The process of evaluation of a new technology: genetic services and the introduction of DNA probes.
This paper gives a summary of the main results and recommendations, contained in reports for the Department of Health, of an evaluation of the introduction of DNA probes in the service activity of clinical genetics. The reports analysed cost and benefits of this technology, the potential demand for its use, the characteristics of the families referred to the service in terms of social and geographical distribution, the relative impact of DNA probes on the work-load of services in comparison with other activities, and the communication skills required by geneticists in relation to patients and other colleagues. However, the major element of this paper is the discussion of issues related to the process of evaluation. There has recently been discussion about ways to improve dissemination of results of health services research. We discuss here the major barriers that public health physicians and health service researchers need to address when playing the role of independent evaluators of services or new technologies. During the course of the evaluation of DNA testing, major changes occurred in the NHS. The evaluator will have to consider not only the costs and effectiveness of the new technology, but also how the findings are interpreted by the providers within the constraints of the new organizational structure.
Rona
R J
RJ
Department of Public Health Medicine, United Medical School, Guy's Hospital, London.
Beech
R
R
D002983:Clinical Competence; D003142:Communication; D003362:Cost-Benefit Analysis; D015342:DNA Probes; D004059:Diffusion of Innovation; D004739:England; D005817:Genetic Counseling / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D005821:Genetic Techniques / Q000191:economics / Q000592:standards*; D005826:Genetics, Medical / Q000193:education; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006302:Health Services Research; D006801:Humans; D011446:Prospective Studies; D011635:Public Health Administration; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013673:Technology Assessment, Biomedical / Q000379:methods*; D000078329:Workforce; D016526:Workload
D015342:DNA Probes