Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-25T04:25:53.208Z Has data issue: false hasContentIssue false
  • English
  • Français

IMPORTANCE OF CONTEXTUAL DATA IN PRODUCING HEALTH TECHNOLOGY ASSESSMENT RECOMMENDATIONS: A CASE STUDY

Published online by Cambridge University Press:  27 February 2018

Thomas G. Poder  and
Christian A. Bellemare
Thomas G. Poder
Affiliation:
UETMIS and CRCHUS, CIUSSS de l'Estrie – [email protected]
Christian A. Bellemare
Affiliation:
DSM, CIUSSS de l'Estrie - CHUS
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Contextual data and local expertise are important sources of data that cannot be ignored in hospital-based health technology assessment (HTA) processes. Despite a lack of or unconvincing evidence in the scientific literature, technology can be recommended in a given context. We illustrate this using a case study regarding biplane angiography for vascular neurointervention.

Methods: A systematic literature review was conducted, along with an analysis of the context in our setting. The outcomes of interest were radiation doses, clinical complications, procedure times, purchase cost, impact on teaching program, the confidence of clinicians in the technology, quality of care, accessibility, and the volume of activity. A committee comprising managers, clinical experts, physicians, physicists and HTA experts was created to produce a recommendation regarding biplane technology acquisition to replace a monoplane device.

Results: The systematic literature review yielded nine eligible articles for analysis. Despite a very low level of evidence in the literature, the biplane system appears to reduce ionizing radiation and medical complications, as well as shorten procedure time. Contextual data indicated that the biplane system could improve operator confidence, which could translate into reduced risk, particularly for complex procedures. In addition, the biplane system can support our institution in its advanced procedures teaching program.

Conclusions: Given the advantages provided by the biplane technology in our setting, the committee has recommended its acquisition. Contextual data were of utmost importance in this recommendation. Moreover, this technology should be implemented alongside a responsibility to collect outcome data to optimize clinical protocol in the doses of ionizing delivered.

Keywords

ContextRecommendationHospital-based health technology assessmentBiplane angiographyNeurointervention
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 1 , 2018 , pp. 63 - 67
Copyright
Copyright © Cambridge University Press 2018 

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. Johnson, AP, Sikich, NJ, Evans, G, et al. Health technology assessment: A comprehensive framework for evidence-based recommendations in Ontario. Int J Technol Assess Health Care. 2009;25:141–150.CrossRefGoogle ScholarPubMed
2. Guyatt, GH, Oxman, AD, Schünemann, HJ, Tugwell, P, Knottnerus, A. GRADE guidelines: A new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011;64:380–382.CrossRefGoogle ScholarPubMed
3. Baum, M. Limitations of nonscience in surgical epistemology. The second-look laparotomy. Int J Technol Assess Health Care. 1989;5:385–389.CrossRefGoogle ScholarPubMed
4. Plumb, J, Lyratzopoulos, G, Gallo, H, Campbell, B. Comparison of the assessment of five new interventional procedures in different countries. Int J Technol Assess Health Care. 2010;26:102–109.CrossRefGoogle ScholarPubMed
5. Loge, P, Delalande, F, Reymond, M-C, Germain, S. Factors influencing reimbursement of medical devices in France. Int J Technol Assess Health Care. 2015;31:399–406.CrossRefGoogle ScholarPubMed
6. Janoudi, G, Amegatse, W, McIntosh, B, Sehgal, C, Richter, T. Health technology assessment of drugs for rare diseases: Insights, trends, and reasons for negative recommendations from the CADTH common drug review. Orphanet J Rare Dis. 2016;11:164.CrossRefGoogle ScholarPubMed
7. Campbell, WB, Barnes, SJ, Kirby, RA, et al. Association of study type, sample size, and follow-up length with type of recommendation produced by the National Institute for Health and Clinical Excellence Interventional Procedures Programme. Int J Technol Assess Health Care. 2007;23:101–107.CrossRefGoogle ScholarPubMed
8. Burns, PB, Rohrich, RJ, Chung, KC. The levels of evidence and their role in evidence-based medicine. Plast Reconstr Surg. 2011;128:305–310.CrossRefGoogle ScholarPubMed
9. Clement, FM, Harris, A, Li, JJ, et al. Using effectiveness and cost-effectiveness to make drug coverage decisions: A comparison of Britain, Australia, and Canada. JAMA. 2009;302:1437–1443.CrossRefGoogle ScholarPubMed
10. Allen, N, Walker, SR, Liberti, L, Salek, S. Health technology assessment (HTA) case studies: Factors influencing divergent HTA reimbursement recommendations in Australia, Canada, England, and Scotland. Value Health. 2017;20:320–328.CrossRefGoogle ScholarPubMed
11. Kolasa, K, Wasiak, R. Health technology assessment in Poland and Scotland: Comparison of process and decisions. Int J Technol Assess Health Care. 2012;28:70–76.CrossRefGoogle ScholarPubMed
12. Mauskopf, J, Chirila, C, Masaquel, C, et al. Relationship between financial impact and coverage of drugs in Australia. Int J Technol Assess Health Care. 2013;29:92–100.CrossRefGoogle ScholarPubMed
13. Chambers, JD, Morris, S, Neumann, PJ, Buxton, MJ. Factors predicting Medicare national coverage: An empirical analysis. Med Care. 2012;50:249–256.CrossRefGoogle ScholarPubMed
14. Bossers, N, Van Engen A, Heemstra L. Predictive analysis of factors influencing health technology assessment recommendation: A literature review. Value Health. 2015;18:A725.CrossRefGoogle Scholar
15. Bossers, N, Ivanescu, C, Heemstra, L. Predictive analysis of factors influencing health technology assessment recommendation: A literature review. Poster presented at the ISPOR 18th Annual European Congress. https://www.ispor.org/research_pdfs/51/pdffiles/PRM242.pdf (accessed January 4, 2018).Google Scholar
16. Martin, J. Difficult decision-making at user interface: Why the traditional approach doesn't work. Presented at the CADTH Symposium in 2009, Ottawa, Canada. Consulted on 3 July 2017. https://www.cadth.ca/media/symp-2009/presentations/PS-1/Janet%20Martin%20-%20Difficult%20Decision-Making%20at%20User%20Interface%20-%20Why%20the%20Traditional%20Approach%20Doesn%27t%20Work.pdf (accessed January 4, 2018).Google Scholar
17. Busse, R, Orvain, J, Velasco, M, et al. Best practice in undertaking and reporting health technology assessments. Working group 4 report. Int J Technol Assess Health Care. 2002;18:361–422.CrossRefGoogle Scholar
18. Martin, J, Lal, A, Moodie, J, Zhu, F, Cheng, D. Hospital-based HTA and Know4Go at MEDICI in London, Ontario, Canada. In: Sampietro-Colom, L, Martin, J, eds. Hospital-based health technology assessment. The next frontier for health technology assessment. Switzerland: Adis; 2016:127–152.CrossRefGoogle Scholar
19. Agence d’évaluation des technologies et des modes d'intervention en santé (AETMIS). La réutilisation du matériel médical à usage unique. Rapport préparé par Geneviève Martin et Lorraine Caron en collaboration avec Alexandra Obadia. AETMIS 2009;5:1-99. https://www.inesss.qc.ca/fileadmin/doc/AETMIS/Rapports/Sterilisation/ETMIS2009_Vol5_No2.pdf (accessed January 4, 2018).Google Scholar
20. Unité d’évaluation des technologies et des modes d'intervention en santé du CIUSSS de l'Estrie – CHUS, Installation CHUS (UETMIS - CIUSSS de l'Estrie – CHUS, Installation CHUS). Réutilisation des cathéters en électrophysiologie: une analyse contextuelle – Rapport d’évaluation préparé par Suzanne K. Bédard et Thomas Poder (UETMIS, CIUSSS de l'Estrie- Installation CHUS – octobre 2015) Sherbrooke « 2015 », XV, 41 p. http://www.chus.qc.ca/fileadmin/doc_chus/Volet_academique_RUIS/ETMIS/2015/Rapport_Reutilisation_Catheters_UETMIS_20151023.pdf (accessed January 4, 2018).Google Scholar
21. The Advisory Board Compagy. Biplane Angiography. 2013. Consulted on 3 July 2017. https://www.advisory.com/~/media/Advisory-com/Research/TI/Online-Library/2013/Ortho-Neuro/2013/Biplane-Angiography3.pdf (accessed January 4, 2018).Google Scholar
22. Bellemare, CA, Poder, TG. Effectiveness of biplane angiography compared to monoplane angiography for vascular neuro-interventions: A systematic review of the literature. Clin Radiol. 2017;72:612.e1e612.e5.CrossRefGoogle ScholarPubMed
23. Downs, SH, Black, N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52:377–384.CrossRefGoogle ScholarPubMed
24. Dillon, A. Responsiveness, language, and alignment: Reflections on some challenges for health echnology assessment. Int J Technol Assess Health Care. 2015;31:223–225.CrossRefGoogle Scholar
25. Baltussen, R, Jansen, MPM, Bijlmakers, L, et al. Value assessment frameworks for HTA agencies: The organization of evidence-informed deliberative processes. Value Health. 2017;20:256–260.CrossRefGoogle ScholarPubMed
26. Callea, G, Armeni, P, Marsilio, M, Jommi, C, Tarricone, R. The impact of HTA and procurement practices on the selection and prices of medical devices. Soc Sci Med. 2017;174:89–95.CrossRefGoogle ScholarPubMed
27. Drummond, MF. Will there ever be a European drug pricing and reimbursement agency? Eur J Health Econ. 2003;4:67–69.CrossRefGoogle Scholar
28. Gagnon, MP, Desmartis, M, Poder, T, Witteman, W. Effects and repercussions of local/hospital-based health technology assessment (HTA): A systematic review. Syst Rev. 2014;3:129.CrossRefGoogle ScholarPubMed
29. Abrishami, P, Boer, A, Horstman, K. Value in co creation: Subjecting innovative in-hospital technologies to multi-stakeholder appraisal. International Journal of Hospital-Based HTA (IJHBHTA). 2017;1:12–30.Google Scholar
30. Halmesmäki, E, Pasternack, I, Roine, R. Hospital-based health technology assessment (HTA) in Finland: A case study on collaboration between hospitals and the national HTA unit. Health Res Policy Syst. 2016;14: 25.CrossRefGoogle ScholarPubMed
Supplementary material: File

Poder and Bellemare supplementary material

Data

Download Poder and Bellemare supplementary material(File)
File 13.1 KB