Pimenta João Félix, Vieira Ana C L
CEGIST, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal.
Appl Health Econ Health Policy. 2025 Jun 7. doi: 10.1007/s40258-025-00981-w.
Efficient resource allocation in the health technology assessment process of medical devices requires a robust selection and prioritization of medical devices for evaluation. Despite its importance, there is currently no generally accepted approach for such a prioritization task, and a comprehensive review of adaptable approaches is needed.
Our study aimed to provide a comprehensive review of existing approaches that could be used or adapted to select and prioritize medical devices for health technology assessment (HTA) evaluation.
Searches were conducted in PubMed, Web of Science, Scopus, and the databases of the International Network of Agencies for Health Technology Assessment and the Centre for Reviews and Dissemination. Following the screening, analyses and comparisons were based on data such as publication year, target jurisdiction, decision context, health technology focus, methods used for value assessment and included attributes, and the social methods used for stakeholder engagement.
From 1055 identified records, 51 studies were eligible for review. Only 31 records mentioned the value assessment method used and, although there was a wide variety of techniques found in this sample, the majority of them (77%) applied multicriteria decision analysis. A total of 22 studies were specifically focused on HTA prioritization and, within this set, the most frequently used value attributes were Clinical efficacy and/or effectiveness (n = 21, 95%), Impact of the disease (n = 13, 59%), and Ethical, social and legal aspects (n = 11, 50%). Social methods commonly implemented were questionnaires/surveys and the Delphi technique, with 15 and 7 reported applications, respectively.
A wide variety of methods have been reported to assess value in HTA contexts, and our premise that a generally accepted approach for prioritizing medical devices for HTA is still lacking was confirmed. Despite such heterogeneity, it was noticed that a multicriteria decision analysis is predominantly applied, with both intervention- and disease-related attributes being considered. Underreporting of the approaches used was recurrent, which should be avoided in the future to ensure their transparency and replicability.
在医疗设备的卫生技术评估过程中，高效的资源分配需要对用于评估的医疗设备进行有力的筛选和排序。尽管其很重要，但目前尚无普遍接受的方法来完成这种排序任务，因此需要对适用方法进行全面综述。
我们的研究旨在对可用于或经改编后用于筛选医疗设备并对其进行排序以进行卫生技术评估（HTA）评价的现有方法进行全面综述。
在PubMed、科学网、Scopus以及卫生技术评估机构国际网络和综述与传播中心的数据库中进行检索。筛选之后，基于诸如出版年份、目标辖区、决策背景、卫生技术重点、用于价值评估的方法及包含的属性，以及用于利益相关者参与的社会方法等数据进行分析和比较。
从1055条识别出的记录中，有51项研究符合综述条件。只有31条记录提及所使用的价值评估方法，尽管在该样本中发现了各种各样的技术，但其中大多数（77%）应用了多标准决策分析。共有22项研究专门关注HTA排序，在此组研究中，最常用的价值属性是临床疗效和/或有效性（n = 21，95%）、疾病影响（n = 13，59%）以及伦理、社会和法律方面（n = 11，50%）。常用的社会方法是问卷调查和德尔菲技术，分别报告了15次和7次应用。
已报告了多种在HTA背景下评估价值的方法，我们关于仍缺乏用于对HTA医疗设备进行排序的普遍接受方法的前提得到了证实。尽管存在这种异质性，但注意到多标准决策分析被广泛应用，同时考虑了与干预和疾病相关的属性。所使用方法的报告不足情况屡见不鲜，未来应避免这种情况以确保其透明度和可重复性。
