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A Framework for Aiding the Translation of Scientific Evidence into Policy: The Experience of a Hospital-Based Technology Assessment Unit

  • Nisha D. Almeida (a1) (a2), Lorraine Mines (a1), Ioana Nicolau (a3), Alison Sinclair (a4), David Felipe Forero (a1) (a2), James M. Brophy (a1) (a2), Nancy Mayo (a2) and Nandini Dendukuri (a1) (a2)...

Abstract

Objectives

Very few practical frameworks exist to guide the formulation of recommendations at hospital-based health technology assessment (HTA) units. The objectives of our study were: (i) to identify decision criteria specific to the context of hospital-based health technologies and interventions, (ii) to estimate the extent to which the expert community agrees on the importance of the identified criteria, (iii) to incorporate the identified criteria into a decision-aid tool, and (iv) to illustrate the application of a prototype decision-aid tool.

Methods

Relevant decision criteria were identified using existing frameworks for HTA recommendations, our past experience, a literature search, and feedback from a survey of diverse stakeholders.

Results

Based on the survey results, twenty-three decision criteria were incorporated into the final framework. We defined an approach that eschewed a scoring system, but instead relied on a visual means for arriving at a final recommendation, by juxtaposing the importance rating for each criterion against the results of the health technology assessment. For a technology to be approved, a majority of criteria considered important should also have received favorable findings.

Conclusions

We created a simple and practical decision-aid tool that incorporates all decision criteria relevant to a hospital-based HTA unit. With its ease of use and accessibility, our tool renders the subjective decision-making process more structured and transparent.

Copyright

Corresponding author

Author for correspondence: Nisha D. Almeida, E-mail: nisha.almeida@mail.mcgill.ca

Footnotes

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J.M.B and N.D. receive salary support from the FRQS (Fonds de recherche du Quebec - Sante), a nonprofit provincial funding agency.

Footnotes

References

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1.Gagnon, MP (2014) Hospital-based health technology assessment: Developments to date. PharmacoEconomics 32, 819824.
2.Facey, K, Boivin, A, Gracia, J, et al. (2010) Patients’ perspectives in health technology assessment: A route to robust evidence and fair deliberation. Int J Technol Assess Health Care 26, 334340.
3.The Ontario Health Technology Advisory Committee (OHTAC) (2010) The OHTAC decision-making process for the development of evidence-based recommendations. http://www.hqontario.ca/en/mas/tech/pdfs/2011/guide_decision.pdf. [accessed July 20, 2018]
4.Johnson, AP, Sikich, NJ, Evans, G, et al. (2009) Health technology assessment: A comprehensive framework for evidence-based recommendations in Ontario. Int J Technol Assess Health Care 25, 141150.
5.Canadian Agency for Drugs and Technologies in Health (2015) Process for Developing Recommendations. Ottawa; 2015. https://www.cadth.ca/sites/default/files/pdf/HTERP_Process.pdf [accessed October 17, 2018]
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7.Goetghebeur, MM, Wagner, M, Khoury, H, et al. (2010) Combining multicriteria decision analysis, ethics and health technology assessment: Applying the EVIDEM decisionmaking framework to growth hormone for Turner syndrome patients. Cost Eff Resour Alloc 8, 4.
8.Andrews, J, Guyatt, G, Oxman, AD, et al. (2013) GRADE guidelines: 14. Going from evidence to recommendations: The significance and presentation of recommendations. J Clin Epidemiol 66, 719725.
9.Poulin, P, Austen, L, Scott, CM, et al. (2013) Multi-criteria development and incorporation into decision tools for health technology adoption. J Health Organ Manag 27, 246265.
10.Sampietro-Colom, L, Morilla-Bachs, I, Gutierrez-Moreno, S, Gallo, P (2012) Development and test of a decision support tool for hospital health technology assessment. Int J Technol Assess Health Care 28, 460465.
11.Tanios, N, Wagner, M, Tony, M, et al. (2013) Which criteria are considered in healthcare decisions? Insights from an international survey of policy and clinical decision makers. Int J Technol Assess Health Care 29, 456465.
12.Ritrovato, M, Faggiano, FC, Tedesco, G, Derrico, P (2015) Decision-oriented health technology assessment: One step forward in supporting the decision-making process in hospitals. Value Health 18, 505511.
13.Hofmann, B, Cleemput, I, Bond, K, et al. (2014) Revealing and acknowledging value judgments in health technology assessment. Int J Technol Assess Health Care 30, 579586.

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Supplementary materials

Almeida et al. supplementary material
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A Framework for Aiding the Translation of Scientific Evidence into Policy: The Experience of a Hospital-Based Technology Assessment Unit

  • Nisha D. Almeida (a1) (a2), Lorraine Mines (a1), Ioana Nicolau (a3), Alison Sinclair (a4), David Felipe Forero (a1) (a2), James M. Brophy (a1) (a2), Nancy Mayo (a2) and Nandini Dendukuri (a1) (a2)...

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