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AN INTEGRATED PERSPECTIVE ON THE ASSESSMENT OF TECHNOLOGIES: INTEGRATE-HTA

Published online by Cambridge University Press:  31 July 2017

Philip Wahlster
Affiliation:
Department of Health Services Research, University of Bremen Center for General Practice, Medical Faculty, Saarland [email protected]
Louise Brereton
Affiliation:
ScHARR, University of Sheffield College of Health Sciences, University of Lincoln
Jacob Burns
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Björn Hofmann
Affiliation:
Centre for Medical Ethics, University of Oslo Institute for the Health Services, Norwegian University for Science and Technology (NTNU)
Kati Mozygemba
Affiliation:
Department of Health Services Research, University of Bremen Health Sciences Bremen, University of Bremen
Wija Oortwijn
Affiliation:
ECORYS Netherlands BV, Rotterdam
Lisa Pfadenhauer
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Stephanie Polus
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Eva Rehfuess
Affiliation:
Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich
Imke Schilling
Affiliation:
Department of Health Services Research, University of Bremen Health Sciences Bremen, University of Bremen
Gert Jan van der Wilt
Affiliation:
Radboud University Medical Center, Nijmegen
Ansgar Gerhardus
Affiliation:
Department of Health Services Research, University of Bremen Health Sciences Bremen, University of Bremen

Abstract

Objectives: Current health technology assessment (HTA) is not well equipped to assess complex technologies as insufficient attention is being paid to the diversity in patient characteristics and preferences, context, and implementation. Strategies to integrate these and several other aspects, such as ethical considerations, in a comprehensive assessment are missing. The aim of the European research project INTEGRATE-HTA was to develop a model for an integrated HTA of complex technologies.

Methods: A multi-method, four-stage approach guided the development of the INTEGRATE-HTA Model: (i) definition of the different dimensions of information to be integrated, (ii) literature review of existing methods for integration, (iii) adjustment of concepts and methods for assessing distinct aspects of complex technologies in the frame of an integrated process, and (iv) application of the model in a case study and subsequent revisions.

Results: The INTEGRATE-HTA Model consists of five steps, each involving stakeholders: (i) definition of the technology and the objective of the HTA; (ii) development of a logic model to provide a structured overview of the technology and the system in which it is embedded; (iii) evidence assessment on effectiveness, economic, ethical, legal, and socio-cultural aspects, taking variability of participants, context, implementation issues, and their interactions into account; (iv) populating the logic model with the data generated in step 3; (v) structured process of decision-making.

Conclusions: The INTEGRATE-HTA Model provides a structured process for integrated HTAs of complex technologies. Stakeholder involvement in all steps is essential as a means of ensuring relevance and meaningful interpretation of the evidence.

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Theme Submissions
Copyright
Copyright © Cambridge University Press 2017 

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