Andellini Martina, Faggiano Francesco, Picardo Sergio Giuseppe, Testa Giuseppina, Perrotta Daniela, Bianchi Roberto, Nocchi Federico, Capussotto Carlo, Bassanelli Elena, Derrico Pietro, Pirozzi Nicola, Pecchia Leandro, Ritrovato Matteo
HTA Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Department of Anesthesia and Critical Care, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Children (Basel). 2021 Nov 1;8(11):986. doi: 10.3390/children8110986.
This paper is aimed at addressing all the critical aspects linked to the implementation of intensive care ventilators in a pediatric setting, highlighting the most relevant technical features and describing the methodology to conduct health technology assessment (HTA) for supporting the decision-making process. Four ventilator models were included in the assessment process. A decision-making support tool (DoHTA method) was applied. Twenty-eight Key Performance Indicators (KPIs) were identified, defining the safety, clinical effectiveness, organizational, technical, and economic aspects. The Performance scores of each ventilator have been measured with respect to KPIs integrated with the total cost of ownership analysis, leading to a final rank of the four possible technological solutions. The final technologies' performance scores reflected a deliver valued, contextualized, and shared outputs, detecting the most performant technological solution for the specific hospital context. HTA results had informed and supported the pediatric hospital decision-making process. This study, critically identifying the pros and cons of innovative features of ventilators and the evaluation criteria and aspects to be taken into account during HTA, can be considered as a valuable proof of evidence as well as a reliable and transferable method for conducting decision-making processes in a hospital context.
本文旨在探讨儿科环境中重症监护呼吸机实施过程中的所有关键方面,突出最相关的技术特征,并描述进行卫生技术评估(HTA)以支持决策过程的方法。评估过程中纳入了四种呼吸机型号。应用了一种决策支持工具(DoHTA方法)。确定了28个关键绩效指标(KPI),用于定义安全、临床有效性、组织、技术和经济方面。根据与总拥有成本分析相结合的KPI对每台呼吸机的性能得分进行了测量,得出了四种可能技术解决方案的最终排名。最终技术的性能得分反映了有价值、情境化且共享的输出结果,为特定医院环境检测出了性能最佳的技术解决方案。HTA结果为儿科医院的决策过程提供了信息并给予了支持。本研究批判性地确定了呼吸机创新特征的优缺点以及HTA期间要考虑的评估标准和方面,可被视为一份有价值的证据,也是在医院环境中进行决策过程的可靠且可推广的方法。