Health Technology Assessment of Public Health Interventions Published 2012 to 2016: An Analysis of Characteristics and Comparison of Methods

Abstract

ObjectivesThe aim of this study was to provide an overview of the methodological characteristics and compare the assessment methods applied in health technology assessments (HTAs) of public health interventions (PHIs).MethodsWe defined a PHI as a population-based intervention on health promotion or for primary prevention of chronic or nonchronic diseases. HTAs on PHIs were identified by systematically searching the Web pages of members of international HTA networks. We included only full HTA reports published between 2012 and 2016. Two reviewers extracted data on the methods used to assess effectiveness/safety, as well as on economic, social, cultural, ethical, and legal aspects using a-priori standardized tables.ResultsWe included ten HTAs provided by four different organizations. Of these, all reports assessed the effectiveness of the interventions and conducted economic evaluations, seven investigated social/cultural aspects, and four each considered legal and ethical aspects, respectively. Some reports addressed applicability, context/setting, and intervention fidelity issues in different ways. We found that most HTAs adapted their methods to some extent, for example, by including nonrandomized studies, expanding the search strategy, involving stakeholders, or applying a framework to guide the HTA process.ConclusionsOur analysis provides a comprehensive overview of methods applied in HTAs on public health interventions. We found that a heterogeneous set of approaches is used to deal with the challenges of evaluating complex public health interventions.

“Same same but different”? On the questionable but crucial differentiation between ethical and social aspects in health technology assessment

“…The approach chosen in each case was never discussed or justified, neither in the methods sections of the reports nor in the content elaboration of the respective domains (0%) (see Figure 1). Additionally, the results of our document analysis are compatible with those of Polus et al [28], who came to similar conclusions in their study on the characteristics and comparison of methods in HTA reports of public health interventions. First, they also observed a frequent combination of the ELSI domains.…”

Evidence-Informed Deliberative Processes for HTA Around the Globe: Exploring the Next Frontiers of HTA and Best Practices Comment on "Use of Evidence-informed Deliberative Processes by Health Technology Assessment Agencies Around the Globe"

“…Second, the use of HTAs for public health interventions is receiving growing attention, 29 , 30 and presents its own set of challenges and opportunities with respect to deliberative processes for HTA. For example, stakeholder involvement can be particularly demanding for public health interventions.…”

Demenzprävention und hausärztliche Versorgung: Schätzung der Zielpopulation

“…Bisher ist wenig bekannt, wie Ergebnisse von Präventionsstudien in die vorhandenen Strukturen der Routineversorgung implementiert werden können. Neuerdings wird das dafür notwendige Wissen im Rahmen von early HTAs [16], von Netzwerk-HTAs [17] und im Rahmen der sogenannten Implementierungs-Wissenschaft [18] generiert. Bei einer frühen Bewertung sind z.B.…”