Oxford Centre for Monitoring and Diagnosis, Department of Primary Health Care, University of Oxford, Oxford OX3 7LF, UK.
BMC Health Serv Res. 2010 May 5;10:109. doi: 10.1186/1472-6963-10-109.
Currently there is no framework for those involved in the identification, evaluation and prioritisation of new diagnostic technologies. Therefore we aimed to develop prioritisation criteria for the assessment of new diagnostic technologies, by gaining international consensus on not only which criteria should be used, but also their relative importance.
A two-round Delphi process was used to generate consensus amongst an international panel of twenty-six experts on priority criteria for diagnostic health technology assessment. Participants represented a range of health care and related professions, including government, industry, health services and academia.
Based on the responses to the first questionnaire 18 criteria were placed into three categories: high, intermediate and moderate priority. For 16 of the 18 criteria, agreement with the categorisation of the criteria into the high, intermediate and moderate categories was high at > or = 70% (10 had agreement > or = 80%). A further questionnaire and panel discussion reduced the criteria to 16 and two categories; seven were classified as high priority and nine intermediate.
This study proposes an objective structure of prioritisation criteria to use when assessing new diagnostic technologies, based on an expert consensus process. The value of these criteria is that no one single component should be used as the decisive driver for prioritisation of new diagnostic technologies for adoption in healthcare settings. Future studies should be directed at establishing the value of these prioritisation criteria across a range of healthcare settings.
目前,尚缺乏用于识别、评估和优先考虑新诊断技术的框架。因此,我们旨在通过就应使用哪些标准以及这些标准的相对重要性达成国际共识,为新诊断技术的评估制定优先排序标准。
采用两轮 Delphi 法,就诊断卫生技术评估的优先排序标准,在 26 名国际专家组成的小组中达成共识。参与者代表了一系列医疗保健和相关专业,包括政府、工业、医疗服务和学术界。
根据第一轮调查问卷的回复,18 项标准被归入三个类别:高度优先、中度优先和低度优先。对于 18 项标准中的 16 项,将标准归入高度、中度和低度类别得到的共识度较高,大于等于 70%(有 10 项共识度大于等于 80%)。进一步的问卷和小组讨论将标准减少到 16 项和两个类别;7 项被归类为高度优先,9 项为中度优先。
本研究提出了一种基于专家共识过程的用于评估新诊断技术的客观优先排序标准结构。这些标准的价值在于,不应将任何单一标准作为在医疗保健环境中采用新诊断技术的决定性驱动因素。未来的研究应致力于在一系列医疗保健环境中确定这些优先排序标准的价值。