Bridges John F P, Jones Christopher
Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA.
Int J Technol Assess Health Care. 2007 Winter;23(1):30-5. doi: 10.1017/S0266462307051549.
In conjunction with other important movements in contemporary medicine, including evidence-based medicine (EBM), health technology assessment (HTA) has promoted a culture of critical evaluation. Despite this impact, institutional and methodological challenges are associated with HTA. For example, only in recent years has HTA attempted an open dialogue with patients; however, this is normally done by giving them a "seat" at the HTA decision-making table, rather than by more scientific means.
The aim of this study was to develop a working definition of patient-based HTA, to identify the current barriers to adopting a patient-based model, and to formulate a vision of how a patient-based HTA could be used to promote patient empowerment and patient-centered care.
In the ideal setting, a patient-based HTA would promote patient knowledge by providing access to information and promoting an informed dialogue between patients and their healthcare professionals. To implement a patient-based HTA, the focus must turn to the patient's issues and incorporate each patient's unique perspective and preferences. Processes must change to increase patient participation in all levels of HTA and aim to promote empowered patients who can make informed decisions.
Present-day HTA is broad and has numerous stakeholders, with none so important as the patient. By asking patient-oriented questions in HTA and better involving patients throughout the entire process, we can easily promote patient empowerment, and as such make patients more capable to play a more active role in healthcare decision making.
与当代医学中的其他重要运动（包括循证医学）相结合，卫生技术评估（HTA）促进了批判性评估的文化。尽管有这种影响，但HTA仍面临机构和方法上的挑战。例如，直到最近几年HTA才尝试与患者进行公开对话；然而，这通常是通过在HTA决策桌上给他们一个“席位”来实现的，而不是通过更科学的方式。
本研究的目的是制定基于患者的HTA的实用定义，确定采用基于患者的模式的当前障碍，并构想如何利用基于患者的HTA来促进患者赋权和以患者为中心的护理。
在理想情况下，基于患者的HTA将通过提供信息获取渠道并促进患者与其医疗保健专业人员之间的明智对话来提高患者知识水平。要实施基于患者的HTA，重点必须转向患者的问题，并纳入每个患者的独特观点和偏好。流程必须改变，以增加患者在HTA各级的参与度，并旨在促进能够做出明智决策的赋权患者。
当今的HTA范围广泛，有众多利益相关者，其中没有一个比患者更重要。通过在HTA中提出以患者为导向的问题并在整个过程中更好地让患者参与，我们可以轻松促进患者赋权，从而使患者更有能力在医疗保健决策中发挥更积极的作用。
