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Application of a health technology assessment framework to digital health technologies that manage chronic disease: a systematic review

Published online by Cambridge University Press:  20 December 2021

Amy von Huben Open the ORCID record for Amy von Huben [Opens in a new window] ,
Martin Howell ,
Joseph Carrello ,
Sarah Norris ,
Sally Wortley Open the ORCID record for Sally Wortley [Opens in a new window] ,
Angus Ritchie  and
Kirsten Howard
Amy von Huben*
Affiliation:
School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Martin Howell
Affiliation:
School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Joseph Carrello
Affiliation:
School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Sarah Norris
Affiliation:
School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Sally Wortley
Affiliation:
Consumer Evidence and Engagement Unit at Australian Department of Health, Canberra, Australian Capital Territory, Australia
Angus Ritchie
Affiliation:
Concord Clinical School, University of Sydney, Sydney, New South Wales, Australia Health Informatics Unit, Sydney Local Health District, Camperdown, New South Wales, Australia
Kirsten Howard
Affiliation:
School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
*
Author for correspondence: Amy von Huben, E-mail: amy.vonhuben@sydney.edu.au
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Abstract

Background

As health services increasingly make investment decisions in digital health technologies (DHTs), a DHT-specific and comprehensive health technology assessment (HTA) process is crucial in assessing value-for-money. Research in DHTs is ever-increasing, but whether it covers the content required for HTA is unknown.

Objectives

To summarize current trends in primary research on DHTs that manage chronic disease at home, particularly the coverage of content recommended for DHT-specific and comprehensive HTA.

Methods

Medline, Embase, Econlit, CINAHL, and The Cochrane Library (1 January 2015 to 20 March 2020) were searched for primary research studies using keywords related to DHT and HTA domains. Studies were assessed for coverage of the most frequently recommended content to be considered in a nine domain DHT-specific HTA previously developed.

Results

A total of 178 DHT interventions were identified, predominantly randomized controlled trials targeting cardiovascular disease/diabetes in high- to middle-income countries. A coverage assessment of the cardiovascular and diabetes DHT studies (112) revealed less than half covered DHT-specific content in all but the health problem domain. Content common to all technologies but essential for DHTs was covered by more than half the studies in all domains except for the effectiveness and ethical analysis domains.

Conclusions

Although DHT research is increasing, it is not covering all the content recommended for a DHT-specific and comprehensive HTA. The inability to conduct such an HTA may lead to health services making suboptimal investment decisions. Measures to increase the quality of trial design and reporting are required in DHT primary research.

Keywords

Health technology assessmentDigital healthRemote monitoringEvaluation frameworksChronic disease
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 38 , Issue 1 , 2022 , e9
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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