Esmail Rosmin, Hanson Heather, Holroyd-Leduc Jayna, Niven Daniel J, Clement Fiona
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D14A Teaching and Wellness Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
Alberta Health Services, Calgary, Alberta, Canada.
BMC Health Serv Res. 2018 Aug 30;18(1):674. doi: 10.1186/s12913-018-3494-y.
Health Technology Reassessment (HTR) is an emerging field that shifts the focus from traditional methods of technology adoption to managing technology throughout its lifecycle. HTR is a mechanism to improve patient care and system efficiency through a reallocation of resources away from low-value care towards interventions and technologies that are high value. To achieve this, the outputs of HTR and its recommendations must be translated into practice. The evolving field of knowledge translation (KT) can provide guidance to improve the uptake of evidence-informed policies and recommendations resulting from the process of HTR. This paper argues how the theories, models and frameworks from KT could advance the HTR process.
First, common KT theories, models and frameworks are presented. Second, facilitators and barriers to KT within the context of HTR are summarized from the literature. Facilitators and barriers to KT include ensuring a solid research evidence-base for the technology under reassessment, assessing the climate and context, understanding the social an political context, initiating linkage and exchange, having a structured HTR Process, adequate resources, and understanding the roles of researchers, knowledge users, and stakeholders can enhance knowledge translation of HTR outputs. Third, three case examples at the individual (micro), organizational (meso), and policy (macro) levels are used to illustrate to describe how a KT theory, model or framework could be applied to a HTR project. These case studies show how selecting and applying KT theories, models and frameworks can facilitate the implementation of HTR recommendations.
HTR and KT are synergistic processes that can be used to optimize technology use throughout its lifecycle. We argue that the application of KT theories, models and frameworks, and the assessment of barriers and facilitators to KT can facilitate translation of HTR recommendations into practice.
卫生技术评估（HTR）是一个新兴领域，它将重点从传统的技术采用方法转移到在技术的整个生命周期内对其进行管理。HTR是一种通过将资源从低价值护理重新分配到高价值的干预措施和技术来改善患者护理和系统效率的机制。为实现这一目标，HTR的产出及其建议必须转化为实践。不断发展的知识转化（KT）领域可以为提高HTR过程中基于证据的政策和建议的采纳率提供指导。本文论述了KT的理论、模型和框架如何推动HTR过程。
首先，介绍了常见的KT理论、模型和框架。其次，从文献中总结了HTR背景下KT的促进因素和障碍。KT的促进因素和障碍包括为重新评估的技术确保坚实的研究证据基础、评估环境和背景、理解社会和政治背景、建立联系和交流、拥有结构化的HTR过程、充足的资源，以及理解研究人员、知识使用者和利益相关者的角色可以提高HTR产出的知识转化。第三，使用个体（微观）、组织（中观）和政策（宏观）层面的三个案例来说明KT理论、模型或框架如何应用于HTR项目。这些案例研究展示了选择和应用KT理论、模型和框架如何促进HTR建议的实施。
HTR和KT是协同过程，可用于在技术的整个生命周期内优化技术使用。我们认为，应用KT理论、模型和框架以及评估KT的障碍和促进因素可以促进将HTR建议转化为实践。
