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Table 2 Extraction form for principles of HTA activities according to Drummond et al.[12]

From: A systematic review of Health Technology Assessment tools in sub-Saharan Africa: methodological issues and implications

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