Decision making in NICE single technological appraisals: How does NICE incorporate patient perspectives?
Decision making in NICE single technological appraisals: How does NICE incorporate patient perspectives?
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DOI：
10.1111/hex.12594
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Brown PR
中科院分区：
文献类型：
--
作者：
Hashem F;Calnan MW;Brown PR
国家卫生和保健卓越研究所（NICE）有一项明确的任务，即让患者和公众参与评估可供国民保健服务提供资金的药品。NICE包括一个评估委员会，在决定是否资助一种药物时，该委员会需要考虑来自患者专家的经验证据以及基于人群的临床和成本效益证据。本文考虑了NICE单一技术评估（STA）委员会如何试图将患者的观点纳入NHS资助药物的决策中。采用前瞻性设计跟踪三种药品，涉及三个不同的评估委员会。采用了三种数据收集方法：对NICE发送的文件证据进行分析，对公开会议和闭门会议进行非参与者非结构化观察，以及进行定性访谈。在9次STA会议上进行了非结构化的非参与性观察，并与NICE STA委员会的委员会成员、患者专家、NICE项目团队的分析师和药品制造商进行了41次半结构化访谈。我们的分析显示了委员会如何表现出对理想类型的患者代表的偏好，委员会在权衡STA过程中的患者陈述时存在分歧，以及对患者参与的更多准备支持。尽管NICE试图采取一种灵活的方法，通过纳入患者意见的正式决策安排来适应患者和护理人员，然而，sta的过程实际上可能会破坏从患者代表那里收集到的证据。
The National Institute for Health and Care Excellence (NICE) has an explicit mandate to include patient and public involvement in the appraisal of medicines to be available for funding on the NHS. NICE involves an appraisal committee who are required to take on board experiential evidence from patient experts alongside population‐based evidence on clinical and cost‐effectiveness when making a decision whether to fund a drug. This paper considers how NICE Single Technological Appraisal (STA) committees attempt to incorporate the views of patients in making decisions about funding medicines on the NHS. A prospective design was employed to follow three pharmaceutical products involving three different appraisal committees. Three data collection methods were used: analysis of documentary evidence sent by NICE, non‐participant unstructured observations of the open and closed sessions of meetings and qualitative interviews. Unstructured non‐participant observations were carried out at nine STA meetings, and 41 semi‐structured interviews were undertaken with committee members from NICE's STA committees, patient experts, analysts from NICE's project team and drug manufacturers. Our analysis showed how the committees displayed a preference for an ideal‐type of patient representative, disagreement among the committee when weighing‐up patient statements in the STA process and more pre‐preparation support for patient involvement. Although NICE has attempted to adopt an approach flexible to patients and carers through formal decision‐making arrangements that incorporate patient views, nonetheless, the processes of the STAs can in fact undermine the very evidence collected from patient representatives.
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DOI：
10.1186/1748-5908-9-24
发表时间：
2014-02-20
期刊：
Implementation science : IS
影响因子：
--
作者：
Boivin A;Lehoux P;Lacombe R;Burgers J;Grol R
通讯作者：
Grol R
影响因子：
3
作者：
Brown, Patrick;Hashem, Ferhana;Calnan, Michael
通讯作者：
Calnan, Michael
影响因子：
4.2
作者：
CHARLES, C;DEMAIO, S
通讯作者：
DEMAIO, S
影响因子：
7.2
作者：
Legare, France;Boivin, Antoine;Burgers, Jako
通讯作者：
Burgers, Jako
影响因子：
1.9
作者：
Barnes, M;Newman, J;Sullivan, H
通讯作者：
Sullivan, H