Review
Introduction
Methods
Search strategy and article selection
Data extraction
Descriptive statistics
Results
Identification of decision criteria from the literature review
Studies reporting on decision criteria | Studies describing a decisionmaking tool | |
---|---|---|
Authors | Type of study and level of decisionmaking* | |
1. Andreae et al.
[9], 2009 | Survey, macro | 1. Bowen et al.
[15], 2005 |
2. Asante et al.
[8], 2009 | Interviews, meso & macro | 2. Browman et al.
[16], 2008 |
3. Baltussen et al.
[12], 2007 | Focus group, macro | 3. Ghaffar et al.
[17], 2010 |
4. Baltussen et al.
[30], 2006 | Focus group, meso & macro | |
5. Baltussen et al.
[11], 2006 | Methodology | 5. Golan et al.
[19], 2010 |
6. Dionne et al.
[31], 2009 | Interviews, macro | 6. Hailey et al.
[20], 2009 |
7. Dolan et al.
[32], 2010 | Methodology | 7. Honore et al.
[21], 2010 |
8. Duthie et al.
[33], 1997 | Interviews, micro, meso & macro | 8. Johnson et al.
[22], 2009 |
9. Gibson et al.
[34], 2006 | Focus group & interviews, meso & macro | 9. Kirby et al.
[23], 2008 |
10. Hofmann et al.
[35], 2005 | Literature review | 10. Meagher et al.
[24], 2010 |
11. Irving et al.
[36], 2010 | Interviews, micro | 11. Menon et al.
[25], 2010 |
12. Jehu-Appiah et al.
[37], 2008 | Focus group, macro | 12. Tannahill et al.
[26], 2008 |
13. Kapiriri et al.
[38], 2009 | Interviews, micro, meso & macro | 13. The University of York
[27], 2002 |
14. Koopmanschap et al.
[39], 2010 | Focus group, macro | 14. Wilson et al.
[28], 2006 |
15. Lasry et al.
[14], 2010 | Interviews, macro | |
16. Lehoux et al.
[40], 2007 | Literature review | |
17. Lopert et al.
[41], 2009 | Focus group, macro | |
18. Martin et al.
[42], 2001 | Focus group, macro | |
19. Mitton et al.
[43], 2006 | Focus group, macro | |
20. Mullen et al.
[44], 2004 | Survey, meso | |
21. Noorani et al.
[45], 2007 | Literature review and interviews, macro | |
22. Saarni et al.
[46], 2008 | Consensus procedure, macro | |
23. Vuorenkoski et al.
[47], 2008 | Literature review | |
24. Wilson et al.
[48], 2007 | Focus group, macro | |
25. Wirtz et al.
[49], 2005 | Interviews, macro | |
26. Youngkong et al.
[13], 2009 | Literature review |
Decision criteria classification and descriptive statistics
Categories of classification system | Criteria of classification system | Terms used in articles |
---|---|---|
A-Health outcomes and benefits of intervention
| Number of criteria: 6 | Number of terms: 44 |
A1: Health benefits: 7 terms, cited 10 times | ||
A2: Efficacy/effectiveness: 11 terms, cited 29 times | · A2 – efficacy
[13, 47], efficacy/effectiveness
[10, 19, 20, 25, 27, 28, 44, 48], effectiveness
[14, 22, 26, 32‐34, 48], clinical benefit
[19, 22, 24, 42, 47], clinical impact
[45], clinical merit
[22], relative clinical benefit in relation with current standards
[16], determine relative value for degree of benefit against benchmarks
[16], magnitude of treatment effect
[22], response rate
[43], onset and duration of treatment/program effect
[43] | |
A3: Life saving: 4 terms, cited 5 times | ||
A4: Safety: 11 terms, 19 times | · A4 – side effects
[33, 41, 47], unintended consequences
[40], safety
[9, 22, 26, 31], safety and tolerability
[10, 19, 20], risks
[20, 22], risk management
[44], harm
[42], adverse effects
[32], inconvenience
[22], risk of event
[22], reduction in symptomatic toxicity compared with standard therapy
[42] | |
A5: PRO: 10 terms, 17 times | · A5 – patients reported outcomes
[10], quality of life
[19, 42, 44, 52], impact on quality of life
[22, 43], number of QALYs gained per patient
[36, 39], disability adjusted life years
[13], likely impact on patient
[16], patient preference
[25], patient autonomy
[26, 35, 40], relative value to patient
[16], best for patient
[38] | |
A6: Quality of care: 1 term, 1 time | · A6 – overall gain in quality of care
[44] | |
B-Type of health benefit
| Number of criteria: 2 | Number of terms: 12 |
B1: Population effect (prevention): 6 terms, 11 times | ||
B2: Individual effect (medical service): 6 terms, 7 times | ||
C-Impact of the disease targeted by intervention
| Number of criteria: 4 | Number of terms: 21 |
C1: Disease severity: 2 terms, 9 times | ||
C2: Disease determinants: 2 terms, 2 times | ||
C3: Disease burden: 7 terms, 13 times | ||
C4: Epidemiology: 10 terms, 16 times | · C4 – prevalence
[9, 13], number of potential beneficiaries
[35, 37, 40], indirect beneficiaries
[40], size of population
[10, 19], prevalence and incidence of disease
[23, 25, 43], number of residents benefiting
[44], number of clients served
[43], number of patients
[47], social/demographics
[22], incidence
[22] | |
D-Therapeutic context of intervention
| Number of criteria: 4 | Number of terms: 18 |
D1: Treatment alternatives: 5 terms, 13 times | ||
D2: Need: 8 terms, 16 times | ||
D3: Clinical guidelines & practices: 4 terms, 7 times | ||
D4: Pre-existing use: 1 term, 1 time | · D4 – pre-existing prescribing of the drug
[47] | |
E-Economic impact of intervention
| Number of criteria: 9 | Number of terms: 36 |
E1: Cost: 3 terms, 11 times | ||
E2: Budget impact: 6 terms, 11 times | ||
E3: Broad financial impact: 7 terms, 7 times | ||
E4: Poverty reduction: 1 terms, 3 times | ||
E5: Cost-effectiveness: 5 terms, 23 times | ||
E6: Value: 2 terms, 3 times | ||
E7: Efficiency and opportunity costs: 6 terms, 10 times | ||
E8: Resources: 5 terms, 6 times | ||
E9: Insurance premiums: 1 term, 1 time | · E9 – impact on health insurance premiums
[9] | |
F-Quality and uncertainty of evidence
| Number of criteria: 6 | Number of terms: 34 |
F1: Evidence available: 7 terms, 9 times | ||
F2: Strength of evidence: 14 terms, 20 times | · F2 – strength of evidence
[16, 44], quality of evidence
[47], quality of data and past decisions
[47], quality of data
[22], quality
[26], validity of evidence
[10, 19], related degree of knowledge certainty
[23], certainty
[48], consistency
[19, 22, 44], consistent
[38], completeness and consistency of reporting evidence
[10], openness
[26, 44], selection of studies
[35, 40], precision of treatment effect
[22] | |
F3: Relevance of evidence: 5 terms, 8 times | ||
F4: Evidence characteristics: 5 terms, 7 times | ||
F5: Research ethics: 2 terms, 4 times | ||
F6: Evidence requirements: 1 term, 1 time | · F6 – adherence to requirement of decision making body
[10] | |
G-Implementation complexity of intervention
| Number of criteria: 9 | Number of terms: 57 |
G1: Legislation: 6 terms, 6 times | ||
G2: Organizational requirements and capacity to implement: 15 terms, 17 times | · G2 – system requirements
[25], physical environment
[44], environment
[22, 26], system capacity
[10], local capacity
[17], ability to implement
[38], implementation
[22], organization’s structure
[51], organizational burden
[49], logistics
[36], process
[28], well-organized
[38], organizational feasibility
[22, 25], feasibility of delivery
[16], deliverability
[48] | |
G3: Skills: 6 terms, 6 times | ||
G4: Flexibility of implementation: 7 terms, 8 times | ||
G5: Characteristics of intervention: 6 terms, 8 times | ||
G6: Appropriate use: 3 terms, 3 times | ||
G7: Barriers and acceptability: 3 terms, 4 times | ||
G8: Integration and system efficiencies: 9 terms, 9 times | · G8 – system integration (best use of elements of healthcare system)
[34], integration into local community
[44], ease of integration
[22], impact on other services
[40], links to other services
[44], compatibility
[22], reduction of the monitoring
[33], reduction of waiting list size
[33], impact
[22] | |
G9: Sustainability: 2 terms, 4 times | ||
H-Priorities, fairness and ethics
| Number of criteria: 7 | Number of terms: 55 |
H1 Population priorities: 5 terms, 5 times | ||
H2 : Access: 10 terms, 17 times | · H2 – population access
[10], access
[19, 27, 47, 49], equity of access improvement
[13], access to care easier
[31, 33, 34], distribution and access to healthcare
[35, 40], accessibility
[22, 44], equity of access
[44], access to health system
[22], geographical equity
[43], timeliness of access
[43] | |
H3 : Vulnerable and needy population: 9 terms, 11 times | · H3 – vulnerable population
[37, 38], potential victims
[40], particular social groups with high risk and/or increased vulnerability
[23], compassion for the vulnerable
[19], particularly needy/vulnerable groups
[44], age of targeted group
[13, 30], maternal mortality
[13], quality of maternity care services
[13], population equity
[43] | |
H4: Equity, fairness and justice: 12 terms, 32 times | · H4 – equity
[8, 13, 14, 19, 22, 25, 27, 40, 44, 46, 48], fairness
[10, 14, 40, 44, 47], health equity
[23, 26], equality
[19, 26, 38], distributive justice
[23, 25], formal justice
[23], social justice
[23], justice
[26, 46], social injustice
[40], addressing health status inequalities at a population level
[44], human integrity and dignity
[35, 40], basic human rights
[35] | |
H5 : Utility: 2 terms, 3 times | ||
H6: Solidarity: 6 terms, 8 times | ||
H7: Ethics and moral aspects: 11 terms, 14 times | · H7 – ethics
[14, 22], ethical values
[22], values
[22], values and beliefs
[51], consistency with societal values
[22], ethical implications
[45], moral obligation to implement a technology
[35, 40], rule of rescue
[25], priority to basic and necessary care
[38], moral consequence of HTA
[35, 40], moral challenges related to certain components of HTA
[35] | |
I-Overall context
| Number of criteria: 11 | Number of terms: 83 |
I1: Mission and mandate of health system: 13 terms, 19 times | · I1 – goals of healthcare
[52, 53], goals
[21], beneficence
[28], non-maleficience and justice
[28], beneficence/non-maleficience
[17, 26, 53], strategic fit
[9, 23], medical and social worth
[45], relevance
[22], present social consensus,
[17, 49] consensus regarding public funding of a therapy
[17, 53], government mandate
[17], national standards
[24], healthcare context positioning
[23] | |
I2: Overall priorities: 6 terms, 6 times | ||
I3: Financial constraints: 8 terms, 13 times | ||
I4: Incentives: 4 terms, 5 times | ||
I5: Political aspects: 5 terms, 7 times | ||
I6: Historical aspects: 3 terms, 3 times | ||
I7: Cultural aspects: 7 terms, 10 times | ||
I8: Innovation: 3 terms, 3 times | ||
I9: Partnership and leadership: 8 terms, 9 times | · I9 – partnership and networking
[16], partnerships
[9], maintaining relationship
[42], leadership
[16], community development
[53], academic commitments: research and education
[9, 23], partnership and collaboration across organizations
[43], contribution to position as a learning organization
[43] | |
I10: Citizen involvement: 3 terms, 3 times | ||
I11: Stakeholders interests and pressures: 23 terms, 28 times | · I11-stakeholders pressure
[52], advocacy
[16, 45], pressure from physician and patients groups and past decisions
[32], clinical expert opinions
[37], patient representative group opinions
[37], power relations among stakeholders
[28], user of the technology interests
[47], challenge the relationship between patient and physician
[47], professional prestige
[28, 47], clinicians excitement and decisions in other hospitals
[32], public reaction and public accountability
[28], HTA’s producer interest
[28, 47], company activities
[32], researchers ethics interests
[28, 47], third party agents involved
[47], recommendations made by other countries
[13], status in other jurisdictions
[49], current status of public funding in other jurisdictions
[17], drugs used in other hospitals
[32], expressed demand
[14, 37], patient demand
[32], expected level of interest (patient and medical)
[34], entitlement
[28] |