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Development of a checklist to guide equity considerations in health technology assessment

Part of: Special Collection - Methods

Published online by Cambridge University Press:  25 January 2021

Maria Benkhalti Open the ORCID record for Maria Benkhalti [Opens in a new window] ,
Manuel Espinoza ,
Richard Cookson ,
Vivian Welch ,
Peter Tugwell  and
Pierre Dagenais Open the ORCID record for Pierre Dagenais [Opens in a new window]
Maria Benkhalti*
Affiliation:
Unité d’évaluation des technologies et des modes d'intervention en santé et services sociaux (UETMISSS), CIUSSS de l'Estrie – CHUS, Sherbrooke, Quebec, Canada J1G 2E8 Faculty of Medicine and Health Sciences, Université de Sherbrooke, 1036 Belvédère Street, Sherbrooke, Quebec, CanadaJ1H 4C4
Manuel Espinoza
Affiliation:
Department of Public Health, Health Technology Assessment Unit, Centre for Clinical Research, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
Richard Cookson
Affiliation:
Centre for Health Economics, University of York, York, UK
Vivian Welch
Affiliation:
Bruyere Research Institute, Ottawa, Canada School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
Peter Tugwell
Affiliation:
Bruyere Research Institute, Ottawa, Canada Faculty of Medicine, University of Ottawa, Ottawa, Canada
Pierre Dagenais
Affiliation:
Unité d’évaluation des technologies et des modes d'intervention en santé et services sociaux (UETMISSS), CIUSSS de l'Estrie – CHUS, Sherbrooke, Quebec, Canada J1G 2E8 Faculty of Medicine and Health Sciences, Université de Sherbrooke, 1036 Belvédère Street, Sherbrooke, Quebec, CanadaJ1H 4C4
*
Author for correspondence: Maria Benkhalti, E-mail: maria.benkhalti.ciussse-chus@ssss.gouv.qc.ca
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Abstract

Objectives

Health technology assessment (HTA) can impact health inequities by informing healthcare priority-setting decisions. This paper presents a novel checklist to guide HTA practitioners looking to include equity considerations in their work: the equity checklist for HTA (ECHTA). The list is pragmatically organized according to the generic HTA phases and can be consulted at each step.

Methods

A first set of items was based on the framework for equity in HTA developed by Culyer and Bombard. After rewording and reorganizing according to five HTA phases, they were complemented by elements emerging from a literature search. Consultations with method experts, decision makers, and stakeholders further refined the items. Further feedback was sought during a presentation of the tool at an international HTA conference. Lastly, the checklist was piloted through all five stages of an HTA.

Results

ECHTA proposes elements to be considered at each one of the five HTA phases: Scoping, Evaluation, Recommendations and Conclusions, Knowledge Translation and Implementation, and Reassessment. More than a simple checklist, the tool provides details and examples that guide the evaluators through an analysis in each phase. A pilot test is also presented, which demonstrates the ECHTA's usability and added value.

Conclusions

ECHTA provides guidance for HTA evaluators wishing to ensure that their conclusions do not contribute to inequalities in health. Several points to build upon the current checklist will be addressed by a working group of experts, and further feedback is welcome from evaluators who have used the tool.

Keywords

EquityHealth technology assessmentHealth disparity
Type
Method
Information
International Journal of Technology Assessment in Health Care , Volume 37 , Issue 1 , 2021 , e17
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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