Authors' objectives: The purpose of the present study was threefold: i) to describe the extent to which organisational and patient-related assessments are included in international HTAs, ii) to describe and discuss the content and handling of the organisational and patient-related assessments included in international HTAs, to describe 'best practice' and to present recommendations for organisational and patient-related assessments in future HTAs, and iii) to describe and discuss the methodology used in HTAs for generating and analysing data in the assessment of organisational and patient-related issues, and to describe the extent to which HTAs report on the methodology used and on the generalisability of the organisational and patient-related results to other contexts.

Authors' recommendations: Inclusion of organisational and patient-related assessments in HTAs was less common than inclusion of technological/clinical and economic assessments. When organisational assessments were included these were mainly concerned with such issues as which actors and organisations were associated with the use of the technology, work flow, staff numbers and skills, and physical, resource and legislative structures. Issues related to organisational culture, communication and the physical and psychological working environment were less often included. When patient-related issues were included these were mainly concerned with such issues as fear and discomfort, impact on the patient's daily life and quality of life, patient accept of the technology and patient information. Issues related to patient involvement in decision-making and impact of a technology on the patient's personal economy and on their significant others were less often included. While some of the HTA assessments were broad, including a variety of issues, often these issues were handled in a rather restricted and superficial way. More comprehensive assessment of the included issues was less often performed. While the way of handling different issues in an HTA depends on the given technology under assessment and the given purpose and policy question of the HTA, the usefulness to decision-making of rather superficial assessments can be questioned. There is also room for improvement in relation to the methodology applied in the assessments. Most reports simply described the methods used for generating and analysing data, while fewer reports discussed the methodological choices made. Many of the HTA reports chose a literature review as the only study design but did not explicitly discuss this choice in relation to the individual HTA assessment or to the purpose and perspective of the study. The choice of study design thus appeared to follow a generally accepted approach rather than involve consideration of the most appropriate design tailored to the individual assessment. The absence of a description of the considerations made when determining the content and methods of the organisational and patient-related assessments limits the usefulness of an HTA. The reader is left uncertain of the relevance and validity of the organisational and patient-related assessments – was the relevant perspective chosen, were the relevant issues included and were they assessed using a relevant methodology?

Project Status: Completed

Year Published: 2007

URL for published report: http://www.sst.dk/publ/Publ2007/MTV/Litteraturstudie/A_review_of_HTAs.pdf

URL for additional information: http://www.sst.dk/Udgivelser/2007/A%20review%20of%20organisational%20and%20patient-related%20assessments%20in%20HTAs%20published%20by%20INAHTA%20members.aspx

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Denmark

Organisation Name: Danish Centre for Evaluation and Health Technology Assessment

Contact Address: National Board of Health, PO Box 1881, Islands Brygge 67, DK-2300 Copenhagen S, Denmark. Tel: 45 72 22 74 48; Fax: 45 72 22 74 07/67

Contact Name: dacehta@sst.dk

Contact Email: dacehta@sst.dk

Copyright: Danish Centre for Health Technology Assessment (DACEHTA)