed to inform optimal patient and caregiver stakeholder recruitment and engagement methods and reduce barriers to participation.
      PubDate: 2020-12-15T00:00:00.000Z
      DOI: 10.1017/S026646232000207X
      Issue No: Vol. 37 (2020)
  • The effects of mobile apps on stress, anxiety, and depression: overview of
           systematic reviews
    • Authors: Fatemeh Khademian; Azam Aslani, Peivand Bastani
      Abstract: ObjectivesDespite a large number of mobile apps in the field of mental health, it is difficult to find a useful and reliable one, mainly due to the fact that the effectiveness of many apps has not been assessed scientifically. The present study aimed to assess the effects of mental health apps on managing the symptoms of stress, anxiety, and depression.MethodsA comprehensive literature search was conducted in PubMed, Scopus, EMBASE, Cochrane, and Web of Science databases for the papers published from 2000 to 2019. Studies were included if they reviewed articles or mobile apps for their effectiveness in stress, anxiety, and depression. The reviews that had considered mobile apps or web-based mobile applications as an intervention or part of intervention were included, as well.ResultsA total of 4,999 peer-reviewed articles were identified, out of which nine systematic reviews met the inclusion criteria. Seven systematic reviews measured depression outcomes, three measured stress, and five systematic reviews measured anxiety symptoms. The applications that used behavior change strategies, such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Behavioral Activation, reported significant effects on depression, anxiety, and stress.ConclusionIt seems that mental health apps can be promising media for reducing depressive symptoms. This field is an emerging area of mobile health, and further research should be done in future in order to reach conclusive evidence.
      PubDate: 2020-12-14T00:00:00.000Z
      DOI: 10.1017/S0266462320002093
      Issue No: Vol. 37 (2020)
  • Qualitative comparative analysis of health economic evaluation guidelines
           for health technology assessment in European countries
    • Authors: Konstantinos Zisis; Panagiota Naoum, Kostas Athanasakis
      Abstract: ObjectiveTo classify, analyze, and compare published guidelines for economic evaluation within health technology assessment (HTA) in European countries and highlight differences and similarities.MethodsWe performed a literature review to identify published guidance for the conduct and assessment of economic evaluation studies that are undertaken within the context of HTA processes in European countries. Organizations and working groups were identified via the ISPOR, INAHTA, and EUnetHTA databases. Following the identification of official documents, we performed a qualitative content analysis to highlight discrepancies or common practices under the following categories: comparator, perspective on costs/benefits, time horizon, economic evaluation method, instrument used for utility measurement, outcome measure, source for efficacy, modeling, sensitivity analysis, discounting, and incremental cost-effectiveness ratio.ResultsA total of nineteen guidance documents were identified (in English) providing data for the analysis in nineteen countries. The comparative content analysis identified common practices in most countries regarding the approaches to the choice of comparator, source of data, the preferred economic evaluation method, the option for a lifetime analytical horizon, discounting, and the choice of key outcome measure—for which, most countries recommend the use of the EQ-5D instrument. Differences were mainly found in the choice of perspective, dealing with uncertainty and sensitivity analysis, the use of end points, and the required use of modeling.ConclusionsThe use of economic evaluation constitutes one of the key pillars of the HTA process in Europe. Although a methodological convergence has occurred during the last few years, notable differences still remain.
      PubDate: 2020-12-10T00:00:00.000Z
      DOI: 10.1017/S0266462320002081
      Issue No: Vol. 37 (2020)
  • Systematic review search methods evaluated using the Preferred Reporting
           of Items for Systematic Reviews and Meta-Analyses and the Risk Of Bias In
           Systematic reviews tool
    • Authors: Shelley de Kock; Lisa Stirk, Janine Ross, Steven Duffy, Caro Noake, Kate Misso
      Abstract: ObjectivesTo evaluate the methodological and reporting characteristics of search methods of systematic reviews (SRs) using the Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) checklist and the Risk Of Bias In Systematic reviews (ROBIS) tool.MethodsA sample of 505 SRs published in 2016 was taken from KSR Evidence, a database of SRs, and analyzed to assess compliance with Information sources and Search of the PRISMA checklist. Domain 2 (D2) (Identification and Selection of Studies) of the ROBIS tool was used to judge the risk of bias in search methods.ResultsRegarding Information sources and Search of PRISMA, twenty percent of SRs which claimed to be PRISMA-compliant in their methods, were compliant; twenty-four percent of SRs published in journals that require PRISMA reporting were compliant; nineteen percent in total were found to be compliant. Twenty-eight percent of SRs were judged to be at a low risk of bias in D2 and so searched widely with an effective strategy and, finally, ten percent were both compliant with the reporting of Information sources and with Search of PRISMA and were judged to be at a low risk of bias in D2.ConclusionsNinety percent of SRs are failing to report search methods adequately and to conduct comprehensive searches using a wide range of resources. Editors of journals and peer reviewers need to ensure that they understand the requirements of PRISMA and that compliance is adhered to. Additionally, the comprehensiveness of search methods for SRs needs to be given more critical consideration.
      PubDate: 2020-12-07T00:00:00.000Z
      DOI: 10.1017/S0266462320002135
      Issue No: Vol. 37 (2020)
  • Toward a common understanding of competencies for health technology
           assessment: enhancing educational and training programs around the globe
    • Authors: Debjani Mueller; Iñaki Gutierrez-Ibarluzea, Marco Chiumente, Wija Oortwijn
      Abstract: BackgroundDepending on the health system context and the demands of relevant stakeholders in countries, the need, organizational structure, and prerequisites for enabling capacity building and development in health technology assessment (HTA) will vary. Core competencies are instrumental in this and include essential knowledge, skills, and attitudes (KSAs). They provide building blocks for delivering high-quality and effective practices of HTA. We aimed to systematically explore and develop an overview of the core competencies necessary for HTA.MethodsThis study was conducted during 2016–19 using different methods in a structured manner. We drew concepts of KSAs from various literature sources, surveyed universities and HTA professionals, and conducted expert workshops to arrive at a common understanding of the required competencies.ResultsThe terminology for KSAs defining competencies in HTA programs has been clarified. In addition, a list of competencies offered through different educational and training programs has been created. The surveys provided clarity on a common understanding of KSAs among HTA stakeholders. Thereafter, a set of competencies was described and classified according to the HTA domains.ConclusionsOur study shows that there is diversity in HTA programs offered by educational institutions. The content of the programs varies due to differences between countries regarding the level of HTA development and the need for HTA, including the understanding of what HTA is. The preparation of a competency checklist or a “menu” of options mirroring the diversity of HTA will ensure that the specific needs of the HTA community will be covered.
      PubDate: 2020-12-07T00:00:00.000Z
      DOI: 10.1017/S0266462320001919
      Issue No: Vol. 37 (2020)
  • Development of a decisional flowchart for meaningful patient involvement
           in Health Technology Assessment
    • Authors: Ana Toledo-Chávarri; Marie-Pierre Gagnon, Yolanda Álvarez-Pérez, Lilisbeth Perestelo-Pérez, Yolanda Triñanes Pego, Pedro Serrano Aguilar
      Abstract: IntroductionThis paper aims to describe the development of a flowchart to guide the decisions of researchers in the Spanish Network for Health Technology Assessment of the National Health System (RedETS) regarding patient involvement (PI) in Health Technology Assessment (HTA). By doing so, it reflects on current methodological challenges in PI in the HTA field: how best to combine PI methods and what is the role of patient-based evidence.MethodsA decisional flowchart for PI in HTA was developed between March and April 2019 following an iterative process, reviewed by the members of the PI Interest Group and other RedETS members and validated during an online deliberative meeting. The development of the flowchart was based on a previous methodological framework assessed in a pilot study.ResultsThe guidelines on how to involve patients in HTA in the RedETS were graphically represented in a flowchart. PI must be included in all HTA reports, except those that assess technologies with no relevant impact on patients’ experiences, values, and preferences. Patient organizations or expert patients related to the topic of the HTA report must be identified and invited. These patients can participate in protocol development, outcomes' identification, assessment process, and report review. When the technology assessed affects in a relevant way patient experiences, values, and preferences, patient-based evidence should be included through a systematic literature review or a primary study.ConclusionsThe decisional flowchart for PI in HTA contributes to the current methodological challenges by proposing a combination of direct involvement and patient-based evidence.
      PubDate: 2020-12-03T00:00:00.000Z
      DOI: 10.1017/S0266462320001956
      Issue No: Vol. 37 (2020)
  • Cost-effectiveness analysis of magnetic resonance-guided focused
           ultrasound ablation for palliation of refractory painful bone metastases
    • Authors: Matthew D. Bucknor; Frandics P. Chan, Jessica Y. Matuoka, Patti K. Curl, James G. Kahn
      Abstract: ObjectiveThe aim of this study was to determine if magnetic resonance-guided focused ultrasound (MRgFUS) is cost-effective compared with medication, for refractory pain from bone metastases in the United States.MethodsWe constructed a Markov state transition model using TreeAge Pro software (TreeAge Software, Inc., Williamstown, MA, USA) to model costs, outcomes, and the cost-effectiveness of a treatment strategy using MRgFUS for palliative treatment of painful bone metastases compared with a Medication Only strategy (Figure 1). Model transition state probabilities, costs (in 2018 US$), and effectiveness data (quality-adjusted life-years [QALYs]) were derived from available literature, local expert opinion, and reimbursement patterns at two U.S. tertiary academic medical centers actively performing MRgFUS. Costs and QALYs, discounted at three percent per year, were accumulated each month over a 24-month time horizon. One-way and probabilistic sensitivity analyses were performed.ResultsIn the base-case analysis, the MRgFUS treatment strategy costs an additional $11,863 over the 2-year time horizon to accumulate additional 0.22 QALYs, equal to a $54,160/QALY ICER, thus making MRgFUS the preferred strategy. One-way sensitivity analyses demonstrate that for the base-case analysis, the crossover point at which Medication Only would instead become the preferred strategy is $23,341 per treatment. Probabilistic sensitivity analyses demonstrate that 67 percent of model iterations supported the conclusion of the base case.ConclusionsOur model demonstrates that MRgFUS is cost-effective compared with Medication Only for palliation of painful bone metastases for patients with medically refractory metastatic bone pain across a range of sensitivity analyses.
      PubDate: 2020-12-03T00:00:00.000Z
      DOI: 10.1017/S0266462320001907
      Issue No: Vol. 37 (2020)
  • Expertise, experience, and excellence. Twenty years of patient involvement
           in health technology assessment at NICE: an evolving story
    • Authors: Laura Norburn; Lizzie Thomas
      Abstract: From its inception in 1999, the National Institute for Health and Care Excellence (NICE) committed to including the expertise, experiences, and perspectives of lay people, patients and carers, and patient organizations in its health technology assessments (HTAs). This is our story of patient involvement in HTA: from early methods designed for use when assessing medicines, widening to address the different requirements of HTAs for interventional procedures, medical technologies, and diagnostic technologies. We also chart the evolution and development of all our patient involvement methods over the past 20 years through regular evaluation and by responding to external challenge. However, we know that processes and methods alone are not enough. Through case studies we demonstrate the value of patient involvement in HTA and highlight the unique perspectives and experiences that patients bring to HTA committees. Finally, we discuss the underpinning principles and commitments that have made NICE a world leader in delivering meaningful and legitimate patient involvement.
      PubDate: 2020-11-10T00:00:00.000Z
      DOI: 10.1017/S0266462320000860
      Issue No: Vol. 37 (2020)
  • Demonstrating the influence of HTA: INAHTA member stories of HTA impact
    • Authors: Sophie Söderholm Werkö; Tracy Merlin, Laurie Jean Lambert, Paul Fennessy, Ana Pérez Galán, Tara Schuller
      Abstract: A central function of health technology assessment (HTA) agencies is the production of HTA reports to support evidence-informed policy and decision making. HTA agencies are interested in understanding the mechanisms of HTA impact, which can be understood as the influence or impact of HTA report findings on decision making at various levels of the health system. The members of the International Network of Agencies for HTA (INAHTA) meet at their annual Congress where impact story sharing is one important activity. This paper summarizes four stories of HTA impact that were finalists for the David Hailey Award for Best Impact Story.The methods to measure impact include: document review; claims analysis and review of reimbursement status; citation analysis; qualitative evaluation of stakeholders’ views; and review of media response. HTA agency staff also observed changes in government activities and priorities based on the HTA. Impact assessment can provide information to improve the HTA process, for example, the value of patient and clinician engagement in the HTA process to better define the assessment question and literature reviews in a more holistic and balanced way.HTA reports produced by publicly funded HTA agencies are valued by health systems around the globe as they support decision making regarding the appropriate use, pricing, reimbursement, and disinvestment of health technologies. HTAs can also have a positive impact on information sharing between different levels of government and across stakeholder groups. These stories show how HTA can have a significant impact, irrespective of the health system and health technology being assessed.
      PubDate: 2020-11-05T00:00:00.000Z
      DOI: 10.1017/S0266462320000835
      Issue No: Vol. 37 (2020)
  • Importance of involving patients and public in health research in
           Bangladesh and Nepal
    • Authors: Bibha Simkhada; Edwin van Teijlingen, Aliya Naheed, Angela Warren, Sue Green
      Abstract: Patient and public involvement/engagement (PPI/E) in public health research and health technology assessment (HTA) in high-income countries (HICs) have significantly increased over the past decade. PPI/E helps to improve research and HTA, ultimately benefitting patients and service users. PPI/E is a very new concept in many low- and middle-income countries (LMICs). This paper considers the importance of PPI in public health research and HTA in the development and implementation of technology in the health sector in South Asia. Currently, in this region, health technology is frequently adopted from HICs without local research and HTA. It also discusses the importance of local co-creation of technology to reflect the needs of users within a culturally appropriate setting. It is important for LMIC-based researchers to understand the potential of PPI/E and how it can contribute to it to improve health care and research, especially perhaps in the era of COVID-19.
      PubDate: 2020-11-05T00:00:00.000Z
      DOI: 10.1017/S0266462320000811
      Issue No: Vol. 37 (2020)
  • Value assessment of antimicrobials and the implications for development,
           access, and funding of effective treatments: Australian stakeholder
    • Authors: Nadine T. Hillock; Tracy L. Merlin, Jonathan Karnon, John Turnidge, Jaklin Eliott
      Abstract: BackgroundThe frameworks used by Health Technology Assessment (HTA) agencies for value assessment of medicines aim to optimize healthcare resource allocation. However, they may not be effective at capturing the value of antimicrobial drugs.ObjectivesTo analyze stakeholder perceptions regarding how antimicrobials are assessed for value for reimbursement purposes and how the Australian HTA framework accommodates the unique attributes of antimicrobials in cost-effectiveness evaluation.MethodsEighteen individuals representing the pharmaceutical industry or policy-makers were interviewed. Interviews were transcribed verbatim, coded, and thematically analyzed.ResultsKey emergent themes were that reimbursement decision-making should consider the antibiotic spectrum when assessing value, risk of shortages, the impact of procurement processes on low-priced comparators, and the need for methodological transparency when antimicrobials are incorporated into the economic evaluation of other treatments.ConclusionsParticipants agreed that the current HTA framework for antimicrobial value assessment is inadequate to properly inform funding decisions, as the contemporary definition of cost-effectiveness fails to explicitly incorporate the risk of future resistance. Policy-makers were uncertain about how to incorporate future resistance into economic evaluations without a systematic method to capture costs avoided due to good stewardship. Lacking financial reward for the benefits of narrower-spectrum antimicrobials, companies will likely focus on developing broad-spectrum agents with wider potential use. The perceived risks of shortages have influenced the funding of generic antimicrobials in Australia, with policy-makers suggesting a willingness to pay more for assured supply. Although antibiotics often underpin the effectiveness of other medicines, it is unclear how this is incorporated into economic models.
      PubDate: 2020-11-03T00:00:00.000Z
      DOI: 10.1017/S0266462320000823
      Issue No: Vol. 37 (2020)
  • How does HTA addresses current social expectations' An international
    • Authors: Hubert Gagnon; Georges-Auguste Legault, Christian A. Bellemare, Monelle Parent, Pierre Dagenais, Suzanne K.-Bédard, Danielle Tapin, Louise Bernier, Jean-Pierre Béland, Charles-Étienne Daniel, Johane Patenaude
      Abstract: ObjectivesIntegration of ethics into technology assessment in healthcare (HTA) reports is directly linked to the need of decision makers to provide rational grounds justifying their social choices. In a decision-making paradigm, facts and values are intertwined and the social role of HTA reports is to provide relevant information to decision makers. Since 2003, numerous surveys and discussions have addressed different aspects of the integration of ethics into HTA. This study aims to clarify how HTA professionals consider the integration of ethics into HTA, so an international survey was conducted in 2018 and the results are reported here.MethodsA survey comprising twenty-two questions was designed and carried out from April 2018 to July 2018. Three hundred and twenty-eight HTA agencies from seventy-five countries were invited to participate in this survey.ResultsEighty-nine participants completed the survey, representing a participation rate of twenty-seven percent. As to how HTA reports should fulfill their social role, over 84 percent of respondents agreed upon the necessity to address this role for decision makers, patients, and citizens. At a lower level, the same was found regarding the necessity to make value-judgments explicit in different report sections, including ethical analysis. This contrasts with the response-variability obtained on the status of ethical analysis with the exception of the expertise required. Variability in stakeholder-participation usefulness was also observed.ConclusionsThis study reveals the importance of a three-phase approach, including assessment, contextual data, and recommendations, and highlights the necessity to make explicit value-judgments and have a systematic ethical analysis in order to fulfill HTA's social role in guiding decision makers.
      PubDate: 2020-10-28T00:00:00.000Z
      DOI: 10.1017/S0266462320000793
      Issue No: Vol. 37 (2020)
  • The NICE MEDLINE and Embase (Ovid) health apps search filters: development
           of validated filters to retrieve evidence about health apps
    • Authors: Lynda Ayiku; Thomas Hudson, Sarah Glover, Nicola Walsh, Rachel Adams, Jemma Deane, Amy Finnegan
      Abstract: ObjectivesHealth apps are software programs that are designed to prevent, diagnose, monitor, or manage conditions. Inconsistent terminology for apps is used in research literature and bibliographic database subject headings. It can therefore be challenging to retrieve evidence about them in literature searches. Information specialists at the United Kingdom's National Institute for Health and Care Excellence (NICE) have developed novel validated search filters to retrieve evidence about apps from MEDLINE and Embase (Ovid).MethodsA selection of medical informatics journals was hand searched to identify a “gold standard” (GS) set of references about apps. The GS set was divided into a development and validation set. The filters’ search terms were derived from and tested against the development set. An external development set containing app references from published NICE products was also used to inform the development of the filters. The filters were then validated using the validation set. Target recall was >90 percent. The filters’ overall recall, specificity, and precision were calculated using all the references identified from the hand search.ResultsBoth filters achieved 98.6 percent recall against their validation sets. Overall, the MEDLINE filter had 98.8 percent recall, 71.3 percent specificity, and 22.6 percent precision. The Embase filter had 98.6 percent recall, 74.9 percent specificity, and 24.5 percent precision.ConclusionsThe NICE health apps search filters retrieve evidence about apps from MEDLINE and Embase with high recall. They can be applied to literature searches to retrieve evidence about the interventions by information professionals, researchers, and clinicians.
      PubDate: 2020-10-27T00:00:00.000Z
      DOI: 10.1017/S026646232000080X
      Issue No: Vol. 37 (2020)
  • Information specialist collaboration in Europe: collaborative methods,
           processes, and infrastructure through EUnetHTA
    • Authors: Siw Waffenschmidt; Marli van Amsterdam-Lunze, Rebeca Isabel Gomez, Maike Rehrmann, Ingrid Harboe, Elke Hausner
      Abstract: The history of European health technology assessment (HTA) goes back more than 30 years. Almost as old as HTA agencies themselves is the desire to achieve European collaboration. This gained further impetus with the establishment of the European Network of Health Technology Assessment (EUnetHTA) in 2006. In this context, the field of information management faced specific challenges. Although these services are an integral part of HTA and information specialists play a key role here, this field is often not adequately represented in the HTA agencies within EUnetHTA. Furthermore, the organization of HTA production, including the types of HTAs produced, as well as funding, varies considerably. In order to meet these different conditions, information specialists have created various products and defined processes. With the EUnetHTA guideline, a common methodological understanding for the production of rapid Relative Effectiveness Assessments now exists. Furthermore, the Standard Operating Procedures map the complex information retrieval processes within EUnetHTA in a hands-on manner. The newly established Information Specialist Network (ISN) will in future ensure that information specialists are involved in all EUnetHTA assessments and that the methods are applied consistently in all assessments. In addition, the steering committee of the ISN manages enquiries and can be contacted to discuss methodological issues. Major barriers such as heterogeneity in the daily work of the EUnetHTA members can only be overcome through more collaboration and training.
      PubDate: 2020-10-21T00:00:00.000Z
      DOI: 10.1017/S0266462320000732
      Issue No: Vol. 37 (2020)
  • Community engagement in Health Technology Assessment and beyond: from
           guests in the process to hosts
    • Authors: Catherine M. Holliday
      Abstract: In Health Technology Assessment (HTA), clinical and economic evidence are assessed in the regulatory and reimbursement environments, with community input considered as complementary to this. Stakeholders are calling for more meaningful community engagement, but this will not be reached without a significant shift. The Centre for Community-Driven Research (CCDR) is a nonprofit organization bringing much needed change to the way we think about community engagement in health. This article is based on CCDR's experience and outlines three system changes needed to advance community engagement in decisions about health and HTA. This paper comes from the perspective of engaging everyday people in the process as opposed to representation on panels and committees. The three key areas of change that are discussed include building holistic evidence, creating supportive environments, and infrastructure for community engagement, with the term community referring to people affected by disease or health conditions and their carers/families.
      PubDate: 2020-10-15T00:00:00.000Z
      DOI: 10.1017/S0266462320000744
      Issue No: Vol. 37 (2020)
  • Rapid qualitative evidence syntheses (rQES) in health technology
           assessment: experiences, challenges, and lessons
    • Authors: Umair Majid; Laura Weeks
      Abstract: Healthcare decision makers are increasingly demanding that health technology assessment (HTA) is patient focused, and considers data about patients' perspectives on and experiences with health technologies in their everyday lives. Related data are typically generated through qualitative research, and in HTA the typical approach is to synthesize primary qualitative research through the conduct of qualitative evidence synthesis (QES). Abbreviated HTA timelines often do not allow for the full 6–12 months it may take to complete a QES, which has prompted the Canadian Agency for Drugs and Technologies in Health (CADTH) to explore the concept of “rapid qualitative evidence synthesis” (rQES). In this paper, we describe our experiences conducting three rQES at CADTH, and reflect on challenges faced, successes, and lessons learned. Given limited methodological guidance to guide this work, our aim is to provide insight for researchers who may contemplate rQES. We suggest several lessons, including strategies to iteratively develop research questions and search for eligible studies, use search of filters and limits, and use of a single reviewer experienced in qualitative research throughout the review process. We acknowledge that there is room for debate, though believe rQES is a laudable goal and that it is possible to produce a quality, relevant, and useful product, even under restricted timelines. That said, it is vital to recognize what is lost in the name of rapidity. We intend our paper to advance the necessary debate about when rQES may be appropriate, and not, and enable productive discussions around methodological development.
      PubDate: 2020-10-09T00:00:00.000Z
      DOI: 10.1017/S0266462320000720
      Issue No: Vol. 37 (2020)
  • Patients, users, caregivers, and citizens' involvement in local health
           technology assessment unit in Quebec: a survey
    • Authors: Thomas G. Poder; Catherine Safianyk, Monique F. Fournier, Isabelle Ganache, Moustapha Touré, Marie-Pascale Pomey, Marie-Pierre Gagnon
      Abstract: ObjectivesIncreasing emphasis is given on involving patients in health technology assessment (HTA). While this is mainly done at the level of regional and national HTA agencies, this tendency is also emerging in local HTA units. In this study, we provide the results of a survey conducted in local HTA units in the province of Quebec, Canada. The aim of the survey was to provide an overview of local HTA unit practices to involve patients, users, caregivers, and citizens in their process, their interest in doing so, and their information needs for this.MethodsThe survey was conducted in 2017 with a response rate of eleven units over a possibility of twelve.ResultsThree units out of eleven (27.3 percent) never involved patients or members of the public in their processes and all indicated that they will involve them in the next few years. The three most important needs for support identified in the HTA units were in: recruiting and selecting patients; integrating experiential knowledge; and knowing and implementing the best methods and practices for partnership.ConclusionPatient involvement in local HTA units is quickly evolving and that is why they urgently need tools to involve more effectively patients and members of the public in their process.
      PubDate: 2020-09-29T00:00:00.000Z
      DOI: 10.1017/S0266462320000707
      Issue No: Vol. 37 (2020)
  • Evaluation of patient involvement strategies in health technology
           assessment in Spain: the viewpoint of HTA researchers
    • Authors: Ana Toledo-Chávarri; Yolanda Triñanes Pego, Eva Reviriego Rodrigo, Nora Ibargoyen Roteta, Blanca Novella-Arribas, María José Vicente Edo, Patricia Gavín Benavent, Elisa Puigdomenech, Juan Máximo Molina Linde
      Abstract: ObjectiveThe Spanish Network of Agencies for Assessing National Health System Technologies and Performance (RedETS) defined a patient involvement (PI) framework for health technology assessment (HTA) activities in 2016. The aim of this study is to evaluate the process and impact of those PI initiatives that were implemented in the first year following the publication of this new framework.MethodsA survey was sent to those HTA researchers who implemented PI in RedETS projects. Responses were reviewed by two authors. An adapted thematic analysis was performed and the results were later discussed by all authors.ResultsSix responses from six agencies/units were analyzed. The objectives of PI initiatives were the following: inclusion of patient perspectives, preferences and values; elicitation of important health outcomes measures; and barriers, facilitators, or suggestions for implementation. Different methods were used for PI: surveys, focus groups, in depth interviews, and participation in an expert panel. Five main themes emerged: (i) challenges with the recruitment process, (ii) needs identified, (iii) impact of PI, (iv) lessons learned, and (v) suggestions for the future.ConclusionsPI initiatives within the RedETS framework were tailored to each HTA project, its specific goals and the individual needs and resources of each HTA agency. The results also pointed out how PI has a relevant impact that has enriched RedETS products providing key information on experiences, values, and preferences of patients, contributions that benefit the HTA and the process of drawing up recommendations. The main challenges were related to recruitment processes and capacity building.
      PubDate: 2020-09-11T00:00:00.000Z
      DOI: 10.1017/S0266462320000586
      Issue No: Vol. 37 (2020)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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