HEALTH TECHNOLOGY REASSESSMENT: THE ART OF THE POSSIBLE
Open accessAbstract
Background:Health technology reassessment (HTR) is “a structured, evidence-based assessment of the clinical, social, ethical, and economic effects of a technology currently used in the healthcare system, to inform optimal use of that technology in comparison to its alternatives.” The purpose of this study is to describe the key themes in the context of current HTR activities and propose a way forward for this newly emerging field. Methods:Data were gathered from a workshop held as part of the 2012 Canadian Agency for Drugs and Technology in Health (CADTH) symposium. The workshop consisted of two panel presentations followed by discussion; data gathered, including presentations and rich audience discussion transcripts, were analyzed for key themes emerging in the field of HTR using constant comparative analysis. Results:The language chosen to describe HTR will set the tone for engagement. The identification of champions at multiple levels and political will are essential. Key lessons from international experience are: disinvestment is difficult, focus on clinical areas not specific technologies, identify clear goals of the HTR agenda. Six key themes were identified to move the HTR agenda forward: emphasize integration over segregation, focus on development of HTR methods and processes, processes are context-specific but lessons must be shared, build capacity in synergistic interdisciplinary fields, develop meaningful stakeholder engagement, strengthen postimplementation monitoring and evaluation. Conclusions:To move this field forward, we must continue to build on international experiences with a focus on developing novel methodological approaches to generating, incorporating, and implementing evidence into policy and practice.
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Disinvestment processes are often context-specific.
“As disinvestment processes are often context-specific [21]”
From What influences the outcome of active disinvestment processes in healthcare? A qualitative interview study on five recent cases of active disinvestment (2021) · cites this paper as [21]
The Results section, under “Moving Forward with Health Technology Reassessment,” says processes ought to be context-specific and may require local adaptation. It is discussing health technology reassessment (HTR) processes, however, and the Abstract distinguishes HTR from disinvestment. The passage therefore supports the general point about context but does not directly establish that disinvestment processes are often context-specific. (LLM, conf=0.83)
Experimental — accuracy not yet measuredInternational literature describes active disinvestment as a very difficult process, hampered by contextual aspects such as political barriers, a lack of dedicated resources, and disinvestment being considered counter-cultural.
“In the international literature, active disinvestment has been described as a very difficult process [21], hampered by contextual aspects such as political barriers [22, 23], a lack of dedicated resources [22], and disinvestment being considered counter-cultural [24].”
From What influences the outcome of active disinvestment processes in healthcare? A qualitative interview study on five recent cases of active disinvestment (2021) · cites this paper as [21]
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Self-citationRotteveel, A. H., Lambooij, M. S., van de Rijt, J. J. A., van Exel, J., Moons, K. G. M., & de Wit, G. A. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06298-3 · Cited by 16 · see citing works
- Authors
- MacKean, G., Noseworthy, T., Elshaug, A. G., Leggett, L., Littlejohns, P., Berezanski, J., & Clement, F.
- Venue
- International Journal of Technology Assessment in Health Care
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-10
- Volume
- 29
- Issue
- 4
- Pages
- 418-423
- ISSN
- 0266-4623 (ISSN-L)
- 1471-6348
- PMC
- PMC3846380
- OpenAlex
- W2161996292
- Cited by
- 75
- References
- 0
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 18 · 2020: 9 · 2019: 3 · 2018: 7 · 2017: 8 · 2016: 3 · 2015: 6 · 2014: 2
- FWCI
- 7.98
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Technology Assessment in Health Care (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc-sa)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Sociology and Political Science › Delphi Technique in Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- stakeholder engagement, evidence-informed health policy, CADTH
- MeSH terms
- Decision Making, Organizational, Technology Assessment, Biomedical, Internationality
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