Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-22T06:44:14.043Z Has data issue: false hasContentIssue false
  • English
  • Français

Health Technology Assessment of Public Health Interventions Published 2012 to 2016: An Analysis of Characteristics and Comparison of Methods

Part of: Special Collection - Methods

Published online by Cambridge University Press:  24 July 2019

Stephanie Polus Open the ORCID record for Stephanie Polus [Opens in a new window] ,
Tim Mathes ,
Corinna Klingler ,
Melanie Messer ,
Ansgar Gerhardus ,
Constance Stegbauer ,
Gerald Willms ,
Heidi Ehrenreich ,
Georg Marckmann  and
Dawid Pieper
Stephanie Polus
Affiliation:
Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Germany
Tim Mathes
Affiliation:
Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Germany
Corinna Klingler
Affiliation:
Institute of Ethics, History & Theory of Medicine, LMU Munich, Germany
Melanie Messer
Affiliation:
Bielefeld University, Faculty of Health Science, Germany
Ansgar Gerhardus
Affiliation:
Department for Health Services Research, Institute for Public Health and Nursing Research, University of Bremen, Germany Health Sciences Bremen, University of Bremen
Constance Stegbauer
Affiliation:
aQua Institute for Applied Quality Improvement and Research in Health Care, Germany
Gerald Willms
Affiliation:
aQua Institute for Applied Quality Improvement and Research in Health Care, Germany
Heidi Ehrenreich
Affiliation:
AOK-Bundesverband, Germany
Georg Marckmann
Affiliation:
Institute of Ethics, History & Theory of Medicine, LMU Munich, Germany
Dawid Pieper*
Affiliation:
Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Germany
*
Author for correspondence: Dawid Pieper, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

The aim of this study was to provide an overview of the methodological characteristics and compare the assessment methods applied in health technology assessments (HTAs) of public health interventions (PHIs).

Methods

We defined a PHI as a population-based intervention on health promotion or for primary prevention of chronic or nonchronic diseases. HTAs on PHIs were identified by systematically searching the Web pages of members of international HTA networks. We included only full HTA reports published between 2012 and 2016. Two reviewers extracted data on the methods used to assess effectiveness/safety, as well as on economic, social, cultural, ethical, and legal aspects using a-priori standardized tables.

Results

We included ten HTAs provided by four different organizations. Of these, all reports assessed the effectiveness of the interventions and conducted economic evaluations, seven investigated social/cultural aspects, and four each considered legal and ethical aspects, respectively. Some reports addressed applicability, context/setting, and intervention fidelity issues in different ways. We found that most HTAs adapted their methods to some extent, for example, by including nonrandomized studies, expanding the search strategy, involving stakeholders, or applying a framework to guide the HTA process.

Conclusions

Our analysis provides a comprehensive overview of methods applied in HTAs on public health interventions. We found that a heterogeneous set of approaches is used to deal with the challenges of evaluating complex public health interventions.

Keywords

Public healthhealth promotionhealth technology assessmentmethodology review
Type
Method
Information
International Journal of Technology Assessment in Health Care , Volume 35 , Issue 4 , 2019 , pp. 280 - 290
Copyright
Copyright © Cambridge University Press 2019 

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

1.World Health Organization (WHO) (2015) 2015 Global survey on health technology assessment by national authorities. Geneva: WHO.Google Scholar
2.Draborg, E, Gyrd-Hansen, D, Poulsen, PB, Horder, M (2005) International comparison of the definition and the practical application of health technology assessment. Int J Technol Assess Health Care 21, 89–95.Google Scholar
3.Lavis, JN, Wilson, MG, Grimshaw, JM, et al. (2010) Supporting the use of health technology assessments in policy making about health systems. Int J Technol Assess Health Care 26, 405–414.Google Scholar
4.Burford, B, Lewin, S, Welch, V, Rehfuess, E, Waters, E (2013) Assessing the applicability of findings in systematic reviews of complex interventions can enhance the utility of reviews for decision making. J Clin Epidemiol 66, 1251–1261.Google Scholar
5.Petticrew, M, Anderson, L, Elder, R, et al. (2013) Complex interventions and their implications for systematic reviews: A pragmatic approach. J Clin Epidemiol 66, 1209–1214.Google Scholar
6.Petticrew, M, Chalabi, Z, Jones, DR (2012) To RCT or not to RCT: Deciding when ‘more evidence is needed’ for public health policy and practice. J Epidemiol Community Health 66, 391–396.Google Scholar
7.Hartling, L, Bond, K, Santaguida, PL, Viswanathan, M, Dryden, DM (2011) Testing a tool for the classification of study designs in systematic reviews of interventions and exposures showed moderate reliability and low accuracy. J Clin Epidemiol 64, 861–871.Google Scholar
8.Akers, J, Aguiar-Ibáñez, R, Baba-Akbari, A (2009) Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care. York: Centre for Reviews and Dissemination (CRD).Google Scholar
9.Mathes, T, Antoine, SL, Prengel, P, et al. (2017) Health technology assessment of public health interventions: A synthesis of methodological guidance. Int J Technol Assess Health Care 33, 135–146.10.1017/S0266462317000228Google Scholar
10.Gerhardus, A, Oortwijn, W, van der Wilt, GJ (2017) How to avoid giving the right answers to the wrong questions: The need for integrated assessments of complex health technologies. Int J Technol Assess Health Care 33, 541–543.Google Scholar
11.Mathes, T, Willms, G, Polus, S, et al. (2018) Health technology assessment of public health interventions: an analysis of characteristics and comparison of methods - Study protocol. Syst Rev 7, 79.Google Scholar
12.Merlin, T, Tamblyn, D, Ellery, B; INAHTA Quality Assurance Group (2015) What's in a name? Developing definitions for common health technology assessment product types of the International Network of Agencies for Health Technology Assessment (inahta). Int J Technol Assess Health Care 30, 430–457.Google Scholar
13.Page, MJ, Shamseer, L, Altman, DG, et al. (2016) Epidemiology and reporting characteristics of systematic reviews of biomedical research: A cross-sectional study. PLoS Med 13, e1002028.Google Scholar
14.EuroHealthNet (2015) European Joint Action on Chronic Diseases and Healthy Ageing Across the Life Cycle, Health Promotion and Primary Prevention in 14 European Countries: A Comparative Overview of Key Policies, Approaches, Gaps and Needs. Brussels: EuroHealthNet.Google Scholar
15.U.S. Preventive Services Task Force (2015) Procedure Manual. Rockville, MD: USPSTF.Google Scholar
16.Balzer, K, Bremer, M, Schramm, S, Lühmann, D, Raspe, H (2012) Sturzprophylaxe bei älteren Menschen in ihrer persönlichen Wohnumgebung. Deutsche Agentur für Health Technology Assessment (DAHTA): Cologne, Germany.Google Scholar
17.Fröschl, B, Brunner-Ziegler, S, Wirl, C (2013) Prävention des fetalen Alkoholsyndroms. Deutschen Institut für Medizinische Dokumentation und Information (DIMDI): Cologne, Germany.Google Scholar
18.Korczak, D, Kister, C, Krause-Girth, C (2012) Effektivität und Effizienz von psychologischen, psychiatrischen, sozialmedizinischen und komplementär- medizinischen Interventionen bei Schreibabys (z. B. regulative Störung) in Schreiambulanzen, in Schriftenreihe Health Technology Assessment (HTA) In der Bundesrepublik Deutschland. 2012, Deutschen Instituts für Medizinische Dokumentation und Information (DIMDI): Cologne.Google Scholar
19.HIQA (2014) Health Technology Assessment (HTA) of Public Access Defibrillation. Health Information and Quality Authority (HIQA): Dublin: HIQA.Google Scholar
20.Tice, JA, Chapman, R, Shore, KK, et al. (2016) Diabetes Prevention Programs: Effectiveness and Value. Boston: Institute for Clinical and Economic Review.Google Scholar
21.Bee, P, Bower, P, Byford, S, et al. (2014) The clinical effectiveness, cost-effectiveness and acceptability of community-based interventions aimed at improving or maintaining quality of life in children of parents with serious mental illness: A systematic review. Health Technol Assess 18, 1–250.Google Scholar
22.Tappenden, P, Campbell, F, Rawdin, A, Wong, R, Kalita, N (2012) The clinical effectiveness and cost-effectiveness of home-based, nurse-led health promotion for older people: A systematic review. Health Technol Assess 16, 1–72.Google Scholar
23.Brown, TJ, Todd, A, O'Malley, C, et al. (2016) Community pharmacy-delivered interventions for public health priorities: A systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation. BMJ Open 6, e009828.10.1136/bmjopen-2015-009828Google Scholar
24.O'Mara-Eves, A, Brunton, G, McDaid, D, et al. (2013) Community engagement to reduce inequalities in health: A systematic review, meta-analysis and economic analysis. Southampton, UK: NIHR Journals Library.Google Scholar
25.Bambra, CL, Hillier, FC, Cairns, J-M, et al. (2015) How Effective Are Interventions at Reducing Socioeconomic Inequalities in Obesity Among Children and Adults? Two Systematic Reviews. Southampton, UK: NIHR Journals Library.Google Scholar
26.Egan, M, Bambra, C, Petticrew, M, Whitehead, M (2009) Reviewing evidence on complex social interventions: Appraising implementation in systematic reviews of the health effects of organisational-level workplace interventions. J Epidemiol Community Health 63, 4–11.Google Scholar
27.Beauchamp, TL, Childress, JF (2013) Principles of Biomedical Ethics. 7th ed. Oxford: Oxford University Press.Google Scholar
28.Cooper, C, Lovell, R, Husk, K, Booth, A, Garside, R (2018) Supplementary search methods were more effective and offered better value than bibliographic database searching: A case study from public health and environmental enhancement. Res Synth Methods 9, 195–223.Google Scholar
29.Polus, S, Pieper, D, Burns, J, et al. (2017) Heterogeneity in application, design, and analysis characteristics was found for controlled before-after and interrupted time series studies included in Cochrane reviews. J Clin Epidemiol 91, 56–69.Google Scholar
30.Mathes, T, Walgenbach, M, Antoine, SL, Pieper, D, Eikermann, M (2014) Methods for systematic reviews of health economic evaluations: A systematic review, comparison, and synthesis of method literature. Med Decis Making 34, 826–840.Google Scholar
31.Lysdahl, KB, Mozygemba, K, Burns, J, et al. (2016) Guidance for assessing effectiveness, economic aspects, ethical aspects, socio-cultural aspects and legal aspects in complex technologies. https://www.integrate-hta.eu/wp-content/uploads/2016/08/IPP_Guidance-INTEGRATE-HTA_Nr.3_FINAL.pdf.Google Scholar
32.DeJean, D, Giacomini, M, Schwartz, L, Miller, FA (2009) Ethics in Canadian health technology assessment: A descriptive review. Int J Technol Assess Health Care 25, 463–469.Google Scholar
33.Hofmann, B (2014) Why not integrate ethics in HTA: Identification and assessment of the reasons. GMS Health Technol Assess 10, p. Doc04.Google Scholar
34.Assasi, N, Schwartz, L, Tarride, JE, Campbell, K, Goeree, R (2014) Methodological guidance documents for evaluation of ethical considerations in health technology assessment: A systematic review. Expert Rev Pharmacoecon Outcomes Res 14, 203–220.Google Scholar
35.Saarni, SI, Braunack-Mayer, A, Hofmann, B, van der Wilt, GJ (2011) Different methods for ethical analysis in health technology assessment: An empirical study. Int J Technol Assess Health Care 27, 305–312.Google Scholar
36.Droste, S (2008) [Systematic search for information on ethical issues in HTA reports on medical technologies or interventions]. Z Evid Fortbild Qual Gesundhwes 102, 329–341.Google Scholar
37.Grunwald, A (2004) The normative basis of (health) technology assessment and the role of ethical expertise. Poiesis Prax 2, 175–193.Google Scholar
38.Craig, P, Dieppe, P, Macintyre, S, et al. (2008) Developing and evaluating complex interventions: The new Medical Research Council guidance. BMJ 337, a1655.Google Scholar
Supplementary material: File

Polus et al. supplementary material

Polus et al. supplementary material 1

Download Polus et al. supplementary material(File)
File 58.4 KB
Supplementary material: File

Polus et al. supplementary material

Polus et al. supplementary material 2

Download Polus et al. supplementary material(File)
File 42.7 KB
Supplementary material: File

Polus et al. supplementary material

Polus et al. supplementary material 3

Download Polus et al. supplementary material(File)
File 90.9 KB