Linking evidence from health technology assessments to policy and decision making: The Alberta Model

2007 ◽  
Vol 23 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Henry Z. Borowski ◽  
Jon Brehaut ◽  
David Hailey
Keyword(s):  
Decision Making ◽  
Health Services ◽  
Newborn Screening ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Public Funding ◽  
Health Technology ◽  
Inborn Errors ◽  
Fetal Fibronectin ◽  
Health Technologies

Objectives: The objective of this study was to develop and implement a decision-making process for public funding of health services that links policy areas with health technology assessment and input from interested parties.Methods: Health authorities, assessment organizations, and healthcare professionals were consulted as a follow-up to recommendations of an expert panel established by the Alberta government. The methods involved formulation of an eight-stage, collaborative process that incorporates identification through the health ministry of health technologies requiring review, assessment of the technologies using expert groups in Alberta, and consultation and formulation of advice within the ministry to inform ministerial funding decisions.Results: All components of the decision process have been put in place and have collaborated to provide advice to inform policy on provincial health services. Of nineteen technologies selected for review, five have been completed and decisions made: laparoscopic adjustable gastric banding, fetal fibronectin assay for premature labor, newborn screening for cystic fibrosis, newborn screening for inborn errors of metabolism, and gastric electrical stimulation. A further six reviews are in progress, and reviews of the remaining technologies are planned for 2007.Conclusions: Bridging the evidence-to-policy gap is more likely to succeed when the policy community is actively engaged and an explicit model is used to put health technology assessment into practice.

PP58 The Alliance Between Health Technology Assessment And Public Health In National Screening Policies

2019 ◽  
Vol 35 (S1) ◽  
pp. 48-48
Author(s):  
Leonor Varela-Lema ◽  
Janet Puñal-Riobóo ◽  
Paula Cantero-Muñoz ◽  
Maria José Faraldo-Vallés
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Newborn Screening ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
National Health System ◽  
Health Technology ◽  
Screening Tests ◽  
Special Focus ◽  
Screening Programs

IntroductionDecision making regarding national population-based prenatal and newborn screening policies is recognized to be highly challenging. This paper aims to describe the formalized collaboration that has been established between the Spanish National Public Health Screening Advisory Committee (PHSAC) and the Spanish Network of Health Technology Assessment (HTA) agencies to support the development of evidence- and consensus-based recommendations to support this process.MethodsIn-depth description and analysis of the strategic and methodological processes that have been implemented within the Spanish National Health System prenatal and newborn screening frameworks, with special emphasis on the role, actions, and responsibilities of HTA agencies.ResultsThe role of HTA agencies is threefold: (i) support the PHSAC by providing evidence on safety, effectiveness and cost/effectiveness of the screening tests/strategies, as well as contextualized information regarding costs, organizational, social, legal and ethical issues; (ii) collaborate with the PHSAC in the development of formal evidence- and consensus-based recommendations for defining population screening programs, when required; (iii) analyze real-world data that is generated by piloted programs. This paper will provide real-life examples of how these processes were implemented in practice, with a special focus on the development of the non-invasive prenatal testing (NIPT) policy. Recommendations for NIPT were developed by a multidisciplinary group based on the European network for Health Technology Assessment (EUnetHTA) rapid assessment report and the predictive models that were built using national statistics and other contextualized data.ConclusionsThe current work represents an innovative approach for prenatal and newborn screening policymaking, which are commonly difficult to evaluate due to the low quality of evidence and the confounding public health issues. The paper raises awareness regarding the importance of joint collaborations in areas where evidence is commonly insufficient for decision making.

scholarly journals The concept of multi-criteria analysis of decision-making in the current system of health technology assessment in Russia

2018 ◽  
Vol 11 (3) ◽  
pp. 3-7 ◽  
Author(s):  
V. V. Omelyanovsky ◽  
V. K. Fedyaeva ◽  
N. Z. Musina
Keyword(s):  
Decision Making ◽  
Decision Analysis ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Government Regulation ◽  
Current System ◽  
Health Technology ◽  
Assessment Methodology ◽  
Current Version ◽  
Health Technologies

In the article, we analyze the current version of Government Regulation No. 871 where the principles of health technologies assessment (HTA) and the reimbursement strategies in Russia have been put forward. We conclude that the HTA methodology in Russia is consistent with the multi-criteria decision analysis. Recommendations on the improvement of the assessment methodology in Regulation No. 871 are provided.

THE ROLE OF PATIENT DECISION-MAKING IN EVALUATING HEALTH TECHNOLOGY ASSESMENT (LITERATURE REVIEW)

Vestnik ◽  
2021 ◽  
pp. 315-323
Author(s):  
Л.К. Кошербаева ◽  
З.Р. Сагындыкова ◽  
Т.Б. Егеубаев
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Expert Knowledge ◽  
Health Technology ◽  
Social Consequences ◽  
Patient Decision Making ◽  
Health Technologies ◽  
Patient Decision ◽  
Giving Feedback

В условиях ограниченных бюджетов для современного здравоохранения рациональное потребление ресурсов является очень актуальной проблемой. Оценка технологий здравоохранения (ДСТБ) - комплексная оценка относительно доказанной клинической и клинико-экономической (фармаколого-экономической) эффективности и безопасности технологий здравоохранения, а также экономических, социальных и этических последствий их применения. Цель оценки технологий здравоохранения-одобрение заявленных технологий здравоохранения и включение заявленных технологий здравоохранения в перечень компенсации и информирование политиков в области здравоохранения. Следует ли применять здоровье сберегающую технологию, как ее применять и какую пользу от нее получают пациенты. Обучение экспертным знаниям о выживаемости, диагностике и лечении болезней и болезней, в том числе о методе оказания помощи (для анализа затрат и выгод), бремени болезней, выявлении пробелов в уходе, выявлении и удовлетворении потребностей. Предоставление отзывов о лечении (или отсутствии лечения и поддержки) социальных последствий заболевания способствует подходу пациентов, процессу принятия решений по мере необходимости. In the context of limited budgets for modern healthcare, rational resource consumption is a very urgent problem. Health Technology Assessment (OST) - a comprehensive assessment of the relatively proven clinical and clinical- economic (pharmacological-economic) effectiveness and safety of health technologies, as well as the economic, social and ethical consequences of their use. The purpose of the health technology assessment is to approve the claimed health technologies and include the claimed health technologies in the compensation list and inform health policy makers. It shows whether healthcare technology should be used or not, how it should be used, and how patients can benefit from it. Providing expert knowledge on the pain and burden of living, diagnosis and treatment, including the method of providing assistance (to analyze costs and benefits), the burden of diseases, identifying gaps in care, identifying and meeting needs. Giving feedback on the treatment (or lack of treatment and support) of the social consequences of the disease contributes to the decision-making process depending on the patient's attitude, needs.

scholarly journals DEVELOPMENT OF THE ONTARIO DECISION FRAMEWORK: A VALUES BASED FRAMEWORK FOR HEALTH TECHNOLOGY ASSESSMENT

2018 ◽  
Vol 34 (3) ◽  
pp. 290-299 ◽  
Author(s):  
Murray Krahn ◽  
Fiona Miller ◽  
Ahmed Bayoumi ◽  
Ann-Sylvia Brooker ◽  
Frank Wagner ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Conflicts Of Interest ◽  
A Priori ◽  
Health Technology ◽  
Optimal Decision ◽  
Decision Framework ◽  
Health Technologies ◽  
Decision Attributes

Objectives:In 2007, the Ontario Health Technology Advisory Committee (OHTAC) developed a decision framework to guide decision making around nondrug health technologies. In 2012, OHTAC commissioned a revision of this framework to enhance its usability and deepen its conceptual and theoretical foundations.Methods:The committee overseeing this work used several methods: (a) a priori consensus on guiding principles, (b) a scoping review of decision attributes and processes used globally in health technology assessment (HTA), (c) presentations by methods experts and members of review committees, and (d) committee deliberations over a period of 3 years.Results:The committee adopted a multi-criteria decision-making approach, but rejected the formal use of multi-criteria decision analysis. Three broad categories of attributes were identified: (I) context criteria attributes included factors such as stakeholders, adoption pressures from neighboring jurisdictions, and potential conflicts of interest; (II) primary appraisal criteria attributes included (i) benefits and harms, (ii) economics, and (iii) patient-centered care; (III) feasibility criteria attributes included budget impact and organizational feasibility.Conclusion:The revised Ontario Decision Framework is similar in some respects to frameworks used in HTA worldwide. Its distinctive characteristics are that: it is based on an explicit set of social values; HTA paradigms (evidence based medicine, economics, and bioethics/social science) are used to aggregate decision attributes; and that it is rooted in a theoretical framework of optimal decision making, rather than one related to broad social goals, such as health or welfare maximization.

scholarly journals Resource allocation and health technology assessment in Australia: Views from the local level

2009 ◽  
Vol 25 (02) ◽  
pp. 134-140 ◽  
Author(s):  
Gisselle Gallego ◽  
Kees van Gool ◽  
Dianne Kelleher
Keyword(s):  
Decision Making ◽  
Health Service ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Online Survey ◽  
Local Level ◽  
Healthcare Providers ◽  
Health Technology ◽  
Health Technologies ◽  
Decision Making Processes

Objectives:Several studies have shown that a key determinant of successful health technology assessment (HTA) uptake is a clear, fair, and consistent decision-making process for the approval and introduction of health technologies. The aim of this study was to gauge healthcare providers' and managers' perceptions of local level decision making and determine whether these processes offer a conducive environment for HTA. An Area Health Service (AHS) aimed to use the results of this study to help design a new process of technology assessment and decision making.Methods:An online survey was sent to all health service managers and healthcare providers working in one AHS in Sydney, Australia. Questions related to perceptions of current health technology decisions in participants' own institution/facility and opinions on key criteria for successful decision-making processes.Results:Less than a third of participants agreed with the statements that local decision-making processes were appropriate, easy to understand, evidence-based, fair, or consistently applied. Decisions were reportedly largely influenced by total cost considerations as well as by the central state health departments and the Area executive.Conclusions:Although there are renewed initiatives in HTA in Australia, there is a risk that such investments will not be productive unless policy makers also examine the decision-making contexts within which HTA can successfully be implemented. The results of this survey show that this is especially true at the local level and that any HTA initiative should be accompanied by efforts to improve decision-making processes.

scholarly journals Health technology assessment in Finland

2009 ◽  
Vol 25 (S1) ◽  
pp. 102-107 ◽  
Author(s):  
Marjukka Mäkelä ◽  
Risto P. Roine
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Evidence Based ◽  
Policy Makers ◽  
Health Technologies ◽  
Based Medicine ◽  
Special Responsibility ◽  
Made In

Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency, with special responsibility in providing assessments to underpin national policies in screening. External evaluations enhanced the rapid growth. In the Finnish environment, decision making on health technologies is extremely decentralized, so Finohta has developed some practical tools for implementing HTA findings. The Managed Uptake of Medical Methods program links the hospital districts to agree on introduction of technologies. The Ohtanen database provides Finnish-language summaries of major assessments made in other countries.

HEALTH TECHNOLOGY ASSESSMENT IN IRELAND

2000 ◽  
Vol 16 (2) ◽  
pp. 449-458 ◽  
Author(s):  
Frank Ahern ◽  
Nessa O'Doherty
Keyword(s):  
Health Services ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
New Technologies ◽  
New Technology ◽  
Health Technology ◽  
Maximum Efficiency ◽  
Hospital System ◽  
Health Technologies ◽  
New Public Health

Ireland's health system is primarily funded from general taxation and is publicly provided, although private health care retains a considerable role. It is a unique structure, a mixture of universal health service free at the point of consumption and a fee-based private system where individuals subscribe to private health insurance that covers some of their medical expenses. The recent history of the Irish health services saw consolidation of existing services and an expansion into new areas to adapt to changing practices and needs. There has also been a drive to extract maximum efficiency so as to maintain the volume and quality of patient services at a time of very tight financial constraints. Introduction of new health technologies continued to accelerate. New technologies tended to spread rapidly before systematic appraisal of their costs and benefits. When the state is involved in funding the public hospital system, acceptance of new technology is a matter for discussion between agencies and the Department of Health and Children. Decisions about spending annual “development funding” have generally not been based on careful assessment of proposals for new technology. In 1995, a healthcare reform put new Public Health Departments in Health Boards in a prime position in Ireland's health services organization. These departments now emphasize evidence-based medicine. While Ireland does not have a national health technology assessment (HTA) program, there are plans to form an advisory group on HTA in 1998. HTA is seen as a significant element of future health policy in Ireland.

Application of a health technology assessment framework to digital health technologies that manage chronic disease: a systematic review

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Amy von Huben ◽  
Martin Howell ◽  
Joseph Carrello ◽  
Sarah Norris ◽  
Sally Wortley ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Health Services ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Digital Health ◽  
Investment Decisions ◽  
Health Technology ◽  
Cochrane Library ◽  
Primary Research ◽  
Health Technologies

Abstract Background As health services increasingly make investment decisions in digital health technologies (DHTs), a DHT-specific and comprehensive health technology assessment (HTA) process is crucial in assessing value-for-money. Research in DHTs is ever-increasing, but whether it covers the content required for HTA is unknown. Objectives To summarize current trends in primary research on DHTs that manage chronic disease at home, particularly the coverage of content recommended for DHT-specific and comprehensive HTA. Methods Medline, Embase, Econlit, CINAHL, and The Cochrane Library (1 January 2015 to 20 March 2020) were searched for primary research studies using keywords related to DHT and HTA domains. Studies were assessed for coverage of the most frequently recommended content to be considered in a nine domain DHT-specific HTA previously developed. Results A total of 178 DHT interventions were identified, predominantly randomized controlled trials targeting cardiovascular disease/diabetes in high- to middle-income countries. A coverage assessment of the cardiovascular and diabetes DHT studies (112) revealed less than half covered DHT-specific content in all but the health problem domain. Content common to all technologies but essential for DHTs was covered by more than half the studies in all domains except for the effectiveness and ethical analysis domains. Conclusions Although DHT research is increasing, it is not covering all the content recommended for a DHT-specific and comprehensive HTA. The inability to conduct such an HTA may lead to health services making suboptimal investment decisions. Measures to increase the quality of trial design and reporting are required in DHT primary research.

scholarly journals 3.L. Workshop: It’s time for timeliness in Health Technology Assessment

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Critical Issue ◽  
Decision Making Process ◽  
Long Term Effects ◽  
Health Technologies ◽  
Increasing Demand ◽  
Set Up

Abstract The timeliness of the release of results is one of the most critical issue regarding Health Technology Assessment (HTA) and its potential to support decision-making. This matter may reflect the deep conflict between HTA doers and users. HTA is a form of evidence-based research, expected to timely inform decision-making at several levels - from health policy (macro) to hospital and clinical management (meso and micro) - ensuring accuracy and assessment of both short- and long-term effects of a health technology. HTA purpose therefore is to respond to real world needs, while not overlook a correct methodology. Fast developing health technologies have rapidly spread over the past decades, hence increasing demand for timely assessment aimed at their prompt implementation and management, especially at meso and micro decisional levels. Furthermore, the need for quick answers is emphasized by the pressures placed on policy-makers when a health technology is publicly promoted or contested. Furthermore, an ill-timed assessment can lead to several consequences, among which possible inequalities in access to healthcare. In order to address the challenge of timeliness, organizations involved in HTA should set up models and tools to deliver timely information. The aim of this workshop is to point out the timeliness of HTA as crucial in the decision-making process as a mismanagement of HTA system could be an obstacle to an appropriate healthcare policy. Else more, the workshop would like to critically present examples where research was on time or too late to be included in the decision-making process and elaborate on possible models to successfully deal with timeliness of HTA deliverables in particular at hospital level. Key messages The timeframe of HTA should ensure the accuracy of information and of methodological and legal steps, without forgetting the timeliness of delivery. Models and instruments should be implemented in order to guarantee the timeliness of HTA reports.

EUR-ASSESS Project Subgroup Report on Methodology:Methodological Guidance for the Conduct of Health Technology Assessment

1997 ◽  
Vol 13 (2) ◽  
pp. 186-219 ◽  
Author(s):  
Alessandro Liberati ◽  
Trevor A. Sheldon ◽  
H. David Banta
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Policy ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Policy Decisions ◽  
Health Technologies ◽  
Benefits And Costs

Health technology assessment (HTA) is primarily concerned with the consequences (benefits and costs) of health care and health policy decisions. Because decision making is complex and outcomes are often uncertain, it is helpful to attempt to assess the consequences. The quality of decisions can be improved by a process that provides a consistent framework for identifying and assessing health technologies.

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