Are we measuring what matters in health technology assessment of disease management? Systematic literature review

2006 ◽  
Vol 22 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Lotte Steuten ◽  
Bert Vrijhoef ◽  
Hans Severens ◽  
Frits van Merode ◽  
Cor Spreeuwenberg
Keyword(s):  
Disease Management ◽  
Literature Review ◽  
Health Technology Assessment ◽  
Systematic Literature Review ◽  
Technology Assessment ◽  
Health Technology ◽  
Substantial Part ◽  
Outcome Indicators ◽  
Process And Outcome ◽  
Process And Outcome Indicators

Objectives:An overview was produced of indicators currently used to assess disease management programs and, based on these findings, provide a framework regarding sets of indicators that should be used when taking the aims and types of disease management programs into account.Methods:A systematic literature review was performed.Results:Thirty-six studies met the inclusion criteria. It appeared that a link between aims of disease management and evaluated structure, process, as well as outcome indicators does not exist in a substantial part of published studies on disease management of diabetes and asthma/chronic obstructive pulmonary disease, especially when efficiency of care is concerned. Furthermore, structure indicators are largely missing from the evaluations, although these are of major importance for the interpretation of outcomes for purposes of decision-making. Efficiency of disease management is mainly evaluated by means ofprocessindicators; the use ofoutcomeindicators is less common. Within a framework, structure, process, and outcome indicators for effectiveness and efficiency are recommended for each type of disease management program.Conclusions:The link between aims of disease management and evaluated structure, process, and outcome indicators does not exist in a substantial part of published studies on disease management. The added value of this study mainly lies in the development of a framework to guide the choice of indicators for health technology assessment of disease management.

PP106 Regional Guidance On Aids For Ostomy

2017 ◽  
Vol 33 (S1) ◽  
pp. 121-121
Author(s):  
Anna Redomi ◽  
Marika Torbol ◽  
Anna Cavazzana ◽  
Rita Mottola ◽  
Margherita Andretta ◽  
...  
Keyword(s):  
Disease Management ◽  
Literature Review ◽  
Health Technology Assessment ◽  
Medical Devices ◽  
Technology Assessment ◽  
Grey Literature ◽  
Health Technology ◽  
International Studies ◽  
Regional Health ◽  
Distribution Features

INTRODUCTION:The Veneto Region established a Technical Panel for Continence (TPC) with the purpose of producing guidance for aids based on a Health Technology Assessment (HTA) approach. TPC is a multidisciplinary experts group that involves local clinicians, pharmacists, health economist and patients associations. Among its tasks, TPC can issue recommendations in the field of appropriate use, purchasing and distribution for aids. Currently the TPC is investigating aids for ostomy patients in order to provide the first regional guidance on appropriateness and disease management for ostomy.METHODS:The Regional Health Technology Assessment Unit (CRUF) conducted a literature review of the evidence on aids for ostomy. Grey literature, and National and Regional laws and regulations were also included in the analysis. TPC discussed the collected evidence by consensus. Final recommendations have been sent to the Regional Technical Committee on Medical Devices (CTRDM) for eventual remarks, before final approval.RESULTS:The literature review did not retrieve any relevant international studies on the topic, except for the Canadian clinical guidelines on ostomy. The upcoming regional guidance will suggest recommendations on: (i) appropriate patient disease management based on a multidisciplinary team evaluation; (ii) characteristics and selection criteria for ostomy aids and related accessories; (iii) prescribing medical specialists, authorization and distribution features; and (iv) specific indicators for appropriateness monitoring.CONCLUSIONS:The regional guidance on aids and accessories for ostomy aim at ensuring the appropriateness throughout the Regional Health Service. The strict monitoring of agreed indicators is essential for appropriateness compliance and consequently the sustainability of regional medical devices expenditure.

scholarly journals Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020617 ◽  
Author(s):  
Bastiaan Van Grootven ◽  
Lynn McNicoll ◽  
Daniel A Mendelson ◽  
Susan M Friedman ◽  
Katleen Fagard ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Delphi Study ◽  
Western Europe ◽  
Outcome Indicators ◽  
Process And Outcome ◽  
Stay Time ◽  
The Usa ◽  
Level Of Agreement ◽  
Process And Outcome Indicators

ObjectiveTo find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes.DesignAn international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers).SettingWestern Europe and the USA.ParticipantsThirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate).MeasuresParticipants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method.ResultsIn the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications.ConclusionThe indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes.

IMPORTANCE OF CONTEXTUAL DATA IN PRODUCING HEALTH TECHNOLOGY ASSESSMENT RECOMMENDATIONS: A CASE STUDY

2018 ◽  
Vol 34 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Thomas G. Poder ◽  
Christian A. Bellemare
Keyword(s):  
Literature Review ◽  
Health Technology Assessment ◽  
Systematic Literature Review ◽  
Technology Assessment ◽  
Health Technology ◽  
Outcome Data ◽  
Teaching Program ◽  
Level Of Evidence ◽  
Contextual Data

Objectives:Contextual data and local expertise are important sources of data that cannot be ignored in hospital-based health technology assessment (HTA) processes. Despite a lack of or unconvincing evidence in the scientific literature, technology can be recommended in a given context. We illustrate this using a case study regarding biplane angiography for vascular neurointervention.Methods:A systematic literature review was conducted, along with an analysis of the context in our setting. The outcomes of interest were radiation doses, clinical complications, procedure times, purchase cost, impact on teaching program, the confidence of clinicians in the technology, quality of care, accessibility, and the volume of activity. A committee comprising managers, clinical experts, physicians, physicists and HTA experts was created to produce a recommendation regarding biplane technology acquisition to replace a monoplane device.Results:The systematic literature review yielded nine eligible articles for analysis. Despite a very low level of evidence in the literature, the biplane system appears to reduce ionizing radiation and medical complications, as well as shorten procedure time. Contextual data indicated that the biplane system could improve operator confidence, which could translate into reduced risk, particularly for complex procedures. In addition, the biplane system can support our institution in its advanced procedures teaching program.Conclusions:Given the advantages provided by the biplane technology in our setting, the committee has recommended its acquisition. Contextual data were of utmost importance in this recommendation. Moreover, this technology should be implemented alongside a responsibility to collect outcome data to optimize clinical protocol in the doses of ionizing delivered.

Overview of information retrieval in a hospital-based health technology assessment center in a Swedish region

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ida Stadig ◽  
Therese Svanberg
Keyword(s):  
Information Retrieval ◽  
Literature Review ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Full Text ◽  
Health Technology ◽  
University Hospital ◽  
Literature Searching ◽  
Medical Library ◽  
Full Text Screening

Abstract Objectives This 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. Methods For 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. Results Region 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. Conclusion In 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.

scholarly journals A toolkit of methods of development-focused health technology assessment

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Janet Bouttell ◽  
Andrew Briggs ◽  
Neil Hawkins
Keyword(s):  
Literature Review ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Technology Development ◽  
Health Technology ◽  
Evidence Base ◽  
Analytic Modeling ◽  
Stakeholder Consultation ◽  
Performance Requirements ◽  
Multiple Markets

Abstract Health technology assessment conducted to inform decisions during technology development (development-focused or DF-HTA) has a number of distinct features compared with HTA conducted to inform reimbursement and usage decisions. In particular, there are a broad range of decisions to be informed related to the development of a technology; multiple markets and decision makers to be considered; a limited (and developing) evidence base; and constrained resources for analysis. These features impact upon methods adopted by analysts. In this paper, we (i) set out methods of DF-HTA against a timeline of technology development; (ii) provide examples of the methods’ use; and (iii) explain how they have been adapted as a result of the features of DF-HTA. We present a toolkit of methods for analysts working with developers of medical technologies. Three categories of methods are described: literature review, stakeholder consultation, and decision analytic modeling. Literature review and stakeholder consultation are often used to fill evidence gaps. Decision analytic modeling is used to synthesize available evidence alongside plausible assumptions to inform developers about price or performance requirements. Methods increase in formality and complexity as the development and evidence base progresses and more resources are available for assessment. We hope this toolkit will be used in conjunction with the framework of features of DF-HTA presented in our earlier article in order to improve the clarity and appropriateness of methods of HTA used in DF-HTA. We also seek to contribute to a continuing dialogue about the nature of, and the best approach to, DF-HTA.

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