Health technology reassessment: the art of the possible.
Health technology reassessment: the art of the possible.
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DOI：
10.1017/s0266462313000494
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发表时间：
2013-10
影响因子：
3.2
通讯作者：
Clement, Fiona
中科院分区：
文献类型：
--
作者：
MacKean, Gail;Noseworthy, Tom;Elshaug, Adam G.;Leggett, Laura;Littlejohns, Peter;Berezanski, Joan;Clement, Fiona
背景资料：卫生技术再评估（HTR）是“对医疗系统中当前使用的技术的临床，社会，伦理和经济影响进行的结构化，循证评估，以告知该技术与其替代品相比的最佳使用。本研究的目的是描述当前HTR活动背景下的关键主题，并为这一新兴领域提出前进的方向。方法：数据收集自2012年加拿大卫生药物和技术机构（CADTH）研讨会的一部分。研讨会包括两个小组报告，然后进行讨论;收集的数据，包括演示文稿和丰富的观众讨论记录，分析了HTR领域出现的关键主题，使用不断的比较分析。结果：选择描述HTR的语言将为参与定下基调。在多个层面确定倡导者和政治意愿至关重要。从国际经验中吸取的主要教训是：撤资困难，侧重于临床领域而不是具体技术，确定HTR议程的明确目标。确定了推进HTR议程的六个关键主题：强调一体化而不是隔离，注重HTR方法和过程的发展，过程是针对具体情况的，但必须分享经验教训，在协同的跨学科领域建立能力，发展有意义的利益相关者参与，加强实施后的监测和评估。结论：为了推动这一领域的发展，我们必须继续借鉴国际经验，重点是开发新的方法论途径，以生成、整合和实施证据，并将其纳入政策和实践。
Background: Health technology reassessment (HTR) is “a structured, evidence-based assessment of the clinical, social, ethical, and economic effects of a technology currently used in the healthcare system, to inform optimal use of that technology in comparison to its alternatives.” The purpose of this study is to describe the key themes in the context of current HTR activities and propose a way forward for this newly emerging field. Methods: Data were gathered from a workshop held as part of the 2012 Canadian Agency for Drugs and Technology in Health (CADTH) symposium. The workshop consisted of two panel presentations followed by discussion; data gathered, including presentations and rich audience discussion transcripts, were analyzed for key themes emerging in the field of HTR using constant comparative analysis. Results: The language chosen to describe HTR will set the tone for engagement. The identification of champions at multiple levels and political will are essential. Key lessons from international experience are: disinvestment is difficult, focus on clinical areas not specific technologies, identify clear goals of the HTR agenda. Six key themes were identified to move the HTR agenda forward: emphasize integration over segregation, focus on development of HTR methods and processes, processes are context-specific but lessons must be shared, build capacity in synergistic interdisciplinary fields, develop meaningful stakeholder engagement, strengthen postimplementation monitoring and evaluation. Conclusions: To move this field forward, we must continue to build on international experiences with a focus on developing novel methodological approaches to generating, incorporating, and implementing evidence into policy and practice.