Health technology assessment in the area of prevention: selected screening cases in Greece.
OBJECTIVE
To explore the impact of health technology assessment (HTA) on health policy and practice in Greece through selected screening case studies in the prevention area. The three cases studied were mammography screening, PSA screening, and routine ultrasonography in normal pregnancy.


METHODS
Official policy recommendations or reports, a literature review of Greek published research as well as gray literature from various sources, and interviews with specialists and medical associations were performed, and their impact on health policy formulation was examined.


RESULTS
The implementation of the screening tests does not take the form of structured mass screening programs. Almost all physicians (urologists-pathologists, gynecologists) apply PSA and routine ultrasonography in normal pregnancy respectively with the purpose of either prevention or diagnosis. Mammography is applied generally for prevention or diagnosis, but there are some mass screening programs at a local level. In addition, the results show no evidence that the efficacy and the cost-effectiveness of the three screening programs have been a matter of serious concern and investigation for the purposes of policy formulation in Greece.


CONCLUSIONS
The results point to a need for the implementation of HTA methods on mass screening preventive programs in which real value and cost remain unclear and whose use is based on empirical and personal assessments.
Mousiama
T
T
University of Athens.
Loakimidou
S
S
Largatzi
E
E
Kaitelidou
D
D
Liaropoulus
L
L
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D005260:Female; D006115:Greece; D006291:Health Policy; D006801:Humans; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000458:organization & administration / Q000706:statistics & numerical data*; D008875:Middle Aged; D019982:Organizational Case Studies; D011247:Pregnancy; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000517:prevention & control; D013673:Technology Assessment, Biomedical; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*
D017430:Prostate-Specific Antigen