Addressing Health System Values in Health Technology Assessment: The Use of Evidence-Informed Deliberative Processes

Oortwijn, Wija; Klein, Philip Α.

doi:10.1017/s0266462319000187

Cited by 11 publications

(8 citation statements)

References 23 publications

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“…We could not identify from the sources studied how the decision criteria are selected including whether stakeholders are involved in the selection ( Supplementary file 1 : Table S2). Previous research on linking health system values and decision criteria also found that it is difficult to retrieve this information from written sources 35 For learning purposes it would be valuable to study the selection processes of decision criteria as used by HTA bodies in more detail using for example semi-structured interviews.…”

Section: Introductionmentioning

confidence: 99%

Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide

Oortwijn¹,

Jansen²,

Baltussen³

2021

Int J Health Policy Manag

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Background. Countries around the world are using health technology assessment (HTA) for health benefit package design. Evidence-informed deliberative processes (EDPs) are a practical and stepwise approach to enhance legitimate health benefit package design based on deliberation between stakeholders to identify, reflect and learn about the meaning and importance of values, informed by evidence on these values. This paper reports on the development of practical guidance on EDPs, while the conceptual framework of EDPs is described in a companion paper. Methods. The first guide on EDPs (2019) is further developed based on academic knowledge exchange, surveying 27 HTA bodies and 66 experts around the globe, and the implementation of EDPs in several countries. We present the revised steps of EDPs and how selected HTA bodies (in Australia, Brazil, Canada, France, Germany, Scotland, Thailand and the United Kingdom) organize key issues of legitimacy in their processes. This is based on a review of literature via PubMed and HTA bodies’ websites. Results. HTA bodies around the globe vary considerable in how they address legitimacy (stakeholder involvement ideally through participation with deliberation; evidence-informed evaluation; transparency; and appeal) in their processes. While there is increased attention for improving legitimacy in decision-making processes, we found that the selected HTA bodies are still lacking or just starting to develop activities in this area. We provide recommendations on how HTA bodies can improve on this. Conclusion. The design and implementation of EDPs is in its infancy. We call for a systematic analysis of experiences of a variety of countries, from which general principles on EDPs might subsequently be inferred.

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Section: Introductionmentioning

confidence: 99%

Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide

Oortwijn¹,

Jansen²,

Baltussen³

2021

Int J Health Policy Manag

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“…The biggest thematic cluster considers the assessment and selection of healthcare and health technologies, within which a subarea of medical and biomedical technology selections was distinguished. Health Technology Assessment (HTA) is a wellestablished research field (Oortwijn & Klein, 2019). Within the search results, documents related to healthcare technologies or health constitute almost 30 % in WoS and around 14 % in Scopus.…”

Section: Discussion Of the Resultsmentioning

confidence: 99%

Methods of Multi-Criteria Analysis in Technology Selection and Technology Assessment: A Systematic Literature Review

Kozłowska

2022

Engineering Management in Production and Services

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Technology assessment and selection problems have gained importance in recent decades as the used technology often determines the enterprises’ competitive advantage. Due to the extensive catalogue of criteria that should be considered and, on the other hand, the extensive catalogue of available technologies and solutions, the decision-making process of choosing a technology becomes a significant challenge for organisations and individuals. This study aims to identify the main research directions and trends in the scientific literature on applying multi-criteria analysis (MCA) in the context of technology assessment and/or technology selection. The author conducted a bibliometric analysis of publications indexed in the Web of Science and Scopus databases. The methodology of this study also included identifying the most productive authors, countries, organisations, and journals and analysing the occurrence and co-occurrence of terms. Final analyses included 380 publications retrieved from the Scopus database and 311 documents retrieved from the Web of Science repository. The analysis of the occurrence of terms and keywords allowed distinguishing two main research directions in using MCA methods in assessing and selecting industrial and health and medicine-related technologies. Some sub-areas have also been distinguished within these two areas: energy and renewable energy technologies, waste management, biomedical and medical technologies, and drug production technologies.

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“…Given the increasing interest and focusin this journal and beyondon both deliberation in MCDA (26)(27)(28) and how deliberation can and should be used to inform HTA more generally (29), this commentary provides further insights and arguments to guide ongoing experimentation and evaluation of different deliberative approaches for health priority-setting on the bases of quality, transparency, and other important goals of decision making. To this end, we propose that it may be more constructive to move away from a typology that distinguishes MCDA in terms of quantitative and qualitative assessment and instead focus on how well different deliberative, multi-criteria approaches are able to incorporate and balance the various types of qualitative and quantitative informational inputs that are morally relevant to the decisions at hand.…”

Section: Resultsmentioning

confidence: 99%

Beyond the numbers: a critique of quantitative multi-criteria decision analysis

DiStefano

Krubiner

2020

Int J Technol Assess Health Care

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When setting priorities for health, there is broad agreement that a range of social values and ethical principles beyond clinical and cost-effectiveness matter, but exactly how health technology assessment (HTA) should account for a broader set of criteria remains an area of ongoing debate. In light of this, we welcome a recent review paper by Baltussen et al. evaluating the potential of different multi-criteria decision analysis (MCDA) approaches to enable HTA agencies to incorporate a broader set of values in their appraisals. The authors describe three approaches to MCDA—qualitative MCDA, quantitative MCDA, and MCDA with decision rules—laying out their relative advantages and disadvantages and providing recommendations for how they can best be implemented. While we endorse many of the authors' assessments and conclusions, including the critical role of deliberation in any MCDA approach and the undertaking of qualitative MCDA at a minimum, we take a stronger position regarding the flaws of quantitative MCDA and strongly caution against it. We find quantitative MCDA antithetical to at least two of the ways MCDA is intended to improve HTA recommendations: (i) enhancing quality and (ii) promoting transparency. Quantitative MCDA may mask the complex tradeoffs that exist within and between decision criteria and remain generally inaccessible to those who are not well-versed in its technical methods of appraisal. We advocate for a predominantly qualitative approach to MCDA appraisal centered around deliberation and supplemented with decision aids to help account for health opportunity costs.

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Addressing Health System Values in Health Technology Assessment: The Use of Evidence-Informed Deliberative Processes

Cited by 11 publications

References 23 publications

Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide

Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide

Methods of Multi-Criteria Analysis in Technology Selection and Technology Assessment: A Systematic Literature Review

Beyond the numbers: a critique of quantitative multi-criteria decision analysis

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