Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-25T05:06:51.946Z Has data issue: false hasContentIssue false
  • English
  • Français

ASSESSING THE IMPACTS OF CITIZEN DELIBERATIONS ON THE HEALTH TECHNOLOGY PROCESS

Published online by Cambridge University Press:  17 July 2013

Julia Abelson ,
Yvonne Bombard ,
François-Pierre Gauvin ,
Dorina Simeonov  and
Sarah Boesveld
Julia Abelson
Affiliation:
Department of Clinical Epidemiology & Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
Yvonne Bombard
Affiliation:
School of Public Health, Yale University, New Haven, Connecticut, USA; Center for Health Policy & Outcomes, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
François-Pierre Gauvin
Affiliation:
McMaster Health Forum, Hamilton, Ontario, Canada
Dorina Simeonov
Affiliation:
Health Council of Canada, Toronto, Ontario, Canada
Sarah Boesveld
Affiliation:
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: We assessed the impacts of a Citizens’ Reference Panel on the deliberations of a provincial health technology advisory committee and its secretariat, which produce, recommendations for the use of health technologies in Ontario, Canada.

Methods: A fourteen-member citizens’ reference panel was convened five times between February 2009 and May 2010 to participate in informed, facilitated discussions to inform the assessment of individual technologies and provincial health technology assessment processes more generally. Qualitative data collection methods were used to document observed and perceived impacts of the citizens’ panel on the health technology assessment (HTA) process.

Results: Panel impacts were observed for all technologies reviewed, at two different stages in the HTA process, and represented macro- (raising awareness) and micro-level (informing recommendations) impacts. These impacts were shaped by periodic opportunities for direct and brokered exchange between the Panel and the expert advisory committee to clarify roles, foster accountability, and build trust. Our findings offer new insights about one of the main considerations in the design of deliberative participatory structures—how to maintain the independence of a citizens’ panel while ensuring that their input is considered at key junctures in the HTA process.

Conclusions: Citizens’ panels can exert various impacts on the HTA process. Ensuring these types of structures include opportunities for direct exchange between citizens and experts, to clarify roles, promote accountability, and build trust will facilitate their impacts in a variety of settings.

Keywords

Health technology assessmentPublic engagementPublic involvementDeliberative methodsHealth policyDecision makingSocial values
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 29 , Issue 3 , July 2013 , pp. 282 - 289
Copyright
Copyright © Cambridge University Press 2013 

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.Gauvin, F-P, Abelson, J, Giacomini, M, Eyles, J, Lavis, J. Moving cautiously – Public involvement and the health technology assessment community. Int J Technol Assess. 2011;27:43–49.CrossRefGoogle ScholarPubMed
2.Gauvin, F-P, Abelson, J, Giacomini, M, Eyles, J, Lavis, J. “It all depends”: Conceptualizing public involvement in the context of health technology assessment agencies. Soc Sci Med. 2010;70:1518–1526.CrossRefGoogle ScholarPubMed
3.Abelson, J, Giacomini, M, Lehoux, P. Bringing ‘The Public’ into health technology assessment and coverage policy decisions: From principles to practice. Health Policy. 2007;82:37–50.CrossRefGoogle ScholarPubMed
4.Pivik, J, Rode, E, Ward, C. A consumer involvement model for health technology assessment in Canada. Health Policy. 2004;69:253–268.CrossRefGoogle ScholarPubMed
5.Reuzel, RPB, vander Wilt, GJ, ten Have, HAMJM, de Bries Robbé, PF.Interactive technology assessment and wide reflective equilibrium. J Med Philos. 2001;26:245–261.CrossRefGoogle ScholarPubMed
6.Moran, R, Davidson, P. An uneven spread: A review of public involvement in the National Institute of Health Research's Health Technology Assessment program. Int J Technol Assess. 2011;27:343–347.CrossRefGoogle ScholarPubMed
7.Royle, J, Oliver, J. Consumer involvement in the health technology assessment process. Int J Health Technol Assess Health Care. 2004;20:493–497.CrossRefGoogle Scholar
8.Einsiedel, EF, Ross, H. Animal spare parts? A Canadian public consultation on xenotransplantation. Sci Eng Ethics. 2002;8:579–591.CrossRefGoogle Scholar
9.Blacksher, E, Diebel, A, Forest, P-G, Goold, S, Abelson, J. What is public deliberation? Hastings Cent Rep. 2012;42:14–17.CrossRefGoogle ScholarPubMed
10.Menon, D, Stafinski, T. Engaging the public in priority-setting for health technology assessment: Findings from a citizens’ jury. Health Expect. 2008;11:282–293.CrossRefGoogle ScholarPubMed
11.Jones, M, Einsiedel, E. 2011. Institutional policy learning and public consultation: The Canadian xenotransplantation experience. Soc Sci Med. 2011;73:655–662.Google ScholarPubMed
12.Bombard, Y, Miller, FA, Hayeems, RZ, et al.Citizens’ values regarding research with stored samples from newborn screening in Canada. Pediatrics. 2012;129:239–247.CrossRefGoogle ScholarPubMed
13.Davies, C, Wetherell, M, Barnett, E. A citizens council in the making: Dilemmas for citizens and their hosts. In: Littlejohns, P, Rawlins, M, eds. Patients, the public and priorities in healthcare. Oxford, UK: Radcliffe Publishing; 2009:129–138.Google Scholar
14.DeVries, R, Stanczyk, A, Wall, I, et al.Assessing the quality of democratic deliberation: A case study of public deliberation on the ethics of surrogate consent for research. Soc Sci Med. 2010;70:1896–1903.CrossRefGoogle Scholar
15.Mitton, C, Smith, N, Peacock, S, Evoy, B, Abelson, J. Public participation in health care priority setting: A scoping review. Health Policy. 2009;91:219–228.CrossRefGoogle ScholarPubMed
16.Weiss, CH.The many meanings of research utilization. Public Admin Rev. 1979;39:426–431.CrossRefGoogle Scholar
17.Davies, C, Wetherell, M, Barnett, E. Citizens at the centre: Deliberative participation in health care decisions. Bristol, UK: The Policy Press; 2006.Google Scholar
18.Pathak-Sen, E.Ordinary people, extraordinary wisdom. In: Littlejohns, P, Rawlins, M, eds. Patients, the public and priorities in healthcare. Oxford, UK: Radcliffe Publishing; 2009:81–88.Google Scholar
19.Johnson, AP, Sikich, NJ, Evans, G, et al.Health technology assessment: A comprehensive framework for evidence-based recommendations in Ontario. Int J Technol Assess. 2009;25:141–150.CrossRefGoogle ScholarPubMed
20.Public Engagement Subcommittee of the Ontario Health Technology Advisory Committee. Final report of the public engagement subcommittee. In OHTAC Reports (Ed.). Toronto: Ontario Health Technology Advisory Committee; 2007.Google Scholar
21.Bombard, Y, Abelson, J, Simeonov, D, Gauvin, FP. Eliciting ethical and social values in health technology assessment: A participatory approach. Soc Sci Med. 2011;73:135–144.CrossRefGoogle ScholarPubMed
22.Sandelowski, M.What’s in a name? Qualitative description revisited. Res Nurs Health, 2010;33:77–84.CrossRefGoogle Scholar
23.Ontario Health Technology Advisory Committee. Screening methods for early detection of colorectal cancers and polyps. September 2009. http://www.health.gov.on.ca/english/providers/program/ohtac/tech/recommend/rec_crc_20090928.pdf (accessed April 24, 2012)Google Scholar
24.Priest, L.Ontario now paying for breast cancer test. Globe and Mail, March 9, 2010, A6.Google Scholar
25.Oliver, S, Armes, D, Gyte, G. Evaluation of public influence on the NHS Health Technology Assessment Programme (Executive summary). London: Social Science Research Unit, Institute of Education, University of London; 2006:12. http://www.hta.ac.uk/public/evaluation_execsumm.pdf (accessed September 27, 2010).Google Scholar