Table 1 Main gaps from the perspective of independent health technology assessment (HTA) researchers and principal investigators (PIs)
From: Research gaps identified in Iran’s health technology assessment reports
Title of HTAs | Main gaps |
|---|---|
Comparison of two health technologies in breast cancer | Reviews have found that this technology is also suitable for treating gastric cancer. Therefore, as a research gap, we can address the issue of whether this technology is suitable for patient populations - It was limited to English-language studies. It may be necessary to reassess it without any language restrictions - The discount rate of 7% was used. It could be repeated with different assumptions and discount rates |
Comparison of two neuroimaging techniques for mapping brain activity | - The report reached uncertain conclusions due to a lack of evidence. Updates could be undertaken when new evidence becomes available - The report mentioned other relevant indications. It is important to investigate those indications - At the time of the project, the device was not available in Iran, so the costs had to be estimated. A new HTA could be conducted during the post-marketing phase of the technology |
Evaluation of two health technologies in the treatment of skin wrinkles and acne scars | Due to the lack of appropriate evidence, great heterogeneity in studies and lack of appropriate evidence in the field of outcomes related to quality of life, the project failed to answer some questions such as: - What is the efficiency, effectiveness and cost–effectiveness of the technology compared with alternative technologies? - What is the experience and acceptance of patients and physicians regarding technology? - What is the lifespan of medical technology in patients? |
Comparison of two health technologies in breast cancer diagnosis | - At the time of the project, the device was not available in Iran, so the costs were estimated. A new HTA could be applied during the post-marketing phase of technology - A threshold of three times the gross domestic product (GDP) per capita was used for the non-quality outcome. This was done to clarify the cost–effectiveness of the technology for policy-makers. Over time and with the completion of evidence, appropriate economic studies could be conducted |
Evaluation of two health technologies in measuring bone density | - The report reached uncertain conclusions due to a lack of evidence and the low quality of the available evidence. Updates could be undertaken when new evidence is made available - At the time of the project, the device was not available in Iran, so the costs had to be estimated. A new HTA could be conducted during the post-marketing phase of the technology |
Evaluation of two health technologies in treatment of patient with heart failure | - The report reaches uncertain conclusions due to a lack of evidence and the low quality of available evidence. Updates could be undertaken when new evidence becomes available - The report mentioned that the experience and acceptance of patients and physicians regarding technology are important. So, this question could be evaluated. - According to the report, the combined method is considered a more effective strategy compared with using each technology alone. Is there a need to conduct a separate study in this field? |
Evaluation of two health technologies in relieving chronic back pain | - Only the cost–effectiveness results have been shown in the final report. So, the main question is: what is the safety and effectiveness of the technology? - Since one of the technologies originates from China, it seems necessary to also examine studies in the Chinese language. But the study limited its search to English-language studies. It seems necessary to reassess it without any language restriction - It is not clear who performed this method. What kind of professionals and what kind of patients can benefit from it? - The proposal mentioned that the economic analysis should be conducted from the society’s perspective. However, in the final report, it was conducted from the perspective the payers. The reason for this contradiction is not clear, and it is necessary to determine which perspective is more appropriate - At the time of the project, there were no head-to-head studies that examined the effectiveness and cost–effectiveness of these two treatment methods. Does the study need to be repeated to gather additional evidence of higher quality and accuracy? |
Safety and efficacy assessment of a health technology in cancer treatment | - The aim of this project was to assess the safety and effectiveness. Is it necessary to conduct a study to assess the cost–effectiveness? - The limited number of studies involved the technology with other standard methods. Included studies are outdated and lack sufficient data to conduct appropriate quantitative analysis. Is it necessary to reassess it as soon as the relevant data becomes available? |
Evaluation of two health technologies in the treatment of major depressive disorder | It is one of the project’s questions, but in the final report the cost-utility question was not addressed. Is it necessary to reassess it as soon as relevant data becomes available? - In the report, we have the following text: “There are statistics available on the prevalence of major depression in Iran. However, there is a lack of statistics specifically related to the prevalence of treatment-resistant depression. As a result, the statistics on the prevalence of major depression were used in the economic evaluation analysis.” - Is it necessary to design studies to identify the prevalence of treatment-resistant depression and then incorporate it into an economic evaluation analysis? - Regarding the clinical effectiveness of this method, the studies have yielded inconsistent results. Some studies confirm the effectiveness, while others do not. Does the study need to be repeated with greater sensitivity and precision to uncover additional evidence? |
Evaluation of two health technologies in imaging systems | - Although the assessment of ethical, structural and social issues was requested, these questions remained unanswered without any explanation. Does the study need to be repeated to find the answers to these questions? - At the time of the project, the device was not available in Iran, so the costs had to be estimated. New HTAs could be conducted during the post-marketing phase of a technology |
Safety, effectiveness and cost–effectiveness of one of the methods of skin rejuvenation | - The report reached uncertain conclusions due to a lack of evidence and the low quality of the available evidence. Updates could be undertaken when new evidence becomes available - The report mentioned some relevant findings. It is important to investigate those indications - The authors of the report believe that the use of microdermabrasion will become more widespread in Iran in the next few years compared with other technologies, thanks to its superior effectiveness and lower costs. New HTAs could be conducted to examine the use of technology and its outcomes |