Setting priorities for health technology assessment : a model process / / Molla S. Donaldson and Harold C. Sox, Jr., editors

• Pubblicazione: Washington, D.C., : National Academy Press, 1992
• Edizione: 1st ed.
• Descrizione fisica: 1 online resource (162 p.)
• Soggetto topico: Medical technology - United States - Evaluation; Technology assessment - United States
• Altri autori: DonaldsonMolla S SoxHarold C
• Note generali: Bibliographic Level Mode of Issuance: Monograph
• Nota di bibliografia: Includes bibliographical references (p. 131-135).
• Nota di contenuto: SETTING PRIORITIES FOR HEALTH TECHNOLOGY ASSESSMENT -- Copyright -- Acknowledgments -- Contents -- Preface -- Summary -- RATIONALE -- METHODS OF PRIORITY SETTING -- GUIDING PRINCIPLES -- THE PROCESS PROPOSED BY THE IOM COMMITTEE -- Steps in the Process -- Seven Criteria -- Reassessment -- The Priority-Setting Cycle -- Human Resources Required to Implement the Process -- Publicly Available Products -- Topics for Which There is Insufficient Evidence to Conduct an Assessment Based on Review of the Literature -- RECOMMENDATIONS -- Recommendation 1 -- Recommendation 2 -- Recommendation 3 -- Recommendation 4 -- Recommendation 5 -- Recommendation 6 -- Recommendation 7 -- Recommendation 8 -- Recommendation 9 -- Recommendation 10 -- Recommendation 11 -- ADOPTION OF THE IOM'S PRIORITY-SETTING PROCESS BY OTHER ORGANIZATIONS -- Technology Assessment and Clinical Practice Guidelines -- POTENTIAL PROBLEMS WITH THE PRIORITY-SETTING PROCESS -- CONCLUDING REMARKS -- 1 Technology Assessment and the Need for Priority Setting -- EVOLUTION OF TECHNOLOGY ASSESSMENT TOWARD OUTCOMES, EFFECTIVENESS, AND APPROPRIATENESS RESEARCH -- The Effectiveness Initiative and Establishment of the Agency for Health Care Policy and Research -- The Office of Health Technology Assessment -- ORIGIN OF THE IOM STUDY -- Previous Pilot Study of Preliminary Model -- STUDY METHODS -- DEFINITIONS -- Medical Technology -- Technology Assessment -- Reassessment -- REPORT STRUCTURE -- SUMMARY -- APPENDIX: THE AGENCY FOR HEALTH CARE POLICY AND RESEARCH -- Center for Medical Effectiveness Research -- Office of the Forum for Quality and Effectiveness in Health Care -- Office of Science and Data Development -- Center for General Health Services Extramural Research and the Division of Technology and Quality Assessment -- Office of Health Technology Assessment -- OHTA Technology Assessments. ; 2 Methods for Priority Setting -- PRIORITY-SETTING PROCESSES USED BY ORGANIZATIONS -- Example 1: Health Care Financing Administration -- Bureau of Policy Development -- Health Care Financing Administration Physicians Panel -- Reevaluation or Assessment of Established Technologies -- Example 2: Private Sector-Pharmaceutical Industry -- Criteria for Assessment -- Criteria for Reassessment -- Internal Process of Priority Setting -- Example 3: Health Care Provider Organizations -- Example 4: Institute of Medicine/Council on Health Care Technology Pilot Study -- Example 5: Food and Drug Administration -- QUANTITATIVE MODELS FOR SETTING PRIORITIES -- Example 6: Technology Assessment Priority-Setting System -- Example 7: The Phelps-Parente Model -- SETTING PRIORITIES FOR SPENDING ON HEALTH SERVICES -- Example 8: Oregon Basic Health Services Act -- DISCUSSION -- Reactive and Implicit Processes -- Strengths and Weaknesses of Reactive Mechanisms -- The IOM/CHCT Process Compared with This IOM Study -- Analytic Models -- Strengths and Weaknesses of Analytic Models -- Need for a Comprehensive, Proactive Process for Priority Setting -- SUMMARY -- APPENDIX: MEDICARE COVERAGE DECISION MAKING -- 3 Guiding Principles -- BUILDING A MODEL PROCESS FOR SETTING PRIORITIES -- PROCESS BUILDING FOR OHTA -- The Process Must Reflect the Mission of OHTA -- Potential to Reduce Pain, Suffering, and Premature Death -- Potential to Reduce Inappropriate Health Care Expenditures -- Potential to Reduce Inequity and Inform Other Social Issues -- The Product of the Process Should Be Consistent with the Needs of Users -- The Process Must Be Efficient -- The Process Must Be Sensitive to the Environment in Which OHTA Operates -- SUMMARY -- 4 Recommendations for a Priority-Setting Process -- PREVIEW OF THE QUANTITATIVE MODEL -- ELEMENTS OF THE PROPOSED PRIORITY-SETTING PROCESS. ; Step 1. Selecting and Weighting Criteria Used to Establish Priorities -- Step 2. Identifying Candidate Conditions And Technologies -- Step 3. Winnowing the List of Candidate Conditions and Technologies -- Step 4. Data Gathering -- Step 5. Creating Criterion Scores -- Step 6. Computing Priority Scores -- Step 7. Review By Ahcpr National Advisory Council -- DETAILS OF THE PROPOSED PRIORITY-SETTING PROCESS -- Step 1. Selecting And Weighting The Criteria Used To Establish Priority Scores -- Selecting Criteria -- Weighting Criteria -- Step 2. Identifying Candidate Conditions And Technologies -- Step 3. Winnowing The List Of Candidate Conditions And Technologies -- Secondary Winnowing Processes -- Step 4. Data Gathering -- Specifying Alternative Technologies And Clinical Conditions -- Staff Summaries Of Clinical Conditions -- Step 5. Creating Criterion Scores -- General Points -- Criteria Recommended For The Iom Priority-Setting Model -- Criterion 1: Prevalence -- Criterion 2: Burden Of Illness -- Criterion 3: Cost -- Criterion 4: Variation In Rates Of Use -- Criterion 5: Potential Of The Results Of An Assessment To Change Health Outcomes -- Criterion 6: Potential Of The Results Of An Assessment To Change Costs -- Criterion 7: Potential of the Results of an Assessment to Inform Ethical, Legal, and Social Issues -- Criteria Rejected by the Committee -- Step 6. Computing Priority Scores -- Derivation of the Model -- Determining Whether Assessment is Desirable and Feasible -- Step 7. Review by Ahcpr National Advisory Council -- REASSESSMENT -- Role of Reassessment in the Complete Assessment Program -- Methods of Identifying Candidates for Reassessment -- Ongoing Tracking of Events Related to Previously Assessed Topics -- Evaluation of the Quality of Studies -- Ranking Candidates for Reassessment -- Final Steps after Establishing Priority for Reassessment. ; Sensitivity Analysis -- Cost Analysis -- SUMMARY -- APPENDIX 4.1: WINNOWING PROCESSES -- Intensity Rankings by Nominating Persons and Organizations -- Preliminary Ranking Processes -- Panel-Based Preliminary Weighting -- Comment -- APPENDIX 4.2: METHODOLOGIC ISSUES -- Properties of Logarithms -- Application to the Iom Model -- 5 Implementation Issues -- THE PRIORITY-SETTING CYCLE -- SETTING CRITERION WEIGHTS -- RESOURCES NEEDED TO IMPLEMENT THE PROCESS -- Technology Assessment Program Staff Requirements -- Priority-Setting Panel -- IMPLEMENTATION CONSIDERATIONS FOR OHTA AND OTHER ORGANIZATIONS -- Validity and Reliability -- Criteria -- Choosing-and Changing-Criteria -- Criterion Weights -- Availability of Data to Generate Criterion Scores -- Publicly Available Products -- WHEN THE SCIENTIFIC EVIDENCE IS INSUFFICIENT FOR ASSESSMENT -- Interim Statements -- Modeling -- SUMMARY -- 6 Recommendations and Conclusions -- REVIEW OF THE COMMITTEE'S RATIONALE AND RECOMMENDATIONS -- Recommendations -- Recommendation 1 -- Recommendation 2 -- Recommendation 3 -- Recommendation 4 -- Recommendation 5 -- Recommendation 6 -- Recommendation 7 -- Recommendation 8 -- Recommendation 9 -- Recommendation 10 -- Recommendation 11 -- REVIEW OF STEPS AND ISSUES IN IMPLEMENTATION -- Steps in a Priority-Setting Process -- Step 1. Selecting and Weighting the Criteria Used to Establish Priority Scores -- Step 2. Identifying Candidate Conditions and Technologies -- Step 3. Winnowing the List of Candidate Conditions and Technologies -- Step 4. Data Gathering -- Step 5. Creating Criterion Scores -- Step 6. Computing Priority Scores -- Step 7. Review of Priority Rankings by the National Advisory Council of the Agency for Health Care Policy and Research -- Resources for Implementation -- The Priority-Setting Cycle -- Publicly Available Products. ; Topics with Insufficient Evidence for Assessment Based on Review of the Literature -- ADOPTION OF THE IOM'S PRIORITY-SETTING PROCESS BY OTHER ORGANIZATIONS -- Technology Assessment and Clinical Practice Guidelines -- POTENTIAL PROBLEMS WITH THE PRIORITY-SETTING PROCESS -- Will a Numerical Priority Score Lead to Unrealistic Inferences About Priority? -- Does Codifying an Idealized Process Lead to Inflexibility? -- Will There Be a Bias Toward Choosing Topics That Are Quantifiable? -- CONCLUSION -- References -- Appendix A Pilot Test of the IOM Model -- METHODS -- Topics and Data for Priority Setting -- Criteria -- Criterion Weighting -- Criterion Scoring -- Convened Pilot -- Objective Criterion Scores. -- Mailed Pilot -- RESULTS -- Feasibility -- Improvements in the Model -- Comparison of Convened and Mailed Methods -- Criterion Weights -- Criterion Scores -- Priority Scores -- IMPLICATIONS OF THE PILOT TESTS FOR THE IOM MODEL -- Criterion Scores -- Appendix B Abbreviations.
• Sommario/riassunto: The problem of deciding which health care technologies to evaluate is urgent. With new technologies proliferating alongside steadily increasing health care costs, it is critical to discriminate among technologies to direct tests and treatments at those who can benefit the most. Given the vast number of clinical problems and technologies to be evaluated, the many months of work required to study just one problem, and the relatively few clinicians with highly developed analytic skills, institutions must set priorities for assessment. This book sets forth criteria and a method that can be used by public agencies such as the Office of Health Technology Assessment (in the U.S. Public Health Service) and by any private organization conducting such work to decide which technologies to assess or reassess.
• Titolo autorizzato: Setting priorities for health technology assessment
• ISBN: 9786610203192; 9781280203190; 1280203196; 9780309575577; 0309575575; 9780585149097; 0585149097
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Lingua di pubblicazione: Inglese
• Record Nr.: 9910957259603321
• Lo trovi qui: Univ. Federico II