PP145 Using Health Technology Assessment To Drive Guideline Development

2018 ◽  
Vol 34 (S1) ◽  
pp. 122-123
Author(s):  
Ann Scott ◽  
Carmen Moga ◽  
Christa Harstall
Keyword(s):  
Clinical Practice ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
De Novo ◽  
Guideline Development ◽  
Contextual Information ◽  
Research Question ◽  
Health Technology ◽  
Rapid Review ◽  
Step Algorithm

Introduction:Clinical practice guidelines (CPGs) are a key vehicle for converting evidence into action. CPGs can be produced by various methods: de novo, adaptation, adoption, or a combination of these. Deciding whether and how to develop a guideline can be challenging. Health technology assessment (HTA) researchers from the Institute of Health Economics developed a multi-step decisional algorithm highlighting the decision nodes in the initial phase of guideline development where HTA products and expertise can be valuable in demystifying these decisions.Methods:A literature search was conducted for articles comparing methods of developing CPGs, with particular focus on finding a priori criteria for deciding when to use one method versus another.Results:The published literature is sparse and there are no specific criteria available for deciding when to use one method of development versus another. The proposed multi-step algorithm identifies similar steps in the production of all types of CPGs: the set-up phase; establishing the need for a new CPG in consultation with a guideline development group and local stakeholders; developing research question(s); conducting searches for suitable existing guidelines; and finalizing the guideline. HTA can help set the health question(s) and identify and screen existing CPGs. When CPGs are not available, HTA methods are implemented to update the evidence in a blend of de novo and adaptation processes by reviewing umbrella reviews, systematic reviews, and primary studies. Quality appraisal of existing guidelines and syntheses of evidence in a rapid review fashion help determine whether there are enough studies to support the guideline scope.Conclusions:Deciding which method of guideline development to employ requires ample methodological expertise, an intimate knowledge of the clinical practice environment, and access to detailed contextual information. The proposed multi-step algorithm shows how to successfully leverage HTA resources to support CPG production and move research evidence into practice.

PP097 Challenges Of Rapid Reviews In Health Technology Assessment: Case Study From An Italian Region

2017 ◽  
Vol 33 (S1) ◽  
pp. 117-118 ◽  
Author(s):  
Antonella Negro ◽  
Maria Domenica Camerlingo ◽  
Susanna Maltoni ◽  
Fabio Trimaglio
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Meta Analysis ◽  
Research Question ◽  
Health Technology ◽  
Outcome Data ◽  
Rapid Review ◽  
Policy Makers ◽  
Technical Performance ◽  
Rapid Reviews

INTRODUCTION:Rapid reviews are an attractive tool for Health Technology Assessment (HTA) as they may be a support in decision making when time and resources are limited. Rapid reviews are carried out in few weeks (from 3 weeks to 6 months) and require adjustments from standard systematic review methods. Methodology on how to carry out rapid reviews is still debated and guidance regarding the most suitable method to apply is lacking. Kaltenthaler (1) has recently proposed a checklist of items to be considered when undertaking a rapid review. We appraised our rapid assessment on the use of frequency domain (FD)-optical coherence tomography in percutaneous coronary interventions, based on a rapid review of the literature, using the items proposed (1).METHODS:The checklist reports four key points to consider when planning a rapid review: (i) scoping search - needed to quantify the available evidence and to inform rapid review protocol, (ii) results reporting – considering heterogeneity of intervention, comparators, and outcomes, (iii) clear communication with policy makers - ensuring that review responds to the policy question and (iv) reporting on methods - methodology used, strengths and limitations.RESULTS:When we applied the checklist proposed by Kaltenthaler (1) to our rapid review on the use of FD-optical coherences tomography it resulted that: the scoping search revealed no useful systematic reviews to answer policy-makers questions and a high number of relevant studies. For results presentation, we used a narrative synthesis reporting outcome data grouped in domains previously defined by an evidence profile. Domains consisted of technical performance, safety, efficacy, and change in management. No meta-analysis was performed due to paucity of randomized controlled trials (RCTs) for the efficacy domain and high heterogeneity in outcomes measures for technical performance. Analysis of some of the outcomes was extremely time-consuming (technical performance) and did not provide particularly useful information for the commissioning body. A clearer and more intensive dialog with policy makers to adjust extent of research question and/or outcomes to be investigated would have probably improved usability for final users. Description of methods was partial.CONCLUSIONS:The checklist by Kaltenthaler (1) helped us to reflect on the method we used to carry out rapid reviews and to pinpoint possible solutions to improve it.

OP91 Developing A Celtic Connections Regional Health Technology Assessment Alliance

2019 ◽  
Vol 35 (S1) ◽  
pp. 23-23
Author(s):  
Susan Myles
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Personal Development ◽  
Economies Of Scale ◽  
Peer Group ◽  
Knowledge Exchange ◽  
Health Technology ◽  
Rapid Review ◽  
Scarce Resources ◽  
Health Technologies

IntroductionThe Irish, Scottish and Welsh national Health Technology Assessment (HTA) bodies (Health Information and Quality Authority, Health Technology Assessment Group, Scottish Health Technologies Group, Health Technology Wales) have recently (2018) established a ‘Celtic connections’ regional HTA alliance on non-medicine technologies. The primary purpose is to add value by realizing potential economies of scale and scope in non-medicine HTA efforts.MethodsA Memorandum of Understanding (MoU) was agreed to: formalize collaboration and partnership working; improve shared understanding of work programs and processes; collaborate on and co-produce evidence reviews of mutual interest; increase both the volume and range of technology topics for which advice is developed in each nation; promote knowledge exchange; and enhance professional and personal development for each agency's staff.ResultsEarly benefits include: collaboration on one technology topic resulting in the production of bespoke guidance in three countries; an update of a partner's rapid review; identification of a further potential topic collaboration (sacral nerve stimulation); a six month senior staff secondment; and reciprocal observer membership on each country's national committees. Other general benefits have included: reduced duplication of effort; improved quality assurance through ‘critical friend’ peer review; enhanced access to methodological advice and a broader range of stakeholders; and development of a forum for discussion and peer support.ConclusionsThe alliance offers real potential to optimize use of the scarce resources for non-medicine technologies across the three countries and increase evidence review and guidance volume through adapting or co-producing outputs. Longer term benefits are anticipated to include: improved knowledge exchange; advancing skills of staff; building and broadening capacity through shared learning and access to a wider professional peer group; improved staff recruitment and retention; production of joint publications and other modes of dissemination; and increased profile for each country's work.

scholarly journals Resolution based on the results of the conference: "RWD/ RWE – Research Tools of Real-World Clinical Practice Today and Tomorrow"

2021 ◽  
Vol 1 (1) ◽  
pp. 21-24
Author(s):  
A. S. Kolbin
Keyword(s):  
Clinical Practice ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Real World ◽  
Health Technology ◽  
Annual Scientific ◽  
International Participation ◽  
Practical Conference ◽  
Research Tools

On September 16, 2021, the Association of Health Technology Assessment Professionals, the Association of Russian Clinical Pharmacologists, St. Petersburg Branch of ISPOR organized the II annual scientific and practical conference with international participation: "RWD/RWE – Research Tools of Real-World Clinical Practice Today and Tomorrow". The topic of the conference brought together leading Russian and world experts in the field of RWD/RWE. 

scholarly journals DOES HEALTH TECHNOLOGY ASSESSMENT AFFECT POLICY-MAKING AND CLINICAL PRACTICE IN SWEDEN?

2014 ◽  
Vol 30 (3) ◽  
pp. 265-272 ◽  
Author(s):  
Måns Rosén ◽  
Sophie Werkö
Keyword(s):  
Clinical Practice ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Clinical Guidelines ◽  
Time Series Data ◽  
Health Technology ◽  
High Impact ◽  
Series Data ◽  
Moderate Degree ◽  
The Impact

Objectives: The aim of this study was to analyze whether health technology assessment (HTA) reports published by SBU have influenced decisions, guidelines, clinical practice, or research priorities in Sweden.Methods: All twenty-six SBU reports between 2006 and 2010 were analyzed. For each project, we searched publications and documentation that reflected impact on decisions, guidelines, research or clinical practice. Written documentation, before–after surveys or register-based time series data were used when available. Based on a conceptual model and on the available evidence, we determined whether HTA reports had a high, moderate, or low impact.Results: HTA reports influenced comprehensive decisions to a high or moderate degree. In the case of fortifying flour with folic acid to a high degree. In ten cases, HTA reports were the primary source of clinical guidelines developed by the National Board of Health and Welfare (NBHW) or professional associations. In the cases of dyspepsia and gastro-esophageal reflux, as well as mild head injury, the HTA reports had a high impact on clinical practice. It was also obvious from this review that research had been initiated as a result of the knowledge gaps identified by HTA reports. In three cases, we had no adequate documentation, suggesting that the impact of the HTA report had been low.Conclusions: Many interrelated forces change practice, but the cases presented here indicate that HTA reports have had a high impact on clinical guidelines, as well as a moderate or high impact on comprehensive decisions, the initiation of research and changes in clinical practice.

scholarly journals Health Technology Assessment Fireside: Antibiotic Prophylaxis and Dental Treatment in Canada

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Mario A. Brondani
Keyword(s):  
At Risk ◽  
Health Technology Assessment ◽  
Antibiotic Prophylaxis ◽  
Technology Assessment ◽  
Dental Treatment ◽  
Research Question ◽  
Health Technology ◽  
Evidence Based ◽  
Population Impact ◽  
Dental Procedures

Objectives. This paper discusses the controversies surrounding the antibiotic prophylaxis preceding dental interventions within the following research question: how effective is dental antibiotic prophylaxis in preventing comorbidity and complications in those at risk? Methods. A synthesis of the available literature regarding antibiotic prophylaxis in dentistry was conducted under the lenses of Kazanjian’s framework for health technology assessment with a focus on economic concerns, population impact, social context, population at risk, and the effectiveness of the evidence to support its use. Results. The papers reviewed show that we have been using antibiotic prophylaxis without a clear and full understanding of its benefits. Although the first guideline for antibiotic prophylaxis was introduced in 1990, it has been revised on several occasions, from 1991 to 2011. Evidence-based clinical guidelines are yet to be seen. Conclusions. Any perceived potential benefit from administering antibiotic prophylaxis before dental procedures must be weighed against the known risks of lethal toxicity, allergy, and development, selection, and transmission of microbial resistance. The implications of guideline changes and lack of evidence for the full use of antibiotic prophylaxis for the teaching of dentistry have to be further discussed.

A voice to be heard: patient and public involvement in health technology assessment and clinical practice guidelines in Malaysia

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Hanin Farhana Kamaruzaman ◽  
Ku Nurhasni Ku Abd Rahim ◽  
Izzuna Mudla Mohamed Ghazali ◽  
Mohd Aminuddin Mohd Yusof
Keyword(s):  
Clinical Practice ◽  
Health Technology Assessment ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Technology Assessment ◽  
Public Involvement ◽  
Health Technology ◽  
Patient And Public Involvement ◽  
Initial Development ◽  
Limited Health Literacy

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.

Priority setting for health technology assessment at CADTH

2010 ◽  
Vol 26 (3) ◽  
pp. 341-347 ◽  
Author(s):  
Don Husereau ◽  
Michel Boucher ◽  
Hussein Noorani
Keyword(s):  
Health Technology Assessment ◽  
Priority Setting ◽  
Technology Assessment ◽  
Contextual Information ◽  
Committee Member ◽  
Research Priorities ◽  
Health Technology ◽  
Deliberative Process ◽  
Comparison Approach ◽  
Available Information

Objectives: The aim of this study was to describe a current practical approach of priority setting of health technology assessment (HTA) research that involves multi-criteria decision analysis and a deliberative process.Methods: Criteria related to HTA prioritization were identified and grouped through a systematic review and consultation with a selection committee. Criteria were scored through a pair-wise comparison approach. Criteria were pruned based on the average weights obtained from consistent (consistency index < 0.2) responders and consensus. HTA proposals are ranked based on available information and a weighted criteria score. The rank, along with additional contextual information and discussion among committee members, is used to achieve consensus on HTA research priorities.Results: Six of eleven criteria represented > 75 percent of the weight behind committee member decisions to conduct an HTA. These criteria were disease burden, clinical impact, alternatives, budget impact, economic impact, and available evidence. Since May 2006, committees have considered 102 proposals at sixteen biannual in-person advisory committee meetings. These have selected twenty-nine research priorities for the HTA program.Conclusions: The approach works well and was easy to implement. Feedback from committee members has been positive. This approach may assist HTA and other research agencies in better priority setting by informing the selection of the most important and policy-relevant topics in the presence of a wide variety of research proposals. This may in turn lead to efficiently allocating resources available for HTA research.

scholarly journals Breaking up is hard to do: why disinvestment in medical technology is harder than investment

2012 ◽  
Vol 36 (2) ◽  
pp. 148 ◽  
Author(s):  
Marion Haas ◽  
Jane Hall ◽  
Rosalie Viney ◽  
Gisselle Gallego
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Policy Makers ◽  
Healthcare Interventions ◽  
Practice Variations ◽  
The Right

Healthcare technology is a two-edged sword - it offers new and better treatment to a wider range of people and, at the same time, is a major driver of increasing costs in health systems. Many countries have developed sophisticated systems of health technology assessment (HTA) to inform decisions about new investments in new healthcare interventions. In this paper, we question whether HTA is also the appropriate framework for guiding or informing disinvestment decisions. In exploring the issues related to disinvestment, we first discuss the various HTA frameworks which have been suggested as a means of encouraging or facilitating disinvestment. We then describe available means of identifying candidates for disinvestment (comparative effectiveness research, clinical practice variations, clinical practice guidelines) and for implementing the disinvestment process (program budgeting and marginal analysis (PBMA) and related techniques). In considering the possible reasons for the lack of progress in active disinvestment, we suggest that HTA is not the right framework as disinvestment involves a different decision making context. The key to disinvestment is not just what to stop doing but how to make it happen - that is, decision makers need to be aware of funding disincentives. What is known about this topic? Disinvestment is an increasingly popular topic amongst academics and policy makers. Most discussions focus on the need to increase disinvestment as a corollary of investment, the lack of overt disinvestment decisions and the use of a framework based on health technology assessment (HTA) to implement disinvestment. What does this paper add? This paper focusses on the difficulties associated with deciding which technologies to disinvest in, and the problems in using an HTA framework to make such decisions, when disinvestment involves a different decision making context from that of investment. What are the implications for practitioners? The key to disinvestment is not just what to stop doing but how to implement such decisions. Making it happen means being aware of funding disincentives.

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