title: KNOW ESSENTIALS: a tool for informed decisions in the absence of formal HTA systems.
abstract: BACKGROUND
  Most developing countries and resource-limited settings lack robust health technology assessment (HTA) systems. Because the development of locally relevant HTA is not immediately viable, and the extrapolation of external HTA is inappropriate, a new model for evaluating health technologies is required.
  
  
  OBJECTIVE
  The aim of this study was to describe the development and application of KNOW ESSENTIALS, a tool facilitating evidence-based decisions on health technologies by stakeholders in settings lacking formal HTA systems.
  
  
  METHODS
  Current HTA methodology was examined through literature search. Additional issues relevant to resource-limited settings, but not adequately addressed in current methodology, were identified through further literature search, appraisal of contextually relevant issues, discussion with healthcare professionals familiar with the local context, and personal experience. A set of thirteen elements important for evidence-based decisions was identified, selected and combined into a tool with the mnemonic KNOW ESSENTIALS. Detailed definitions for each element, coding for the elements, and a system to evaluate a given health technology using the tool were developed.
  
  
  CONCLUSIONS
  Developing countries and resource-limited settings face several challenges to informed decision making. Models that are relevant and applicable in high-income countries are unlikely in such settings. KNOW ESSENTIALS is an alternative that facilitates evidence-based decision making by stakeholders without formal expertise in HTA. The tool could be particularly useful, as an interim measure, in healthcare systems that are developing HTA capacity. It could also be useful anywhere when rapid evidence-based decisions on health technologies are required.
authors: Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India. joseph.l.mathew@gmail.com
authors: Joseph L
authors: JL
authors: Mathew
mesh_terms: D003657:Decision Making; D020000:Decision Support Systems, Clinical / Q000191:economics*; D003906:Developing Countries; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000191:economics*; D013673:Technology Assessment, Biomedical / Q000191:economics*