Use of health technology assessment in decision making: coresponsibility of users and producers?
OBJECTIVE
Health technology assessment (HTA) is a policy-oriented form of research designed to inform decision-makers on the introduction, use, and dissemination of health technology. Whereas research on knowledge transfer has focused on knowledge producers, little attention has been given to the user's perspective. This study examines how health-care provider, administrator, and patient associations across Canada use HTA reports and the limitations they encounter when accessing and using scientific knowledge.


METHODS
This study draws from semistructured interviews (n=42) conducted with three types of user, located in British Columbia, Alberta, Saskatchewan, Ontario, and Quebec. Applying well-established conceptual categories in knowledge utilization research, our qualitative analyses sought to define more precisely how HTA is used by interviewees as well as the most significant barriers they encounter.


RESULTS
The vast majority of users recognize the usefulness and credibility of HTA reports. Of interest, the way they use HTA takes different forms. Although administrators and health-care providers are in a better position than patient associations to act directly on HTA messages--making an instrumental use of HTA--we also found conceptual and symbolic uses across all groups. Our results also indicate that significant organizational, scientific, and material limitations hinder the use of scientific evidence. Overcoming such barriers requires a greater commitment from both HTA producers and users.


CONCLUSIONS
This study argues that, to ensure better uptake of HTA, it should become a shared responsibility between HTA producers and various types of user.
Hivon
Myriam
M
Department of Health Administration and Interdisciplinary Health Research Group, University of Montreal, Quebec, Canada. myriam.hivon@umontreal.ca
Lehoux
Pascale
P
Denis
Jean-Louis
JL
Tailliez
Stéphanie
S
D002170:Canada; D003659:Decision Making, Organizational; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D006740:Hospital Administrators / Q000523:psychology; D006801:Humans; D007255:Information Services / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D008119:Lobbying; D010361:Patients / Q000523:psychology; D010820:Physicians / Q000523:psychology; D036301:Qualitative Research; D012941:Social Responsibility; D013673:Technology Assessment, Biomedical / Q000706:statistics & numerical data*