Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-25T05:39:31.215Z Has data issue: false hasContentIssue false
  • English
  • Français

FACTORS INFLUENCING DECISION MAKING ON THERAPEUTIC INTERVENTIONS

Published online by Cambridge University Press:  17 July 2013

Sang Moo Lee ,
Gaeun Kim ,
Jeonghoon Ahn ,
Hae Sun Suh  and
Dae Seog Heo
Sang Moo Lee
Affiliation:
National Evidence-based Healthcare Collaboration Agency
Gaeun Kim
Affiliation:
National Evidence-based Healthcare Collaboration Agency
Jeonghoon Ahn
Affiliation:
National Evidence-based Healthcare Collaboration Agency
Hae Sun Suh
Affiliation:
National Evidence-based Healthcare Collaboration Agency; College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University
Dae Seog Heo
Affiliation:
National Evidence-based Healthcare Collaboration Agency, College of Medicine, Seoul National University
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The aim of this study was to explore factors that influenced decision making in the assessment of new health technology in Korea.

Methods: We analyzed the decision-making results of the Committee for New Health Technology Assessment (CnHTA) on fifty-three new nondrug health technologies in Korea from July 2007 to December 2010. The scope of the committee was mainly limited to safety and efficacy/effectiveness, and every decision was based on a systematic review of the literature. The committee was composed of healthcare professionals, policy makers, lawyers, and representatives from nongovernmental organizations. Decisions made on therapeutic interventions were included, while those on diagnostic procedures were excluded.

Results: Factors that positively influenced decisions were lower complication rate than existing technology, similar or greater effectiveness compared with existing technology, ability to save critical organs, absence of alternative intervention, decreased invasiveness, expansion of patient's set of choices, and similarity to the mechanism of existing technology. Factors that negatively influenced decisions were higher complication rates than existing technology, lower effectiveness than comparable technology, low levels of evidence, unknown mechanisms of intervention, inconsistency, lack of long-term outcomes, lack of comparative data, nonstandardized technology, heterogeneity between control and treatment, excessively diverse indications, and nongeneralizability.

Conclusions: This qualitative analysis of past decision-making results provided us with clues on the values that decision makers on the Korean CnHTA considered in terms of safety and effectiveness. These findings will help us develop appraisal guidelines and enhance the objectivity of decision-making processes in Korea.

Keywords

decision makingtechnologytherapeutic interventionsafetyefficacy
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 29 , Issue 3 , July 2013 , pp. 331 - 335
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.IOM (Institute of Medicine). Value in health care: Accounting for cost, quality, safety, outcomes and innovation: Workshop summary. Washington, DC: The National Academies Press; 2010.Google Scholar
2.Goetghebeur, M, Wagner, M, Khoury, H, et al.Evidence and Value: Impact on DEcisionMaking – the EVIDEM framework and potential applications. BMC Health Serv Res. 2008;8:270.CrossRefGoogle ScholarPubMed
3.Singer, S, Bergthold, L, Vorhaus, C, et al.Decreasing variation in medical necessity decision making. California: Center for Health Policy, Stanford University; 1999.Google Scholar
4.BlueCross BlueShield Association [Internet]. http://www.bcbs.com (accessed July 18, 2011).Google Scholar
5.Park, SH, Lee, SM. Evidence-based decision-making and health technology assessment in South Korea. Value Health. 2008;11(Suppl):S163–164.CrossRefGoogle ScholarPubMed
6.SIGN (Scottish Intercollegiate Guidelines Network) [Internet]. http://www.sign.ac.uk (accessed April 3, 2011).Google Scholar
7.Barrington, MJ, Olive, D, Low, K, et al.Continuous femoral nerve blockade or epidural analgesia after total knee replacement: A prospective randomized controlled trial. Anesth Analg. 2005;101:1824–1829.CrossRefGoogle ScholarPubMed
8.De Ruyter, ML, Brueilly, KE, Harrison, BA, et al.A pilot study on continuous femoral perineural catheter for analgesia after total knee arthroplasty: The effect on physical rehabilitation and outcomes. J Arthroplasty. 2006;21:1111–1117.CrossRefGoogle ScholarPubMed
9.Ilfeld, BM, Le, LT, Meyer, RS, et al.Ambulatory continuous femoral nerve blocks decrease time to discharge readiness after tricompartment total knee arthroplasty: A randomized, triple-masked, placebo-controlled study. Anesthesiology. 2008;108:703–713.CrossRefGoogle ScholarPubMed
10.Akar, R, Durdu, S, Arat, M, et al.Therapeutic angiogenesis by autologous transplantation of bone-marrow mononuclear cells for Buersger's patients with retractable limb ischaemia: A preliminary report. Turk J Haematol. 2004;21:13–21.Google ScholarPubMed
11.Durdu, S, Akar, AR, Arat, M, et al.Autologous bone-marrow mononuclear cell implantation for patients with Rutherford grade II-III thromboangiitis obliterans. J Vasc Surg. 2006;44:732–739.CrossRefGoogle ScholarPubMed
12.Tateishi-Yuyama, E, Matsubara, H, Murohara, T, et al.Therapeutic Angiogenesis using Cell Transplantation (TACT) Study Investigators. Therapeutic angiogenesis for patients with limb ischaemia by autologous transplantation of bone-marrow cells: A pilot study and a randomized controlled trial. Lancet. 2002;360:427–435.CrossRefGoogle Scholar
13.Bahar, I, Kaiserman, I, Levinger, E, et al.Retrospective contralateral study comparing descemet stripping automated endothelial keratoplasty with penetrating keratoplasty. Cornea. 2009;28:485–488.CrossRefGoogle ScholarPubMed
14.Bahar, I, Kaiserman, I, McAllum, P, et al.Comparison of posterior lamellar keratoplasty techniques to penetrating keratoplasty. Ophthalmology. 2008;115:1525–1533.CrossRefGoogle ScholarPubMed
15.Hjortdal, J, Ehlers, N. Descemet's stripping automated endothelial keratoplasty and penetrating keratoplasty for Fuchs’ endothelial dystrophy. Acta Opthalmol. 2009;87:310–314.CrossRefGoogle ScholarPubMed
16.Hawaii State Legislature [Internet]. http://www.capitol.hawaii.gov. (accessed March 16, 2011).Google Scholar