ScHARR,University of Sheffield.
Department of Health Services Research,University of Bremen.
Int J Technol Assess Health Care. 2017 Jan;33(5):552-561. doi: 10.1017/S026646231700068X. Epub 2017 Sep 4.
Internationally, funders require stakeholder involvement throughout health technology assessment (HTA). We report successes, challenges, and lessons learned from extensive stakeholder involvement throughout a palliative care case study that demonstrates new concepts and methods for HTA.
A 5-step "INTEGRATE-HTA Model" developed within the INTEGRATE-HTA project guided the case study. Using convenience or purposive sampling or directly / indirectly identifying and approaching individuals / groups, stakeholders participated in qualitative research or consultation meetings. During scoping, 132 stakeholders, aged ≥ 18 years in seven countries (England, Italy, Germany, The Netherlands, Norway, Lithuania, and Poland), highlighted key issues in palliative care that assisted identification of the intervention and comparator. Subsequently stakeholders in four countries participated in face-face, telephone and / or video Skype meetings to inform evidence collection and / or review assessment results. An applicability assessment to identify contextual and implementation barriers and enablers for the case study findings involved twelve professionals in the three countries. Finally, thirteen stakeholders participated in a mock decision-making meeting in England.
Views about the best methods of stakeholder involvement vary internationally. Stakeholders make valuable contributions in all stages of HTA; assisting decision making about interventions, comparators, research questions; providing evidence and insights into findings, gap analyses and applicability assessments. Key challenges exist regarding inclusivity, time, and resource use.
Stakeholder involvement is feasible and worthwhile throughout HTA, sometimes providing unique insights. Various methods can be used to include stakeholders, although challenges exist. Recognition of stakeholder expertise and further guidance about stakeholder consultation methods is needed.
在国际上，资助者要求在整个卫生技术评估（HTA）中让利益相关者参与进来。我们报告了在姑息治疗案例研究中广泛的利益相关者参与所取得的成功、挑战和经验教训，该案例研究展示了 HTA 的新概念和新方法。
在 INTEGRATE-HTA 项目中开发的 5 步“INTEGRATE-HTA 模型”指导了该案例研究。通过便利抽样或目的抽样，或直接/间接确定和接触个人/团体，利益相关者参与了定性研究或磋商会议。在范围界定阶段，来自七个国家（英国、意大利、德国、荷兰、挪威、立陶宛和波兰）的 132 名年龄≥18 岁的利益相关者强调了姑息治疗中的关键问题，这些问题有助于确定干预措施和对照措施。随后，来自四个国家的利益相关者参加了面对面、电话和/或视频 Skype 会议，为证据收集和/或审查评估结果提供信息。为了识别案例研究结果的背景和实施障碍及促进因素，对三个国家的 12 名专业人员进行了适用性评估。最后，在英国，13 名利益相关者参加了一次模拟决策会议。
国际上对利益相关者参与的最佳方法的看法存在差异。利益相关者在 HTA 的所有阶段都做出了有价值的贡献；协助干预措施、对照措施、研究问题的决策；为发现、差距分析和适用性评估提供证据和见解。在包容性、时间和资源利用方面存在关键挑战。
利益相关者参与在 HTA 中是可行且值得的，有时可以提供独特的见解。可以使用各种方法来让利益相关者参与进来，尽管存在挑战。需要承认利益相关者的专业知识，并进一步指导利益相关者咨询方法。
