Health Technology Assessments By The National Institute For Health And Clinical Excellence

The National Institute for Health and Clinical Excellence (NICE) has been regarded as a role model for the implementation of cost-effectiveness analysis (CEA), and is being closely watched by health care policy makers across the globe. This book examines Britain’s highly acclaimed approach to CEA and its international potential. It dissects the robustness of the agency’s technology appraisal processes as NICE evaluates innovative methods for diagnosis and intervention. Coverage provides a step-by-step explanation of the NICE appraisal process and examines its successes and limitations.

This is the first book to offer a comprehensive guide to involving patients in health technology assessment (HTA). Defining patient involvement as patient participation in the HTA process and research into patient aspects, this book includes detailed explanations of approaches to participation and research, as well as case studies. Patient Involvement in HTA enables researchers, postgraduate students, HTA professionals and experts in the HTA community to study these complementary ways of taking account of patients’ knowledge, experiences, needs and preferences. Part I includes chapters discussing the ethical rationale, terminology, patient-based evidence, participation and patient input. Part II sets out methodology including: Qualitative Evidence Synthesis, Discrete Choice Experiments, Analytical Hierarchy Processes, Ethnographic Fieldwork, Deliberative Methods, Social Media Analysis, Patient-Reported Outcome Measures, patients as collaborative research partners and evaluation. Part III contains 15 case studies setting out current activities by HTA bodies on five continents, health technology developers and patient organisations. Each part includes discussion chapters from leading experts in patient involvement. A final chapter reflects on the need to clearly define the goals for patient involvement within the context of the HTA to identify the optimal approach. With cohesive contributions from more than 80 authors from a variety of disciplines around the globe, it is hoped this book will serve as a catalyst for collaboration to further develop patient involvement to improve HTA. "If you’re not involving patients, you're not doing HTA!" - Dr. Brian O’Rourke, President and CEO of CADTH, Chair of INAHTA

A timely work describing how localized hospital-based health technology assessment (HB-HTA) complements general, ‘arms-length’ HTA agency efforts, and what has been the collective global impact of HB-HTA across the globe. While HB-HTA has gained significant momentum over the past few years, expertise in the field, and information on the operation and organization of HB-HTA, has been scattered. This book serves to bring this information together to inform those who are currently working in the field of HTA at the hospital, regional, national or global level. In addition, this book is intended for decision-makers and policy-makers with a stake in determining the uptake and decommissioning of new and established technologies in the hospital setting. HTA has traditionally been performed at the National/Regional level by HTA Agencies, typically linked to governments. Yet hospitals are the main entry door for most health technologies (HTs). Hospital decision-makers must undertake multiple high stakes investment and disinvestment decisions annually for innovative HTs, usually without adequate information. Despite the existence of arms-length HTA Agencies, inadequate information is available to hospital decision-makers either because relevant HTA reports are not yet released at the time of entry of new technologies to the field, or because even when the report exists, the information contained is insufficient to clarify the contextualized informational needs of hospital decision makers. Therefore, there has recently been a rising trend toward hospital-based HTA units and programs. These units/programs complement the work of National/Regional HTA Agencies by providing the key and relevant evidence needed by hospital decision makers in their specific hospital context, and within required decision-making timelines. The emergence of HB-HTA is creating a comprehensive HTA ecosystem across health care levels, which creates better bridges for knowledge translation through relevance and timeliness.

′This handbook is an excellent reflection of the growing maturity and methodological sophistication of the field of Health Technology Assessment. The Handbook covers a spectrum of issues, from primary evidence (clinical trials) through reviews and meta-analysis, to identifying and filling gaps in the evidence. Up-to-date, clearly written, and well-edited, the handbook is a needed addition to any personal or professional library dealing with Health Technology Assessment.′ Professor David Banta, TNO Prevention and Health, The Netherlands ′This text presents the most advanced knowledge on methodology in health care research, and will form the backbone of many future studies′ - Paula Roberts, Nurse Researcher The `effectiveness revolution′ both in research and clinical practice, has tested available methods for health services research to the extreme. How far can observational methods, routine data and qualitative methods be used in health care evaluation? What cost and outcome measures are appropriate, and how should data be gathered? With the support of over two million pounds from the British Health Technology Assessment Research Programme, the research project for this Handbook has led to both a synthesis of all of the existing knowledge in these areas and an agenda for future debate and research. The chapters and their authors have been selected through a careful process of peer review and provide a coherent and complete approach to the field. The handbook has been a unique collaboration between internationally regarded clinicians, statisticians, epidemiologists, social scientists, health economists and ethicists. It provides the most advanced thinking and the most authoritative resource for a state of the art review of methods of evaluating health care and will be required reading for anyone involved in health services research and management.

Considers medical technology consensus development programs in Canada, Denmark, Finland, Netherlands, Norway, Sweden, England and the United States.

This book provides an introduction to decision analytic cost-effectiveness modelling, giving the theoretical and practical knowledge required to design and implement analyses that meet the methodological standards of health technology assessment organisations. The book guides you through building a decision tree and Markov model and, importantly, shows how the results of cost-effectiveness analyses are interpreted. Given the complex nature of cost-effectiveness modelling and the often unfamiliar language that runs alongside it, we wanted to make this book as accessible as possible whilst still providing a comprehensive, in-depth, practical guide that reflects the state of the art – that includes the most recent developments in cost-effectiveness modelling. Although the nature of cost effectiveness modelling means that some parts are inevitably quite technical, across the 13 chapters we have broken down explanations of theory and methods into bite-sized pieces that you can work through at your own pace; we have provided explanations of terms and methods as we use them. Importantly, the exercises and online workbooks allow you to test your skills and understanding as you go along.