OP170 How Can Health Technology Assessment Participate In The Healthcare Quality Improvement?

2019 ◽  
Vol 35 (S1) ◽  
pp. 37-37
Author(s):  
Wafa Allouche ◽  
Sami El Gouddi ◽  
Emna Allouche ◽  
Ali Mrabet
Keyword(s):  
Quality Improvement ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Ethical Issues ◽  
Healthcare Quality ◽  
Health Technology ◽  
Legal Aspects ◽  
Patient Centeredness ◽  
Theoretical Concepts ◽  
Healthcare Quality Improvement

IntroductionProviding high-quality and affordable care is a big challenge facing policy makers, especially in low and middle income countries (LMIC). The purpose of this presentation is to illustrate how health technology assessment (HTA) benefits the improvement of the healthcare quality, and to highlight the fact that HTA domains match to the dimensions of health quality: safety, effectiveness, efficiency and patient-centeredness.MethodsThis presentation will be based on explaining the ability of HTA to improve the quality of healthcare. Some countries, mainly LMIC where resources are limited, do not have formal HTA whose goal is to inform the development of safe, effective and patient centered health policies. The theoretical concepts of HTA demonstrate a strong connection between HTA and healthcare quality improvement. By way of illustration an example of successful experiences will be given.ResultsThe presentation items are: - The definition of health technology - Introduction to health technology assessment as a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology. - Why is health technology assessment used, the identification of the HTA report domains including Safety, Clinical Effectiveness, Ethical analysis, Social aspects, Legal aspects and the importance of patient experience in HTA. - The identification of the six dimensions of healthcare quality and the determination of the connection between HTA and healthcare quality improvement. - A presentation of the international Decision Support Initiative (iDSI) experience in some LMIC.ConclusionsHTA has many meeting points with healthcare quality dimensions. HTA is likely to become an increasingly important influence in health decisions.

scholarly journals Bridging health technology assessment and healthcare quality improvement using international consortium of health outcomes measurement standard sets

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Rachel R. J. Kalf ◽  
Marloes Zuidgeest ◽  
Diana M. J. Delnoij ◽  
Marcel L. Bouvy ◽  
Wim G. Goettsch
Keyword(s):  
Quality Improvement ◽  
Health Outcomes ◽  
Health Technology Assessment ◽  
Outcome Measures ◽  
Technology Assessment ◽  
Healthcare Quality ◽  
Health Technology ◽  
Outcomes Measurement ◽  
Healthcare Quality Improvement ◽  
Standard Sets

Abstract Objective Although health technology assessment (HTA) and healthcare quality improvement are distinct processes, a greater level of alignment in outcome measures used may increase the quality and efficiency of data collection. This study evaluates the agreement in outcome measures used in oncology for healthcare quality improvement and HTAs, and how these align to the International Consortium for Health Outcomes Measurement (ICHOM) standard sets. Methods We conducted a cross-sectional comparative analysis of ICHOM sets focusing on oncological indications and publicly available measures for healthcare quality and HTA reports published by the National Health Care Institute from the Netherlands and the National Institute for Health and Care Excellence from the United Kingdom. Results All ICHOM sets and HTAs used overall survival, whereas quality improvement used different survival estimates. Different progression estimates for cancer were used in HTAs, ICHOM sets, and quality improvement. Data on health-related quality of life (HRQoL) was recommended in all ICHOM sets and all HTAs, but selectively for quality improvement. In HTAs, generic HRQoL questionnaires were preferred, whereas, in quality improvement and ICHOM sets, disease-specific questionnaires were recommended. Unfavorable outcomes were included in all HTAs and all ICHOM sets, but not always for quality improvement. Conclusions Although HTA and quality improvement use outcome measures from the same domains, a greater level of alignment seems possible. ICHOM may provide input on standardized outcome measures to support this alignment. However, residual discrepancies will remain due to the different objectives of HTA and quality improvement.

scholarly journals Methods of synthesizing qualitative research studies for health technology assessment

2011 ◽  
Vol 27 (4) ◽  
pp. 384-390 ◽  
Author(s):  
Nicola Ring ◽  
Ruth Jepson ◽  
Karen Ritchie
Keyword(s):  
Qualitative Research ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Research ◽  
Service Providers ◽  
Health Technology ◽  
Qualitative Studies ◽  
Patient Centeredness ◽  
Summary Table ◽  
Thematic Synthesis

Objectives: Synthesizing qualitative research is an important means of ensuring the needs, preferences, and experiences of patients are taken into account by service providers and policy makers, but the range of methods available can appear confusing. This study presents the methods for synthesizing qualitative research most used in health research to-date and, specifically those with a potential role in health technology assessment.Methods: To identify reviews conducted using the eight main methods for synthesizing qualitative studies, nine electronic databases were searched using key terms including meta-ethnography and synthesis. A summary table groups the identified reviews by their use of the eight methods, highlighting the methods used most generally and specifically in relation to health technology assessment topics.Results: Although there is debate about how best to identify and quality appraise qualitative research for synthesis, 107 reviews were identified using one of the eight main methods. Four methods (meta-ethnography, meta-study, meta-summary, and thematic synthesis) have been most widely used and have a role within health technology assessment. Meta-ethnography is the leading method for synthesizing qualitative health research. Thematic synthesis is also useful for integrating qualitative and quantitative findings. Four other methods (critical interpretive synthesis, grounded theory synthesis, meta-interpretation, and cross-case analysis) have been under-used in health research and their potential in health technology assessments is currently under-developed.Conclusions: Synthesizing individual qualitative studies has becoming increasingly common in recent years. Although this is still an emerging research discipline such an approach is one means of promoting the patient-centeredness of health technology assessments.

OP101 Do We Need To Extend Health Technology Assessment To Health Enhancement Assessment?

2017 ◽  
Vol 33 (S1) ◽  
pp. 46-46
Author(s):  
Bjørn Hofmann
Keyword(s):  
Health Care ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Cognitive Abilities ◽  
Literature Search ◽  
Ethical Issues ◽  
Health Technology ◽  
Health Technologies ◽  
Health And Wellbeing ◽  
Wide Range

INTRODUCTION:Several health technologies used for therapy can also be used for health enhancement. Drugs stimulating cognitive abilities are but one example. Health Technology Assessment (HTA) has not been developed for assessing enhancements. This raises the question of how HTA should address the blurred distinction between therapy and enhancement. Should we (i) carve out a distinction between therapy and enhancement and limit HTA to therapy, (ii) use HTA for both therapy and enhancement (with some modifications), or (iii) should we develop a separate health enhancement assessment (HEA)?METHODS:A literature search of the medical, philosophical, and bioethical literature was conducted for debates, arguments, and suggested solutions to the issue of therapy versus enhancement.RESULTS:The same improvement in health may be therapeutic in one patient, but an enhancement in another. Moreover, both therapy and enhancement share the same goal: increased health and wellbeing. A wide range of arguments try to establish a difference between therapy and enhancement. They refer to naturalness, rehabilitation, normality, species-typical functioning/potential, disease, sustainability, and responsibility. On closer scrutiny few of these arguments do the job in bolstering the therapy-enhancement distinction. We already use a wide range of means to extend human abilities. Moreover, the therapy-enhancement distinction raises a wide range of ethical issues that are relevant for the assessment of a number of emerging health technologies.CONCLUSIONS:Existing HTA methodology can address a wide range of non-therapeutic health enhancements. However, a series of broader issues related to the goal of health care and responsibility for altering human evolution may not be addressed within traditional HTA frameworks. Specific HEAs may therefore be helpful.

COMPREHENSIVE ASSESSMENT OF COMPLEX TECHNOLOGIES: INTEGRATING VARIOUS ASPECTS IN HEALTH TECHNOLOGY ASSESSMENT

2017 ◽  
Vol 33 (5) ◽  
pp. 570-576 ◽  
Author(s):  
Kristin Bakke Lysdahl ◽  
Kati Mozygemba ◽  
Jacob Burns ◽  
Jan Benedikt Brönneke ◽  
James B. Chilcott ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Stakeholder Involvement ◽  
Complex Interventions ◽  
Health Technology ◽  
Legal Aspects ◽  
Added Value ◽  
Health Technologies ◽  
Stakeholder Perspectives ◽  
Wide Range

Objectives: Despite recent development of health technology assessment (HTA) methods, there are still methodological gaps for the assessment of complex health technologies. The INTEGRATE-HTA guidance for effectiveness, economic, ethical, socio-cultural, and legal aspects, deals with challenges when assessing complex technologies, such as heterogeneous study designs, multiple stakeholder perspectives, and unpredictable outcomes. The objective of this article is to outline this guidance and describe the added value of integrating these assessment aspects.Methods: Different methods were used to develop the various parts of the guidance, but all draw on existing, published knowledge and were supported by stakeholder involvement. The guidance was modified after application in a case study and in response to feedback from internal and external reviewers.Results: The guidance consists of five parts, addressing five core aspects of HTA, all presenting stepwise approaches based on the assessment of complexity, context, and stakeholder involvement. The guidance on effectiveness, health economics and ethics aspects focus on helping users choose appropriate, or further develop, existing methods. The recommendations are based on existing methods’ applicability for dealing with problems arising with complex interventions. The guidance offers new frameworks to identify socio-cultural and legal issues, along with overviews of relevant methods and sources.Conclusions: The INTEGRATE-HTA guidance outlines a wide range of methods and facilitates appropriate choices among them. The guidance enables understanding of how complexity matters for HTA and brings together assessments from disciplines, such as epidemiology, economics, ethics, law, and social theory. This indicates relevance for a broad range of technologies.

PP089 Health Technology Assessment Of An Automated Compounding Of Parenteral Nutrition

2017 ◽  
Vol 33 (S1) ◽  
pp. 112-112
Author(s):  
Francesco Faggiano ◽  
Martina Andellini ◽  
Francesca Sabusco ◽  
Liliana De Vivo ◽  
Pietro Derrico ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Automatic System ◽  
Scientific Evidence ◽  
Clinical Effectiveness ◽  
Health Technology ◽  
Legal Aspects ◽  
Context Analysis ◽  
Study Results

INTRODUCTION:Pediatric parenteral nutrition is mainly used in neonatal intensive care units (NICU) and requires close collaboration with the hospital pharmacy, especially for manufacturing time, application, preparation and delivery (1). In this context, a Health Technology Assessment (HTA) to evaluate an automatic system compared with a manual system was carried out.METHODS:The Decision-oriented HTA (DoHTA) method (2), coordinated by Bambino Gesù Children's Hospital (BGCH) HTA Unit, was applied to carefully assess the technology. It was developed starting from the European Network for HTA (EUnetHTA) Core Model® and integrated with the Analytic Hierarchy Process (AHP). Its purpose is to identify all the relevant assessment aspects of automatic system integrating the evidence from the scientific literature with experts’ judgments and the specific context analysis for BGCH: an evaluation scheme inherent safety, clinical effectiveness, technical and organizational aspects (represented by a decision tree at three levels: dimensions of evaluation, I and II level indicators) was subsequently created. A weight was finally associated to each identified element and the alternatives’ ranking was defined.RESULTS:The study results show a “performance value” associated with the automatic system greater than about thirty-two percentage points compared to the manual system.CONCLUSIONS:At the current state of the scientific evidence and the results of analysis carried out by the working group, it is believed that the choice should be made to introduce the automatic system is available in BGCH.More specifically, from the point of view of safety, automatic system is safer for both patient and operators; about clinical effectiveness, the system improves the nutritional intake, allows a reduction of post-infusional adverse events and the use of antibiotic therapy; concerning economic aspects, the analysis of available data shows a substantial equivalence between the alternatives considered; the technical-functional aspects show an improvement according to almost all indicators; organizational aspects show a slight improvement in the working and in process management and finally the legal aspects indicate a slight advantage for the automatic system.

OP83 Thinking Explicitly About Ethical Issues In Health Technology Assessment: Lessons From The Canadian Agency For Drugs And Technologies In Health

2018 ◽  
Vol 34 (S1) ◽  
pp. 30-31
Author(s):  
Ken Bond ◽  
Katherine Duthie
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Ethical Issues ◽  
Health Technology ◽  
Dna Mismatch ◽  
Additional Information ◽  
Obstructive Sleep ◽  
Starting Point ◽  
Explicit Analysis ◽  
End Stage

Introduction:While methods for ethics analysis in health technology assessment (HTA) exist, there have been relatively few applications and assessments of these methods. The Canadian Agency for Drugs and Technologies in Health (CADTH) began to include an explicit analysis of ethical issues within its HTAs in 2015. To examine some of the differences among ethics analyses, we critically compared the conduct and contribution of the analysis of ethical issues for four CADTH HTAs.Methods:Two experts in ethics in HTA examined ethics analyses conducted by CADTH for four technologies: DNA mismatch repair testing for colorectal cancer, treatments for obstructive sleep apnea, dialysis for end-stage liver disease, and human papillomavirus screening for cervical cancer. The methods of analysis and presentation of results, extent to which the ethics analysis was used in committee deliberations was gathered via meeting notes, recommendation documents, and discussion, and were summarized narratively.Results:The amount of literature explicitly discussing ethical issues pertaining to particular technologies varied and was not predicted by the age and maturity of a technology. The axiological approach proved a helpful starting point for ethical reflection, but other methods were used for analysis and presentation. Explicit discussion of ethical issues identified the need for additional information to ensure robust deliberation. Committee members expressed the belief that ethics analysis “brought together” individual sections of the HTA.Conclusions:While many methods exist for ethics analysis, ethics expertise is required to identify and explicitly discuss the complete range of ethical issues relevant to a particular HTA. Ethics analyses create space to challenge assumptions underlying the clinical and economic evidence, raise issues about the value of technologies, and help to integrate the HTA results.

The Social Role of Technology in Healthcare Quality Improvement

2012 ◽  
pp. 178-186
Author(s):  
Anastasia K. Kadda
Keyword(s):  
Quality Improvement ◽  
Social Role ◽  
Healthcare Quality ◽  
Health Technology ◽  
Healthcare Services ◽  
Healthcare Quality Improvement ◽  
Current Trends ◽  
The Social

The aim of this study is to describe the social role of technology in healthcare quality improvement. Methodologically, the study was based on a review of the relevant literature, Greek and foreign, as well as Internet sources related to the social role of technology in healthcare quality improvement. The main conclusions drawn were the following: a) The development of new technologies in the field of health and their involvement within the social context is today a fast accelerating process; b) The presentday expansion of health-oriented technology is of vital importance because of current trends in the field of healthcare and of the social evolution on healthcare services; c) Information technology is capable of profoundly contributing to the improvement of the quality of health, and thus to the wellbeing of the citizens in a society; d) By the use of health technology, more efficient and productive financial management is achieved with numerous benefits for the economy; e) Electronic health can improve the quality of healthcare thereby facilitating the work of health professionals; f) Greek society is being increasingly influenced by both international and domestic scientific and technological advances in health technology despite the existence of significant legal barriers; g) Current trends in the European Union as far as health technology is concerned are intimately connected with expanding citizen participation in the electronic revolution and their increasing access to the Information Society.

scholarly journals Different methods for ethical analysis in health technology assessment: An empirical study

2011 ◽  
Vol 27 (4) ◽  
pp. 305-312 ◽  
Author(s):  
Samuli I. Saarni ◽  
Annette Braunack-Mayer ◽  
Bjørn Hofmann ◽  
Gert Jan van der Wilt
Keyword(s):  
Empirical Study ◽  
Health Technology Assessment ◽  
Obesity Surgery ◽  
Technology Assessment ◽  
Ethical Issues ◽  
Personal Responsibility ◽  
Public Funding ◽  
Stakeholder Involvement ◽  
Health Technology ◽  
Ethical Analysis

Objectives: Ethical analysis can highlight important ethical issues related to implementing a technology, values inherent in the technology itself, and value-decisions underlying the health technology assessment (HTA) process. Ethical analysis is a well-acknowledged part of HTA, yet seldom included in practice. One reason for this is lack of knowledge about the properties and differences between the methods available. This study compares different methods for ethical analysis within HTA.Methods: Ethical issues related to bariatric (obesity) surgery were independently evaluated using axiological, casuist, principlist, and EUnetHTA models for ethical analysis within HTA. The methods and results are presented and compared.Results: Despite varying theoretical underpinnings and practical approaches, the four methods identified similar themes: personal responsibility, self-infliction, discrimination, justice, public funding, and stakeholder involvement. The axiological and EUnetHTA models identified a wider range of arguments, whereas casuistry and principlism concentrated more on analyzing a narrower set of arguments deemed more important.Conclusions: Different methods can be successfully used for conducting ethical analysis within HTA. Although our study does not show that different methods in ethics always produce similar results, it supports the view that different methods of ethics can yield relevantly similar results. This suggests that the key conclusions of ethical analyses within HTA can be transferable between methods and countries. The systematic and transparent use of some method of ethics appears more important than the choice of the exact method.

scholarly journals Tackling ethical issues in health technology assessment: A proposed framework

2011 ◽  
Vol 27 (3) ◽  
pp. 230-237 ◽  
Author(s):  
Amanda Burls ◽  
Lorraine Caron ◽  
Ghislaine Cleret de Langavant ◽  
Wybo Dondorp ◽  
Christa Harstall ◽  
...  
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Development Process ◽  
Ethical Issues ◽  
Health Technology ◽  
Face To Face ◽  
Context Sensitive ◽  
Ethical Implications ◽  
Starting Point ◽  
Methodological Approaches

Objectives: Values are intrinsic to the use of health technology assessments (HTAs) in health policy, but neglecting value assumptions in HTA makes their results appear more robust or normatively neutral than may be the case. Results of a 2003 survey by the International Network of Agencies for Health Technology Assessment (INAHTA) revealed the existence of disparate methods for making values and ethical issues explicit when conducting HTA.Methods: An Ethics Working Group, with representation from sixteen agencies, was established to develop a framework for addressing ethical issues in HTA. Using an iterative approach, with email exchanges and face-to-face workshops, a report on Handling Ethical Issues was produced.Results: This study describes the development process and the agreed upon framework for reflexive ethical analysis that aims to uncover and explore the ethical implications of technologies through an integrated, context-sensitive approach and situates the proposed framework within previous work in the development of ethics analysis in HTA.Conclusions: It is important that methodological approaches to address ethical reflection in HTA be integrative and context sensitive. The question-based approach described and recommended here is meant to elicit this type of reflection in a way that can be used by HTA agencies. The questions proposed are considered only as a starting point for handling ethics issues, but their use would represent a significant improvement over much of the existing practice.

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