Hopkin Gareth, Branson Richard, Campbell Paul, Coole Holly, Cooper Sophie, Edelmann Francesca, Salmon Mark
Science Evidence and Analytics Directorate, National Institute for Health and Care Excellence (NICE), Manchester, England, UK.
Software Team, Healthcare Quality and Access Group, Medicines and Healthcare products Regulatory Agency, London, England, UK.
Digit Health. 2024 Nov 4;10:20552076241293313. doi: 10.1177/20552076241293313. eCollection 2024 Jan-Dec.
Digital mental health technologies (DMHTs) are becoming well established within mental health services and through direct-to-consumer models. Due to their scalable nature, DMHTs may support services to bridge the gap between demand and the available workforce, particularly where existing pathways have long delays or restricted capacity. Challenges and risks associated with DMHTs also need consideration. Regulatory and health technology assessment (HTA) agencies play a key role in ensuring the potential of DMHTs is achieved and their risks are mitigated. However, the nature of DMHTs and advances in digital technology present challenges for regulation and evaluation. In this paper, we describe eight key considerations across the regulatory and HTA pathway for DMHTs. These relate to 1) intended purpose, 2) qualification and classification, 3) risk management, 4) clinical evidence, 5) resource requirements and economic evidence, 6) post-market surveillance and life cycle assessment, 7) replicability and equity, and 8) wider responsibilities. Ensuring clarity within these considerations and addressing outstanding uncertainties is necessary to ensure that the benefits of DMHTs are unlocked, while also ensuring that people have access to high quality and safe tools.
数字心理健康技术(DMHTs)正在心理健康服务领域以及通过直接面向消费者的模式逐渐确立起来。由于其可扩展的特性,DMHTs 可以支持心理健康服务弥合需求与现有劳动力之间的差距,特别是在现有途径存在长时间延误或能力受限的情况下。与 DMHTs 相关的挑战和风险也需要加以考虑。监管机构和卫生技术评估(HTA)机构在确保实现 DMHTs 的潜力并降低其风险方面发挥着关键作用。然而,DMHTs 的性质和数字技术的进步给监管和评估带来了挑战。在本文中,我们描述了 DMHTs 在监管和 HTA 流程中的八个关键考量因素。这些因素涉及:1)预期用途;2)资格认定和分类;3)风险管理;4)临床证据;5)资源需求和经济证据;6)上市后监测和生命周期评估;7)可复制性和平等性;8)更广泛的责任。确保这些考量因素清晰明确并解决悬而未决的不确定性对于释放 DMHTs 的益处至关重要,同时也要确保人们能够使用高质量且安全的工具。
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