title: All nations depend on the global knowledge pool--analysis of country of origin of studies used for health technology assessments in Germany.
abstract: BACKGROUND
  Health Technology Assessments (HTAs) are used to inform decision-making and their usefulness depends on the quality and relevance of research and specific studies for health-policy decisions. Little is known about the country of origin of studies used for HTAs.
  
  
  OBJECTIVE
  To investigate which countries have made the largest contributions to inform health policy decisions through studies included in HTAs in Germany.
  
  
  METHODS
  The country of origin was extracted from all studies included in HTAs of the German Institute for Quality and Efficiency in Health Care, (IQWiG), published from 2/2006 to 9/2010. Studies were ranked according to the total number of studies per country, adjusted for population size, gross domestic product (GDP), and total health expenditure.
  
  
  RESULTS
  1087 studies were included in 54 HTA reports. Studies were assigned to 45 countries. Most of the studies (27%) originated from the United States (USA), 18% were multinational, followed by 7% from the United Kingdom (UK) and 5% from Germany. Nordic countries led the ranking when adjusting for population size/million (ranks 1-3,6,9/45 countries), GDP/billion US$ (1,2,5,9,14/45), or health expenditure/billion US$ (1,3,5,12,13/45). The relative contribution of the UK was stable in the analyses when adjusted for population size (7/45), GDP (7/45), and health expenditure (9/45), whereas the USA (13, 18, and 30/45) and Germany (17, 19, and 21/45) dropped in the ranking.
  
  
  CONCLUSIONS
  More than half of the studies relevant for evidence-informed decision-making in Germany originated from the USA, followed by multinational research and the UK. Only 5% of the studies originated from Germany. According to our findings, there appears to be some discrepancy between the use of globally generated evidence and the contribution to the knowledge pool by individual countries.
authors.affiliation: Institute for Quality and Efficiency in Health Care, Cologne, Germany. Kirsten.Herrmann@iqwig.de
authors.forename: Kirsten H
authors.initials: KH
authors.lastname: Herrmann
authors.forename: Robert
authors.initials: R
authors.lastname: Wolff
authors.forename: Fueloep
authors.initials: F
authors.lastname: Scheibler
authors.forename: Siw
authors.initials: S
authors.lastname: Waffenschmidt
authors.forename: Lars G
authors.initials: LG
authors.lastname: Hemkens
authors.forename: Stefan
authors.initials: S
authors.lastname: Sauerland
authors.forename: Gerd
authors.initials: G
authors.lastname: Antes
mesh_terms: D020811:Biomedical Technology / Q000379:methods*; D003657:Decision Making; D005858:Germany; D013673:Technology Assessment, Biomedical / Q000379:methods*; D006113:United Kingdom; D014481:United States