Resources to guide you in the right direction
"Knowledge is an unending adventure at the edge of uncertainty" (Jacob Bronowski)
The concept for this toolbox evolved out of an pre-conference workshop 2003 on dealing with data uncertainty in health policy.
Health technology assessment (HTA) is an important component of evidence-based health policy. It makes sense that many HTA agencies have created decision support materials to guide sound, defensible choices based on the available evidence and the uncertainty that comes with it.
This toolbox is a collection of products from members of INAHTA. These products were designed to promote transparent, evidence-based decision making processes within their respective health care systems, and may have global application. This is a dynamic resource; products will be added to the list as they become available.
The INAHTA Toolbox for health care decision makers was initially prepared by Liz Adams (VATAP, USA).
Framework for the Assessment of Genetic Testing is developed by AETSA with the objective to propose the main dimensions and criteria that must be taken into account when deciding the incorporation of new genetic tests into the services portfolio of the Andalusian Public Health System. This proposal of criteria has subsequently served as a basis for developing a decision-making tool or guidelines to help decision-makers in the introduction of these tests. It has been published, both in English and Spanish, and is available below:Genetic Testing Framework English (pdf) Genetic Testing Framework Spanish (pdf) Guide for the Acquisition of New Technologies (GANT). Agencia de Evaluación de Tecnologías Sanitarias de Andalucía (AETSA) Spain (1999). Assists managers in deciding which new technologies or modifications to existing technologies should be incorporated into the Andalusian Health Service.www.juntadeandalucia.es/salud/orgdep/AETSA/pdf/Informes/GANTv3_pub.PDF (Spanish)www.juntadeandalucia.es/salud/orgdep/AETSA/gant_eng.pdf (English)
Users support in health-related decision-making: available tools and synthesis of the evidence. Agencia de Evaluacion de Tecnologias Sanitarias de Andalucia (AETSA) Spain (2002). Provides patients with valid information on the scientific research in the field of Users' Decision-Making Tools and proposes areas of work to increase their participation and informed choices in decisions about their own health. www.juntadeandalucia.es/salud/orgdep/AETSA/Informe%20ATD_DEF.pdf
HTA Initiatives. AHFMR's HTA Unit (now at IHE, Canada). Available in print by emailing Wendy McIndoo Wendy McIndoo (email@example.com) & on the web site www.ihe.ca/hta/publications.html:
Decisions on the status of health technologies. AHFMR's HTA Unit (now at IHE, Canada), 2001. Assists health care decision makers in Alberta in considering when to support the use of emerging technologies. www.ihe.ca/documents/hta/info1.pdf
General Guidelines for Assessing, Approving & Introducing New Procedures into a Hospital or Health Service. Australian Safety and Efficacy Register of New Interventional Procedures - Surgical/ Royal Academy College of Surgeons (ASERNIP-S/RACS) Australia (2002). A guide for hospitals on the acquisition of new technologies. www.surgeons.org/AM/Template.cfm?Section=ASERNIP_S_Publications.
The Galician HTA agency (avalia-t), in collaboration with other Spanish HTA agencies/institutions, has developed two web prioritisation tools that are highly innovative, and as far as we know, the only tools available for decision making regarding the selection of technologies that are deemed relevant to monitor after they are introduced into daily clinical practice and technologies that are potentially obsolete. Since these tools are envisioned to be of great value for any organization/institution dealing with these issues, of growing interest in present times, we feel it could be highly important to include them in the INAHTA toolbox section within the health care decision makers resources. The tools can be accessed free of charge through the web page of avalia-t (http://avalia-t.sergas.es) or directly at (www.pritectools.com) or (www.pritectools.es) and are available in spanish and english.
A linear scoring system to prioritise elective cataract surgery, hip arthroplasty, and knee arthroplasty for patients in waiting lists. CAHTA (Spain). Describes an ongoing project to develop a scoring system in Catalonia for prioritizing three procedures based on different categories such as seriousness of the pathology, pain, limits for daily life, etc. www.aatrm.net/html/en/dir404/doc8809.html
The ACME Plus Instrument (International collaborative project with CAHTA participation). Describes a European project to devise a hospital Admission Case-Mix system for Elderly patients, plus a standardized method of recording hospital outcome, suitable for use in older people entering hospital in different countries in Europe. www.abdn.ac.uk/acmeplus/
Medicare Coverage Advisory Committee Executive Committee Recommendations for Evaluating Effectiveness. Centers for Medicare and Medicaid Services. United States. (2001) Provides advice on scientific and clinical questions regarding Medicare coverage. Includes principles to guide the panel decisions when the evidence is not sufficient to draw a strong conclusion. www.cms.hhs.gov/mcd/ncpc_view_document.asp?id=10
Mini-HTA. In cooperation with local HTA environments, DACEHTA has developed a flexible decision support tool, which can be used by hospital managements locally and regionally when contemplating the introduction of new health technology. This publication introduces the decision support tool, which is based on a form and an accompanying guide. The tool is called mini-HTA as it is based on the reasoning involved in HTA. View the mini-HTA (pdf) Read more at DACEHTA's website
HTA handbook. The handbook presents updated and new scientific methods and approaches to HTA. It deals with analysis elements of Danish HTA, namely technology, patient, organization, economy and ethics.You can view the handbook at http://www.sst.dk/publ/Publ2008/MTV/Metode/HTA_Handbook_net_final.pdf
Setting Priorities for the Adoption of Health Technologies on a National Level - the Israeli Experience. Shani S, Siebzehner M, Luxenburg O, Shemer J. Health Policy 2000 Dec:54;169-85. PMID: 11154787. Proposes a practical and pragmatic model for the inclusion of new health technologies at a national level based on HTA and explicit priority setting. For more information, contact Nina Hakak at NinaH@gertner.health.gov.il.
The NHS HTA programme in England. Run by the NCCHTA. Produces technology assessment reports (around 200 thus far) which can be downloaded as executive summaries or full reports from their website. These reports, also available on a fully searchable CD-ROM, cover a wide range of diagnostic, therapeutic and screening technologies, and take the form of both systematic reviews and primary research. Includes many helpful reports on new developments in HTA methodology. Website gives full details of how the programme identifies, prioritises, and commissions HTA reports, and details of ongoing projects. www.ncchta.org
Interim Guide to the Interventional Procedures Programme. National Institute for Clinical Excellence (NICE) United Kingdom. (Feb 2003). Describes how NICE assesses the safety and efficacy of new and established interventional procedures introduced in the NHS that will allow clinical innovation to be responsibly managed. www.nice.org.uk/pdf/ipinterimprocessmanual.pdf
Guideline development process manuals. National Institute for Clinical Excellence (NICE) United Kingdom. Describe how the NICE clinical guidelines are produced. www.nice.org.uk/cat.asp?c=22334
Guide to the Technology Appraisal Process - Draft for consultation. National Institute for Clinical Excellence (NICE) United Kingdom. Describes the process and methods for NICE technology appraisals and provides guidance for organizations invited to contribute to these appraisals. www.nice.org.uk/pdf/Techappprocessconsultation.pdf
Long way from evidence to clinical recommendations. Rehnqvist N. Lakartidningen. 2001 Mar 21;98(12):1355-6. PMID: 11320782. Describes a process developed by Sweden's National Board of Health and Welfare for health care decision making that grades need and assesses cost-effectiveness. For more information, contact Nina Rehnqvist firstname.lastname@example.org.
Succinct Timely Evaluated Evidence Reviews. (Information provided by NCCHTA). Wessex Institute for Health R&D (WIHRD) together with Bazian Ltd. A service designed to support the decisions of NHS commissioners and policy makers in England and Wales by providing reports of the evidence on the effectiveness of health care interventions. STEER reports are succinct systematic reviews, usually of about 1000-1500 words and produced on request in about 12 weeks. The STEER team uses robust and reproducible scientific methods. The full list to date of STEER reports is available on www.wihrd.soton.ac.uk/projx/signpost/steers/, and click on "STEER reports".
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INAHTA – International Network of Agencies for Health Technology Assessment e-mail: INAHTA@surgeons.org