Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-25T16:48:31.989Z Has data issue: false hasContentIssue false
  • English
  • Français

HEALTH TECHNOLOGY ASSESSMENT OF PUBLIC HEALTH INTERVENTIONS: A SYNTHESIS OF METHODOLOGICAL GUIDANCE

Part of: Special Collection - Methods

Published online by Cambridge University Press:  24 April 2017

Tim Mathes ,
Sunya-Lee Antoine ,
Peggy Prengel ,
Stefanie Bühn ,
Stephanie Polus  and
Dawid Pieper
Tim Mathes
Affiliation:
Institute for Research in Operative Medicinetim.mathes@uni-wh.de
Dawid Pieper
Affiliation:
Institute for Research in Operative Medicine
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The evaluation of public health interventions poses some challenges. As a consequence, health technology assessment (HTA) methods for public health interventions (PHI) have to be adapted. This study aimed to summarize the available guidance on methods for HTA of PHI.

Methods: We systematically searched for methodological guidance on HTA of PHIs. Our focus was on research synthesis methods to evaluate effectiveness. Relevant information was synthesized narratively in a standardized way.

Results: Only four guidance documents were identified specifically for HTAs of PHI. The approaches used for HTAs of PHIs are broader and more flexible than those for medical interventions. For this reason, there is a tendency to identify the intervention components and context factors that influence the effectiveness and transferability of an intervention rather than to assess its effectiveness in general. The details in the guidance vary without justification. Unjustified heterogeneity between the different guidance approaches is most pronounced for quality assessment, assessment of applicability, and methods to integrate qualitative and quantitative evidence. Descriptions for the assessment of integrity, heterogeneity, sustainability, context factors, and applicability are often vague.

Conclusions: The heterogeneity in approaches indicates that there is currently no consensus on methods to deal with the challenges of the PHI evaluations. A possible explanation for this may be that the methods are not sufficiently developed, and advantages and disadvantages of a certain method in relation to the research question (e.g., broad/focused) have not yet been sufficiently evaluated.

Keywords

HTAPublic healthHealth promotionEvidence synthesis
Type
Methods
Information
International Journal of Technology Assessment in Health Care , Volume 33 , Issue 2 , 2017 , pp. 135 - 146
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Draborg, E, Gyrd-Hansen, D, Poulsen, PB, Horder, M. International comparison of the definition and the practical application of health technology assessment. Int J Technol Assess Health Care. 2005;21:89-95.CrossRefGoogle ScholarPubMed
2. Sackett, DL. The arrogance of preventive medicine. CMAJ. 2002;167:363-364.Google ScholarPubMed
3. Lavis, JN, Wilson, MG, Grimshaw, JM, et al. Supporting the use of health technology assessments in policy making about health systems. Int J Technol Assess Health Care. 2010;26:405-414.CrossRefGoogle ScholarPubMed
4. Petticrew, M, Chalabi, Z, Jones, DR. To RCT or not to RCT: Deciding when ‘more evidence is needed’ for public health policy and practice. J Epidemiol Community Health. 2012;66 (5):391-6. Epub 2011/06/10.CrossRefGoogle ScholarPubMed
5. Espallargues, M, Pons, JM, Almazan, C, de Sola-Morales, O. [Health technology assessment in public health interventions: Is prevention better than cure?]. Gac sanit. 2011;25 (Suppl 1):40-48. La evaluacion de tecnologias sanitarias en intervenciones de salud publica: mas vale prevenir que curar?CrossRefGoogle ScholarPubMed
6. Armstrong, R, Waters, E. Guidelines for systematic reviews of health promotion and public health interventions. Version 2. 2007. The Cochrane Collaboration.Google Scholar
7. National Institute for Health and Clinical Excellence (NICE). Methods for the development of NICE public health guidance (third edition). September 2012. Paris: NICE.Google Scholar
8. Haas, S, Breyer, E, Knaller, C, Weigl, M. Evidenzrecherche in der Gesundheitsförderung. Band Nr. 10 aus der Reihe WISSEN (Teil 2 Kurzanleitung). [electronic ressource]. Gesundheit Österreich GmbH/Fonds Gesundes Österreich (ed.). Retrieved on 05.06.2013.Google Scholar
9. Akers, J, Aguiar-Ibáñez, R, Baba-Akbari, A. Systematic reviews: CRD's guidance for undertaking reviews in health care. York: Centre for Reviews and Dissemination (CRD); 2009.Google Scholar
10. Haas, S, Breyer, E, Knaller, C, Weigl, M. Evidenzrecherche in der Gesundheitsförderung (Wissen 10 Teil 1 Handbuch), hg. v. GÖG/FGÖ. Gesundheit Österreich / Geschäftsbereich Fonds Gesundes Österreich. Wien; 2013.Google Scholar
11. Wang, S, Moss, JR, Hiller, JE. Applicability and transferability of interventions in evidence-based public health. Health Promot Int. 2006;21:76-83.CrossRefGoogle ScholarPubMed
12. Craig, P, Dieppe, P, Macintyre, S, Michie, S, Nazareth, I, Petticrew, M. Developing and evaluating complex interventions: The new Medical Research Council guidance. Int J Nurs Stud. 2013;50:587-592.CrossRefGoogle ScholarPubMed
13. Anderson, LM, Petticrew, M, Rehfuess, E, et al. Using logic models to capture complexity in systematic reviews. Res Synth Methods. 2011;2:33-42.CrossRefGoogle ScholarPubMed
14. Osrin, D, Azad, K, Fernandez, A, et al. Ethical challenges in cluster randomized controlled trials: Experiences from public health interventions in Africa and Asia. Bull World Health Organ. 2009;87:772-779.CrossRefGoogle ScholarPubMed
15. West, SG, Duan, N, Pequegnat, W, et al. Alternatives to the Randomized Controlled Trial. Am J Public Health. 2008;98:1359-1366.CrossRefGoogle Scholar
16. Sanderson, S, Tatt, ID, Higgins, JP. Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: A systematic review and annotated bibliography. Int J Epidemiol. 2007;36:666-676.CrossRefGoogle ScholarPubMed
17. Pawson, R, Greenhalgh, T, Harvey, G, Walshe, K. Realist review – A new method of systematic review designed for complex policy interventions. J Health Serv Res policy. 2005;10 (Suppl 1):21-34.CrossRefGoogle ScholarPubMed
18. Ogilvie, D, Fayter, D, Petticrew, M, et al. The harvest plot: A method for synthesising evidence about the differential effects of interventions. BMC med res methodol. 2008;8:8.CrossRefGoogle ScholarPubMed
19. Anzures-Cabrera, J, Higgins, JPT. Graphical displays for meta-analysis: An overview with suggestions for practice. Res Synth Methods. 2010;1:66-80.CrossRefGoogle ScholarPubMed
20. Baker, WL, White, CM, Cappelleri, JC, et al. Understanding heterogeneity in meta-analysis: The role of meta-regression. Int J Clin Pract. 2009;63:1426-1434.CrossRefGoogle ScholarPubMed
21. Mavridis, D, Salanti, G. A practical introduction to multivariate meta-analysis. Stat Methods Med Res. 2013;22:133-158.CrossRefGoogle ScholarPubMed
22. Sandelowski, M, Voils, CI, Barroso, J. Defining and designing mixed research synthesis studies. Research in the schools: A nationally refereed journal sponsored by the Mid-South Educational Research Association and the University of Alabama. 2006. http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.567.748 (accessed March 14, 2017).Google Scholar
23. Kahan, B, Goodstadt, M. The interactive domain model of best practices in health promotion: Developing and implementing a best practices approach to health promotion. Health Promot Pract. 2001;2:43-67.CrossRefGoogle Scholar
24. Dahlgren, G, Whitehead, M. Policies and strategies to promote social equity in health. Background document to WHO-Strategy paper for Europe. Stockholm: Institute for Futures Studies; 1991.Google Scholar
25. Tugwell, P, Petticrew, M, Kristjansson, E, et al. Assessing equity in systematic reviews: Realising the recommendations of the Commission on Social Determinants of Health. BMJ. 2010;341:c4739.CrossRefGoogle ScholarPubMed
26. Welch, V, Petticrew, M, O'Neill, J, et al. Health equity: Evidence synthesis and knowledge translation methods. Syst Rev. 2013;2:43.CrossRefGoogle ScholarPubMed
27. Welch, V, Brand, K, Kristjansson, E, Smylie, J, Wells, G, Tugwell, P. Systematic reviews need to consider applicability to disadvantaged populations: Inter-rater agreement for a health equity plausibility algorithm. BMC Med Res Methodol. 2012;12:187.CrossRefGoogle ScholarPubMed
28. Wiltsey Stirman, S, Kimberly, J, Cook, N, Calloway, A, Castro, F, Charns, M. The sustainability of new programs and innovations: A review of the empirical literature and recommendations for future research. Implement Sci. 2012;7:17.CrossRefGoogle ScholarPubMed
29. Burchett, H, Umoquit, M, Dobrow, M. How do we know when research from one setting can be useful in another? A review of external validity, applicability and transferability frameworks. J Health Serv Res Policy. 2011;16:238-244.CrossRefGoogle ScholarPubMed
30. Burford, B, Lewin, S, Welch, V, Rehfuess, E, Waters, E. Assessing the applicability of findings in systematic reviews of complex interventions can enhance the utility of reviews for decision making. J Clin Epidemiol. 2013;66:1251-1261.CrossRefGoogle ScholarPubMed
31. U.S. Preventive Services Task Force. Procedure manual. Rockville, MD: U.S. Preventive Services Task Force; 2015.Google Scholar
32. Higgins, J, Green, S, eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 The Cochrane Collaboration; 2011. www.cochrane-handbook.org (accessed June 12, 2016).Google Scholar
33. Petticrew, M, Anderson, L, Elder, R, et al. Complex interventions and their implications for systematic reviews: A pragmatic approach. J Clin Epidemiol. 2013;66:1209-1214.CrossRefGoogle ScholarPubMed
Supplementary material: File

Mathes supplementary material

Mathes supplementary material 1

Download Mathes supplementary material(File)
File 25.9 KB