Fasterholdt Iben, Lee Anne, Kidholm Kristian, Yderstræde Knud Bonnet, Pedersen Kjeld Møller
CIMT - Centre for Innovative Medical Technology, Odense University Hospital, Sdr. Boulevard 29, Entrance 102, 3rd floor, 5000, Odense C, Denmark.
Department of Business and Economics, University of Southern Denmark, Odense, Denmark.
BMC Health Serv Res. 2018 Nov 6;18(1):837. doi: 10.1186/s12913-018-3647-z.
Hospitals increasingly make decisions about early development of and investment in innovative medical technologies (IMTs), but at present often without an early assessment of their potential to ensure selection of the most promising candidates for further development. This paper explores how early assessment is carried out in different health organisations and then discusses relevant learning points for hospitals.
A qualitative study design with a structured interview guide covering four themes was used. Content analyses of interview notes were performed covering four predetermined themes: context, basis for decision-making, process and structure, and perceptions. A fifth theme, handling cognitive bias, was identified during data analysis.
A total of 11 organisations participated; eight from the private health industry and three public hospitals. The interviews identified four areas in which early assessment is performed in similar manner across the studied organisations and four areas where differences exist between public hospitals and private organisations. Public hospitals indicate a lower degree of formalised early assessment and less satisfaction with how early assessment is performed, compared to private organisations. Based on the above findings, two learning points may carry promise for hospitals. First, having dedicated prioritising committees for IMTs making stop/go decisions. This committee is separate from the IMT development processes and involved staff. Secondly, the committee should base decisions on a transparent early assessment decision-support tool, which include a broad set of domains, is iterative, describes uncertainty, and minimise cognitive biases.
Similarities and differences in the way early assessment is done in different health organisations were identified. These findings suggest promising learning points for the development of an early assessment model for hospitals.
医院越来越多地对创新医疗技术(IMT)的早期开发和投资做出决策,但目前往往没有对其潜力进行早期评估,以确保选择最有前途的候选技术进行进一步开发。本文探讨了不同卫生组织如何进行早期评估,然后讨论了医院的相关经验教训。
采用定性研究设计,使用涵盖四个主题的结构化访谈指南。对访谈记录进行内容分析,涵盖四个预定主题:背景、决策依据、过程与结构以及看法。在数据分析过程中确定了第五个主题,即处理认知偏差。
共有11个组织参与;其中8个来自私立卫生行业,3个是公立医院。访谈确定了在所研究的组织中以类似方式进行早期评估的四个领域,以及公立医院和私立组织之间存在差异的四个领域。与私立组织相比,公立医院的早期评估形式化程度较低,对早期评估的执行方式满意度也较低。基于上述发现,有两个经验教训可能对医院有借鉴意义。第一,设立专门的IMT优先级委员会来做出继续/终止决策。该委员会独立于IMT开发流程及相关工作人员。第二,该委员会应基于一个透明的早期评估决策支持工具做出决策,该工具应涵盖广泛的领域,具有迭代性,描述不确定性,并尽量减少认知偏差。
确定了不同卫生组织进行早期评估方式的异同。这些发现为医院早期评估模型的开发提供了有前景的经验教训。