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Evaluation of Ethical Analyses in Seven Reports from the European Network for Health Technology Assessment

Part of: Special Collection - Methods

Published online by Cambridge University Press:  16 July 2019

Perihan Elif Ekmekci  and
Müberra Devrim Güner
Perihan Elif Ekmekci*
Affiliation:
TOBB ETU Medical School, Department of History of Medicine and Ethics
Müberra Devrim Güner
Affiliation:
TOBB ETU Medical School, Department of Medical Pharmacology
*
Author for correspondence: Perihan Elif Ekmekci, E-mail: p.ekmekci@etu.edu.tr
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Abstract

Objectives

Ethics has been considered among the core domains of health technology assessment (HTA), but there are still disputes regarding ethical analysis. This study aimed to examine full final reports of the European Network for Health Technology Assessment (EUnetHTA) in terms of their compliance with the ethical methodology and ethical perspective of the HTA Core Model®.

Methods

The study examines seven full final HTA reports of EUnetHTA written based on the methodology proposed in the HTA Core Model®. The reports were analyzed using the following parameters: competency of the person/group who conducted ethical analysis, assessment elements, and the methodology of ethical analysis.

Results

The results show that, although the HTA Core Model® helped to standardize the final reports of the assessment, there are still concerns regarding the competency of the ethical analysis team, the perspectives on the purpose of ethical analysis, data sources and viewpoints of various stakeholders, use of ethical analysis methodology, and the evaluation of the ethical appropriateness of the entire HTA process.

Conclusions

The HTA Core Model® helped to standardize the final reports on the HTA; however, not all issues with the content and outcomes were solved. The lack of expertise in ethics and insufficiency of the teams regarding ethical analysis are other existing problems. This study also demonstrated that stakeholder viewpoints in general and patient perspectives, in particular, have been overlooked in the HTA process.

Keywords

Health technology assessmentEthical analysisMethodologyEthical expertise
Type
Method
Information
International Journal of Technology Assessment in Health Care , Volume 35 , Issue 4 , 2019 , pp. 273 - 279
Copyright
Copyright © Cambridge University Press 2019 

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Footnotes

This research received no specific grant from any funding agency, commercial or not-for-profit sectors

References

1.Goodman, CS (2014) HTA 101: Introduction to Health Technology Assessment. Bethesda, MD: National Library of Medicine (US). https://www.nlm.nih.gov/nichsr/hta101/HTA_101_FINAL_7-23-14.pdf.Google Scholar
2.The International Network of Agencies for Health Technology Assessment (INAHTA) http://www.inahta.org/.Google Scholar
3.EUnetHTA Joint Action 2, Work Package 8. The HTA core model® version 3.0; 2016. https://www.eunethta.eu/wp-content/uploads/2018/03/HTACoreModel3.0-1.pdf.Google Scholar
4.Heitman, E (1998) Ethical issues in technology assessment. Conceptual categories and procedural considerations. Int J Technol Assess Health Care 14, 544–566.Google Scholar
5.Hofmann, BM (2008) Why ethics should be part of health technology assessment. Int J Technol Assess Health Care 24, 423–429.Google Scholar
6.Leys, M (2003) Health care policy: Qualitative evidence and health technology assessment. Health Policy 65, 217–226.Google Scholar
7.Bellemare, C, Dagenais, P, K-Bédard, S, et al. (2018) Ethics in health technology assessment: A systematic review. Int J Technol Assess Health Care 34, 447–547.Google Scholar
8.Weinstein, BD (1993) What is an expert? Theoret Med 14, 57–73.Google Scholar
9.EUnetHTA (2014) Fecal immunochemical test (FIT) vs guaiac-based fecal occult blood test (FOBT) for colorectal cancer screening (Core HTA 1). https://www.eunethta.eu/fecal-immunochemical-test-fit-vs-guaiac-based-fecal-occult-blood-test-fobt-for-colorectal-cancer-screening-core-hta-1/.Google Scholar
10.EUnetHTA (2015) Structured telephone support (STS) for adult patients with chronic heart failure (Core HTA 3). https://www.eunethta.eu/structured-telephone-support-sts-for-adult-patients-with-chronic-heart-failure-core-hta-3/.Google Scholar
11.EUnetHTA (2015) Use of intravenous immunoglobulins for Alzheimer's disease including mild cognitive impairment (Core HTA 2). https://www.eunethta.eu/use-of-intravenous-immunoglobulins-for-alzeheimers-disease-including-mild-cognitive-impairment-core-hta-2/.Google Scholar
12.EUnetHTA (2008) Core HTA on MSCT angiography. https://www.eunethta.eu/core-hta-on-msct-angiography/.Google Scholar
13.EUnetHTA (2013) Prognostic tests for breast cancer recurrence (PTBCR). https://www.eunethta.eu/prognostic-tests-for-breast-cancer-recurrence-ptbcr/.Google Scholar
14.EUnetHTA (2008) Core HTA on drug eluting stents. https://www.eunethta.eu/core-hta-on-drug-eluting-stents/.Google Scholar
15.EUnetHTA (2013) Abdominal aorta aneurysm screening. https://www.eunethta.eu/abdominal-aorta-aneurysm-screening-aaa/.Google Scholar
16.Saarni, SI, Hofmann, B, Lampe, K, et al. (2008) Ethical analysis to improve decision-making on health technologies. Bull World Health Organ 86, 617–623.Google Scholar
17.Duthie, K, Bond, K (2011) Improving ethics analysis in health technology assessment. Int J Technol Assess Health Care 27, 64–70.10.1017/S0266462310001303Google Scholar
18.Hofmann, B (2001) On the value-ladenness of technology in medicine. Med Health Care Philos 4, 335–346.Google Scholar
19.Arellano, LE, Willett, JM, Borry, P (2011) International survey on attitudes toward ethics in health technology assessment: An exploratory study. Int J Technol Assess Health Care 27, 50–54.Google Scholar
20.Refolo, P, Sacchini, D, Brereton, L, et al. (2016) Why is it so difficult to integrate ethics in Health Technology Assessment (HTA)? The epistemological viewpoint. Eur Rev Med Pharmacol Sci 20, 4202–4208.Google Scholar
21.Lysdahl, KB, Oortwijn, W, van der Wilt, GJ, et al. (2016) Ethical analysis in HTA of complex health interventions. BMC Med Ethics 17, 16.Google Scholar
22.Annas, GJ, Glantz, LH, Mariner, WK (1989) Brief for bioethicists for privacy as amicus curiae supporting appellees. Am J Law Med 15, 169–177.Google Scholar
23.Hofmann, B (2014) Why not integrate ethics in HTA: Identification and assessment of the reasons. GMS Health Technol Assess 10, Doc04.Google Scholar
24.Lehoux, P, Blume, S (2000) Technology assessment and the sociopolitics of health technologies. J Health Polit Policy Law 25, 1083–1120.Google Scholar
25.Assasi, N, Schwartz, L, Tarride, JE, Campbell, K, Goeree, R (2014) Methodological guidance documents for evaluation of ethical considerations in health technology assessment: A systematic review. Expert Rev Pharmacoecon Outcomes Res 14, 203–220.Google Scholar
26.Assasi, N, Schwartz, L, Tarride, JE, O'Reilly, D, Goeree, R (2015) Barriers and facilitators influencing ethical evaluation in health technology assessment. Int J Technol Assess Health Care 31, 113–123.Google Scholar
27.Arellano, LE, Willett, JM, Borry, P (2011) International survey on attitudes toward ethics in health technology assessment: An exploratory study. Int J Technol Assess Health Care 27, 50–54.Google Scholar
28.Reuzel, RPB (2004) Interactive technology assessment of pediatric cochlear implantation. Poiesis Prax 2–3, 119–137.Google Scholar
29.Clausen, C, Yoshinaka, Y (2004) Social shaping of technology in TA and HTA. Poiesis Prax 2–3, 221–246.Google Scholar
30.Salazar-Acosta, M, Holbrook, A (2012) Some Notes on Theories of Technology, Society and Innovation Systems for S&T Policy Studies. CPROST Report 08–02. Vancouver, BC: Centre for Policy Research on Science and Technology Simon Fraser University.Google Scholar
31.Sacchini, D, Spagnolo, AG, Minacori, R, Carrasco de Paula, I (2005) HTA and ethics: The framework of ethical positions and the proposal of a person-centred model. Ital J Public Health 2, 304.Google Scholar