Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-15T13:31:14.278Z Has data issue: false hasContentIssue false
  • English
  • Français

It's Time To Rethink Health Care Technology Assessment

Published online by Cambridge University Press:  14 October 2009

Clifford Goodman
Clifford Goodman
Affiliation:
Swedish Council on Technology Assessment in Health Care
Get access Rights & Permissions [Opens in a new window]

Abstract

Health care technology assessment is broadly and ambiguously interpreted, diluting its role. It is time to recast the field. We must elucidate it in the contemporary context of health inquiry, explicitly relating it to such pursuits as quality assurance, health services research, effectiveness research, medical informatics, and technological innovation.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 8 , Issue 2 , Spring 1992 , pp. 335 - 358
Copyright
Copyright © Cambridge University Press 1992

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.Archibald, K.Three views of the expert's role in policymaking: Systems analysis, incremen-talism, and the clinical approach. Policy Science, 1970, 1, 73–86.CrossRefGoogle Scholar
2.Arnstein, S. A.Technology assessment: Opportunities and obstacles. IEEE Transactions on Systems, Man, and Cybernetics, 1977, SMC-7, 571–82.CrossRefGoogle Scholar
3.Banta, H. D., & Andreasen, P. B.The political dimension in health care technology assessment programs. International Journal of Technology Assessment in Health Care, 1990, 6, 115–23.CrossRefGoogle ScholarPubMed
4.Banta, H. D., Behney, C. J., & Willems, J. S.Toward rational technology in medicine. New York: Springer, 1981.Google ScholarPubMed
5.Banta, H. D., & Thacker, S. B.The case for reassessment of health care technology: Once is not enough. Journal of the American Medical Association, 1990, 264, 235–40.CrossRefGoogle ScholarPubMed
6.Barry, M. J., Mulley, A. G., Fowler, F. J., et al. Watchful waiting vs. immediate transurethral resection for symptomatic prostatism: The importance of patients’ preferences. Journal of the American Medical Association, 1988, 259, 3010–17.CrossRefGoogle ScholarPubMed
7.Baum, M., Zilka, K., & Houghton, J.Ethics of clinical research: Lessons for the future. British Medical Journal, 1989, 299, 251–53.CrossRefGoogle ScholarPubMed
8.Bergner, M.Quality of life, health status, and clinical research. Medical Care, 1989, 27, S148–56.CrossRefGoogle ScholarPubMed
9.Berwick, D. M.Continuous improvement as an ideal in health care. New England Journal of Medicine, 1989, 320, 53–56.CrossRefGoogle ScholarPubMed
10.Berwick, D. M., & Wald, D. L.Hospital leaders’ opinions of the HCFA mortality data. Journal of the American Medical Association, 1990, 263, 247–49.CrossRefGoogle ScholarPubMed
11.Bloom, B. S.Does it work? The outcomes of medical interventions. International Journal of Technology Assessment in Health Care, 1990, 6, 326–32.CrossRefGoogle ScholarPubMed
12.Bonair, A., Rosenfield, P., & Tengvald, K.Medical technologies in developing countries: Issues of technology development, transfer, diffusion and use. Social Science & Medicine, 1989, 28, 769–81.CrossRefGoogle ScholarPubMed
13.Brook, R. H.Health services research: Is it good for you and me? Academic Medicine, 1989, 4, 124–30.CrossRefGoogle Scholar
14.Brook, R. H., & Lohr, K. N.Efficacy, effectiveness, variations, and quality: Boundary-crossing research. Medical Care, 1985, 23, 710–22.CrossRefGoogle ScholarPubMed
15.Brooks, H., & Bowers, R.The assessment of technology. Science, 1970, 222, 13–20.Google Scholar
16.Bunge, M.Technology as applied science. Technology and Culture, 1966, 7, 329–47.CrossRefGoogle Scholar
17.Byar, D. P., Schoenfeld, D. A., Green, S. B., et al. Design considerations for AIDS trials. New England Journal of Medicine, 1990, 323, 1343–38.CrossRefGoogle ScholarPubMed
18.Chassin, M. R., Kosecoff, J., Park, R. E., et al. Does inappropriate use explain geographic variations in the use of health care services? A study of three procedures. Journal of the American Medical Association, 1987, 258, 533–37.Google ScholarPubMed
19.Coates, J.Some methods and techniques for comprehensive impact assessments. Technological Forecasting and Social Change, 1974, 6, 341–57.CrossRefGoogle Scholar
20.Coates, V. T.Technology and public policy: Summary report. Washington DC: Geo Washington University, 1972.Google Scholar
21.Coates, V. T.President's message. Journal of the International Society for Technoloy Assessment, 1976, 2, 4–6.Google Scholar
22.Cochrane, A. L.Effectiveness and efficiency: Random reflections on health services. London: Nuffield Provincial Hospitals Trust, 1972.Google Scholar
23.Cook, T. D., & Campbell, D. T.Quasi-experimentation: Design and analysis issues for field settings. Chicago, IL: Rand McNally, 1979.Google Scholar
24.Cotton, P.Is there still too much extrapolation from data on middle-aged white men? Journal of the American Medical Association, 1990, 263, 1049–50.CrossRefGoogle ScholarPubMed
25.Cotton, P.Examples abound of gaps in medical knowledge because of groups excluded from scientific study. Journal of the American Medical Association, 1990, 263, 1051–52CrossRefGoogle ScholarPubMed
26.Council on Ethical and Judicial Affairs, American Medical Association. Gender disparities in clinical decision making. Journal of the American Medical Association 1991, 266, 559–62.CrossRefGoogle Scholar
27.Deyo, R. A., & Patrick, D. L.Barriers to the use of health status measures in clinical investigation, patient care, and policy research. Medical Care, 1989, 27, S254–68.CrossRefGoogle Scholar
28.Donabedian, A.Quality assessment and assurance: Unity of purpose, diversity of means Inquiry, 1988, 25, 173–92.Google ScholarPubMed
29.Eddy, D. M. Should we change the rules for evaluating medical technologies? In Gelijns, A. C. (ed.), Medical innovation at the crossroads: Modern methods of clinical investigation. Washington, DC: National Academy Press, 1990, 117–34.Google Scholar
30.Elliot, D., & Elliot, R.The control of technology. London: Wykeham Publications, 1976.Google Scholar
31.Ellwood, P. M.Outcomes management: A technology of patient experience. New England Journal of Medicine, 1988, 318, 1549–56.CrossRefGoogle ScholarPubMed
32.Evans, R. W., Manninen, D. L., Overcast, T. D., et al. The National Heart Transplantation Study: Final report, vols. 1–5. Seattle, WA: Battelle Human Affairs Research Centers, 1984.Google Scholar
33.Feeny, D. New health technologies: Their effect on health and the cost of health care. In Feeny, D., Guyatt, G., & Tugwell, P. (eds.), Health care technology: Effectiveness, efficiency, and public policy. Montreal, Quebec: Institute for Research on Public Policy, 1986 5–24.Google Scholar
34.Flagle, C. Technology assessment in the literature of medical informatics. In Flagle, C., Gremy, F., & Perry, S.(eds.), Assessment of medical informatics technology. Proceedings: Joint working conference of the International Medical Informatics Association, the International Society for Technology Assessment in Health Care, and the Ecole Nationale de la Santé Publique. Rennes Cedex (France): Éditions ENSP, 1991, 165–77.Google Scholar
35.Flood, A. B.Peaks and pits of using large data bases to measure quality of care. International Journal of Technology Assessment in Health Care, 1990, 6, 253–62.CrossRefGoogle ScholarPubMed
36.Fuchs, V. R., & Garber, A. M.The new technology assessment. New England Journal of Medicine, 1990, 323, 673–77.CrossRefGoogle ScholarPubMed
37.Galbraith, J.The new industrial state. New York: The New American Library, 1977.Google Scholar
38.Gelijns, A. C. (ed.). Medical innovation at the crossroads: Modern methods of clinical investigation. Washington, DC: National Academy Press, 1990.Google Scholar
39.Gendron, B.Technology and the human condition. New York: St. Martin's Press, 1977.Google Scholar
40.Goodman, C.A practical guide to technology assessment. Business & Health 1987 4(10) 14–19.Google ScholarPubMed
41.Goodman, C. (ed.). Medical technology assessment directory. Washington, DC: National Academy Press, 1988.Google Scholar
42.Goodman, C. S. Profiles of 20 technology assessment programs. In Institute of Medicine, Assessing medical technologies. Washington, DC: National Academy Press, 1985, 255–489Google Scholar
43.Hammond, K. R., Mumpower, J., Dennis, R. L., et al. Fundamental obstacles to the use of scientific information in public policy making. Technological Forecasting and Social Change, 1983, 24, 287–97.CrossRefGoogle Scholar
44.Healy, B.Women's health, public welfare. Journal of the American Medical Associating 1991, 266, 566–68.CrossRefGoogle ScholarPubMed
45.Heithoff, K. A., & Lohr, K. N. (eds.). Effectiveness and outcomes in health care. Washington, DC: National Academy Press, 1990.Google Scholar
46.Hisashige, A., Sakurai, T., & Kaihara, S. Medical technology assessment and medical information technology in Japan: Present and future. In C., Flagle, F., Gremy, & S., Perry (eds.), Assessment of medical informatics technology. Proceedings: Joint working conference of the International Medical Informatics Association, the International Society for Technology Assessment in Health Care, and the École Nationalé de la Santé Publique. Rennes Cedex (France): Éditions ENSP, 1991, 509–19.Google Scholar
47.Institute of Medicine. Assessing medical technologies. Washington, DC: National Academy Press, 1985.Google Scholar
48.Institute of Medicine. The NLM and health care technology assessment: Improving the information. Washington, DC: National Academy Press, 1989.Google Scholar
49.Institute of Medicine. Core Committee on HCFA Effectiveness Initiative. Promise and limitations of effectiveness and outcomes research. In Heithoff, K. A. & Lohr, K. N. (eds.), Effectiveness and outcomes in health care. Washington, DC: National Academy Press, 1990, 8–18.Google Scholar
50.Jönsson, B. What can Americans learn from Europeans? In Organisation for Economic Co-Operation and Development, Health care systems in transition: The search for efficiency. Paris: OECD Social Policy Studies, no. 7, 1990, 87–101.Google Scholar
51.Kahn, K. L., Kosecoff, J., Chassin, J. R., et al. Measuring the clinical appropriateness of the use of a procedure: Can we do it? Medical Care, 1988, 26, 415–22.CrossRefGoogle ScholarPubMed
52.Kikuchi, M.status of medical engineering technology assessment in Japan. Frontiers of Medical and Biological Engineering, 1991, 3, 3–15.Google ScholarPubMed
53.Lara, M. E., & Goodman, C. (eds.). National priorities for the assessment of clinical conditions and medical technologies: Report of a pilot study. Washington, DC: National Academy Press, 1990.Google Scholar
54.Leape, L. L., Park, R. E., Solomon, D. H., et al. Does inappropriate use explain small-area variations in the use of health care services? Journal of the American Medical Association, 1990, 263, 669–72.CrossRefGoogle ScholarPubMed
55.Lohr, K. N. (ed.). Breast cancer: Setting priorities for effectiveness research. Washington, DC: National Academy Press, 1990.Google Scholar
56.Lohr, K. N., & Rettig, R. A. (eds.). Quality of care and technology assessment. Washington, DC: National Academy Press, 1988.Google Scholar
57.Mckie, J.Management of medical technology in developing countries. Journal of Biomedical Engineering, 1990, 12, 259–61.CrossRefGoogle ScholarPubMed
58.McNeil, B. J., Pauker, S. G., Sox, H. C. Jr, et al. On the elicitation of preferences for alternative therapies. New England Journal of Medicine, 1982, 306, 1259–62.CrossRefGoogle ScholarPubMed
59.McPherson, K., Wennberg, J. E., Hovind, O. B., et al. Small-area variation in the use of common surgical procedures: An international comparison of New England, England, and Norway. New England Journal of Medicine, 1982, 307, 1310–14.CrossRefGoogle ScholarPubMed
60.Merigan, T. C.You can teach an old dog new tricks: How AIDS trials are pioneering new strategies. New England Journal of Medicine, 1990, 323, 1341–43.CrossRefGoogle ScholarPubMed
61.Mosteller, F., & Falotico-Taylor, J. (eds). Quality of life and technology assessment. Washington, DC: National Academy Press, 1989.Google ScholarPubMed
62.National Academy of Engineering, Committee on Public Engineering Policy. A study of technology assessment. Washington, DC: U.S. Government Printing Office, 1969.Google Scholar
63.Neuhauser, D.Ernest Amory Codman, M.D., and end results of medical care. International Journal of Technology Assessment in Health Care, 1990, 6, 307–25.CrossRefGoogle Scholar
64.O'Brien, D. M., & Marchand, D. A. Politics, technology, and technology assessment. In O'Brien, D. M. & Marchand, D. A. (eds.), The politics of technology assessment: Institutions, processes, and policy disputes. Lexington, MA: D. C. Heath and Company, 1982.Google Scholar
65.Palca, J.Women left out at NIH: News. Science, 1990, 248, 1601–02.CrossRefGoogle Scholar
66.Park, R. E., Brook, R. H., Kosecoff, J., et al. Explaining variations in hospital death rates. Journal of the American Medical Association, 1990, 264, 484–90.CrossRefGoogle ScholarPubMed
67.Pauker, S. G., & McNeil, B. J.Impact of patient preferences on the selection of therapy. Journal of Chronic Diseases, 1981, 34, 77–86.CrossRefGoogle ScholarPubMed
68. Pharmaceutical Manufacturers Association. 1988–1990 annual survey report, U.S. pharmaceutical industry. Washington, DC.Google Scholar
69.Porter, A. L., Rossini, F. A., Carpenter, S. R., & Roper, A. T.A guidebook for technology assessment and impact analysis. New York: North Holland, 1980.Google Scholar
70.Relman, A. S.Assessment of medical practices: A simple proposal. New England Journal of Medicine, 1980, 303, 153–54.CrossRefGoogle ScholarPubMed
71.Roper, W. L., Winkenwerder, W., Hackbarth, G. M., & Krakauer, H.Effectiveness in health care: An initiative to evaluate and improve medical practice. New England Journal of Medicine, 1988, 319, 1197–202.CrossRefGoogle ScholarPubMed
72.Rossini, F. A., Carpenter, S. R., Havick, J., et al. Multiple technology assessments. Journal of the International Society for Technology Assessment, 1976, 2, 21–28.Google Scholar
73.Sackett, D. L.Bias in analytic research. Journal of Chronic Diseases, 1979, 32, 51–63.CrossRefGoogle ScholarPubMed
74.Schwartz, J. S., & Lurie, N.Assessment of medical outcomes: New opportunities for achieving a long sought-after objective. International Journal of Technology Assessment in Health Care, 1990, 6, 333–39.CrossRefGoogle ScholarPubMed
75.Sox, H., Stern, S., Owens, D., & Abrams, H. L.Assessment of diagnostic technology in health care: Rationale, methods, problems, and directions. Washington, DC: National Academy Press, 1989.Google ScholarPubMed
76.Steinwachs, D. M.Application of health status measures in policy research. Medical Care, 1989, 27, S12–26.Google ScholarPubMed
77.Sullivan, L. W., & Hays, L. B.Medicare hospital mortality information, 1986, 1987,1988. Washington, DC: Health Care Financing Administration, U.S. Department of Health and Human Services, 1989 (HCFA publication 00701).Google Scholar
78.Talbot, J. L.Climbing the ladder. Second Source Biomedical, 1990, 1(September/October), 28–31.Google Scholar
79.Temple, R.Problems in the use of large data sets to assess effectiveness. International Journal of Technology Assessment in Health Care, 1990, 6, 211–19.CrossRefGoogle ScholarPubMed
80.Tugwell, P., Bennett, K., Feeny, D., et al. A framework for the evaluation of technology: The technology assessment iterative loop. In Feeny, D., Guyatt, G., & Tugwell, P. (eds.), Health care technology: Effectiveness, efficiency, and public policy. Montreal, Quebec: Institute for Research on Public Policy, 1986, 41–56.Google Scholar
81.U.S. Congress. Public Law 101–239. The Omnibus Budget Reconciliation Act of 1989.Google Scholar
82.U.S. Congress, House of Representatives. Committee on Interstate and Foreign Commerce. A discursive dictionary of health care. Washington, DC: U.S. Government Printing Office, 1976.Google Scholar
83.U.S. Congress, House of Representatives. Committee on Science and Astronautics. Technology assessment. Statement of Emilio Q. Daddario, Chairman, Subcommittee on Science Research and Development. 90th Congress, 1st session, Washington, DC, 1967.Google Scholar
84.U.S. Congress. Office of Technology Assessment. Development of medical technology: Opportunities for assessment. Washington, DC: U.S. Government Printing Office, 1976.Google Scholar
85.U.S. Congress. Office of Technology Assessment. Assessing the efficacy and safety of medical technologies. Washington, DC: U.S. Government Printing Office, 1978.Google Scholar
86.U.S. Congress. Office of Technology Assessment. Strategies for medical technology assessment. Washington, DC: U.S. Government Printing Office, 1982.Google Scholar
87.U.S. Congress. Office of Technology Assessment. Life-sustaining technologies and the elderly. Washington, DC: U.S. Government Printing Office, 1987.Google Scholar
88.U.S. Department of Health and Human Services. Agency for Health Care Policy and Research. AHCPR grant awards, fiscal year 1990. AHCPR Program Note. Rockville, MD: Agency for Health Care Policy and Research, 1990.Google Scholar
89.U.S. Department of Health and Human Services. Health Care Financing Administration, Office of the Actuary. Data from the Office of National Cost Estimates, 1990.Google Scholar
90.US. Department of Health and Human Services, National Library of Medicine. The basics of searching MEDLINE. Bethesda, MD: 1989 (PB89–146179).Google Scholar
91.U.S. Department of Health and Human Services, National Library of Medicine. Medical subject headings-annotated alphabetic list, 1991. Bethesda, MD: 1990 (PB91–100008).Google Scholar
92.U.S. Department of Health and Human Services, National Library of Medicine. Medical subject headings-Tree structures, 1991. Bethesda, MD: 1990 (PB91–100016).Google Scholar
93.Wennberg, J. E.Dealing with medical practice variations: A proposal for action. Health Affairs, 1984, 3(Summer), 6–32.CrossRefGoogle ScholarPubMed
94.Wennberg, J. E. What is outcomes research? In Gelijns, A. C. (ed.), Medical innovation at the crossroads: Modern methods of clinical investigation. Washington, DC: National Academy Press, 1990, 33–46.Google Scholar
95.Wennberg, J. E., Bunker, J. P., & Barnes, B.The need for assessing the outcome of common medical practices. Annual Review of Public Health, 1980, 1, 277–95.CrossRefGoogle ScholarPubMed
96.Wennberg, J. E., & Gittelsohn, A.Variation in medical care among small areas. Scientific American, 1982, 246, 811–14.CrossRefGoogle ScholarPubMed