title: Preferences for engagement in health technology assessment decision-making: a nominal group technique with members of the public.
abstract: OBJECTIVE
  To identify characteristics (factors) about health technology assessment (HTA) decisions that are important to the public in determining whether public engagement should be undertaken and the reasons for these choices.
  
  
  METHODS
  Focus groups using a nominal group technique to identify and rank factors relevant to public engagement in HTA decision-making. Thematic analysis was also undertaken to describe reasons underpinning participants' choices and rankings.
  
  
  METHODS
  Members of the Australian general public.
  
  
  METHODS
  58 people, aged 19-71 years participated in 6 focus groups.
  
  
  RESULTS
  24 factors were identified by participants that were considered important in determining whether public engagement should be undertaken. These factors were individually ranked and grouped into 4 themes to interpret preferences for engagement. Members of the public were more likely to think public engagement was needed when trade-offs between benefits and costs were required to determine 'value', uncertainties in the evidence were present, and family members and/or carers were impacted. The role of public engagement was also seen as important if the existent system lacked transparency and did not provide a voice for patients, particularly for conditions less known in the community.
  
  
  CONCLUSIONS
  Members of the public considered value, impact, uncertainty, equity and transparency in determining when engagement should be undertaken. This indicates that the public's preferences on when to undertake engagement relate to both the content of the HTA itself as well as the processes in place to support HTA decision-making. By understanding these preferences, decision-makers can work towards more effective, meaningful public engagement by involving the public in issues that are important to them and/or improving the processes around decision-making.
authors.affiliation: Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Sally
authors.identifier: http://orcid.org/0000-0003-2519-2582
authors.initials: S
authors.lastname: Wortley
authors.affiliation: Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia Centre for Kidney Research, The Children's Hospital at Westmead Corner Hawkesbury and Hainsworth Street, Westmead, New South Wales, Australia.
authors.forename: Allison
authors.identifier: http://orcid.org/0000-0001-8973-9538
authors.initials: A
authors.lastname: Tong
authors.affiliation: Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Howard
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D003256:Community Participation; D003258:Consumer Behavior; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D013673:Technology Assessment, Biomedical; D055815:Young Adult
keywords: consumer preferences; decision-making; health technology assessment; public engagement
references.citation: Cochrane Database Syst Rev. 2006;(3):CD004563
references.pmid: 16856050
references.citation: Expert Rev Pharmacoecon Outcomes Res. 2011 Feb;11(1):75-89
references.pmid: 21351860
references.citation: BMC Med Inform Decis Mak. 2015;15:52
references.pmid: 26166149
references.citation: Value Health. 2013 Jan-Feb;16(1):155-63
references.pmid: 23337227
references.citation: Cost Eff Resour Alloc. 2014 Aug 29;12:18
references.pmid: 25246855
references.citation: Patient Educ Couns. 1993 Dec 31;22(3):133-40
references.pmid: 8153035
references.citation: Health Expect. 2016 Apr;19(2):331-44
references.pmid: 25703958
references.citation: BMJ Open. 2014;4(5):e005437
references.pmid: 24793259
references.citation: Health Expect. 2014 Oct;17(5):637-50
references.pmid: 22809132
references.citation: J Health Organ Manag. 2012;26(3):285-92
references.pmid: 22852452
references.citation: Int J Technol Assess Health Care. 2007 Fall;23(4):436-42
references.pmid: 17937831
references.citation: Patient. 2012;5(3):199-211
references.pmid: 22804831
references.citation: Am J Kidney Dis. 2012 Aug;60(2):186-96
references.pmid: 22578839
references.citation: Health Policy. 2015 Feb;119(2):127-36
references.pmid: 25267072
references.citation: J Natl Cancer Inst. 2013 Mar 20;105(6):380-6
references.pmid: 23378639
references.citation: Soc Sci Med. 2010 May;70(10):1518-26
references.pmid: 20207061
references.citation: Am J Bioeth. 2001 Spring;1(2):2-16
references.pmid: 11951872
references.citation: Health Expect. 2015 Dec;18(6):1918-26
references.pmid: 24813243
references.citation: Int J Technol Assess Health Care. 2010 Jul;26(3):334-40
references.pmid: 20584364
references.citation: J Health Serv Res Policy. 2011 Apr;16(2):81-9
references.pmid: 21447843
references.citation: Soc Sci Med. 2015 Apr;131:114-21
references.pmid: 25770463
references.citation: Cost Eff Resour Alloc. 2012 Jul 18;10(1):9
references.pmid: 22808944
references.citation: Pharmacoeconomics. 2015 Jan;33(1):1-4
references.pmid: 25145801
references.citation: Int J Technol Assess Health Care. 2010 Jul;26(3):341-7
references.pmid: 20584365
references.citation: Health Policy. 1999 Oct;49(1-2):45-61
references.pmid: 10827290
references.citation: Patient. 2014;7(4):365-86
references.pmid: 24872225
references.citation: Health Expect. 2008 Sep;11(3):282-93
references.pmid: 18816324
references.citation: J Health Organ Manag. 2012;26(3):293-316
references.pmid: 22852453
references.citation: BMC Health Serv Res. 2014;14:476
references.pmid: 25281284