Southern California Evidence-Based Practice Center Site at the RAND Corporation, Santa Monica, California.
Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California.
JAMA Netw Open. 2018 Nov 2;1(7):e185108. doi: 10.1001/jamanetworkopen.2018.5108.
Health care costs have increased substantially over the past few decades, in part owing to the development and diffusion of new medical treatments. Forecasting potential future technologic innovations can allow for more informed planning.
To assess the predictive validity of a structured formal method for forecasting future technologic innovations in health care.
DESIGN, SETTING, AND PARTICIPANTS: This pilot study combined an untested, unvalidated combination of a consensus process and group judgment process to evaluate forecasts made in 2001 for technologic innovations by 2021 in Alzheimer disease (AD) and cardiovascular disease (CVD). Six experts in AD and 7 experts in CVD composed the judgment group. The study was conducted in 2017-2018.
Year 2001 forecasts for 2021 that were judged by experts as being close to correct, directionally correct, or not correct, as well as innovations that occurred since 2001 that were not predicted.
Four forecasts of innovations in AD, each considered to be between 30% and 40% likely to be achieved by 2021, were judged to be close to correct. One forecast was considered to be directionally correct, with a likelihood of occurrence of 40%, in that it was overoptimistic. One innovation that occurred was missed: new imaging techniques (amyloid β plaque and tau tangle positron emission tomographic imaging). Five forecasts of CVD innovations were considered to be at least 50% likely to occur by 2021, and of these, 2 were judged to be close to correct, 1 was judged as being directionally correct, and 2 were judged as being not correct (although in one of these forecasts, the overarching innovation has been achieved but with a different noninvasive imaging modality). Of 7 additional forecasts considered to be less likely to be achieved by 2021, 4 were judged to be close to correct and 3 were judged as being directionally correct. Two innovations occurred but were missed: transcatheter aortic valve replacement and cardiac resynchronization therapy. Across both conditions, 15 of 17 innovations forecasted were judged to be close to correct or directionally correct, 2 were judged to be incorrect, and there were 3 missed innovations.
Expert elicitation provided a useful, but not fully accurate, lens into future innovation.
在过去几十年中，医疗保健成本大幅增加，部分原因是新医疗技术的开发和普及。预测潜在的未来技术创新可以为更明智的规划提供依据。
评估一种用于预测医疗保健未来技术创新的结构化正式方法的预测有效性。
设计、设置和参与者：这项初步研究结合了未经测试、未经验证的共识过程和群体判断过程，以评估 2001 年对 2021 年阿尔茨海默病 (AD) 和心血管疾病 (CVD) 技术创新的预测。6 名 AD 专家和 7 名 CVD 专家组成了判断小组。该研究于 2017-2018 年进行。
专家判断为接近正确、方向正确或不正确的 2001 年 2021 年预测，以及自 2001 年以来未预测到的创新。
四项 AD 创新预测被认为在 2021 年有 30%-40%的可能性实现，被判断为接近正确。一项预测被认为是方向正确的，发生的可能性为 40%，因为它过于乐观。一项已经发生的创新被遗漏了：新的成像技术（淀粉样β斑块和 tau 缠结正电子发射断层扫描成像）。五项 CVD 创新预测被认为在 2021 年有至少 50%的可能性发生，其中两项被判断为接近正确，一项被判断为方向正确，两项被判断为不正确（尽管在其中一项预测中，主要创新已经实现，但采用了不同的非侵入性成像方式）。另外 7 项被认为不太可能在 2021 年实现的预测中，有 4 项被判断为接近正确，3 项被判断为方向正确。有两项创新已经发生但被遗漏了：经导管主动脉瓣置换术和心脏再同步治疗。在这两种情况下，17 项预测中有 15 项被判断为接近正确或方向正确，2 项被判断为不正确，有 3 项创新被遗漏。
专家启发法为未来创新提供了一个有用但不完全准确的视角。
