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DECISION-COMPONENTS OF NICE'S TECHNOLOGY APPRAISALS ASSESSMENT FRAMEWORK

Published online by Cambridge University Press:  10 April 2018

Joost de Folter Open the ORCID record for Joost de Folter [Opens in a new window] ,
Mark Trusheim ,
Pall Jonsson  and
Sarah Garner
Joost de Folter
Affiliation:
National Institute for Health and Care Excellence (NICE)joost.defolter@nice.org.uk; folterj@gmail.com
Mark Trusheim
Affiliation:
Massachusetts Institute of Technology (MIT)
Pall Jonsson
Affiliation:
National Institute for Health and Care Excellence (NICE)Pall.Jonsson@nice.org.uk
Sarah Garner
Affiliation:
National Institute for Health and Care Excellence (NICE)
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Abstract

Objectives: Value assessment frameworks have gained prominence recently in the context of U.S. healthcare. Such frameworks set out a series of factors that are considered in funding decisions. The UK's National Institute of Health and Care Excellence (NICE) is an established health technology assessment (HTA) agency. We present a novel application of text analysis that characterizes NICE's Technology Appraisals in the context of the newer assessment frameworks and present the results in a visual way.

Methods: A total of 243 documents of NICE's medicines guidance from 2007 to 2016 were analyzed. Text analysis was used to identify a hierarchical set of decision factors considered in the assessments. The frequency of decision factors stated in the documents was determined and their association with terms related to uncertainty. The results were incorporated into visual representations of hierarchical factors.

Results: We identified 125 decision factors, and hierarchically grouped these into eight domains: Clinical Effectiveness, Cost Effectiveness, Condition, Current Practice, Clinical Need, New Treatment, Studies, and Other Factors. Textual analysis showed all domains appeared consistently in the guidance documents. Many factors were commonly associated with terms relating to uncertainty. A series of visual representations was created.

Conclusions: This study reveals the complexity and consistency of NICE's decision-making processes and demonstrates that cost effectiveness is not the only decision-criteria. The study highlights the importance of processes and methodology that can take both quantitative and qualitative information into account. Visualizations can help effectively communicate this complex information during the decision-making process and subsequently to stakeholders.

Keywords

Decision makingEvidence-based medicineSocial valuesTechnology assessment
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 2 , 2018 , pp. 163 - 171
Copyright
Copyright © Cambridge University Press 2018 

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References

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Supplementary material: PDF

de Folter et al. supplementary material

Table S1

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de Folter et al. supplementary material

Table S2

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Table S3

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