DECISION-COMPONENTS OF NICE'S TECHNOLOGY APPRAISALS ASSESSMENT FRAMEWORK

Objectives: Value assessment frameworks have gained prominence recently in the context of U.S. healthcare. Such frameworks set out a series of factors that are considered in funding decisions. The UK's National Institute of Health and Care Excellence (NICE) is an established health technology assessment (HTA) agency. We present a novel application of text analysis that characterizes NICE's Technology Appraisals in the context of the newer assessment frameworks and present the results in a visual way.Methods: A total of 243 documents of NICE's medicines guidance from 2007 to 2016 were analyzed. Text analysis was used to identify a hierarchical set of decision factors considered in the assessments. The frequency of decision factors stated in the documents was determined and their association with terms related to uncertainty. The results were incorporated into visual representations of hierarchical factors.Results: We identified 125 decision factors, and hierarchically grouped these into eight domains: Clinical Effectiveness, Cost Effectiveness, Condition, Current Practice, Clinical Need, New Treatment, Studies, and Other Factors. Textual analysis showed all domains appeared consistently in the guidance documents. Many factors were commonly associated with terms relating to uncertainty. A series of visual representations was created.Conclusions: This study reveals the complexity and consistency of NICE's decision-making processes and demonstrates that cost effectiveness is not the only decision-criteria. The study highlights the importance of processes and methodology that can take both quantitative and qualitative information into account. Visualizations can help effectively communicate this complex information during the decision-making process and subsequently to stakeholders.

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ISPOR’s Initiative on US Value Assessment Frameworks: The Use of Cost-Effectiveness Research in Decision Making among US Insurers

Value in Health ◽

10.1016/j.jval.2017.12.004 ◽

2018 ◽

Vol 21 (2) ◽

pp. 166-168 ◽

Cited By ~ 6

Author(s):

Brian Solow ◽

Edmund J. Pezalla

Keyword(s):

Decision Making ◽

Cost Effectiveness ◽

Effectiveness Research ◽

Value Assessment

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Introduction of emerging medical devices on the market: A new procedure in Belgium

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462307070687 ◽

2007 ◽

Vol 23 (4) ◽

pp. 449-454 ◽

Cited By ~ 7

Author(s):

Imgard Vinck ◽

Mattias Neyt ◽

Nancy Thiry ◽

Marleen Louagie ◽

Dirk Ramaekers

Keyword(s):

Health Care ◽

Decision Making ◽

Health Insurance ◽

Cost Effectiveness ◽

Medical Devices ◽

Clinical Effectiveness ◽

Added Value ◽

Scientific Evaluation ◽

Medical Technologies ◽

Organizational Issues

When new medical technologies enter the market, there is often uncertainty about the added value for the patient and for society, hampering well-considered decision making about reimbursement. Current Belgian legislation already offered opportunities for the managed uptake of possibly innovative emerging implants. However, it has also some shortcomings such as the lack of a clear research design, rendering the scientific evaluation of clinical effectiveness, cost-effectiveness, and patient or organizational issues more difficult. Against this background, a new procedure was elaborated by the Belgian health insurance institute and the Belgian Health Care Knowledge Centre.

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Clinical Effectiveness and Cost-Effectiveness of HIV Pre-Exposure Prophylaxis in Men Who Have Sex with Men: Risk Calculators for Real-World Decision-Making

PLoS ONE ◽

10.1371/journal.pone.0108742 ◽

2014 ◽

Vol 9 (10) ◽

pp. e108742 ◽

Cited By ~ 31

Author(s):

Anders Chen ◽

David W. Dowdy

Keyword(s):

Decision Making ◽

Cost Effectiveness ◽

Real World ◽

Clinical Effectiveness ◽

Sex With Men ◽

Exposure Prophylaxis

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PARTICIPATION OF INDIVIDUALS IN PUBLIC DECISIONS IN THE POLISH LEGAL SYSTEM-THE OUTLINE

Proceedings of CBU in Social Sciences ◽

10.12955/pss.v1.40 ◽

2020 ◽

Vol 1 ◽

pp. 21-27

Author(s):

Agata Barczewska-Dziobek

Keyword(s):

Decision Making ◽

Rule Of Law ◽

Legal System ◽

Text Analysis ◽

Good Governance ◽

The Body ◽

The Rule Of Law ◽

Decision Making Processes ◽

Polish Law ◽

The Relationship

The idea of good governance is associated with the postulate of participatory and interactive democracy. This results in the appearance in the legal system of solutions reflecting the recommendations of the so-called "good administration." Good administration is the subjective right which, in the relationship between the body and the citizen, defines the individual's rights and the duties of the administration to act in a particular way. It may be interpreted differently, but it must comply with universal standards. They have been defined in international, European and soft law. These include the rule of law, equality, administrative transparency, confidence and trust, as well as the opportunity to participate in decisions. The last of these relates to procedures for involving citizens in administrative decision-making. The purpose of the article is to present normative solutions in Polish law that guarantee citizens participation in decision-making processes at various levels of administration and their systematics. To achieve this goal, the method of legal text analysis was used, which allows us to indicate the existence of many different mechanisms of participation. Their presence in Polish law determines the varying levels of civic influence on public decisions.

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PRE-ASSESSMENT TO ASSESS THE MATCH BETWEEN COST-EFFECTIVENESS RESULTS AND DECISION MAKERS' INFORMATION NEEDS

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462303000035 ◽

2003 ◽

Vol 19 (1) ◽

pp. 17-27 ◽

Cited By ~ 11

Author(s):

Maarten J. IJzerman ◽

Robert P. B. Reuzel ◽

Hans L. Severens

Keyword(s):

Decision Making ◽

Cost Effectiveness ◽

Information Needs ◽

Clinical Effectiveness ◽

Rehabilitation Medicine ◽

Decision Makers ◽

Insurance Companies ◽

Healthcare Decision ◽

Structured Interviews ◽

Effectiveness Studies

Objective: To determine if a pre-assessment can be used to establish whether cost-effectiveness results would meet the actual information needs of Dutch healthcare decision makers.Methods: Two recent studies in rehabilitation medicine served as study material. Based on Wholey, a limited pre-assessment was performed in which the potential impact of cost-effectiveness analysis (CEA) results on intended users' decision making was assessed. Desk research and semi-structured interviews with several intended users of CEA results were performed. These included general practitioners, representatives of health insurance companies, the Health Care Insurance Board (CvZ), and medical guidelines committees.Results: In day-to-day decision making of the interviewed decision makers, a cost-effectiveness criterion seemed to be of limited importance. Instead, results from clinical effectiveness studies and budget impact studies appeared to be sufficient. CvZ, however, preferred relative cost-effectiveness to be a criterion for inclusion in future reimbursement guidelines. In both cases the limited pre-assessments changed the expectations of the investigators regarding decision-making impact of an economic evaluation.Conclusion: This study revealed that the use of CEA results for Dutch micro- and meso-level healthcare decision making is not self-evident. The main purpose of CEA results is to support health policy making and planning at a macroeconomic level. Pre-assessment can be a valuable tool in designing a CEA to support the actual information needs of the decision makers.

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Cognitive Processing of Miscommunication in Interactive Listening: An Evaluation of Listener Indecision and Cognitive Effort

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-20-00128 ◽

2021 ◽

pp. 1-17

Author(s):

Jennifer M. Roche ◽

Arkady Zgonnikov ◽

Laura M. Morett

Keyword(s):

Decision Making ◽

Cognitive Processing ◽

Language Processing ◽

Cognitive Effort ◽

Mouse Tracking ◽

Computer Mouse ◽

Decision Making Processes ◽

Computer Mouse Tracking ◽

Listening Task ◽

Processing Effort

Purpose The purpose of the current study was to evaluate the social and cognitive underpinnings of miscommunication during an interactive listening task. Method An eye and computer mouse–tracking visual-world paradigm was used to investigate how a listener's cognitive effort (local and global) and decision-making processes were affected by a speaker's use of ambiguity that led to a miscommunication. Results Experiments 1 and 2 found that an environmental cue that made a miscommunication more or less salient impacted listener language processing effort (eye-tracking). Experiment 2 also indicated that listeners may develop different processing heuristics dependent upon the speaker's use of ambiguity that led to a miscommunication, exerting a significant impact on cognition and decision making. We also found that perspective-taking effort and decision-making complexity metrics (computer mouse tracking) predict language processing effort, indicating that instances of miscommunication produced cognitive consequences of indecision, thinking, and cognitive pull. Conclusion Together, these results indicate that listeners behave both reciprocally and adaptively when miscommunications occur, but the way they respond is largely dependent upon the type of ambiguity and how often it is produced by the speaker.

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“It's Not Humanly Possible to Do Everything”: Perspectives on Intervention Decision-Making Processes of Parents of Children with Autism Spectrum Disorders

Perspectives on Language Learning and Education ◽

10.1044/lle22.1.13 ◽

2015 ◽

Vol 22 (1) ◽

pp. 13-21 ◽

Cited By ~ 5

Author(s):

Erinn Finke ◽

Kathryn Drager ◽

Elizabeth C. Serpentine

Keyword(s):

Decision Making ◽

Individualized Education Program ◽

Children With Autism ◽

Autism Spectrum ◽

Sources Of Information ◽

Individual Decision ◽

Decision Making Processes ◽

Spectrum Disorders ◽

Interview Methodology ◽

Communication Interventions

Purpose The purpose of this investigation was to understand the decision-making processes used by parents of children with autism spectrum disorder (ASD) related to communication-based interventions. Method Qualitative interview methodology was used. Data were gathered through interviews. Each parent had a child with ASD who was at least four-years-old; lived with their child with ASD; had a child with ASD without functional speech for communication; and used at least two different communication interventions. Results Parents considered several sources of information for learning about interventions and provided various reasons to initiate and discontinue a communication intervention. Parents also discussed challenges introduced once opinions of the school individualized education program (IEP) team had to be considered. Conclusions Parents of children with ASD primarily use individual decision-making processes to select interventions. This discrepancy speaks to the need for parents and professionals to share a common “language” about interventions and the decision-making process.

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