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健康技术评估中获益-风险评估的方法学指南和出版物:范围综述。

Methodological guidelines and publications of benefit-risk assessment for health technology assessment: a scoping review.

机构信息

Departamento de Medicina Preventiva, Faculdade de Medicina - FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil

Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria.

出版信息

BMJ Open. 2024 Jun 8;14(6):e086603. doi: 10.1136/bmjopen-2024-086603.

Abstract

OBJECTIVES

To map the available methodological guidelines and documents for conducting and reporting benefit-risk assessment (BRA) during health technologies' life cycle; and to identify methodological guidelines for BRA that could serve as the basis for the development of a BRA guideline for the context of health technology assessment (HTA) in Brazil.

DESIGN

Scoping review.

METHODS

Searches were conducted in three main sources up to March 2023: (1) electronic databases; (2) grey literature (48 HTA and regulatory organisations) and (3) manual search and contacting experts. We included methodological guidelines or publications presenting methods for conducting or reporting BRA of any type of health technologies in any context of the technology's life cycle. Selection process and data charting were conducted by independent reviewers. We provided a structured narrative synthesis of the findings.

RESULTS

From the 83 eligible documents, six were produced in the HTA context, 30 in the regulatory and 35 involved guidance for BRA throughout the technology's life cycle. We identified 129 methodological approaches for BRA in the documents. The most commonly referred to descriptive frameworks were the Problem, Objectives, Alternatives, Consequences, Trade-offs, Uncertainty, Risk and Linked decisions and the Benefit-Risk Action Team. Multicriteria decision analysis was the most commonly cited quantitative framework. We also identified the most cited metric indices, estimation and utility survey techniques that could be used for BRA.

CONCLUSIONS

Methods for BRA in HTA are less established. The findings of this review, however, will support and inform the elaboration of the Brazilian methodological guideline on BRA for HTA.

TRIAL REGISTRATION NUMBER

https://doi.org/10.17605/OSF.IO/69T3V.

摘要

目的

绘制用于在卫生技术生命周期中进行和报告获益-风险评估(BRA)的现有方法学指南和文件;并确定可作为巴西卫生技术评估(HTA)背景下 BRA 指南制定基础的 BRA 方法学指南。

设计

范围综述。

方法

截至 2023 年 3 月,在三个主要来源中进行了搜索:(1)电子数据库;(2)灰色文献(48 个 HTA 和监管组织)和(3)手动搜索和联系专家。我们纳入了方法学指南或出版物,介绍了在卫生技术生命周期的任何背景下进行或报告任何类型的卫生技术的 BRA 的方法。选择过程和数据图表由独立审查员进行。我们对研究结果进行了结构叙述性综合。

结果

从 83 份合格文件中,有 6 份是在 HTA 背景下编制的,30 份是在监管背景下编制的,35 份涉及贯穿技术生命周期的 BRA 指南。我们在文件中确定了 129 种 BRA 方法学方法。最常提到的描述性框架是问题、目标、替代方案、后果、权衡、不确定性、风险和关联决策以及获益-风险行动团队。多标准决策分析是最常引用的定量框架。我们还确定了最常引用的指标指数、估计和效用调查技术,可用于 BRA。

结论

HTA 中的 BRA 方法尚不成熟。然而,本综述的结果将支持和为巴西 HTA 中的 BRA 方法学指南的制定提供信息。

试验注册编号

https://doi.org/10.17605/OSF.IO/69T3V。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91c1/11163601/9bfd44efa85d/bmjopen-2024-086603f01.jpg

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