title: Patients' perspectives in health technology assessment: a route to robust evidence and fair deliberation.
abstract: There is increasing emphasis on providing patient-focused health care and ensuring patient involvement in the design of health services. As health technology assessment (HTA) is meant to be a multidisciplinary, wide-ranging policy analysis that informs decision making, it would be expected that patients' views should be incorporated into the assessment. However, HTA is still driven by collection of quantitative evidence to determine the clinical and cost effectiveness of a health technology. Patients' perspectives about their illness and the technology are rarely included, perhaps because they are seen as anecdotal, biased views. There are two distinct but complementary ways in which HTAs can be strengthened by: (i) gathering robust evidence about the patients' perspectives, and (ii) ensuring effective engagement of patients in the HTA process from scoping, through evidence gathering, assessment of value, development of recommendations and dissemination of findings. Robust evidence eliciting patients' perspectives can be obtained through social science research that is well conducted, critically appraised and carefully reported, either through meta-synthesis of existing studies or new primary research. Engagement with patients can occur at several levels and we propose that HTA should seek to support effective patient participation to create a fair deliberative process. This should allow two-way flow of information, so that the views of patients are obtained in a supportive way and fed into decision-making processes in a transparent manner.
authors.affiliation: HTAi Interest Group on Patient/Citizen Involvement in HTA and University of Glasgow, Glasgow G12 8RZ, United Kingdom. k.facey@btinternet.com
authors.forename: Karen
authors.initials: K
authors.lastname: Facey
authors.forename: Antoine
authors.initials: A
authors.lastname: Boivin
authors.forename: Javier
authors.initials: J
authors.lastname: Gracia
authors.forename: Helle Ploug
authors.initials: HP
authors.lastname: Hansen
authors.forename: Alessandra
authors.initials: A
authors.lastname: Lo Scalzo
authors.forename: Jean
authors.initials: J
authors.lastname: Mossman
authors.forename: Ann
authors.initials: A
authors.lastname: Single
mesh_terms: D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D013673:Technology Assessment, Biomedical / Q000379:methods*