Setting priorities for health technology assessment : a model process

Setting priorities for health technology assessment a model process

Detalles Bibliográficos
Otros Autores: Donaldson, Molla S. (-), Sox, Harold C.
Formato: Libro electrónico
Idioma:Inglés
Publicado: Washington, D.C. : National Academy Press 1992.
Edición:1st ed
Materias:
Medical technology > United States > Evaluation.
Technology assessment > United States.
Ver en Biblioteca Universitat Ramon Llull:https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009820307706719
Tabla de Contenidos:
  • SETTING PRIORITIES FOR HEALTH TECHNOLOGY ASSESSMENT
  • Copyright
  • Acknowledgments
  • Contents
  • Preface
  • Summary
  • RATIONALE
  • METHODS OF PRIORITY SETTING
  • GUIDING PRINCIPLES
  • THE PROCESS PROPOSED BY THE IOM COMMITTEE
  • Steps in the Process
  • Seven Criteria
  • Reassessment
  • The Priority-Setting Cycle
  • Human Resources Required to Implement the Process
  • Publicly Available Products
  • Topics for Which There is Insufficient Evidence to Conduct an Assessment Based on Review of the Literature
  • RECOMMENDATIONS
  • Recommendation 1
  • Recommendation 2
  • Recommendation 3
  • Recommendation 4
  • Recommendation 5
  • Recommendation 6
  • Recommendation 7
  • Recommendation 8
  • Recommendation 9
  • Recommendation 10
  • Recommendation 11
  • ADOPTION OF THE IOM'S PRIORITY-SETTING PROCESS BY OTHER ORGANIZATIONS
  • Technology Assessment and Clinical Practice Guidelines
  • POTENTIAL PROBLEMS WITH THE PRIORITY-SETTING PROCESS
  • CONCLUDING REMARKS
  • 1 Technology Assessment and the Need for Priority Setting
  • EVOLUTION OF TECHNOLOGY ASSESSMENT TOWARD OUTCOMES, EFFECTIVENESS, AND APPROPRIATENESS RESEARCH
  • The Effectiveness Initiative and Establishment of the Agency for Health Care Policy and Research
  • The Office of Health Technology Assessment
  • ORIGIN OF THE IOM STUDY
  • Previous Pilot Study of Preliminary Model
  • STUDY METHODS
  • DEFINITIONS
  • Medical Technology
  • Technology Assessment
  • Reassessment
  • REPORT STRUCTURE
  • SUMMARY
  • APPENDIX: THE AGENCY FOR HEALTH CARE POLICY AND RESEARCH
  • Center for Medical Effectiveness Research
  • Office of the Forum for Quality and Effectiveness in Health Care
  • Office of Science and Data Development
  • Center for General Health Services Extramural Research and the Division of Technology and Quality Assessment
  • Office of Health Technology Assessment
  • OHTA Technology Assessments.
  • 2 Methods for Priority Setting
  • PRIORITY-SETTING PROCESSES USED BY ORGANIZATIONS
  • Example 1: Health Care Financing Administration
  • Bureau of Policy Development
  • Health Care Financing Administration Physicians Panel
  • Reevaluation or Assessment of Established Technologies
  • Example 2: Private Sector-Pharmaceutical Industry
  • Criteria for Assessment
  • Criteria for Reassessment
  • Internal Process of Priority Setting
  • Example 3: Health Care Provider Organizations
  • Example 4: Institute of Medicine/Council on Health Care Technology Pilot Study
  • Example 5: Food and Drug Administration
  • QUANTITATIVE MODELS FOR SETTING PRIORITIES
  • Example 6: Technology Assessment Priority-Setting System
  • Example 7: The Phelps-Parente Model
  • SETTING PRIORITIES FOR SPENDING ON HEALTH SERVICES
  • Example 8: Oregon Basic Health Services Act
  • DISCUSSION
  • Reactive and Implicit Processes
  • Strengths and Weaknesses of Reactive Mechanisms
  • The IOM/CHCT Process Compared with This IOM Study
  • Analytic Models
  • Strengths and Weaknesses of Analytic Models
  • Need for a Comprehensive, Proactive Process for Priority Setting
  • SUMMARY
  • APPENDIX: MEDICARE COVERAGE DECISION MAKING
  • 3 Guiding Principles
  • BUILDING A MODEL PROCESS FOR SETTING PRIORITIES
  • PROCESS BUILDING FOR OHTA
  • The Process Must Reflect the Mission of OHTA
  • Potential to Reduce Pain, Suffering, and Premature Death
  • Potential to Reduce Inappropriate Health Care Expenditures
  • Potential to Reduce Inequity and Inform Other Social Issues
  • The Product of the Process Should Be Consistent with the Needs of Users
  • The Process Must Be Efficient
  • The Process Must Be Sensitive to the Environment in Which OHTA Operates
  • SUMMARY
  • 4 Recommendations for a Priority-Setting Process
  • PREVIEW OF THE QUANTITATIVE MODEL
  • ELEMENTS OF THE PROPOSED PRIORITY-SETTING PROCESS.
  • Step 1. Selecting and Weighting Criteria Used to Establish Priorities
  • Step 2. Identifying Candidate Conditions And Technologies
  • Step 3. Winnowing the List of Candidate Conditions and Technologies
  • Step 4. Data Gathering
  • Step 5. Creating Criterion Scores
  • Step 6. Computing Priority Scores
  • Step 7. Review By Ahcpr National Advisory Council
  • DETAILS OF THE PROPOSED PRIORITY-SETTING PROCESS
  • Step 1. Selecting And Weighting The Criteria Used To Establish Priority Scores
  • Selecting Criteria
  • Weighting Criteria
  • Step 2. Identifying Candidate Conditions And Technologies
  • Step 3. Winnowing The List Of Candidate Conditions And Technologies
  • Secondary Winnowing Processes
  • Step 4. Data Gathering
  • Specifying Alternative Technologies And Clinical Conditions
  • Staff Summaries Of Clinical Conditions
  • Step 5. Creating Criterion Scores
  • General Points
  • Criteria Recommended For The Iom Priority-Setting Model
  • Criterion 1: Prevalence
  • Criterion 2: Burden Of Illness
  • Criterion 3: Cost
  • Criterion 4: Variation In Rates Of Use
  • Criterion 5: Potential Of The Results Of An Assessment To Change Health Outcomes
  • Criterion 6: Potential Of The Results Of An Assessment To Change Costs
  • Criterion 7: Potential of the Results of an Assessment to Inform Ethical, Legal, and Social Issues
  • Criteria Rejected by the Committee
  • Step 6. Computing Priority Scores
  • Derivation of the Model
  • Determining Whether Assessment is Desirable and Feasible
  • Step 7. Review by Ahcpr National Advisory Council
  • REASSESSMENT
  • Role of Reassessment in the Complete Assessment Program
  • Methods of Identifying Candidates for Reassessment
  • Ongoing Tracking of Events Related to Previously Assessed Topics
  • Evaluation of the Quality of Studies
  • Ranking Candidates for Reassessment
  • Final Steps after Establishing Priority for Reassessment.
  • Sensitivity Analysis
  • Cost Analysis
  • SUMMARY
  • APPENDIX 4.1: WINNOWING PROCESSES
  • Intensity Rankings by Nominating Persons and Organizations
  • Preliminary Ranking Processes
  • Panel-Based Preliminary Weighting
  • Comment
  • APPENDIX 4.2: METHODOLOGIC ISSUES
  • Properties of Logarithms
  • Application to the Iom Model
  • 5 Implementation Issues
  • THE PRIORITY-SETTING CYCLE
  • SETTING CRITERION WEIGHTS
  • RESOURCES NEEDED TO IMPLEMENT THE PROCESS
  • Technology Assessment Program Staff Requirements
  • Priority-Setting Panel
  • IMPLEMENTATION CONSIDERATIONS FOR OHTA AND OTHER ORGANIZATIONS
  • Validity and Reliability
  • Criteria
  • Choosing-and Changing-Criteria
  • Criterion Weights
  • Availability of Data to Generate Criterion Scores
  • Publicly Available Products
  • WHEN THE SCIENTIFIC EVIDENCE IS INSUFFICIENT FOR ASSESSMENT
  • Interim Statements
  • Modeling
  • SUMMARY
  • 6 Recommendations and Conclusions
  • REVIEW OF THE COMMITTEE'S RATIONALE AND RECOMMENDATIONS
  • Recommendations
  • Recommendation 1
  • Recommendation 2
  • Recommendation 3
  • Recommendation 4
  • Recommendation 5
  • Recommendation 6
  • Recommendation 7
  • Recommendation 8
  • Recommendation 9
  • Recommendation 10
  • Recommendation 11
  • REVIEW OF STEPS AND ISSUES IN IMPLEMENTATION
  • Steps in a Priority-Setting Process
  • Step 1. Selecting and Weighting the Criteria Used to Establish Priority Scores
  • Step 2. Identifying Candidate Conditions and Technologies
  • Step 3. Winnowing the List of Candidate Conditions and Technologies
  • Step 4. Data Gathering
  • Step 5. Creating Criterion Scores
  • Step 6. Computing Priority Scores
  • Step 7. Review of Priority Rankings by the National Advisory Council of the Agency for Health Care Policy and Research
  • Resources for Implementation
  • The Priority-Setting Cycle
  • Publicly Available Products.
  • Topics with Insufficient Evidence for Assessment Based on Review of the Literature
  • ADOPTION OF THE IOM'S PRIORITY-SETTING PROCESS BY OTHER ORGANIZATIONS
  • Technology Assessment and Clinical Practice Guidelines
  • POTENTIAL PROBLEMS WITH THE PRIORITY-SETTING PROCESS
  • Will a Numerical Priority Score Lead to Unrealistic Inferences About Priority?
  • Does Codifying an Idealized Process Lead to Inflexibility?
  • Will There Be a Bias Toward Choosing Topics That Are Quantifiable?
  • CONCLUSION
  • References
  • Appendix A Pilot Test of the IOM Model
  • METHODS
  • Topics and Data for Priority Setting
  • Criteria
  • Criterion Weighting
  • Criterion Scoring
  • Convened Pilot
  • Objective Criterion Scores.
  • Mailed Pilot
  • RESULTS
  • Feasibility
  • Improvements in the Model
  • Comparison of Convened and Mailed Methods
  • Criterion Weights
  • Criterion Scores
  • Priority Scores
  • IMPLICATIONS OF THE PILOT TESTS FOR THE IOM MODEL
  • Criterion Scores
  • Appendix B Abbreviations.

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