Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-13T04:17:06.476Z Has data issue: false hasContentIssue false
  • English
  • Français

KNOW ESSENTIALS: A tool for informed decisions in the absence of formal HTA systems

Published online by Cambridge University Press:  29 March 2011

Joseph L. Mathew
Joseph L. Mathew*
Affiliation:
Postgraduate Institute of Medical Education and Research (P.G.I.M.E.R)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Most developing countries and resource-limited settings lack robust health technology assessment (HTA) systems. Because the development of locally relevant HTA is not immediately viable, and the extrapolation of external HTA is inappropriate, a new model for evaluating health technologies is required.

Objectives: The aim of this study was to describe the development and application of KNOW ESSENTIALS, a tool facilitating evidence-based decisions on health technologies by stakeholders in settings lacking formal HTA systems.

Methods: Current HTA methodology was examined through literature search. Additional issues relevant to resource-limited settings, but not adequately addressed in current methodology, were identified through further literature search, appraisal of contextually relevant issues, discussion with healthcare professionals familiar with the local context, and personal experience. A set of thirteen elements important for evidence-based decisions was identified, selected and combined into a tool with the mnemonic KNOW ESSENTIALS. Detailed definitions for each element, coding for the elements, and a system to evaluate a given health technology using the tool were developed.

Results and Conclusions: Developing countries and resource-limited settings face several challenges to informed decision making. Models that are relevant and applicable in high-income countries are unlikely in such settings. KNOW ESSENTIALS is an alternative that facilitates evidence-based decision making by stakeholders without formal expertise in HTA. The tool could be particularly useful, as an interim measure, in healthcare systems that are developing HTA capacity. It could also be useful anywhere when rapid evidence-based decisions on health technologies are required.

Keywords

Developing countriesEvidence-based medicineDecision makingHealth technology assessment
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 27 , Issue 2 , April 2011 , pp. 139 - 150
Copyright
Copyright © Cambridge University Press 2011

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. Anon. Health technology assessment. http://www.inahta.org/HTA/ (accessed November 28, 2010).Google Scholar
2. Anon. Pneumonia: The forgotten killer of children. The United Nations Children's Fund (UNICEF)/World Health Organization (WHO), 2006.Google Scholar
3. Begg, CB, Berlin, JA. Publication bias: A problem in interpreting medical data. J R Stat Soc. 1998;151:419–463.Google Scholar
4. Booth, A. How much searching is enough? Comprehensive versus optimal retrieval for technology assessments. Int J Technol Assess Health Care. 2010;26:431–435.Google Scholar
5. Chalkidou, K, Levine, R, Dillon, A. Helping poorer countries make locally informed health decisions. BMJ. 2010;341:c3651.Google Scholar
6. Doherty, T, Chopra, M, Jackson, D, et al. Effectiveness of the WHO/UNICEF guidelines on infant feeding for HIV-positive women: Results from a prospective cohort study in South Africa. AIDS. 2007;21:1791–1797.Google Scholar
7. Droste, S, Dintsios, C, Gerber, A. Information on ethical issues in health technology assessment: How and where to find them. Int J Technol Assess Health Care. 2010;26:441–449.Google Scholar
8. Drummond, MF, Schwartz, JS, Jönsson, B, et al. Key principles for the improved conduct of health technology assessments for resource allocation decisions. Int J Technol Assess Health Care. 2008;24:244–258.CrossRefGoogle ScholarPubMed
9. Ehlers, L, Vestergaard, M, Kidholm, K, et al. Doing mini-health technology assessments in hospitals: A new concept of decision support in health care? Int J Technol Assess Health Care. 2006;22:295–301.CrossRefGoogle ScholarPubMed
10. EUnetHTA Work Package 8. EUnetHTA handbook on health technology assessment capacity building. Barcelona (Spain): Catalan Agency for Health Technology Assessment and Research. Catalan Health Service. Department of Health Autonomous Government of Catalonia; 2008.Google Scholar
11. EUnetHTA Work Package 4. HTA Core ModelTM for Diagnostic Technologies v. 1.0r; 2008. http://www.eunethta.net/Public/Work_Packages/EUnetHTA-Project-2006-08/EUnetHTA_Deliverables_project_2006-2008/ (accessed October 27, 2010).Google Scholar
12. EUnetHTA Work Package 4. HTA Core ModelTM for Medical and Surgical Interventions v. 1.0r; 2008. http://www.eunethta.net/Public/Work_Packages/EUnetHTA-Project-2006-08/EUnetHTA_Deliverables_project_2006-2008/ (accessed October 27, 2010).Google Scholar
13. EVIPNet. http://www.evipnet.org/modules/dia/ (accessed November 15, 2010).Google Scholar
14. Glanville, J, Paisley, S. Identifying economic evaluations for health technology assessment. Int J Technol Assess Health Care. 2010;26:436–440.Google Scholar
15. Hailey, D. Commentary on the article “Key principles for the improved conduct of health technology assessments for resource allocation decisions”. Int J Technol Assess Health Care. 2008;24:365–366.Google Scholar
16. Hailey, D, Corabian, P, Harstall, C, Schneider, W. The use and impact of rapid health technology assessments. Int J Technol Assess Health Care. 2000;16:651–656.Google Scholar
17. Huda, SN, Shahab, T, Ali, SM, Afzal, K, Khan, HM. A comparative clinical trial of artemether and quinine in children with severe malaria. Indian Pediatr. 2003;40:939–945.Google Scholar
18. INAHTA (International Network of Agencies for Health Technology Assessment), Ethics Working Group. INAHTA's working group on handling ethical issues: Final report. Stockholm: SBU; 2005.Google Scholar
19. Indian Academy Of Pediatrics Committee on Immunization (IAPCOI). Recommendations on immunization, 2008. Indian Pediatr. 2008;45:635–648.Google Scholar
20. Infectious Diseases Chapter, Indian Academy of Pediatrics. Management of malaria in children: Update 2008. Indian Pediatr. 2008;45:731–735.Google Scholar
21. Jones, KL, Donegan, S, Lalloo, DG. Artesunate versus quinine for treating severe malaria. Cochrane Database Syst Rev. 2007;4:CD005967.Google Scholar
22. Kahveci, R, Meads, C. Analysis of strengths, weaknesses, opportunities, and threats in the development of a health technology assessment program in Turkey. Int J Technol Assess Health Care. 2008;24:235–240.Google Scholar
23. Kundu, R, Ganguly, N, Ghosh, TK, Choudhury, P, Shah, RC. Diagnosis and management of malaria in children. Recommendations and IAP plan of action. Indian Pediatr. 2005;42:1101–1114.Google Scholar
24. Mathew, JL. Pneumococcal vaccination in developing countries: Where does science end and commerce begin? Vaccine. 2009;27:4247–4251.Google Scholar
25. Mathew, JL. Testing the feasibility of KNOW ESSENTIALS – an algorithm for informed decision-making in the absence of formal HTA. Oral presentation at HTAi 7th Annual Meeting, Dublin, Ireland, 2010.Google Scholar
26. Mathew, JL. Artemisinin derivatives versus quinine for severe malaria in children: A systematic review and meta-analysis. Indian Pediatr. 2010;47:423–428.Google Scholar
27. McGregor, M, Brophy, JM. End-user involvement in health technology assessment (HTA) development: A way to increase impact. Int J Technol Assess Health Care. 2005;21:263–267.Google Scholar
28. McIntosh, H, Olliaro, P. Artemisinin derivatives for treating severe malaria. Cochrane Database Syst Rev. 2000;2:CD000527.Google Scholar
29. Mittal, SK, Mathew, JL. Polio eradication in India: The way forward. Indian J Pediatr. 2007;74:153–160.Google Scholar
30. Mohanty, AK, Rath, BK, Mohanty, R, Samal, AK, Mishra, K. Randomized control trial of quinine and artesunate in complicated malaria. Indian J Pediatr. 2004;71:291–295.CrossRefGoogle ScholarPubMed
31. National Malaria Eradication Programme. http://www.mrcindia.org/Guidelines_for_Diagnosis2010.pdf (accessed May 10, 2010).Google Scholar
32. Oxman, AD, Yohannes, AM, Røttingen, J. Options for improving malaria treatment: Introduction. Int J Technol Assess Health Care. 2010;26:228.CrossRefGoogle Scholar
33. Phuong, CXT, Bethell, DB, Phuong, PT, et al. Comparison of artemisinin suppositories, intramuscular artesunate and intravenous quinine for the treatment of severe childhood malaria. Trans R Soc Trop Med Hyg. 1997;91:335–342.Google Scholar
34. Pichon-Riviere, A, Augustovski, F, Rubinstein, A, et al. Health technology assessment for resource allocation decisions: Are key principles relevant for Latin America? Int J Technol Assess Health Care. 2010;26:421–427.Google Scholar
35. Piñeros, M, Wiesner, C, Cortés, C, Trujillo, LM. HPV vaccine introduction at the local level in a developing country: Attitudes and criteria among key actors. Cad Saude Publica. 2010;26:900–908.Google Scholar
36. Republic of Rwanda, Ministry of Financial Planning, Ministry of Health. Scaling up to achieve the health MDGs in Rwanda. 2006. www.oecd.org/dataoecd/34/39/37759625.pdf (accessed May 16, 2009).Google Scholar
37. Rollins, NC, Becquet, R, Bland, RM, et al. Infant feeding, HIV transmission and mortality at 18 months: The need for appropriate choices by mothers and prioritization within programmes. AIDS. 2008;22:2349–2357.Google Scholar
38. Seoane-Vazquez, E, Rodriguez-Monguio, R. Negotiating antiretroviral drug prices: The experience of the Andean countries. Health Policy Plan. 2007;22:63–72.Google Scholar
39. Taylor, TE, Wills, BA, Courval, JM, Molyneux, ME. Intramuscular artemether vs intravenous quinine: An open, randomized trial in Malawian children with cerebral malaria. Trop Med Int Health. 1998;3:3–8.Google Scholar
40. Teerawattananon, Y, Tantivess, S, Yothasamut, J, Kingkaew, P, Chaisiri, K. Historical development of health technology assessment in Thailand. Int J Technol Assess Health Care. 2009;25 (Suppl 1):241–252.Google Scholar
41. Thuma, PE, Bhat, GJ, Mabeza, GF, et al. A randomized controlled trial of artemotil (beta-arteether) in Zambian children with cerebral malaria. Am J Trop Med Hyg. 2000;62:524–529.Google Scholar
42. Vancelik, S, Beyhun, NE, Acemoglu, H, Calikoglu, O. Impact of pharmaceutical promotion on prescribing decisions of general practitioners in Eastern Turkey. BMC Public Health. 2007;7:122.Google Scholar
43. Wang, S, Moss, JR, Hiller, JE. Applicability and transferability of interventions in evidence-based public health. Health Promot Int. 2006;21:76–83.Google Scholar
44. Watt, A, Cameron, A, Sturm, L, et al. Rapid reviews versus full systematic reviews: An inventory of current methods and practice in health technology assessment. Int J Technol Assess Health Care. 2008;24:133–139.Google Scholar
45. Williamson, NE, Liku, J, McLoughlin, K, Nyamongo, IK, Nakayima, F. A qualitative study of condom use among married couples in Kampala, Uganda. Reprod Health Matters. 2006;14:89–98.Google Scholar
46. Wecker, JR, Phillips, DC, Hayes, J. Rotavirus vaccines: The role of researchers in moving evidence to action. Vaccine. 2009;27 (Suppl 5):F4–F6.Google Scholar
47. WHO Global burden of disease initiative. www.who.int/healthinfo/global_burden_disease/about/en/index.html (accessed October 29, 2010).Google Scholar
48. World Health Organization. Guidelines for the treatment of malaria. Second Edition. World Health Organization, 2010. http://www.rollbackmalaria.org/docs/hbsm.pdf (accessed March 25, 2010).Google Scholar
49. World Health Organization. Severe falciparum malaria. Trans R Soc Trop Med Hyg. 2000;94 (Suppl 1):S1–S90.Google Scholar
Supplementary material: File

Mathew supplementary material

Supplementary table

Download Mathew supplementary material(File)
File 65.5 KB