Fuchs Sabine, Olberg Britta, Panteli Dimitra, Perleth Matthias, Busse Reinhard
Department of Health Care Management, Berlin University of Technology, Germany.
Department of Health Care Management, Berlin University of Technology, Germany; Medical Consultancy Department, Federal Joint Committee (G-BA), Germany.
Health Policy. 2017 Mar;121(3):215-229. doi: 10.1016/j.healthpol.2016.08.010. Epub 2016 Sep 14.
Health Technology Assessment (HTA) of Medical devices (MDs) and MD-based procedures can be challenging due to the unique features and particularities of this group of technologies, such as device-operator interaction. The aim of this study was to (1) clarify, and supplement earlier findings on European HTA institutions' structural, procedural and methodological characteristics with regard to the assessment of MDs and to (2) capture the institutions' perceptions regarding challenges and future trends.
Semi-structured telephone interviews with 16 representatives from leading European HTA institutions were performed between April and July 2015. Summative and directed content analysis was used for the analysis, which is reported according to the COREQ checklist.
Findings from the analysis of the interviews were manifold and partially confirmed what has been noted in the literature (e.g. scarce evidence; identifying relevant studies challenging due to more incremental innovations). Additional themes emerged that can be important for future considerations by HTA institutions and policy-makers alike (e.g. areas for future research; need for specific tools).
The collective opinion of 16 European HTA institutions on MD evaluation could provide ideas to ameliorate the current regulatory situation beyond the modified EU regulation and start broader, more in-depth methodological discussions around the issue. Interviewed experts seem to agree that new approaches such as coverage with evidence development as some countries already introduced could help to overcome the problem with scarce evidence.
由于医疗设备(MDs)及其相关程序具有独特的特性和特殊性,如设备与操作人员的交互,对其进行卫生技术评估(HTA)可能具有挑战性。本研究的目的是:(1)澄清并补充早期关于欧洲卫生技术评估机构在评估医疗设备方面的结构、程序和方法学特征的研究结果;(2)了解这些机构对挑战和未来趋势的看法。
2015年4月至7月间,对欧洲领先的卫生技术评估机构的16名代表进行了半结构化电话访谈。采用总结性和定向性内容分析法进行分析,并根据COREQ清单进行报告。
访谈分析结果是多方面的,部分证实了文献中所指出的内容(如证据稀缺;由于创新的渐进性更强,确定相关研究具有挑战性)。还出现了一些对卫生技术评估机构和政策制定者未来考虑可能很重要的其他主题(如未来研究领域;对特定工具的需求)。
16个欧洲卫生技术评估机构对医疗设备评估的集体意见,可为改善当前欧盟法规修订之外的监管状况提供思路,并围绕该问题展开更广泛、更深入的方法学讨论。受访专家似乎一致认为,一些国家已经采用的诸如证据开发覆盖等新方法,有助于克服证据稀缺的问题。