Erschienen:
Cambridge University Press (CUP), 2018
Erschienen in:International Journal of Technology Assessment in Health Care
Sprache:
Englisch
DOI:
10.1017/s0266462318000235
ISSN:
0266-4623;
1471-6348
Entstehung:
Anmerkungen:
Beschreibung:
<jats:sec id="S0266462318000235_sec_a1"><jats:title>Objectives:</jats:title><jats:p>In 2007, the Ontario Health Technology Advisory Committee (OHTAC) developed a decision framework to guide decision making around nondrug health technologies. In 2012, OHTAC commissioned a revision of this framework to enhance its usability and deepen its conceptual and theoretical foundations.</jats:p></jats:sec><jats:sec id="S0266462318000235_sec_a3"><jats:title>Methods:</jats:title><jats:p>The committee overseeing this work used several methods: (a) <jats:italic>a priori</jats:italic> consensus on guiding principles, (b) a scoping review of decision attributes and processes used globally in health technology assessment (HTA), (c) presentations by methods experts and members of review committees, and (d) committee deliberations over a period of 3 years.</jats:p></jats:sec><jats:sec id="S0266462318000235_sec_a4"><jats:title>Results:</jats:title><jats:p>The committee adopted a multi-criteria decision-making approach, but rejected the formal use of multi-criteria decision analysis. Three broad categories of attributes were identified: (I) context criteria attributes included factors such as stakeholders, adoption pressures from neighboring jurisdictions, and potential conflicts of interest; (II) primary appraisal criteria attributes included (i) benefits and harms, (ii) economics, and (iii) patient-centered care; (III) feasibility criteria attributes included budget impact and organizational feasibility.</jats:p></jats:sec><jats:sec id="S0266462318000235_sec_a5" sec-type="conclusion"><jats:title>Conclusion:</jats:title><jats:p>The revised Ontario Decision Framework is similar in some respects to frameworks used in HTA worldwide. Its distinctive characteristics are that: it is based on an explicit set of social values; HTA paradigms (evidence based medicine, economics, and bioethics/social science) are used to aggregate decision attributes; and that it is rooted in a theoretical framework of optimal decision making, rather than one related to broad social goals, such as health or welfare maximization.</jats:p></jats:sec>