Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-23T00:25:15.987Z Has data issue: false hasContentIssue false
  • English
  • Français

Patients' perspectives in health technology assessment: A route to robust evidence and fair deliberation

Published online by Cambridge University Press:  29 June 2010

Karen Facey ,
Antoine Boivin ,
Javier Gracia ,
Helle Ploug Hansen ,
Alessandra Lo Scalzo ,
Jean Mossman  and
Ann Single
Karen Facey
Affiliation:
HTAi Interest Group on Patient/Citizen Involvement in HTA and University of Glasgow
Antoine Boivin
Affiliation:
Radboud University Nijmegen Medical Center
Javier Gracia
Affiliation:
Agencia Laín Entralgo
Helle Ploug Hansen
Affiliation:
University of Southern Denmark
Alessandra Lo Scalzo
Affiliation:
Agenzia Nazionale per I Servizi Sanitari Regionali – AGENAS
Jean Mossman
Affiliation:
HTAi Interest Group on Patient/Citizen Involvement in HTA
Ann Single
Affiliation:
HTAi Interest Group on Patient/Citizen Involvement in HTA
Get access Rights & Permissions [Opens in a new window]

Abstract

There is increasing emphasis on providing patient-focused health care and ensuring patient involvement in the design of health services. As health technology assessment (HTA) is meant to be a multidisciplinary, wide-ranging policy analysis that informs decision making, it would be expected that patients’ views should be incorporated into the assessment. However, HTA is still driven by collection of quantitative evidence to determine the clinical and cost effectiveness of a health technology. Patients’ perspectives about their illness and the technology are rarely included, perhaps because they are seen as anecdotal, biased views. There are two distinct but complementary ways in which HTAs can be strengthened by: (i) gathering robust evidence about the patients’ perspectives, and (ii) ensuring effective engagement of patients in the HTA process from scoping, through evidence gathering, assessment of value, development of recommendations and dissemination of findings. Robust evidence eliciting patients’ perspectives can be obtained through social science research that is well conducted, critically appraised and carefully reported, either through meta-synthesis of existing studies or new primary research. Engagement with patients can occur at several levels and we propose that HTA should seek to support effective patient participation to create a fair deliberative process. This should allow two-way flow of information, so that the views of patients are obtained in a supportive way and fed into decision-making processes in a transparent manner.

Keywords

Patient-centered carePatient participationTechnology assessmentSystematic reviewQualitative research
Type
METHODS
Information
International Journal of Technology Assessment in Health Care , Volume 26 , Issue 3 , July 2010 , pp. 334 - 340
Copyright
Copyright © Cambridge University Press 2010

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. Abelson, J, Forest, PG, Eyles, J, Smith, P, Martin, E, Gauvin, FP. Deliberations about deliberative methods: Issues in the design and evaluation of public participation processes. Soc Sci Med. 2003;57:239–251.CrossRefGoogle ScholarPubMed
2. Bailey, KD. Methods of social research. New York: The Free Press; 1982.Google Scholar
3. Barroso, J, Gollop, CJ, Sandelowski, M, et al. The challenges of searching for and retrieving qualitative studies. West J Nurs Res. 2003;25:153–178.CrossRefGoogle ScholarPubMed
4. Bridges, JFP, Jones, C. Patient based health technology assessment: A vision of the future. Int J Technol Assess Health Care. 2007;23:30–35.CrossRefGoogle ScholarPubMed
5. Dixon-Woods, M, Bonas, S, Booth, A, et al. How can systematic reviews incorporate qualitative research? A critical perspective. Qual Res. 2006;6:27–44.CrossRefGoogle Scholar
6. Edwards, P, Roberts, I, Clarke, M, et al. Methods to increase response rates to postal questionnaires. Cochrane Database Syst Rev. 2007;2:MR000008.Google Scholar
7. Gagnon, M-P, Lepage-Savary, D, Gagnon, J, et al. Introducing patient perspective in health technology assessment at the local level. BMC Health Serv Res. 2009;9:54.CrossRefGoogle ScholarPubMed
8. Gauvin, F-P. Public involvement in health technology assessment agencies: A comparative analysis of Canada, Denmark, and the United Kingdom [PhD thesis]. Hamilton: McMaster University; 2008.Google Scholar
9. Hailey, D. Consumer involvement in HTA. Alberta: Alberta Heritage Foundation for Medical Research HTA Unit; 2005. http://www.ihe.ca/documents/HTA-FR21.pdf (accessed May 27, 2009).Google Scholar
10. Hailey, D, Nordwall, M. Survey on the involvement of consumers in health technology assessment programs. Int J Technol Assess Health Care. 2006;22:497–499.CrossRefGoogle ScholarPubMed
11. Health Equality Europe. Understanding health technology assessment. Europe: Health Equality Europe; 2008 http://www.htai.org/index.php?id=85 (accessed May 27, 2009).Google Scholar
12. Hewlett, S, DeWit, M, Richards, P, et al. Patients and professionals as research partners: Challenges, practicalities and benefits. Arthritis Rheum. 2006;55:676–680.CrossRefGoogle ScholarPubMed
13. Kristensen, FB, Sigmund, H. Health technology assessment handbook. Copenhagen: Danish Centre for Health Technology Assessment, National Board of Health; 2007.Google Scholar
14. Kuper, A, Reeves, S, Levinson, W. An introduction to reading and appraising qualitative research. BMJ. 2008;337:a288.CrossRefGoogle ScholarPubMed
15. Lampe, K, Mäkelä, M. HTA core model for medical and surgical interventions 1.0R. – Section 3.6 Ethical Analysis. Copenhagen: EUnetHTA Work Package 4; 2008. http://www.eunethta.net/upload/WP4/Final%20Deliverables/HTA%20Core%20Model%20for%20Medical%20and%20Surgical%20Interventions%201%200r.pdf (accessed March 29, 2010).Google Scholar
16. Lee, A, Sinding, LS. A review of organizational and patient-related assessments in HTAs published by INAHTA members. Dan Health Technol Assess. 2007;9:2.Google Scholar
17. Lehoux, P, Daudelin, G, Demers-Payette, O, Boivin, A. Fostering deliberations about health innovation: What do we want to know from publics? Soc Sci Med. 2009;68:2002–2009.CrossRefGoogle ScholarPubMed
18. Malterud, K. Qualitative research: Standards, challenges and guidelines. Lancet. 2001;358:483–488.CrossRefGoogle ScholarPubMed
19. Nicholas, DB, Globerman, J, Antle, BJ, McNeill, T, Lach, LM. Processes of metastudy: A study of psychosocial adaptation to childhood chronic health conditions. Int J Qual Methods. 2006;5:1–10. www.ualberta.ca/~iiqm/backissues/5_1/pdf/nicholas.pdf (accessed May 27, 2009).Google Scholar
20. Noblitt, GW, Hare, RD. Meta-ethnography: Synthesizing qualitative studies. California: Sage Publications; 1988.CrossRefGoogle Scholar
21. Popay, J, Roberts, H, Sowden, A, et al. Guidance on the conduct of narrative synthesis in systematic reviews. Draft report from ESRC Methods Programme. University of Lancaster: Institute for Health Research; 2004.Google Scholar
22. Rowe, G, Frewer, LJ. A typology of public engagement mechanisms. Sci Technol Hum Values. 2005;30:251–290. http://sth.sagepub.com/cgi/content/abstract/30/2/251 (accessed June 10, 2009).CrossRefGoogle Scholar
23. Street, J, Braunack-Mayer, A, Facey, K, et al. Virtual community consultation? Using the literature and weblogs to link community perspectives and health technology assessment. Health Expect. 2008;11:189–200.CrossRefGoogle ScholarPubMed
24. Telford, R, Boote, J, Cooper, C. What does it mean to involve consumers successfully in NHS research? A consensus study. Health Expect. 2004;7:209–220.CrossRefGoogle ScholarPubMed
25. Webler, T. “Right” discourse in citizen participation: An evaluative yardstick. In: Renn, O, Webler, T, Wiedemann, P, eds. Fairness and competence in citizen participation: Evaluating models for environmental discourse. Dordrecht: Kluwer Academic; 1995.Google Scholar