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KNOW ESSENTIALS: A tool for informed decisions in the absence of formal HTA systems

Published online by Cambridge University Press:  29 March 2011

Joseph L. Mathew
Joseph L. Mathew*
Affiliation:
Postgraduate Institute of Medical Education and Research (P.G.I.M.E.R)
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Abstract

Background: Most developing countries and resource-limited settings lack robust health technology assessment (HTA) systems. Because the development of locally relevant HTA is not immediately viable, and the extrapolation of external HTA is inappropriate, a new model for evaluating health technologies is required.

Objectives: The aim of this study was to describe the development and application of KNOW ESSENTIALS, a tool facilitating evidence-based decisions on health technologies by stakeholders in settings lacking formal HTA systems.

Methods: Current HTA methodology was examined through literature search. Additional issues relevant to resource-limited settings, but not adequately addressed in current methodology, were identified through further literature search, appraisal of contextually relevant issues, discussion with healthcare professionals familiar with the local context, and personal experience. A set of thirteen elements important for evidence-based decisions was identified, selected and combined into a tool with the mnemonic KNOW ESSENTIALS. Detailed definitions for each element, coding for the elements, and a system to evaluate a given health technology using the tool were developed.

Results and Conclusions: Developing countries and resource-limited settings face several challenges to informed decision making. Models that are relevant and applicable in high-income countries are unlikely in such settings. KNOW ESSENTIALS is an alternative that facilitates evidence-based decision making by stakeholders without formal expertise in HTA. The tool could be particularly useful, as an interim measure, in healthcare systems that are developing HTA capacity. It could also be useful anywhere when rapid evidence-based decisions on health technologies are required.

Keywords

Developing countriesEvidence-based medicineDecision makingHealth technology assessment
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 27 , Issue 2 , April 2011 , pp. 139 - 150
Copyright
Copyright © Cambridge University Press 2011

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