Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-23T07:35:42.294Z Has data issue: false hasContentIssue false

Use of health technology assessment in decision making: Coresponsibility of users and producers?

Published online by Cambridge University Press:  26 April 2005

Myriam Hivon
Affiliation:
University of Montreal
Pascale Lehoux
Affiliation:
University of Montreal
Jean-Louis Denis
Affiliation:
University of Montreal
Stéphanie Tailliez
Affiliation:
University of Montreal

Abstract

Objectives: Health technology assessment (HTA) is a policy-oriented form of research designed to inform decision-makers on the introduction, use, and dissemination of health technology. Whereas research on knowledge transfer has focused on knowledge producers, little attention has been given to the user's perspective. This study examines how health-care provider, administrator, and patient associations across Canada use HTA reports and the limitations they encounter when accessing and using scientific knowledge.

Methods: This study draws from semistructured interviews (n = 42) conducted with three types of user, located in British Columbia, Alberta, Saskatchewan, Ontario, and Quebec. Applying well-established conceptual categories in knowledge utilization research, our qualitative analyses sought to define more precisely how HTA is used by interviewees as well as the most significant barriers they encounter.

Results: The vast majority of users recognize the usefulness and credibility of HTA reports. Of interest, the way they use HTA takes different forms. Although administrators and health-care providers are in a better position than patient associations to act directly on HTA messages—making an instrumental use of HTA—we also found conceptual and symbolic uses across all groups. Our results also indicate that significant organizational, scientific, and material limitations hinder the use of scientific evidence. Overcoming such barriers requires a greater commitment from both HTA producers and users.

Conclusions: This study argues that, to ensure better uptake of HTA, it should become a shared responsibility between HTA producers and various types of user.

Type
RESEARCH REPORTS
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Battista RN, Banta HD, Jonsson E, Hodge M, Gelbland H. 1994 Lessons from eight countries. Health Policy. 30: 397421.Google Scholar
Battista RN, Lance JM, Lehoux P, Régnier G. 1999 Health technology assessment and the regulation of medical devices and procedures in Quebec: Synergy, collusion or collision? Int J Technol Assess Health Care. 15: 593601.Google Scholar
Battista RN, Dery V, Jacob R, et al. 2003. L'évaluation des technologies et des modes d'intervention en santé dans les hôpitaux universitaires. Montréal: AÉTMIS
Bero LA, Jadad AR. 1997 How consumers and policy-makers can use systematic reviews for decision-making. Ann Intern Med. 127: 3742.Google Scholar
Bero LA, Grilli R, Grimshaw JM, et al. 1998 Closing the gap between research and practice: An overview of systematic reviews of interventions to promote the implementation of research findings. BMJ. 317: 465468.Google Scholar
Buxton M, Hanney S. 1996 How can payback from health services research be assessed? J Health Services Res. 1: 3543.Google Scholar
Cookson R, Maynard A. 2000 Health technology assessment in Europe. Improving clarity and performance. Int J Technol Assess Health Care. 16: 639650.Google Scholar
Davis E, Littlejohns P. 2002 Views of directors of public health about NICE appraisal guidance: Results of the postal survey. J Public Health Med. 24: 319325.Google Scholar
Dobrow MJ, Vivek G, Upshur REG. 2004 Evidence-based health policy: Context and utilization. Soc Sci Med. 58: 207217.Google Scholar
Hanney SR, Gonzalez-Block MA, Buxton MJ, Kogan M. 2003 The utilization of health research in policy-making: Concepts, examples and methods of assessment. Health Res Policy Systems. 1: 2.Google Scholar
Hailey D, Corabian P, Harstall C, Schneider W. 2000 The use and impact of rapid health technology assessments. Int J Technol Assess Health Care. 16: 651656.Google Scholar
Jacob R, McGregor M. 1997 Assessing the impact of health technology assessment. Int J Technol Assess Health Care. 13: 6880.Google Scholar
Lavis J. Knowledge transfer and exchange: The challenge for research organizations. McMaster University. Presentation given at the University of Montreal on April 7, 2003.
Lehoux P, Battista RN, Lance JM. 2000 Monitoring health technology assessment agencies. Can J Program Eval. 15: 133.Google Scholar
Lehoux P. 2002 Could new regulatory mechanisms be designed after a critical assessment of the value of health innovations? Commission on the Future of Health Care in Canada. Discussion paper No. 37
Lehoux P, Tailliez S, Denis J-L, Hivon M. 2004 Redefining health technology assessment in Canada: Diversification of products and contextualization of findings. Int J Technol Assess Health Care. 20 (3): 325336.Google Scholar
Lehoux P, Denis JL, Tailliez S, Hivon M. (in press) Disseminating health technology assessment: Identifying the visions guiding an evolving policy intervention in Canada. J Health Polit Policy Law.
Lomas J, Fulop N, Gagnon D. 2003 On being a good listener: Setting priorities for applied health services research. Milbank Q. 81: 363388.Google Scholar
Marshall C, Rossman G. 1989. Designing qualitative research. Newbury Park: Sage
Menon D, Topfer LA. 2000 Health technology assessment in Canada. A decade in review. Int J Technol Assess Health Care. 16: 896902.Google Scholar
Miles MB, Huberman AM. 1984. Qualitative data analysis. Beverly Hills: Sage
Murphy E, Dingwall R, Greatbatch D, Parker S, Watson P. 1998 Qualitative research methods in health technology assessment: A review of the literature. Health Technol Assess. 2: 16.Google Scholar
Pelz DC. 1978 Some expanded perspectives on the use of social science in public policy. In: Yinger JM, Cutler SJ, eds. Major social issues: A multidisciplinary view. New York: Free Press; 346357.
Richards TJ, Richards L. 1994 Using computers in qualitative research. In: Denzin NK, Lincoln YS, eds. Handbook of qualitative research. Newbury Park: Sage; 445462.
Strauss A, Corbin J. 1990. Basics of qualitative research. Newbury Park: Sage
Walshe K, Rundall TG. 2001 Evidence-based management: From theory to practice in health care. Milbank Q. 79: 429457.Google Scholar
Weiss C, ed. 1977. Using social research in public policy making. Toronto: Lexington Books