Douma Kirsten F L, Karsenberg Kim, Hummel Marjan J M, Bueno-de-Mesquita Jolien M, van Harten Wim H
The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan, The Netherlands.
Int J Technol Assess Health Care. 2007 Spring;23(2):162-8. doi: 10.1017/S0266462307070262.
Technologies in health care are evolving quickly, with new findings in the area of biotechnological and genetic research being published regularly. A health technology assessment (HTA) is often used to answer the question of whether the new technology should be implemented into clinical practice. International evidence confirms that the results of HTA research sometimes have limited impact on practical implementation and on coverage decisions; the study design is commonly based on the paradigm of stability of both the technology and the environment, which is often not the case. Constructive technology assessment (CTA) was first described in the 1980s. In addition to the traditional HTA elements, this approach also takes into account the technology dynamics by emphasizing sociodynamic processes. With a CTA approach, comprehensive assessment can be combined with an intentional influence in a favorable direction to improve quality.
In this study, the methodological aspects mainly concerning the diagnostic use of CTA are explained. The methodology will be illustrated using the controlled introduction of a new technology, called microarray analysis, into the clinical practice of breast cancer treatment as a case study. Attention is paid to the operationalization of the phases of development and implementation and the research methods most appropriate for CTA.
In addition to HTA, CTA can be used as a complementary approach, especially in technologies that are introduced in an early stage of development in a controlled way.
医疗保健技术发展迅速，生物技术和基因研究领域新发现定期发表。卫生技术评估（HTA）常被用于回答新技术是否应应用于临床实践的问题。国际证据证实，HTA研究结果有时对实际应用和覆盖决策的影响有限；研究设计通常基于技术和环境稳定性的范式，但实际情况往往并非如此。建设性技术评估（CTA）最早在20世纪80年代被描述。除了传统的HTA要素外，这种方法还通过强调社会动态过程来考虑技术动态。采用CTA方法，可以将全面评估与朝着有利方向的有意影响相结合，以提高质量。
在本研究中，主要解释了与CTA诊断应用相关的方法学方面。将以向乳腺癌治疗临床实践中控制性引入一种名为微阵列分析的新技术为例，说明该方法。关注开发和实施阶段的操作化以及最适合CTA的研究方法。
除了HTA外，CTA可作为一种补充方法，特别是在以可控方式在开发早期引入的技术中。
