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What influences the choice of assessment methods in health technology assessments? Statistical analysis of international health technology assessments from 1989 to 2002

Published online by Cambridge University Press:  27 February 2006

Eva Draborg
Affiliation:
University of Southern Denmark
Christian Kronborg Andersen
Affiliation:
University of Southern Denmark

Abstract

Objectives: Health technology assessment (HTA) has been used as input in decision making worldwide for more than 25 years. However, no uniform definition of HTA or agreement on assessment methods exists, leaving open the question of what influences the choice of assessment methods in HTAs. The objective of this study is to analyze statistically a possible relationship between methods of assessment used in practical HTAs, type of assessed technology, type of assessors, and year of publication.

Methods: A sample of 433 HTAs published by eleven leading institutions or agencies in nine countries was reviewed and analyzed by multiple logistic regression.

Results: The study shows that outsourcing of HTA reports to external partners is associated with a higher likelihood of using assessment methods, such as meta-analysis, surveys, economic evaluations, and randomized controlled trials; and with a lower likelihood of using assessment methods, such as literature reviews and “other methods.” The year of publication was statistically related to the inclusion of economic evaluations and shows a decreasing likelihood during the year span. The type of assessed technology was related to economic evaluations with a decreasing likelihood, to surveys, and to “other methods” with a decreasing likelihood when pharmaceuticals were the assessed type of technology.

Conclusions: During the period from 1989 to 2002, no major developments in assessment methods used in practical HTAs were shown statistically in a sample of 433 HTAs worldwide. Outsourcing to external assessors has a statistically significant influence on choice of assessment methods.

Type
GENERAL ESSAYS
Copyright
© 2006 Cambridge University Press

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References

Banta D. 2003 The development of health technology assessment. Health Policy. 63: 121132.Google Scholar
Banta HD, Luce BR. 1993. Health care technology and its assessment. An international perspective. Oxford: Oxford University Press;
Banta HD, Perry S. 1997 A history of ISTAHC. A personal perspective on its first 10 years. Int J Technol Assess Health Care. 13: 430453.Google Scholar
Birch S, Gafni A. 2002 On being NICE in the UK: Guidelines for technology appraisal for the NHS in England and Wales. Health Econ. 11: 185191.Google Scholar
Cookson R, Maynard A. 2000 Health technology assessment in Europe. Improving clarity and performance. Int J Technol Assess Health Care. 16: 639650.Google Scholar
Davies H, Laycock G, Nutley S, Sebba J, Sheldon T. 2000: Astrategic approach to research and development. In: Davies HTO, Nutley SM, Smith PC, eds. What works? Evidence-based policy and practice in public services. Bristol, UK: The Policy Press; 229250.
Draborg E, Gyrd-Hansen D. 2005 Time-trends in health technology assessments: An analysis of developments in composition of international health technology assessments from 1989 to 2002. Int J Technol Assess Health Care. 21: 492498.Google Scholar
Draborg E, Gyrd-Hansen D, Poulsen PB, Horder M. 2005; An international comparison of the definition and the practical application of health technology assessment. Int J Technol Assess Health Care. 21: 8995.Google Scholar
Eisenberg JM. 1999 Ten lessons for evidence-based technology assessment. JAMA. 282: 18651869.Google Scholar
Fuchs VR. 1993. The future of health policy. Cambridge, MA: Harvard University Press;
García-Altés A, Ondategui-Parra S, Neumann PJ. 2004; Cross-national comparison of technology assessment processes. Int J Technol Assess Health Care. 20: 300310.Google Scholar
Goodman CS, Ahn R. 1999; Methodological approaches of health technology assessment. Int J Med Inform. 56: 97105.Google Scholar
Hailey D. 2003 Toward transparency in health technology assessment. A checklist for HTA reports. Int J Technol Assess Health Care. 19: 17.Google Scholar
Jonsson E. 2002 Development of health technology assessment in Europe. A personal perspective. Int J Technol Assess Health Care. 18: 171183.Google Scholar
Jonsson E, Banta D. 1999 Management of health technologies: An international view. BMJ. 319: 1293.Google Scholar
Lehoux P, Tailliez S, Denis J-L, Hivon M. 2004 Redefining health technology assessment in Canada: Diversification of products and contextualization of findings. Int J Technol Assess Health Care. 20: 325336.Google Scholar
Liberati A, Sheldon TA, Banta HD. 1997 EUR-ASSESS project subgroup report on methodology. Methodological guidance for the conduct of health technology assessment. Int J Technol Assess Health Care. 13: 186219.Google Scholar
Maynard A, McDaid D. 2003 Evaluating health interventions: Exploiting the potential. Health Policy. 63: 215226.Google Scholar
Mears R, Taylor R, Littlejohns P, Dillon A. 2000. Review of International Health Technology Assessments (IHTA). London: National Institute of Clinical Excellence;
Menon D. 2000. Health technology assessment in Canada: A ten year review. Part 1. Working Paper 00-4. Edmonton: Institute of Health Economics;
Menon D. 2000. Health technology assessment in Canada: A ten year review. Part 2. Working Paper 00-5. Edmonton: Institute of Health Economics;
Menon D, Marshall D. 1996; The internationalization of health technology assessment. Int J Technol Assess Health Care. 12: 4551.Google Scholar
Menon D, Topfer LA. 2000; Health technology assessment in Canada. A decade in review. Int J Technol Assess Health Care. 16: 896902.Google Scholar
Milne R, Clegg A, Stevens A. 2003 HTA responses and the classic HTA report. J Public Health Med. 25: 102106.Google Scholar
Perleth M, Jakubowski E, Busse R. 2001 What is ‘best practice’ in health care? State of the art and perspectives in improving the effectiveness and efficiency of the European health care systems. Health Policy. 56: 235250.Google Scholar
Perry S, Gardner E, Thamer M. 1997 The status of health technology assessment worldwide. Results of an international survey. Int J Technol Assess Health Care. 13: 8198.Google Scholar
Perry S, Thamer M. 1997 Health technology assessment: Decentralized and fragmented in the US compared to other countries. Health Policy. 40: 177198.Google Scholar
Poulsen PB. 1999. Health technology assessment and diffusion of health technology. Odense: Odense University Press;
Sassi F. 2000 The European way to health technology assessment. Lessons from an evaluation of EUR-ASSESS. Int J Technol Assess Health Care. 16: 282290.Google Scholar
Velasco M, Perleth M, Drummond M, et al. 2002 Best practice in undertaking and reporting health technology assessments. Int J Technol Assess Health Care. 18: 361422.Google Scholar