Establishing a comprehensive continuum from an evidentiary base to policy development for health technologies: the Ontario experience.
OBJECTIVE
The aim of this study was to describe a comprehensive continuum that has developed in Ontario between government and key stakeholder groups, including hospitals, physicians, academic institutions, clinical epidemiologists, health economists, industry, and bioethicists to achieve evidence-based recommendations for policy development.


METHODS
The various components of the comprehensive model that has evolved to develop an evidentiary platform for policy development are summarized, and the flow between these components is described.


RESULTS
The development of the Ontario Health Technology Advisory Committee (OHTAC) and associated programs demonstrate the need to go beyond the traditional steps taken within most health technology assessment paradigms. These components include pragmatic postmarketing studies, human factors, and safety analyses, and formalized interactions with a broad spectrum of potential end-users of each technology, experts, and industry. Thesecomponents, taken together with an expanded systematic review to include a range of economic analyses, and societal impacts augment the traditional systematic review processes. This approach has been found to be important in assisting decision making and has resulted in an 81 percent conversion from evidence to policy consideration for eighty-three technologies that had been assessed at the time this article was submitted.


CONCLUSIONS
The comprehensive model, centered around OHTAC, has added important new dimensions to health policy by improving its relevance to decision makers and providing an accountable and transparent basis for government to invest appropriately in health technologies. This study could also form a basis for further research into appropriate methodologies and outcome measurements as they relate to each component of this approach.
Levin
Leslie
L
Ministry of Health and Long-Term Care and University of Toronto, Ontario, Canada. les.levin@moh.gov.on.ca
Goeree
Ron
R
Sikich
Nancy
N
Jorgensen
Birthe
B
Brouwers
Melissa C
MC
Easty
Tony
T
Zahn
Catherine
C
D026683:Advisory Committees / Q000458:organization & administration; D020811:Biomedical Technology / Q000458:organization & administration*; D003256:Community Participation; D006291:Health Policy; D006292:Health Priorities; D006801:Humans; D009864:Ontario; D011050:Policy Making; D013673:Technology Assessment, Biomedical / Q000458:organization & administration*; D014600:Utilization Review / Q000458:organization & administration