Departamento de Economía, Universidad Nacional del Sur, Bahia Blanca, Argentina.
Instituto de Investigaciones Epidemiológicas de la Academia Nacional de Medicina de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
Int J Technol Assess Health Care. 2020;36(1):50-57. doi: 10.1017/S0266462319000734. Epub 2019 Dec 13.
To synthetize the state of the art of methods for identifying candidate technologies for disinvestment and propose an evidence-based framework for executing this task.
An interpretative review was conducted. A systematic literature search was performed to identify secondary or tertiary research related to disinvestment initiatives and/or any type of research that specifically described one or more methods for identifying potential candidates technologies, services, or practices for disinvestment. An iterative and critical analysis of the methods described alongside the disinvestment initiatives was performed.
Seventeen systematic reviews on disinvestment or related terms (health technology reassessment or medical reversal) were retrieved and methods of 45 disinvestment initiatives were compared. On the basis of this evidence, we proposed a new framework for identifying these technologies based on the wide definition of evidence provided by Lomas et al. The framework comprises seven basic approaches, eleven triggers and thirteen methods for applying these triggers, which were grouped in embedded and ad hoc methods.
Although identification methods have been described in the literature and tested in different contexts, the proliferation of terms and concepts used to describe this process creates considerable confusion. The proposed framework is a rigorous and flexible tool that could guide the implementation of strategies for identifying potential candidates for disinvestment.
综合评估用于识别撤资候选技术的方法现状，并提出一个基于证据的执行该任务的框架。
进行了解释性综述。进行了系统的文献检索，以确定与撤资举措相关的二级或三级研究，或任何专门描述一种或多种用于识别撤资潜在候选技术、服务或实践的方法的研究。对描述撤资举措的方法进行了迭代和批判性分析。
检索到 17 篇关于撤资或相关术语（卫生技术重新评估或医疗逆转）的系统评价，并比较了 45 项撤资举措的方法。基于这些证据，我们根据 Lomas 等人提供的广泛证据定义，提出了一种新的识别这些技术的框架。该框架包括七种基本方法、十一个触发因素和十三种应用这些触发因素的方法，这些方法分为嵌入式方法和特定用途方法。
尽管文献中已经描述了识别方法并在不同背景下进行了测试，但用于描述这一过程的术语和概念的大量增加造成了相当大的混乱。所提出的框架是一个严格而灵活的工具，可以指导识别撤资潜在候选者的策略的实施。
