title: Case studies on forecasting for innovative technologies: frequent revisions improve accuracy.
abstract: Health technology forecasting is designed to provide reliable predictions about costs, utilization, diffusion, and other market realities before the technologies enter routine clinical use. In this article we address three questions central to forecasting's usefulness: Are early forecasts sufficiently accurate to help providers acquire the most promising technology and payers to set effective coverage policies? What variables contribute to inaccurate forecasts? How can forecasters manage the variables to improve accuracy? We analyzed forecasts published between 2007 and 2010 by the ECRI Institute on four technologies: single-room proton beam radiation therapy for various cancers; digital breast tomosynthesis imaging technology for breast cancer screening; transcatheter aortic valve replacement for serious heart valve disease; and minimally invasive robot-assisted surgery for various cancers. We then examined revised ECRI forecasts published in 2013 (digital breast tomosynthesis) and 2014 (the other three topics) to identify inaccuracies in the earlier forecasts and explore why they occurred. We found that five of twenty early predictions were inaccurate when compared with the updated forecasts. The inaccuracies pertained to two technologies that had more time-sensitive variables to consider. The case studies suggest that frequent revision of forecasts could improve accuracy, especially for complex technologies whose eventual use is governed by multiple interactive factors.
authors: Jeffrey C. Lerner (JLERNER@ECRI.org) is president and CEO of the ECRI Institute, in Plymouth Meeting, Pennsylvania.
authors: Jeffrey C
authors: JC
authors: Lerner
authors: Diane C. Robertson is director of health technology assessment information services at the ECRI Institute.
authors: Diane C
authors: DC
authors: Robertson
authors: Sara M. Goldstein, a former health policy research analyst at the ECRI Institute, is now privacy and compliance counsel at MRO Corporation, in King of Prussia, Pennsylvania.
authors: Sara M
authors: SM
authors: Goldstein
mesh_terms: D001021:Aortic Valve / Q000601:surgery; D020811:Biomedical Technology / Q000191:economics / Q000592:standards / Q000639:trends*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics; D003365:Costs and Cost Analysis; D018795:Device Approval / Q000592:standards*; D004059:Diffusion of Innovation; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods / Q000592:standards; D005260:Female; D005544:Forecasting / Q000379:methods; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000191:economics / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000191:economics / Q000592:standards; D006801:Humans; D008327:Mammography / Q000191:economics / Q000379:methods / Q000592:standards; D020380:Needs Assessment; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D011358:Product Surveillance, Postmarketing / Q000191:economics / Q000379:methods / Q000592:standards*; D061766:Proton Therapy / Q000191:economics / Q000592:standards / Q000639:trends; D065287:Robotic Surgical Procedures / Q000191:economics / Q000379:methods; D013673:Technology Assessment, Biomedical / Q000191:economics / Q000379:methods* / Q000592:standards
keywords: Medical technology; Research And Technology