Table 2 Extraction form for principles of HTA activities according to Drummond et al.[12]
Author(s) | Mathew | Abaza and Tawfik | Hutubessy et al. | Miot et al. | Govender et al. | Ueffing et al. |
|---|---|---|---|---|---|---|
Study name | KNOW ESSENTIALS: A tool for informed decisions in the absence of formal HTA systems | Appropriate medical technologies for developing countries: application to cardiovascular disorders | Generalized cost-effectiveness analysis for national-level priority-setting in the health sector | Field testing of a multicriteria decision analysis (MCDA) framework for coverage of a screening test for cervical cancer in South Africa | Purchasing of medical equipment in public hospitals: the mini-HTA tool | Equity-oriented toolkit for health technology assessment and knowledge translation: application to scaling up of training and education for health workers |
Structure of HTA Programs | ||||||
Are the goal and scope of the HTA explicit and relevant to its use? | Yes, outcomes of interest are clearly defined at the beginning of process (no detailed scoping document mentioned) | Yes, deals with specific disease and all relevant health technologies (medical devices) | Yes, cost effectiveness analysis of specific health technology | Yes, HTA report clearly outlines the purpose | Yes, the form clearly asks to define medical technology and scope of proposal | Yes, criteria and requirements are clearly defined |
Is it unbiased and transparent? | Yes, evidence based and steps have clear criteria (no independent party conducting HTA is mentioned) | Yes, systematic and evidence-based software | Yes, evidence based and systematic approach | Yes, evidence based and priorities of stakeholders are clearly defined and addressed | No, the stakeholders working on the form can make subjective assessments | Yes, evidence based and different stakeholders are involved |
Does it include all relevant technologies? | Yes, takes into account alternatives | Yes, all medical devices dealing with disease and diagnostic procedure of interest are included in database | Yes, the WHO-CHOICE project used includes an extensive database of evidence | Yes, considers alternatives | Yes, considers alternatives | Not stated |
Does a clear system for setting priorities exist? | Not stated, does not mention priority setting prior to the implementation of tool | Yes, systematic search by software of medical devices most relevant to stakeholder’s preferences | Not stated, does not mention priority setting prior to the implementation of approach | Yes, weights were assigned to criteria of the framework by stakeholders | Not stated, does not mention priority setting prior to the implementation of approach | Yes, includes concepts of needs assessment and priority setting |
Methods of HTA | ||||||
Does it incorporate appropriate methods for assessing costs and benefits? | Yes, assesses available evidence to determine costs of technology and providing the technology and its cost-effectiveness. Also assesses effectiveness and safety of technology | No, does not assess cost-effectiveness of health technologies at this moment | Yes, tool determines cost-effectiveness and assesses the benefits and drawbacks of implementing or not implementing the health technology along with combinations of health technologies | Yes, HTA report assesses the economics and various benefits of the intervention | Yes, addresses costs for different stakeholders and assesses the risks and benefits of the health technology | Yes, in its economic evaluation it assesses the benefits and costs as well as the trade-offs between equity and efficiency |
Does it consider a wide range of evidence and outcomes? | Yes, considers available evidence and long-term outcomes of using or rejecting the health technology | Yes, it incorporates all available information about the medical devices | Yes, with the use of the WHO-CHOICE project databases for evidence and one of its tools, PopMod, for analysing outcomes of using and rejecting health technology (among other scenarios) | Yes, a thorough search for evidence in different databases and other sources is undertaken for each criterion | Yes, a search and quality assessment is undertaken of the available literature | Yes, uses a strong evidence base |
Is a full societal perspective considered? | Yes, takes into account social issues and interests of different stakeholders | Not stated | Not stated | Not stated | Yes, takes into consideration effects of proposal on other departments in the hospital and the cooperation with other hospitals | Yes, includes both societal and individual determinants |
Does it explicitly characterize uncertainty surrounding estimates? | Not stated | Not stated | Yes, with the use Monte Carlo League software, an analytical tool, to find the uncertainty around point estimates | Yes, quality of evidence is assessed in the HTA report portion of approach | Yes, the person filling out the form notes the uncertainties that apply to the calculations | Not stated |
Does it consider and address issues of generalizability and transferability? | Yes, generalizability and transferability of evidence from similar cohorts needs to be justified | Not stated | Yes, the WHO-CHOICE project uses international dollars to be able to make meaningful comparisons and adjustments according to practice settings are made to resulting estimates of generalized CEA | Yes, local costs were used when assessing cost-effectiveness to improve transferability | Not stated | Yes, considers community effectiveness or the “real world” efficacy of an intervention |
Processes for Conducting HTA | ||||||
Are all key stakeholder groups actively engaged? | Yes, tool includes or considers stakeholders throughout its process | No, only purchaser of medical devices is actively engaged and consideration of key stakeholders is not stated | No, not all stakeholders addressed | Yes, key stakeholders are included throughout the process | Yes, key stakeholders are included or considered throughout the process | Yes, forms a national planning authority that brings together different stakeholders |
Is all available data actively being sought? | Yes, all available data is sought and used in decision making table | Yes, all available data about medical devices included is actively sought and regular updates are mentioned | Yes, all available data is sought including contextual data | Yes, all available data is sought during the HTA report process | Yes, all available data is sought and consulting a librarian to ensure quality is advised | Yes, strong evidence base is needed for the implementation of this tool |
Are findings monitored? | Not stated | Not stated | Not stated | Not stated | Not stated | Not stated |
Use of HTA in Decision-Making | ||||||
Is it timely? | Not stated | Yes, it is a system of three forms that can be done very quickly | Not stated | Not stated | Yes, the form takes within 5 to 15 hours to answer (excluding evidence retrieval and assessment) | Not stated |
Are findings communicated appropriately to different decision makers? | Yes, the Decision-Making Table allows decision makers to see the evidence related to the criteria and become informed of the health technologies being assessed | Not stated | Not stated | Yes, the HTA report allows decision makers to see the evidence related to the criteria and become informed of the health technologies being assessed | Yes, the form gives a clear overview for decision makers | Yes, it has included new advances in knowledge translation |
Is the link between HTA findings and decision-making processes transparent and clearly defined? | Yes, HTA findings and decision making process are clearly separate | Not stated | Not stated | Yes, HTA findings and decision making process are clearly separate | Yes, the purpose of the mini-HTA is stated to be only part of the basis of a proposal for decision makers | Not stated |