Hostname: page-component-7c8c6479df-8mjnm Total loading time: 0 Render date: 2024-03-28T08:49:52.672Z Has data issue: false hasContentIssue false

Supporting the use of health technology assessments in policy making about health systems

Published online by Cambridge University Press:  06 October 2010

John N. Lavis
Affiliation:
McMaster University
Michael G. Wilson
Affiliation:
McMaster University
Jeremy M. Grimshaw
Affiliation:
University of Ottawa and Ottawa Hospital Research Institute
R. Brian Haynes
Affiliation:
McMaster University and Hamilton Health Sciences
Mathieu Ouimet
Affiliation:
Université Laval and CHUQ Research Centre
Parminder Raina
Affiliation:
McMaster University
Russell L. Gruen
Affiliation:
Monash University and National Trauma Research Institute
Ian D. Graham
Affiliation:
University of Ottawa and Canadian Institutes of Health Research

Abstract

Objectives: The objective of this study is to profile the health technology assessments (HTAs) produced in Canada and other selected countries and assess their potential to inform policy making about health systems in jurisdictions other than the ones for which they were produced, and to develop and pilot test prototypes for packaging and assessing the relevance of HTAs for health system managers and policy makers.

Methods: We compiled an inventory of all HTAs that were produced by nine HTA agencies between September 2003 and August 2006; coded the title and abstract of each HTA according to the technologies assessed, methods used, and whether or not context-specific actionable messages were provided; developed a prototype for a structured, decision-relevant HTA summary and for a relevance-assessment form; and pilot-tested the prototypes using semistructured telephone interviews with a purposive sample of Canadian healthcare managers and policy makers.

Results: Our review of the 223 HTAs identified that: (i) 44 HTAs addressed health system arrangements (20 percent); (ii) 205 incorporated a systematic review (92 percent), whereas only 12 incorporated a sociopolitical assessment using explicit methods (5 percent); and (iii) 50 contained context-specific actionable messages (22 percent). Our interviews identified significant support for both the general idea of an HTA summary and the prototype's specific elements, but mixed views about using peer assessments of relevance.

Conclusions: Those involved in supporting the use of HTAs in policy making about health systems may wish to produce structured decision-relevant summaries for their systematic review-containing HTAs to increase the prospects for their HTAs being used outside the jurisdiction for which they were produced.

Type
POLICIES
Copyright
Copyright © Cambridge University Press 2010

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

REFERENCES

1. Battista, RN, Banta, HD, Jonsson, E, Hodge, M, Gelbland, H. Lessons from the eight countries. Health Policy. 1994;30:397421.CrossRefGoogle ScholarPubMed
2. Battista, RN, Lance, J-M, Lehoux, P, Regnier, G. Health technology assessment and the regulation of medical devices and procedures in Quebec: Synergy, collusion, or collision? Int J Technol Assess Health Care. 1999;15:593601.CrossRefGoogle ScholarPubMed
3. Canadian Agency for Drugs and Technologies in Health. FAQ. Ottawa, Canada: Canadian Agency for Drugs and Technologies in Health. http://www.cadth.ca/index.php/en/hta/faq (accessed December 23, 2009).Google Scholar
4. Chou, R, Helfand, M. Challenges in systematic reviews that assess treatment harms. Ann Intern Med. 2005;142 (pt 2):10901099.CrossRefGoogle ScholarPubMed
5. Cookson, R, Maynard, A. Health technology assessment in Europe: Improving clarity and performance. Int J Technol Assess Health Care. 2000;16:639650.CrossRefGoogle ScholarPubMed
6. DeJean, D, Giacomini, M, Schwartz, L, Miller, FA. Ethics in Canadian health technology assessment: A descriptive review. Int J Technol Assess Health Care. 2009;25:463469.CrossRefGoogle ScholarPubMed
7. Draborg, E, Anderson, CK. Recommendations in health technology assessments worldwide. Int J Technol Assess Health Care. 2006;22:155160.CrossRefGoogle ScholarPubMed
8. Draborg, E, Gyrd-Hansen, D. Time-trends in health technology assessments: An analysis of developments in composition of international health technology assessments from 1989 to 2002. Int J Technol Assess Health Care. 2005;21:492498.CrossRefGoogle ScholarPubMed
9. Draborg, E, Gyrd-Hansen, D, Poulsen, PB, Horder, M. International comparison of the definition and the practical application of health technology assessment. Int J Technol Assess Health Care. 2005;21:8995.CrossRefGoogle ScholarPubMed
10. Eisenberg, JM. Ten lessons for evidence-based technology assessment. JAMA. 1999;282:18651869.CrossRefGoogle ScholarPubMed
11. EUnetHTA Work Package 5 Members. Applicability testing of WP5 toolkit – Round two: Summary report. Southampton, England: NIHR Coordinating Centre for Health Technology Assessment (NCCHTA); 2008.Google Scholar
12. Fretheim, A, Munabi-Babigumira, S, Oxman, AD, Lavis, JN, Lewin, S. SUPPORT Tools for evidence-informed health Policymaking (STP) 6: Using research evidence to address how an option will be implemented. Health Res Policy Syst. 2009;7 (Suppl 1):S6.CrossRefGoogle Scholar
13. Giacomini, M. The which-hunt: Assembling health technologies for assessment and rationing. J Health Polit Policy Law. 1999;24:715758.CrossRefGoogle ScholarPubMed
14. Goodman, CS, Ahn, R. Methodological approaches of health technology assessment. Int J Med Inform. 1999;56:97105.CrossRefGoogle ScholarPubMed
15. GRADE Working Group. Education and debate: Grading quality of evidence and strength of recommendations. BMJ. 2004;328:14901494.CrossRefGoogle Scholar
16. Granados, A, Jonsson, E, Banta, HD, et al. EUR-ASSESS project subgroup report on dissemination and impact. Int J Technol Assess Health Care. 1997;13:220286.CrossRefGoogle ScholarPubMed
17. Hailey, D. Toward transparency in health technology assessment. Int J Technol Assess Health Care. 2003;19:17.CrossRefGoogle ScholarPubMed
18. Haynes, RB. bmjupdates+, a new free service for evidence-based clinical practice. Evid Based Nurs. 2005;8:39.CrossRefGoogle ScholarPubMed
19. Haynes, RB, Cotoi, C, Holland, J, et al. Second-order peer review of the medical literature for clinical practitioners. JAMA. 2006;295:18011808.CrossRefGoogle ScholarPubMed
20. Haynes, RB, Holland, J, Cotoi, C, et al. McMaster PLUS: A cluster randomized clinical trial of an intervention to accelerate clinical use of evidence-based information from digital libraries. J Am Med Inform Assoc. 2006;13:593600.CrossRefGoogle Scholar
21. International Network of Agencies for Health Technology Assessment. A checklist for health technology assessment reports. Stockholm, Sweden: INAHTA Secretariat; 2001.Google Scholar
22. International Network of Agencies for Health Technology Assessment. HTA resources: Definitions – technology assessment. Stockholm, Sweden: International Network of Agencies for Health Technology Assessment. http://www.inahta.org (accessed December 23, 2009).Google Scholar
23. Jonsson, E, Banta, D. Management of health technologies: An international view. BMJ. 1999;319:1293.CrossRefGoogle Scholar
24. Lavis, JN. How can we support the use of systematic reviews in policymaking? PLoS Med. 2009;6:e1000141.CrossRefGoogle ScholarPubMed
25. Lavis, JN, Davies, HTO, Oxman, AD, et al. Towards systematic reviews that inform health care management and policy-making. J Health Serv Res Policy. 2005;10 (Suppl 1):S1:35–S1:48.CrossRefGoogle ScholarPubMed
26. Lavis, JN, Posada, FB, Haines, A, Osei, E. Use of research to inform public policymaking. Lancet. 2004;364:16151621.CrossRefGoogle ScholarPubMed
27. Lavis, JN, Wilson, MG, Oxman, AD, et al. SUPPORT Tools for evidence-informed health Policymaking (STP) 5: Using research evidence to frame options to address a problem. Health Res Policy Syst. 2009;7 (Suppl 1):S5.CrossRefGoogle ScholarPubMed
28. Lavis, JN, Wilson, MG, Oxman, AD, Lewin, S, Fretheim, A. SUPPORT Tools for evidence-informed health Policymaking (STP) 4: Using research evidence to clarify a problem. Health Res Policy Syst. 2009;7 (Suppl 1):S4.CrossRefGoogle ScholarPubMed
29. Lehoux, P, Blume, S. Technology assessment and the sociopolitics of health technologies. J Health Polit Policy Law. 2000;25:10831120.CrossRefGoogle ScholarPubMed
30. Lehoux, P, Denis, JL, Tailliez, S, Hivon, M. Dissemination of health technology assessments: Identifying the visions guiding an evolving policy innovation in Canada. J Health Polit Policy Law. 2005;30:603641.CrossRefGoogle ScholarPubMed
31. Lehoux, P, Tailliez, S, Denis, JL, Hivon, M. Redefining health technology assessment in Canada: Diversification of products and contextualization of findings. Int J Technol Assess Health Care. 2004;20:325336.CrossRefGoogle ScholarPubMed
32. Lomas, J, Culyer, T, McCutcheon, C, McAuley, L, Law, S. Conceptualizing and combining evidence for health system guidance. Ottawa, Canada: Canadian Health Services Research Foundation; 2005.Google Scholar
33. McGregor, M, Brophy, JM. End-user involvement in health technology assessment (HTA) development: A way to increase impact. Int J Technol Assess Health Care. 2005;21:263267.CrossRefGoogle ScholarPubMed
34. Mears, R, Taylor, R, Littlejohns, P, Dillon, A. Review of international health technology assessment. London, England: National Institute for Clinical Excellence; 2000.Google Scholar
35. Menon, D. An assessment of health technology assessment in Canada. Can J Public Health. 2000;91:120.CrossRefGoogle ScholarPubMed
36. Menon, D, Topfer, LA. Health technology assessment in Canada: A decade in review. Int J Technol Assess Health Care. 2000;16:896902.CrossRefGoogle Scholar
37. Office of Technology Assessment. Development of medical technologies: Opportunities for assessment. Washington, DC: US Government Printing Office; 1976.Google Scholar
38. Oxman, AD, Guyatt, GH. A consumers' guide to subgroup analyses. Ann Intern Med. 1992;116:7884.CrossRefGoogle ScholarPubMed
39. Pignone, M, Saha, S, Hoerger, T, Lohr, KN, Teutsch, S, Mandelblatt, J. Challenges in systematic reviews of economic analyses. Ann Intern Med. 2005;142 (pt 2):10731090.CrossRefGoogle ScholarPubMed
40. Tsikata, S, Robinson, V, Petticrew, M. Do Cochrane systematic reviews contain useful information about health equity? Barcelona, Spain: 11th Cochrane Colloquium; 2003.Google Scholar
41. Velasco Garrido, M, Busse, R. Health technology assessment: An introduction to objectives, role of evidence and structures in Europe. Copenhagen, Denmark: WHO Regional Office for Europe/ European Observatory on Health Systems and Policies; 2005.Google Scholar
42. Velasco Garrido, M, Gerhardus, A, Røttingen, JA, Busse, R. Developing health technology assessment to address health care system needs. Health Policy. 2010;94:196202.CrossRefGoogle ScholarPubMed
43. Velasco Garrido, M, Perleth, M, Drummond, M, et al. Best practice in undertaking and reporting health technology assessments: Working group 4 report. Int J Technol Assess Health Care. 2002;18:361422.Google Scholar
44. Velasco Garrido, M, Zentner, A, Busse, R. Health systems, health policy and health technology assessment. In: Velasco Garrido, M, Kristensen, FB, Nielsen, CP, Busse, R, eds. Health technology assessment and health policy-making in Europe: Current status, challenges and potential. Copenhagen, Denmark: World Health Organization; 2008:5379.Google Scholar
45. World Health Organization. The Mexico statement on health research: Knowledge for better health: Strengthening health systems. Geneva, Switzerland: World Health Organization; 2004.Google Scholar
46. World Health Organization. World report on knowledge for better health: Strengthening health systems. Geneva, Switzerland: World Health Organization; 2004.Google Scholar
47. World Health Organization. The Bamako call to action on research for health: Strengthening research for health, development, and equity. Geneva, Switzerland: World Health Organization; 2008.Google Scholar
Supplementary material: File

Lavis et al. supplementary material

Appendices

Download Lavis et al. supplementary material(File)
File 167.4 KB