Application of a health technology assessment framework to digital health technologies that manage chronic disease: a systematic review

Huben, Amy Von; Howell, Martin; Carrello, Joseph; Norris, Sarah; Wortley, Sally; Ritchie, Angus; Howard, Kirsten

doi:10.1017/s0266462321001665

Cited by 9 publications

(24 citation statements)

References 10 publications

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“…The Consensus-Based Standards for the Selection of Health Measurement Instruments initiative [ 80 , 81 ] was used by Muro-Culebras et al [ 50 ], whereas the Digital Health Scorecard [ 8 , 82 ] was used by Sedhom et al [ 17 ], and the European Network for Health Technology Assessment (EUNetHTA) Core Model [ 83 , 84 ] was used by von Huben et al [ 60 ]. Stoyanov et al [ 55 ] used the European Union UsabilityNet [ 85 ] and the Nielsen Norman user experience criteria [ 86 ].…”

Section: Resultsmentioning

confidence: 99%

“…Finally, the Replicating Effective Programs (REP) framework [ 97 ] was used by Camacho et al [ 18 ]. Multimedia Appendix 5 [ 8 , 15 - 18 , 21 , 30 , 32 , 34 - 38 , 46 , 48 , 50 , 52 , 55 - 57 , 60 - 62 , 74 - 93 , 95 - 97 ] presents the frameworks and guidelines that resulted from or were used in the included studies and provides more details on their contexts and the assessment criteria that each of them encompassed.…”

Section: Resultsmentioning

confidence: 99%

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Assessing the Quality and Impact of eHealth Tools: Systematic Literature Review and Narrative Synthesis

Jacob¹,

Lindeque²,

Klein³

et al. 2023

JMIR Hum Factors

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Background Technological advancements have opened the path for many technology providers to easily develop and introduce eHealth tools to the public. The use of these tools is increasingly recognized as a critical quality driver in health care; however, choosing a quality tool from the myriad of tools available for a specific health need does not come without challenges. Objective This review aimed to systematically investigate the literature to understand the different approaches and criteria used to assess the quality and impact of eHealth tools by considering sociotechnical factors (from technical, social, and organizational perspectives). Methods A structured search was completed following the participants, intervention, comparators, and outcomes framework. We searched the PubMed, Cochrane, Web of Science, Scopus, and ProQuest databases for studies published between January 2012 and January 2022 in English, which yielded 675 results, of which 40 (5.9%) studies met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions were followed to ensure a systematic process. Extracted data were analyzed using NVivo (QSR International), with a thematic analysis and narrative synthesis of emergent themes. Results Similar measures from the different papers, frameworks, and initiatives were aggregated into 36 unique criteria grouped into 13 clusters. Using the sociotechnical approach, we classified the relevant criteria into technical, social, and organizational assessment criteria. Technical assessment criteria were grouped into 5 clusters: technical aspects, functionality, content, data management, and design. Social assessment criteria were grouped into 4 clusters: human centricity, health outcomes, visible popularity metrics, and social aspects. Organizational assessment criteria were grouped into 4 clusters: sustainability and scalability, health care organization, health care context, and developer. Conclusions This review builds on the growing body of research that investigates the criteria used to assess the quality and impact of eHealth tools and highlights the complexity and challenges facing these initiatives. It demonstrates that there is no single framework that is used uniformly to assess the quality and impact of eHealth tools. It also highlights the need for a more comprehensive approach that balances the social, organizational, and technical assessment criteria in a way that reflects the complexity and interdependence of the health care ecosystem and is aligned with the factors affecting users’ adoption to ensure uptake and adherence in the long term.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Assessing the Quality and Impact of eHealth Tools: Systematic Literature Review and Narrative Synthesis

Jacob¹,

Lindeque²,

Klein³

et al. 2023

JMIR Hum Factors

View full text Add to dashboard Cite

show abstract

“…See for the final list of twenty-four DHT attributes. References to the DHT evaluation framework literature and the EUnetHTA Core Model domains and issue identifiers (1) that suggested the content are given for each attribute/grouped issue for traceability with our prior work (12;13) and integration with the EUnetHTA model.…”

Section: Methodsmentioning

confidence: 99%

“…To identify issues to be considered when evaluating DHTs for funding, we conducted an extensive systematic review of international peer-reviewed and gray literature to identify evaluation frameworks specific to DHTs that manage chronic disease at home (12). We compiled comprehensive lists of the most frequently recommended content across a nine-domain HTA and refined this into a more practical set of questions for each issue by applying them to a systematic review of recent primary research studies (13).…”

Section: Development Of the Issues And Dht Attributesmentioning

confidence: 99%

Stakeholder preferences for attributes of digital health technologies to consider in health service funding

Huben

Howell

Norris

et al. 2023

Int J Technol Assess Health Care

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Objectives Health service providers are currently making decisions on the public funding of digital health technologies (DHTs) for managing chronic diseases with limited understanding of stakeholder preferences for DHT attributes. This study aims to understand the community, patient/carer, and health professionals’ preferences to help inform a prioritized list of evaluation criteria. Methods An online best–worst scaling survey was conducted in Australia, New Zealand, Canada, and the United Kingdom to ascertain the relative importance of twenty-four DHT attributes among stakeholder groups using an efficient incomplete block design. The attributes were identified from a systematic review of DHT evaluation frameworks for consideration in a health technology assessment. Results were analyzed with multinomial models by stakeholder group and latent class. Results A total of 1,251 participants completed the survey (576 general community members, 543 patients/carers, and 132 health professionals). Twelve attributes achieved a preference score above 50 percent in the stakeholder group model, predominantly related to safety but also covering technical features, effectiveness, ethics, and economics. Results from the latent class model supported this prioritization. Overall, connectedness with the patient’s healthcare team seemed the most important; with “Helps health professionals respond quickly when changes in patient care are needed” as the most highly prioritized of all attributes. Conclusions It is proposed that these prioritized twelve attributes be considered in all evaluations of DHTs that manage chronic disease, supplemented with a limited number of attributes that reflect the specific perspective of funders, such as equity of access, cost, and system-level implementation considerations.

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“…Although PROs have already been used in health technology assessment, 134,135 their systematic inclusion, particularly in digital health technologies, 136 should be more frequent. 135,136 The precedence of using PROs to claim medical benefits comes from the German Federal Institute for Drugs and Medical Devices (BfArM), who listed quality of life alongside morbidity and mortality as a hard medical outcome. 137 Health care resource allocation can be improved by understanding the impact of a condition on the lives of the affected persons or their experiences with diabetes care delivery.…”

Section: Beneficiaries and Importance Of Person-reported Outcomes And...mentioning

confidence: 99%

Person‐reported outcomes in diabetes care: What are they and why are they so important?

Hermanns,

Kulzer,

Ehrmann

2024

Diabetes Obesity Metabolism

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In this review, we aim to show how person‐reported outcomes (PROs) and person‐reported experiences (PREs) can significantly contribute to the way diabetes care is delivered, the involvement of people with diabetes in diabetes care, and the collaboration between health care professionals and people with diabetes. This review focuses on the definition and measurement of PROs and PREs, the importance of PROs and PREs for person‐centred diabetes care, and integrating the perspectives of people with diabetes in the evaluation of medical, psychological and technological interventions. PROs have been increasingly accepted by Health Technology Assessment bodies and are therefore valued in the context of reimbursement decisions and consequently by regulators and other health care stakeholders for the allocation of health care resources. Furthermore, the review identified current challenges to the assessment and use of PROs and PREs in clinical care and research. These challenges relate to the combination of questionnaires and ecological momentary assessment for measuring PROs and PREs, lack of consensus on a core outcome set, limited sensitivity to change within many measures and insufficient standardization of what can be considered a minimal clinically important difference. Another issue that has not been sufficiently addressed is the involvement of people with diabetes in the design and development of measures to assess PROs and PREs.

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Application of a health technology assessment framework to digital health technologies that manage chronic disease: a systematic review

Cited by 9 publications

References 10 publications

Assessing the Quality and Impact of eHealth Tools: Systematic Literature Review and Narrative Synthesis

Assessing the Quality and Impact of eHealth Tools: Systematic Literature Review and Narrative Synthesis

Stakeholder preferences for attributes of digital health technologies to consider in health service funding

Person‐reported outcomes in diabetes care: What are they and why are they so important?

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