Health technology assessment and primary data collection for reducing uncertainty in decision making.
BACKGROUND
Health care expenditures continue to escalate, and pressures for increased spending will continue. Health care decision makers from publicly financed systems, private insurance companies, or even from individual health care institutions, will continue to be faced with making difficult purchasing, access, and reimbursement decisions. As a result, decision makers are increasingly turning to evidence-based platforms to help control costs and make the most efficient use of existing resources. Most tools used to assist with evidence-based decision making focus on clinical outcomes.
Health technology assessment (HTA) is increasing in popularity because it also considers other factors important for decision making, such as cost, social and ethical values, legal issues, and factors such as the feasibility of implementation. In some jurisdictions, HTAs have also been supplemented with primary data collection to help address uncertainty that may still exist after conducting a traditional HTA.
The HTA process adopted in Ontario, Canada, is unique in that assessments are also made to determine what primary data research should be conducted and what should be collected in these studies. In this article, concerns with the traditional HTA process are discussed, followed by a description of the HTA process that has been established in Ontario, with a particular focus on the data collection program followed by the Programs for Assessment of Technology in Health Research Institute. An illustrative example is used to show how the Ontario HTA process works and the role value of information analyses plays in addressing decision uncertainty, determining research feasibility, and determining study data collection needs.
Goeree
Ron
R
Programs for Assessment of Technology in Health Research Institute, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada. goereer@mcmaster.ca
Levin
Les
L
Chandra
Kiran
K
Bowen
James M
JM
Blackhouse
Gord
G
Tarride
Jean-Eric
JE
Burke
Natasha
N
Bischof
Matthias
M
Xie
Feng
F
O'Reilly
Daria
D
D020811:Biomedical Technology / Q000145:classification* / Q000639:trends*; D003661:Decision Support Techniques; D003952:Diagnostic Imaging / Q000639:trends*; D011871:Radiology / Q000639:trends*; D013673:Technology Assessment, Biomedical / Q000379:methods* / Q000639:trends*; D014481:United States