Co‐construction of health technology assessment recommendations with patients: An example with cardiac defibrillator replacement

Pomey, Marie‐Pascale; Brouillard, Philippe; Ganache, Isabelle; Lambert, Laurie; Boothroyd, Lucy J.; Collette, Caroline; Bédard, Sylvain; Grégoire, Alexandre; Peláez, Sandra; Demers‐Payette, Olivier; Goetghebeur, Mireille; Guise, Michèle de; Roy, Denis

doi:10.1111/hex.12989

Cited by 14 publications

(29 citation statements)

References 29 publications

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“…This window of opportunity allowed the project team to combine multiple patient engagement modalities, from including PPs on the advisory committee and patient association feedback regarding the recommendations developed (14). Moreover, the interviews with patients of two Lyme disease profiles and with a Lyme patient association and the feedback from the PPs on the patient experience literature review increased the place that patient voices, perspectives, and experiences held in this evaluation (15–18). In fact, this study illustrates that it is possible for an HTA organization to engage patients in a combination of ways and enrich their evaluations (15).…”

Section: Discussionmentioning

confidence: 99%

Developing recommendations for the diagnosis and treatment of Lyme disease: the role of the patient's perspective in a controversial environment

Pomey

Bush²,

Demers‐Payette³

et al. 2020

Int J Technol Assess Health Care

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Context The Ministry of Health in Québec requested the National Institute of Excellence in Health and Social Services to produce clinical and implementation recommendations for the prophylaxis, diagnosis, and treatment of Lyme disease. Objectives (i) Describe the process of trialing different modalities of patient engagement as a means to integrate a diversity of patient perspectives and (ii) Describe the learning process of INESSS regarding the integration of the patient perspective. Methodology All documents were analyzed, and a survey with all advisory committee members and semi-structured interviews with stakeholders were conducted. Each interview was transcribed verbatim and imported into QDA miner software for the purposes of analysis. Data analysis was carried out concurrently with data collection to allow for an iterative approach between data collection and analysis. Results Five methods to integrate the perspectives of patients were used: (i) interviews with patients, (ii) inclusion of patient partners within the advisory committee, (iii) literature review, (iv) focus groups with one patient association, and (v) feedback from patient associations on recommendations intended for decision makers and other targeted stakeholders. The patient partners influenced decisions by sharing their experiential knowledge. The patient interviews and the literature review added an in-depth perspective on the disease and experience with the healthcare system. The patient association members shared their perspectives and helped disseminate the recommendation to sustain a practice change. Conclusion The combination of methods to collect and integrate patients’ knowledge and patient associations’ perspectives helped develop a comprehensive understanding of a controversial object of evaluation.

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Section: Discussionmentioning

confidence: 99%

Developing recommendations for the diagnosis and treatment of Lyme disease: the role of the patient's perspective in a controversial environment

Pomey

Bush²,

Demers‐Payette³

et al. 2020

Int J Technol Assess Health Care

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“…The approach often depends on the HTA organization or project type. For example, the U.K. National Institute for Health and Care Excellence (NICE) promotes fairness and patient inclusion in decisions related to their health and well-being (15 (17). Although the goal of patient engagement is similar for horizon scanning and HTA, the timing of engagement varies.…”

Section: Discussionmentioning

confidence: 99%

“…The approach often depends on the HTA organization or project type. For example, the U.K. National Institute for Health and Care Excellence (NICE) promotes fairness and patient inclusion in decisions related to their health and well-being (15). The Canadian Agency for Drugs and Technologies in Health (CADTH) involves patients on working groups and committees at several levels in the assessment process for medications and medical devices (15).…”

Section: Discussionmentioning

confidence: 99%

“…For example, the U.K. National Institute for Health and Care Excellence (NICE) promotes fairness and patient inclusion in decisions related to their health and well-being (15). The Canadian Agency for Drugs and Technologies in Health (CADTH) involves patients on working groups and committees at several levels in the assessment process for medications and medical devices (15). In January 2020, the U.K. National Institute for Health Research launched the Centre for Engagement and Dissemination to make research representative, relevant, and ready to use by stakeholders (16).…”

Section: Discussionmentioning

confidence: 99%

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Patient and caregiver engagement in the Patient-Centered Outcomes Research Institute (PCORI) Health Care Horizon Scanning System (HCHSS) process

Tipton

Lurio

Erinoff

et al. 2020

Int J Technol Assess Health Care

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Objective The Patient-Centered Outcomes Research Institute (PCORI) horizon scanning system is an early warning system for healthcare interventions in development that could disrupt standard care. We report preliminary findings from the patient engagement process. Methods The system involves broadly scanning many resources to identify and monitor interventions up to 3 years before anticipated entry into U.S. health care. Topic profiles are written on included interventions with late-phase trial data and circulated with a structured review form for stakeholder comment to determine disruption potential. Stakeholders include patients and caregivers recruited from credible community sources. They view an orientation video, comment on topic profiles, and take a survey about their experience. Results As of March 2020, 312 monitored topics (some of which were archived) were derived from 3,500 information leads; 121 met the criteria for topic profile development and stakeholder comment. We invited fifty-four patients and caregivers to participate; thirty-nine reviewed at least one report. Their perspectives informed analyst nominations for fourteen topics in two 2019 High Potential Disruption Reports. Thirty-four patient stakeholders completed the user-experience survey. Most agreed (68 percent) or somewhat agreed (26 percent) that they were confident they could provide useful comments. Ninety-four percent would recommend others to participate. Conclusions The system has successfully engaged patients and caregivers, who contributed unique and important perspectives that informed the selection of topics deemed to have high potential to disrupt clinical care. Most participants would recommend others to participate in this process. More research is needed to inform optimal patient and caregiver stakeholder recruitment and engagement methods and reduce barriers to participation.

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“…Real-world evaluations could be a major asset in informing AI decision making. In the context of uncertainty, iterative and reflective evaluation approaches should be developed to encourage dialog and collaboration among all relevant stakeholders (eg, payers, health care providers, technology providers, regulators, citizens/patients, academic researchers, and evaluation agencies) [ 63 , 78 , 79 ]. In addition, an early dialog between these stakeholders is needed to identify the evidence required to inform decision making [ 63 , 78 ].…”

Section: Introductionmentioning

confidence: 99%

Artificial Intelligence and Health Technology Assessment: Anticipating a New Level of Complexity

Alami¹,

Lehoux²,

Auclair³

et al. 2020

J Med Internet Res

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Artificial intelligence (AI) is seen as a strategic lever to improve access, quality, and efficiency of care and services and to build learning and value-based health systems. Many studies have examined the technical performance of AI within an experimental context. These studies provide limited insights into the issues that its use in a real-world context of care and services raises. To help decision makers address these issues in a systemic and holistic manner, this viewpoint paper relies on the health technology assessment core model to contrast the expectations of the health sector toward the use of AI with the risks that should be mitigated for its responsible deployment. The analysis adopts the perspective of payers (ie, health system organizations and agencies) because of their central role in regulating, financing, and reimbursing novel technologies. This paper suggests that AI-based systems should be seen as a health system transformation lever, rather than a discrete set of technological devices. Their use could bring significant changes and impacts at several levels: technological, clinical, human and cognitive (patient and clinician), professional and organizational, economic, legal, and ethical. The assessment of AI’s value proposition should thus go beyond technical performance and cost logic by performing a holistic analysis of its value in a real-world context of care and services. To guide AI development, generate knowledge, and draw lessons that can be translated into action, the right political, regulatory, organizational, clinical, and technological conditions for innovation should be created as a first step.

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Co‐construction of health technology assessment recommendations with patients: An example with cardiac defibrillator replacement

Cited by 14 publications

References 29 publications

Developing recommendations for the diagnosis and treatment of Lyme disease: the role of the patient's perspective in a controversial environment

Developing recommendations for the diagnosis and treatment of Lyme disease: the role of the patient's perspective in a controversial environment

Patient and caregiver engagement in the Patient-Centered Outcomes Research Institute (PCORI) Health Care Horizon Scanning System (HCHSS) process

Artificial Intelligence and Health Technology Assessment: Anticipating a New Level of Complexity

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