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利用专家判断贯穿 NICE 指南制定项目:对当前流程的审查和现有工具对支持专家启发式应用的适用性。

Use of Expert Judgement Across NICE Guidance-Making Programmes: A Review of Current Processes and Suitability of Existing Tools to Support the Use of Expert Elicitation.

机构信息

York Health Economics Consortium, Enterprise House, Innovation Way, University of York, York, UK.

National Institute of Health and Care Excellence, London, UK.

出版信息

Appl Health Econ Health Policy. 2018 Dec;16(6):819-836. doi: 10.1007/s40258-018-0415-5.

Abstract

OBJECTIVES

This study aimed to review current use of experts within National Institute for Health and Care Excellence (NICE) guidance-making programmes, identify improvements in use of expert judgement, and to assess tools and protocols to support the elicitation of information from experts for use by NICE.

METHODS

The study comprised a review of NICE process guides; semi-structured interviews with individuals representing each NICE guidance-making programme and a comparison of the suitability of currently available tools and protocols for expert elicitation to the requirements of NICE programmes.

RESULTS

Information elicited from experts and the way in which it is used varies across NICE guidance-making programmes. Experts' involvement can be as intensive as being a member of a committee and thus having direct influence on recommendations or limited one-off consultations on specific parameters. We identified 16 tools for expert elicitation that were potentially relevant. None fully met the requirements of NICE, although an existing tool could be potentially adapted. Ongoing research to develop a reference protocol for expert elicitation in healthcare decision making may be of use in future.

CONCLUSIONS

NICE uses expert judgement across all its guidance-making programmes, but its uses vary considerably. There is no currently available tool for expert elicitation suitable for use by NICE. However, adaptation of an existing tool or ongoing research in the area could address this in the future.

摘要

目的

本研究旨在回顾英国国家卫生与临床优化研究所(NICE)指南制定项目中专家的使用现状,明确专家判断使用方面的改进,并评估支持从 NICE 使用的专家处获取信息的工具和方案。

方法

该研究包括对 NICE 流程指南的审查;对每个 NICE 指南制定项目的代表进行半结构化访谈,并比较当前可用的专家 elicitation 工具和方案与 NICE 项目要求的适用性。

结果

NICE 指南制定项目中专家所获取的信息及其使用方式存在差异。专家的参与程度可能非常高,例如成为委员会成员,从而对建议有直接影响,或者对特定参数进行一次性的有限咨询。我们确定了 16 种潜在相关的专家 elicitation 工具。没有一种工具完全符合 NICE 的要求,尽管现有的工具可能可以进行适当的调整。目前正在进行开发医疗保健决策中专家 elicitation 的参考方案的研究,将来可能会有所帮助。

结论

NICE 在其所有指南制定项目中都使用了专家判断,但使用方式存在很大差异。目前没有适合 NICE 使用的专家 elicitation 工具。但是,对现有工具的调整或该领域的持续研究将来可能会解决这个问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7815/6244638/48b81ba1620f/40258_2018_415_Fig1_HTML.jpg

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