Authors' recommendations: The Ontario Health Technology Advisory Committee (OHTAC) reviewed and accepted the findings of the health technology assessment conducted by Health Quality Ontario. Based on the evidence, the Ontario Health Technology Advisory Committee reached a consensus that there is considerable uncertainty in the clinical benefit of the procedure and because the procedure costs are very high it does not provide good value for money. The committee recognized that improving the certainty in clinical benefit by generating higher-quality evidence is challenging because the number of patients eligible to receive the procedure is very small. The committee also agreed that the individual circumstances of patients may affect the trade-offs of benefits and harms, and the evidence does not capture such unique scenarios. The Ontario Health Technology Advisory Committee reviewed the public comments received on the draft recommendation. The comments noted the following concerns: the evidence was not generalizable to the Ontario context, the evidence did not capture the unique clinical situations of eligible Ontario patients that may allow the benefits of the procedure to outweigh the risks, there was a lack of societal and ethical values consideration, there was an overestimation of the procedure cost, and patient engagement was not done to inform the recommendation. The committee deliberated on these comments and felt that despite these concerns, the main issues were that the overall clinical benefit of the procedure is uncertain and the costs associated with the procedure are very high. The Ontario Health Technology Advisory Committee advised that because of the lack of high- quality evidence the procedure should be done in the context of a research study where costs, benefits, and harms could be accurately measured.

Project Status: Completed

Year Published: 2016

URL for published report: http://www.hqontario.ca/Portals/0/Documents/evidence/reports/recommendation-limb-transplant-en-1606.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Health Quality Ontario

Contact Address: Evidence Development and Standards, Health Quality Ontario, 130 Bloor Street West, 10th floor, Toronto, Ontario Canada M5S 1N5

Contact Name: EDSinfo@hqontario.ca

Contact Email: OH-HQO_hta-reg@ontariohealth.ca

Copyright: Health Quality Ontario (HQO)