Exploring the perspectives and preferences for HTA across German healthcare stakeholders using a multi-criteria assessment of a pulmonary heart sensor as a case study.
Exploring the perspectives and preferences for HTA across German healthcare stakeholders using a multi-criteria assessment of a pulmonary heart sensor as a case study.
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DOI：
10.1186/s12961-015-0011-1
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发表时间：
2015-04-28
影响因子：
4
通讯作者：
National Leading-Edge Cluster Medical Technologies ‘Medical Valley EMN’
中科院分区：
文献类型：
--
作者：
Wahlster P;Goetghebeur M;Schaller S;Kriza C;Kolominsky-Rabas P;National Leading-Edge Cluster Medical Technologies ‘Medical Valley EMN’
卫生技术评估和医疗保健决策是基于多个标准和证据，以及参与利益相关者的不同意见。多标准决策分析（MCDA）提供了一个潜在的框架，使这一过程系统化，并考虑到不同的观点。本研究的目的是探索德国利益相关者在评估医疗保健干预措施时的观点和偏好，使用心肺传感器的多标准评估作为案例研究。使用综合MCDA框架（EVIDEM V2.2）对100名德国医疗保健利益相关者进行了在线调查。要求参与者提供i）框架中每个标准的相对权重; ii）基于每个标准合成的可用数据的健康肺部传感器的性能评分;以及iii）关于背景标准考虑的定性反馈。使用线性模型将归一化权重和分数结合起来，以计算不同利益相关者的价值估计。探讨了各类利益攸关方之间的差异。调查由54名参与者完成。最重要的标准是疗效、患者报告的结局、疾病严重程度、安全性和证据质量（相对权重均>0.075）。与所有参与者相比，决策者更重视预算影响和证据质量。肺源性心脏传感器的定量评估显示，在标准水平上，利益相关者组之间的这种干预的评分性能存在差异。行业代表对传感器的最高估计值为0.68（0到1，1代表最大值），政策制定者报告的最低值为0.40，而所有参与者的最低值为0.48。与会者表示，应考虑大多数质量标准，并透明地反映这些标准对定量评估的影响。该研究发现，在评估医疗保健干预措施时，德国利益相关者的观点存在重要差异，并表明MCDA可以为所有参与的利益相关者展示特定技术的价值。更好地理解标准层面的这些差异，特别是政策制定者和行业代表之间的差异，对于关注与患者健康和医疗保健系统价值观和限制相一致的创新非常重要。本文的在线版本（doi：10.1186/s12961-015-0011-1）包含补充材料，可供授权用户使用。
Health technology assessment and healthcare decision-making are based on multiple criteria and evidence, and heterogeneous opinions of participating stakeholders. Multi-criteria decision analysis (MCDA) offers a potential framework to systematize this process and take different perspectives into account. The objectives of this study were to explore perspectives and preferences across German stakeholders when appraising healthcare interventions, using multi-criteria assessment of a heart pulmonary sensor as a case study. An online survey of 100 German healthcare stakeholders was conducted using a comprehensive MCDA framework (EVIDEM V2.2). Participants were asked to provide i) relative weights for each criterion of the framework; ii) performance scores for a health pulmonary sensor, based on available data synthesized for each criterion; and iii) qualitative feedback on the consideration of contextual criteria. Normalized weights and scores were combined using a linear model to calculate a value estimate across different stakeholders. Differences across types of stakeholders were explored. The survey was completed by 54 participants. The most important criteria were efficacy, patient reported outcomes, disease severity, safety, and quality of evidence (relative weight >0.075 each). Compared to all participants, policymakers gave more weight to budget impact and quality of evidence. The quantitative appraisal of a pulmonary heart sensor revealed differences in scoring performance of this intervention at the criteria level between stakeholder groups. The highest value estimate of the sensor reached 0.68 (on a scale of 0 to 1, 1 representing maximum value) for industry representatives and the lowest value of 0.40 was reported for policymakers, compared to 0.48 for all participants. Participants indicated that most qualitative criteria should be considered and their impact on the quantitative appraisal was captured transparently. The study identified important variations in perspectives across German stakeholders when appraising a healthcare intervention and revealed that MCDA can demonstrate the value of a specified technology for all participating stakeholders. Better understanding of these differences at the criteria level, in particular between policymakers and industry representatives, is important to focus innovation aligned with patient health and healthcare system values and constraints. The online version of this article (doi:10.1186/s12961-015-0011-1) contains supplementary material, which is available to authorized users.
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DOI：
10.2165/11539470-000000000-00000
发表时间：
2010
期刊：
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