Patients' perspectives in health technology assessment: A route to robust evidence and fair deliberation
Patients' perspectives in health technology assessment: A route to robust evidence and fair deliberation
复制标题
DOI：
10.1017/s0266462310000395
复制
发表时间：
2010-07-01
影响因子：
3.2
通讯作者：
Single, Ann
中科院分区：
文献类型：
--
作者：
Facey, Karen;Boivin, Antoine;Single, Ann
越来越强调提供以病人为中心的保健，并确保病人参与保健服务的设计。由于卫生技术评估的目的是为决策提供信息的多学科、广泛的政策分析，因此预计应将患者的意见纳入评估。然而，HTA仍然是由收集定量证据来确定卫生技术的临床和成本效益所驱动的。病人对他们的疾病和技术的看法很少被包括在内，也许是因为他们被视为道听途说，有偏见的观点。有两种不同但互补的方式可以加强HTA: (i)收集关于患者观点的有力证据，以及（ii）确保患者有效参与HTA过程，从范围确定到证据收集、价值评估、建议制定和结果传播。通过对现有研究的综合或新的初步研究，可以通过良好的社会科学研究、严格的评估和仔细的报告，获得引起患者观点的有力证据。与患者的接触可以发生在几个层面上，我们建议HTA应该寻求支持有效的患者参与，以创造一个公平的审议过程。这应该允许双向信息流动，以便以一种支持性的方式获得患者的意见，并以透明的方式将其纳入决策过程。
There is increasing emphasis on providing patient-focused health care and ensuring patient involvement in the design of health services. As health technology assessment (HTA) is meant to be a multidisciplinary, wide-ranging policy analysis that informs decision making, it would be expected that patients' views should be incorporated into the assessment. However, HTA is still driven by collection of quantitative evidence to determine the clinical and cost effectiveness of a health technology. Patients' perspectives about their illness and the technology are rarely included, perhaps because they are seen as anecdotal, biased views. There are two distinct but complementary ways in which HTAs can be strengthened by: (i) gathering robust evidence about the patients' perspectives, and (ii) ensuring effective engagement of patients in the HTA process from scoping, through evidence gathering, assessment of value, development of recommendations and dissemination of findings. Robust evidence eliciting patients' perspectives can be obtained through social science research that is well conducted, critically appraised and carefully reported, either through meta-synthesis of existing studies or new primary research. Engagement with patients can occur at several levels and we propose that HTA should seek to support effective patient participation to create a fair deliberative process. This should allow two-way flow of information, so that the views of patients are obtained in a supportive way and fed into decision-making processes in a transparent manner.