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Redefining health technology assessment in Canada: Diversification of products and contextualization of findings

Published online by Cambridge University Press:  01 August 2004

Pascale Lehoux ,
Stéphanie Tailliez ,
Jean-Louis Denis  and
Myriam Hivon
Pascale Lehoux
Affiliation:
University of Montreal
Stéphanie Tailliez
Affiliation:
University of Montreal
Jean-Louis Denis
Affiliation:
University of Montreal
Myriam Hivon
Affiliation:
University of Montreal
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Abstract

Objectives: While strategies for enhancing the dissemination and impact of Health Technology Assessment (HTA) are now being increasingly examined, the characteristics of HTA production have received less attention.

Methods: This study presents the results of a content analysis of the HTA documents (n=187) produced by six Canadian agencies from 1995 to 2001, supplemented by interviews with chief executive officers and researchers (n=40). The goal of this analysis was to characterize the agencies' portfolios and to analyze the challenges these agencies face in responding to the increased demand for HTA.

Results: On average, thirty HTA products were issued annually by the agencies. While the bulk of documents produced were full HTA reports (76 percent), two agencies showed significant diversification in their products. Three agencies in particular actively supported the publication of results in scientific journals. Three agencies showed evidence of adapting to different institutional environments by specializing in certain areas (drugs, health services). Overall, a significant portion of the agencies' HTAs contained data on costs (37 percent) and effectiveness (48 percent), whereas ethical and social issues were rarely addressed (17 percent). Most agencies addressed issues and outcomes that did not strictly fall under the typical definition of HTA but that increased the “contextualization” of their findings.

Conclusions: Our discussion highlights four paradoxes and reflects further on challenges raised by the coordination of HTA within large countries and among European states. This study concludes that HTA is being redefined in Canada as HTA agencies offer a more contextualized informational basis, an approach that may prove more compatible with the increased demand for HTA.

Keywords

Health technology assessmentCanadaContent of assessments
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 20 , Issue 3 , August 2004 , pp. 325 - 336
Copyright
© 2004 Cambridge University Press

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References

Banta HD, Oortwijn WJ, van Beekum WT. 1995. The organization of health care technology assessment in the Netherlands. The Hague: Rathenau Institute
Battista RN, Banta HD, Jonsson E, et al. 1994 Lessons from eight countries. Health Policy. 30: 397– 421.Google Scholar
Battista RN, Feeny DH, Hodge M. 1995 Evaluation of the Canadian Coordinating Office for Health Technology Assessment. Int J Technol Assess Health Care. 11: 102– 116.Google Scholar
Battista RN, Lance JM, Lehoux P, et al. 1999 Health technology assessment and the regulation of medical devices and procedures in Quebec: Synergy, collusion or collision? Int J Technol Assess Health Care. 15: 593– 601.Google Scholar
Bero LA, Jadad AR. 1997 How consumers and policymakers can use systematic reviews for decision making. Ann Intern Med. 127: 37– 42.Google Scholar
Borlum Krisetensen F, Gabbay J, Antes G, et al. 2002 Education and support networks for assessment of health interventions. Int J Technol Assess Health Care. 18: 423– 446.Google Scholar
Buxton M, Hanney S. 1996 How can payback from health services research be assessed? J Health Serv Res. 1: 35– 43.Google Scholar
Cookson R, Maynard A. 2000 Health technology assessment in Europe. Improving clarity and performance. Int J Technol Assess Health Care. 16: 639– 650.Google Scholar
Davies E, Littlejohns P. 2002 Views of directors of public health about NICE appraisal guidance: Results of a postal survey. J Public Health Med. 24: 319– 325.Google Scholar
Deber R, Wiktorowicz M, Leatt P, et al. 1995 Technology acquisition in Canadian hospitals: How are we doing? Healthcare Manage Forum. 8: 23– 28.Google Scholar
Drummond M, Weatherly H. 2000 Implementing the findings of health technology assessments. If the cat got out of the bag, can the tail wag the dog? Int J Technol Assess Health Care. 16: 1– 12.Google Scholar
Edquist C, Johnson B. 1997 Institutions and organizations in systems of innovation. In: Edquist C, editor. Systems of innovation. Technologies, institutions and organizations. London: Pinter: 41– 63.
Foray D. 1997 Generation and distribution of technological knowledge: Incentives, norms, and institutions. In: Edquist C, editor. Systems of innovation. Technologies, institutions and organizations. London: Pinter: 64– 84.
Gibbons M, Limoges C, Nowotny H, et al. 1994. The new production of knowledge. London: Sage Publications
Grilli R, Lomas J. 1994 Evaluating the message: The relationship between compliance rate and the subject of a practice guideline. Med Care. 132: 202– 213.Google Scholar
Hailey D, Corabian P, Harstall C, et al. 2000 The use and impact of rapid health technology assessments. Int J Technol Assess Health Care. 16: 651– 656.Google Scholar
Hailey D, Topfler LA, Wills F. 2001 Providing information on emerging health technologies to provincial decision makers: A pilot project. Health Policy. 58: 15– 26.Google Scholar
Hailey D. 1993 The influence of technology assessments by advisory bodies on health policy and practice. Health Policy. 25: 243– 254.Google Scholar
Hanney SR, Gonzalez-Block MA, Buxton MJ, et al. 2003 The utilization of health research in policy-making: Concepts, examples and methods of assessment. Health Res Policy Syst. 1.Google Scholar
Jacob R, McGregor M. 1997 Assessing the impact of health technology assessment. Int J Technol Assess Health Care. 13: 68– 80.Google Scholar
Jacob R, Battista RN. 1993 Assessing technology assessment: Early results of the Quebec experience. Int J Technol Assess Health Care. 9: 564– 572.Google Scholar
Johri M, Lehoux P. 2003 The great escape? Health technology assessment as a means of cost control. Int J Technol Assess Health Care. 19: 179– 193.Google Scholar
Lavis JN, Ross SE, Hurley JE, et al. 2002 Examining the role of health services research in public policy-making. Milkbank Q. 80: 125– 154.Google Scholar
Lehoux P, Blume S. 2000 Technology assessment and the sociopolitics of health technologies. J Health Polit Policy Law. 25: 1083– 1120.Google Scholar
Lehoux P, Battista RN, Lance JM. 2000 Monitoring health technology assessment agencies. Can J Program Eval. 15: 1– 33.Google Scholar
Lehoux P, Denis JL, Tailliez S, Hivon H. Dissemination of HTA in Canada: Do visions match strategies? J Health Polit Policy Law. Submitted.
Lehoux P. 2002. Could new regulatory mechanisms be designed after a critical assessment of the value of headline innovations? Discussion paper number 37. Commission on the Future of Health Care in Canada, Chaired by R. Romanow
Lomas J. 1990 Finding audiences, changing beliefs: The structure of research use in Canadian health policy. J Health Polit Policy Law. 15: 525– 542.Google Scholar
Lomas J. 1993 Making clinical policy explicit. Int J Technol Assess Health Care. 9: 11– 25.Google Scholar
McDaid D. 2003 Co-ordinating health technology assessment in Canada: A European perspective. Health Policy. 63: 205– 213.Google Scholar
Menon D, Topfer LA. 2000 Health technology assessment in Canada. A decade in review. Int J Technol Assess Health Care. 16: 896– 902.Google Scholar
Mowatt G, Grant AM, Bower DJ, et al. 2001 Timing of assessment of fast-changing health technologies. In: Stevens A, Abrams K, Brazier J, et al., editors. The advanced handbook of methods in evidenced-based health care. London: SAGE Publications: 471– 484.
Nowotny H, Scott P, Gibbons M. 2001. Re-thinking science: Knowledge and the public in an age of uncertainty. Cambridge: Polity Press
Romanow RJ. 2002. Building on values: The future of health care in Canada. Saskatoon, Sask: Commission on the Future of Health Care in Canada
Smits R, Leyten L. 1988 Key issues in the institutionalization of technology assessment. Development of technology assessment in five European countries and the USA. Futures. February: 19– 36.Google Scholar
Strauss A, Corbin J. 1990. Basics of qualitative research. Newbury Park: Sage