OP160 Enhancing Innovation Through HTA: Experience From South Australia

2018 ◽  
Vol 34 (S1) ◽  
pp. 58-58
Author(s):  
Naomi Burgess ◽  
Deborah Chen
Keyword(s):  
Decision Making ◽  
High Risk ◽  
Clinical Outcomes ◽  
State Government ◽  
New Technologies ◽  
Specific Treatment ◽  
South Australia ◽  
Health Technologies ◽  
Hospital Networks ◽  
Decision Making Criteria

Introduction:A statewide health technology assessment (HTA) program was implemented to increase equity of access and support robust assessment of technologies, with a focus on those that are high-cost, high-risk, or have state-wide impact.Methods:Local hospital networks and clinicians refer technologies to the South Australia Policy Advisory Committee on Technology (SAPACT) for assessment. Independently produced, comprehensive HTA reports are developed using internationally recognized evidence and critical appraisal methodologies. Clinical and economic systematic analyses are utilized, with extensive clinical consultation, to develop recommendations for new technologies and their role in models of care. Feasibility of adoption and local implementation are considered, including existing service delivery and appropriate training and credentialing. For approved technologies, SAPACT may also develop audit criteria and seek implementation reports on clinical outcomes.Results:The HTA framework has been successfully adopted across South Australia Health, increasing the incorporation of evidence-based decision making in the use of high-cost and high-risk health technologies. Over 35 evidence evaluations for high-risk and high-cost health technologies have been conducted for a broad range of treatment interventions. SAPACT develops and utilizes HTA decision-making criteria for transparency of Committee considerations. The program recommends adoption or rejection of technologies, or it may request a re-submission due to safety concerns or a lack of proven effectiveness. SAPACT has also granted temporary approval through adoption under clinical evaluation to inform investment decisions. A key component is working with clinicians to define specific treatment criteria and patient selection. SAPACT continues to strengthen relationships with all stakeholders, increase patient input through the development of public summary documents for technologies, and improve monitoring and reporting of clinical outcomes.Conclusions:The HTA program has been very productive and positively received. The success of the program is underpinned by its engagement with clinicians, hospital networks, and consumers. The completion of SAPACT HTA reviews and the publication of the SAPACT decision-making criteria have increased the credibility of decisions, supporting enhancements in patient care and cost efficiency for the state government.

PP99 Hospital-Based Health Technology Assessment Units In Brazil: Present And Future

2019 ◽  
Vol 35 (S1) ◽  
pp. 56-57
Author(s):  
Mírian Cohen ◽  
Ana Flávia Lima ◽  
Sandro Miguel ◽  
Marina Aziz ◽  
Ricardo Bertoglio Cardoso ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
New Technologies ◽  
Guideline Development ◽  
Health Technology ◽  
Teaching Hospitals ◽  
Decision Making Process ◽  
Online Questionnaire ◽  
Health Technologies

IntroductionSince 2007, 23 Núcleos de Avaliação de Tecnologias em Saúde or hospital-based health technology assessment (HB-HTA) units have been established in teaching hospitals across Brazil. These units aim to promote the development of health technology assessment in hospitals, assisting the decision-making process for implementing new technologies and evaluating and promoting the rational use of widespread technologies.MethodsAn online questionnaire was sent by e-mail to all HB-HTA units registered in the Brazilian Network for Evaluation of Health Technologies. Information was acquired to comprehensively assess the activity of the units.ResultsAll 23 HB-HTA units answered the questionnaire. Of these, 65 percent had a technology prioritization process. The technologies assessed included drug therapies (73%), equipment (64%), medical devices (64%), clinical protocols (46%), and emerging technologies (27%). The dimensions of health technology assessment (HTA) evaluated by these organizations were: efficacy (76%); effectiveness (67%); safety (67%); costs (52%); cost effectiveness or cost utility (52%); and budget impact (43%). The hospital departments that required more HTA studies were: cardiology (50%); infectious diseases (45%); hospital management (45%); oncology (40%); surgery (40%); and endocrinology (20%). HTA studies supported: incorporation of new technologies (81%); protocol or guideline development (57%); new indications for already approved technologies (38%); and withdrawal of obsolete technologies (29%). Half of the institutions also conducted educational or training activities. The main difficulties reported were a lack of trained professionals (78%), funding (70%), and material resources (48%).ConclusionsFor low- and middle-income countries, the process of implementing HB-HTA units remains a challenge. Even though human resources and funding are scarce, HB-HTA units continue to develop. Given their importance in the decision-making process, it is imperative that every effort is made to ensure their activities continue.

scholarly journals Decision makers' perceptions of health technology decision making and priority setting at the institutional level

2008 ◽  
Vol 32 (3) ◽  
pp. 520 ◽  
Author(s):  
Gisselle Gallego ◽  
Sandra Fowler ◽  
Kees van Gool
Keyword(s):  
Decision Making ◽  
Health Service ◽  
Ad Hoc ◽  
Nurse Managers ◽  
New Technologies ◽  
Decision Makers ◽  
Structured Interviews ◽  
Institutional Level ◽  
Health Technologies ◽  
Decision Making Processes

This study describes health care decision makers? perceptions about decision making processes for the introduction, diffusion and prioritisation of new health technologies at the regional and institutional level. The aim of the study was to aid the design of a new process of technology assessment and decision making for the Northern Sydney and Central Coast Area Health Service (NSCCAHS). Twelve in-depth, semi-structured interviews were conducted with senior health service managers, nurse managers and senior medical clinicians in the NSCCAHS. Interviewees described prioritisation and decision-making processes as ?ad hoc?. Safety and effectiveness were considered the most important criteria in decision making but budgetary consideration often drove decisions about the uptake and diffusion of new technologies. Current dissatisfaction with decision- making processes creates opportunities for reform, including the introduction of consistent local technology assessments.

scholarly journals Making Patient-Specific Treatment Decisions Using Prognostic Variables and Utilities of Clinical Outcomes

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2741
Author(s):  
Pavlos Msaouel ◽  
Juhee Lee ◽  
Peter F. Thall
Keyword(s):  
Decision Making ◽  
Clinical Outcomes ◽  
Specific Treatment ◽  
Patient Specific ◽  
Prognostic Information ◽  
Cell Renal Cell Carcinoma ◽  
Trade Offs ◽  
Patient Heterogeneity ◽  
Informed Patient

We argue that well-informed patient-specific decision-making may be carried out as three consecutive tasks: (1) estimating key parameters of a statistical model, (2) using prognostic information to convert these parameters into clinically interpretable values, and (3) specifying joint utility functions to quantify risk–benefit trade-offs between clinical outcomes. Using the management of metastatic clear cell renal cell carcinoma as our motivating example, we explain the role of prognostic covariates that characterize between-patient heterogeneity in clinical outcomes. We show that explicitly specifying the joint utility of clinical outcomes provides a coherent basis for patient-specific decision-making.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

DEVELOPMENT OF VALUATION METHOD OF THE STATUS OF BASE STATIONS FOR DETERMINING THE NEED OF THEIR UPGRADING

2017 ◽  
pp. 60-70
Author(s):  
Natalya Ivanovna Shaposhnikova ◽  
Alexander Aleksandrovich Sorokin
Keyword(s):  
Decision Making ◽  
Fuzzy Sets ◽  
Cellular Network ◽  
New Technologies ◽  
Base Station ◽  
Base Stations ◽  
Valuation Method ◽  
The Status ◽  
Telecommunications Services ◽  
Theory Of Fuzzy Sets

The article consideres the problems of determining the need to modernize the base stations of the cellular network based on the mathematical apparatus of the theory of fuzzy sets. To improve the quality of telecommunications services the operators should send significant funding for upgrading the equipment of base stations. Modernization can improve and extend the functions of base stations to provide cellular communication, increase the reliability of the base station in operation and the functionality of its individual elements, and reduce the cost of maintenance and repair when working on a cellular network. The complexity in collecting information about the equipment condition is determined by a large number of factors that affect its operation, as well as the imperfection of obtaining and processing the information received. For a comprehensive assessment of the need for modernization, it is necessary to take into account a number of indicators. In the structure of indicators of the need for modernization, there were introduced the parameters reflecting both the degree of aging and obsolescence(the technical gap and the backlog in connection with the emergence of new technologies and standards). In the process of a problem solving, the basic stages of decision-making on modernization have been allocated. Decision-making on the need for modernization is based not only on measuring information that takes into account the decision-makers, but also on linguistic and verbal information. Therefore, to determine the need for upgrading the base stations, the theory of fuzzy sets is used, with the help of which experts can be attracted to this issue. They will be able to formulate additional fuzzy judgments that help to take into account not only measuring characteristics, but also poorly formalized fuzzy information. To do this, the main indicators of the modernization need have been defined, and fuzzy estimates of the need for modernization for all indicators and a set of indicators reflecting the need for upgrading the base stations have been formulated.

Factors Affecting Customer Switching Behavior towards Hybrid Electrical Vehicles (HEV’s) from a Customer Perspective in Jordan

2018 ◽  
Vol 1 (3) ◽  
pp. 53
Author(s):  
Bushra Mahadin
Keyword(s):  
Decision Making ◽  
Consumer Behaviour ◽  
New Technologies ◽  
International Marketing ◽  
Current Trend ◽  
Switching Behavior ◽  
Future Research ◽  
Decision Making Process ◽  
Customer Switching ◽  
Electrical Vehicles

Purpose-This paper aims to investigate factors that affect customer switching from Internal Combustion Engine Vehicles (ICEV’s) to Hybrid Electrical Vehicles (HEV’s), in Jordan for the period of (2010-2014).Design/methodology/approach-A self-administered survey was hand-delivered to the targeted sample of car users in Jordan. The authors delivered 400 questionnaires to customers, from which 333 were deemed valid for the analysis, corresponding to the percentage of (83.25%) which indicates the validity of the study. Findings- There was no difference in switching behavior between (ICEV’s) and (HEV’s) based on gender in the Jordanian market. Fuel consumption efficiency was the number one variable that supports the switching behavior towards (HEV's), followed by Eco friendliness, lower taxes and technological features. Price and the current trend in the market were the least supporting factors. In addition to that the perception of the battery life of (HEV's), limited choices in the market, lack of information and fear of the relatively new technology were the major hindering factors of choosing an (HEV).Research limitations-Future research needs to investigate other factors that may affect customers’ behavior such as perceived image, trust, and subjective norms. Future research should investigate into the importance of environmental awareness and new technologies, and gender differences in behavior. From an international marketing standpoint, comparative studies between Jordanian and non-Jordanian customers are potential areas of future research for international marketing strategies and cross-cultural consumer behaviour analysis. Practical implications-The paper identifies the determinants of switching behavior. marketers should focus addressing customers concerns in terms of providing enough information and building awareness towards the technology and it's benefits towards the society and the environment.Originality/value-Our study is one of the few in Jordan that investigates the switching behavior towards vehicles technology. Our study is thought to have made a modest contribution to consumer behaviour literature and, specifically, for decision making process. It offers marketers insights into the determinants of switching behavior towards the hybrid vechicle technology and how this contribute to consumers’ decision making process and attitudes to achieve the intended behavioural outcomes

Research and analysis of business management processes implemented under conditions of incomplete certainty

2020 ◽  
Author(s):  
Igor Klimenko ◽  
A. Ivlev
Keyword(s):  
Decision Making ◽  
A Priori ◽  
Business Management ◽  
Statistical Uncertainty ◽  
Management Processes ◽  
Classical Decision ◽  
Decision Making Criteria

The study carried out in this work made it possible to expand the rank scale for a priori assessment of the chosen strategy in terms of increasing the sensitivity of assessing the caution / negligence ratio using risky, as well as classical decision-making criteria under conditions of statistical uncertainty.

scholarly journals A day in the life: a qualitative study of clinical decision-making and uptake of neurorehabilitation technology

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Courtney Celian ◽  
Veronica Swanson ◽  
Maahi Shah ◽  
Caitlin Newman ◽  
Bridget Fowler-King ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
New Technologies ◽  
Clinical Decision ◽  
Relative Advantage ◽  
Personal Attributes ◽  
Design Work ◽  
Cognitive Limitations ◽  
Knowledge And Beliefs ◽  
Cord Injury

Abstract Background Neurorehabilitation engineering faces numerous challenges to translating new technologies, but it is unclear which of these challenges are most limiting. Our aim is to improve understanding of rehabilitation therapists’ real-time decision-making processes on the use of rehabilitation technology (RT) in clinical treatment. Methods We used a phenomenological qualitative approach, in which three OTs and two PTs employed at a major, technology-encouraging rehabilitation hospital wrote vignettes from a written prompt describing their RT use decisions during treatment sessions with nine patients (4 with stroke, 2 traumatic brain injury, 1 spinal cord injury, 1 with multiple sclerosis). We then coded the vignettes using deductive qualitative analysis from 17 constructs derived from the RT literature and the Consolidated Framework for Implementation Research (CFIR). Data were synthesized using summative content analysis. Results Of the constructs recorded, the five most prominent are from CFIR determinants of: (i) relative advantage, (ii) personal attributes of the patients, (iii) clinician knowledge and beliefs of the device/intervention, (iv) complexity of the devices including time and setup, and (v) organizational readiness to implement. Therapists characterized candidate RT as having a relative disadvantage compared to conventional treatment due to lack of relevance to functional training. RT design also often failed to consider the multi-faceted personal attributes of the patients, including diagnoses, goals, and physical and cognitive limitations. Clinicians’ comfort with RT was increased by their previous training but was decreased by the perceived complexity of RT. Finally, therapists have limited time to gather, setup, and use RT. Conclusions Despite decades of design work aimed at creating clinically useful RT, many lack compatibility with clinical translation needs in inpatient neurologic rehabilitation. New RT continue to impede the immediacy, versatility, and functionality of hands-on therapy mediated treatment with simple everyday objects.

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