Authors' objectives:

To discuss the epidemiological assessment of health technologies.

Authors' recommendations: Technology evaluation is a systematic technique of data generation or collection of available information so that through its critical analysis and synthesis, valid recommendations may be obtained to help in health decision making. The techniques most used by the bodies that carry out health technology evaluations, are those based on the revision and synthesis of the relevant evidence as well as those based on expert opinions. Technology evaluation requires rapid responses to questions raised, as we are witnessing the almost constant creation of new technologies that many times are incorporated into normal clinical practice, without having unequivocally demonstrated their effectiveness. One of the most important contributions of technology evaluation of health systems has been to give greater importance to the quality of the information and the emphasis placed on improving it. Thus, on using the existent information, the quality of the evaluation work will depend to a large extent on the quality of the studies used. However, on many occasions the information gathered does not comprise all the information there is on the subject of evaluation. In order to avoid publication bias as far as possible, those sources that are not susceptible to being biased will be searched for, or the largest number of bibliographic search techniques within our reach will be combined in order to complete the information gathered. Maximum effort must be made to carry out the revisions and summaries of this information as objectively as possible. In this sense, meta-analysis is a tool of great value that provides two basic pillars: the systematic gathering of information and the obtention of a quantitative result. It must be used whenever possible, and may or may not be combined with expert opinions. A matter of utmost interest in technology evaluation, is the distribution of the reports produced. In spite of the fact that not many studies have researched the impact that technology evaluation reports have on clinical practice, it seems that their influence is still minor. There are a number of factors that must be borne in mind and that are contrary to technological innovation. For example, the prevalent theories and explanations that are widely accepted in the scientific world are at times difficult to replace. Other factors such as the importance of the clinical situation to which the technology is applied, the incentives, even commercial, and the social pressure that at times goes with technological innovation, or the communication channels used to distribute the information, play a crucial role in the scientific and social acceptability of health technologies. The role of evaluation among all these factors, is difficult to measure. It could act directly on the perception of the doctors, influence the experts who in turn, may influence the doctors, or it may play a direct role in the decision making of the health administrators. In order to achieve the incorporation of new technologies into the health systems, their incorporation is being based to a greater degree on information regarding their effectiveness, security, efficiency and reasonable price. The distribution channels of the recommendations made by the evaluation teams must be as extensive as possible and aptly managed. This way, besides involving the health professionals, from clinic attendants to those in charge of the administration and planning, the idea of technology evaluation and the recommendations made, must be incorporated into the training of the persons responsible for health in the future. To conclude, we once again wish to emphasize that the quality of the information available is a key element in the result of technology evaluation. In spite of this, we will find that many times the information does not suffice. As the basis for health decision making, an effort must be made in technology evaluation to provide recommendations on a particular subject. Decisions must be made continuously and they must have a minimum amount of supportive information. Hence, the worst evaluation is always that which is not carried out.

Authors' methods: Discussion

Project Status: Completed

URL for project: http://www.isciii.es/aets

Year Published: 1995

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Agencia de Evaluacion de Tecnologias Sanitarias

Contact Address: Instituto de Salud "Carlos III", Calle Sinesio Delgado 6, Pabellon 4, 28029 Madrid, Spain. Tel: +34 9 1 822 2005; Fax: +34 9 1 387 7841;

Contact Name: Luis M. Sánchez Gómez

Contact Email: luism.sanchez@isciii.es

Copyright: Agencia de Evaluacion de Tecnologias Sanitarias (AETS)