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.

PP142 A Mental Health Hospital-based Health Technology Assessment In Quebec, Canada: Structure And Products

2017 ◽  
Vol 33 (S1) ◽  
pp. 137-138
Author(s):  
Ionela Gheorghiu ◽  
Alain Lesage ◽  
Adam Mongodin ◽  
Marlène Galdin
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Health Technology Assessment ◽  
Social Services ◽  
Technology Assessment ◽  
Literature Search ◽  
New Technologies ◽  
Psychiatric Patients ◽  
Health Technology ◽  
Decision Making Process

INTRODUCTION:Our Hospital-based Health Technology Assessment unit (HB-HTA) was founded in 2011 following the nomination of Louis-H. Lafontaine hospital as the Montreal University Mental Health Institute (IUSMM). From the beginning, the HB-HTA has been supporting and advising the Chief Executive Officer of IUSMM in the decision-making process concerning the implementation of new technologies and practices in mental health. Since 2015, the HB-HTA is part of the East of Montreal Regional Integrated Health and Social Services Centre (CIUSSS de l'Est-de-l’Île de Montréal), continuing to support decisions in mental health. Currently, the HB-HTA unit is nested in the Quality, Performance and Ethics department.METHODS:Formed by a coordinator, a scientific advisor and a manager, the HB-HTA team plans, organizes and sets up the evaluation activities. The unit benefits from the support of a Steering Committee which consists of representatives of clinical, administrative and research directions, as well as of health users and families. This committee determine the strategic orientation of the HB-HTA unit, prioritize the projects, approves the evaluation products and gives indications on the knowledge transfer process.RESULTS:To answer the decision questions, our HB-HTA unit employs two types of products: evaluation reports and informative notes. Based on an exhaustive literature search and consultations with stakeholders, the evaluation reports offer recommendations to support the decision-making process. The informative notes are rapid responses based on a partial literature search. The nature of this type of analysis does not allow the formulation of recommendations, however, a conclusion of the consulted literature is offered.CONCLUSIONS:Based on the work of our HB-HTA unit, some important decisions were made by the IUSMM. As an example, the systematic screening of psychiatric patients for drug and alcohol was not favored by our institution; rather than this, priority was given to staff training, in order to better identify and treat psychiatric patients with substance abuse comorbidity.

Hard choices: Reflections from the tomb of the unknown patient

2019 ◽  
Vol 32 (6) ◽  
pp. 288-292
Author(s):  
Christopher McCabe ◽  
Jeff Round
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Health System ◽  
Technology Assessment ◽  
New Technologies ◽  
Health Technology ◽  
Access To Healthcare ◽  
Decision Making Process ◽  
Fixed Costs

Health Technology Assessment (HTA) has always sought to incorporate the evidence of all patients affected in the decision-making process. While health system budgets could increase to cover costs of new technologies, the relevant patients are those benefitting from access to the technology being appraised. More recently, with health system budgets effectively fixed, costs of new technologies are covered by displacing other, currently funded care. This reallocation means the patients affected by the decision include those whose healthcare is displaced. These patients are typically unidentified, however, and so HTA in this instance involves choosing between identified and unidentified patients. We argue that HTA should take account of identifiability bias in this decision-making, to avoid promoting inequitable and inefficient access to healthcare.

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.

scholarly journals REVEALING AND ACKNOWLEDGING VALUE JUDGMENTS IN HEALTH TECHNOLOGY ASSESSMENT

2014 ◽  
Vol 30 (6) ◽  
pp. 579-586 ◽  
Author(s):  
Bjørn Hofmann ◽  
Irina Cleemput ◽  
Kenneth Bond ◽  
Tanja Krones ◽  
Sigrid Droste ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Social Issues ◽  
Health Technology ◽  
Social Value ◽  
Decision Making Process ◽  
Value Judgments ◽  
Health Technologies ◽  
Scientific Endeavor

Background:Although value issues are increasingly addressed in health technology assessment (HTA) reports, HTA is still seen as a scientific endeavor and sometimes contrasted with value judgments, which are considered arbitrary and unscientific. This article aims at illustrating how numerous value judgments are at play in the HTA process, and why it is important to acknowledge and address value judgments.Methods:A panel of experts involved in HTA, including ethicists, scrutinized the HTA process with regard to implicit value judgments. It was analyzed whether these value judgments undermine the accountability of HTA results. The final results were obtained after several rounds of deliberation.Results:Value judgments are identified before the assessment when identifying and selecting health technologies to assess, and as part of assessment. They are at play in the processes of deciding on how to select, frame, present, summarize or synthesize information in systematic reviews. Also, in economic analysis, value judgments are ubiquitous. Addressing the ethical, legal, and social issues of a given health technology involves moral, legal, and social value judgments by definition. So do the appraisal and the decision-making process.Conclusions:HTA by and large is a process of value judgments. However, the preponderance of value judgments does not render HTA biased or flawed. On the contrary they are basic elements of the HTA process. Acknowledging and explicitly addressing value judgments may improve the accountability of HTA.

SUPPORTING DECISION MAKING IN CROSS-BORDER REGIONS: A HEALTH TECHNOLOGY ASSESSMENT TOOL FOR HOSPITALS

2012 ◽  
Vol 29 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Saskia Knies ◽  
Gloria Lombardi ◽  
Matt Commers ◽  
Hans-Peter Dauben ◽  
Silvia Evers ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Decision Making Process ◽  
Decision Tool ◽  
Health Technologies ◽  
Border Regions ◽  
Cross Border

Objectives: The aim of this study was to develop an health technology assessment (HTA) decision tool to support the decision-making process on health technologies for hospital decision makers in cross-border regions.Methods: Several methods were used to collect information necessary to develop the cross-border mini-HTA decision tool. The literature was inventoried on HTA in border regions and local settings and the use of HTA by local decision makers. Semi-structured interviews with hospital decision makers in cross-border regions were also performed. Based on group discussion of the resulting information, it was decided to use the Danish mini-HTA guideline as a starting point for development of the decision tool. After finishing the first version of the decision tool it was tested in two pilot studiesResults: Some questions in the Danish mini-HTA guideline were not relevant. Other questions needed rephrasing and questions about cross-border situations were added. The pilots showed several missing topics, including legal questions and reimbursement issues. The final decision tool consists of three sections: a general section, a section for hospitals not cooperating cross-border and a section for hospitals that are cooperating with hospitals across a national or regional border.Conclusions: Based on our literature search, this may be the first cross-border mini-HTA decision tool. The decision tool will be of help for healthcare professionals and decision makers in border settings who would like to use HTA evidence to support their decision-making process.

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.

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