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COMPREHENSIVE ASSESSMENT OF COMPLEX TECHNOLOGIES: INTEGRATING VARIOUS ASPECTS IN HEALTH TECHNOLOGY ASSESSMENT

Published online by Cambridge University Press:  07 August 2017

Kristin Bakke Lysdahl
Affiliation:
Centre for Medical Ethics, University of Oslo Faculty of Health Sciences, Oslo and Akershus University College of Applied SciencesKristin.Bakke.Lysdahl@usn.no
Kati Mozygemba
Affiliation:
Department of Health Services Research, University of Bremen Health Sciences Bremen
Jacob Burns
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Jan Benedikt Brönneke
Affiliation:
Federal Joint Committee (G-BA)
James B. Chilcott
Affiliation:
ScHARR, University of Sheffield
Sue Ward
Affiliation:
ScHARR, University of Sheffield
Bjørn Hofmann
Affiliation:
Centre for Medical Ethics, University of Oslo The Norwegian University for Science and Technology (NTNU)

Abstract

Objectives: Despite recent development of health technology assessment (HTA) methods, there are still methodological gaps for the assessment of complex health technologies. The INTEGRATE-HTA guidance for effectiveness, economic, ethical, socio-cultural, and legal aspects, deals with challenges when assessing complex technologies, such as heterogeneous study designs, multiple stakeholder perspectives, and unpredictable outcomes. The objective of this article is to outline this guidance and describe the added value of integrating these assessment aspects.

Methods: Different methods were used to develop the various parts of the guidance, but all draw on existing, published knowledge and were supported by stakeholder involvement. The guidance was modified after application in a case study and in response to feedback from internal and external reviewers.

Results: The guidance consists of five parts, addressing five core aspects of HTA, all presenting stepwise approaches based on the assessment of complexity, context, and stakeholder involvement. The guidance on effectiveness, health economics and ethics aspects focus on helping users choose appropriate, or further develop, existing methods. The recommendations are based on existing methods’ applicability for dealing with problems arising with complex interventions. The guidance offers new frameworks to identify socio-cultural and legal issues, along with overviews of relevant methods and sources.

Conclusions: The INTEGRATE-HTA guidance outlines a wide range of methods and facilitates appropriate choices among them. The guidance enables understanding of how complexity matters for HTA and brings together assessments from disciplines, such as epidemiology, economics, ethics, law, and social theory. This indicates relevance for a broad range of technologies.

Type
Theme Submissions
Copyright
Copyright © Cambridge University Press 2017 

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