International journal of technology assessment in health care
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The evidence supporting the use of new, or established, interventions may be derived from either (or both) experimental or observational study designs. Although a rigorous examination of the evidence base for clinical and cost-effectiveness is essential, it is never sufficient, and those undertaking a health technology assessment (HTA) also have to exercise judgments. ⋯ How scientific and social value judgments might be most appropriately captured is a challenge for all HTA agencies. Although competent HTA bodies should be able to exercise scientific judgments they have no legitimacy to impose their own social values. These must ultimately be informed by the general public.
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Int J Technol Assess Health Care · Jan 2014
Harmonization of ethics in health technology assessment: a revision of the Socratic approach.
Ethics has been part of health technology assessment (HTA) from its beginning in the 1970s, and is currently part of HTA definitions. Several methods in ethics have been used in HTA. Some approaches have been developed especially for HTA, such as the Socratic approach, which has been used for a wide range of health technologies. The Socratic approach is used in several ways, and there is a need for harmonization to promote its usability and the transferability of its results. Accordingly, the objective of this study was to stimulate experts in ethics and HTA to revise the Socratic approach. ⋯ The presented revision of the Socratic approach is the result of a joint effort of experts in the field of ethics and HTA. Consensus is reached in the expert panel on an approach that is considered to be more clear, comprehensive, and applicable for addressing ethical issues in HTA.
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Int J Technol Assess Health Care · Oct 2013
Comparative StudyTelemedical versus conventional heart patient monitoring: a survey study with German physicians.
In this study, we explored crucial factors that explain a person's attitude toward and his or her assessment of telemedical systems. Special focus lies on the link between the perspective of physicians (telemedicine users) and technicians (telemedicine designers) to find potential barriers hindering the broad application of telemedical systems in hospitals and doctors' offices. ⋯ The perceived drawbacks are attributed to a general uncertainty about the reliability of telemedical systems, in combination with concerns about personal data privacy, security, and loss of control. The reported fear of not being able to correctly use and handle the systems assumes a low usability of devices. To acquaint medical professionals with the benefits and limitations of telemedical systems, telemonitoring and tele-treatment should be included in the education of medical personnel at an early stage.
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Int J Technol Assess Health Care · Jul 2013
Collaboration in health technology assessment (EUnetHTA joint action, 2010-2012): four case studies.
The aim of this study was to present the first four collaborative health technology assessment (HTA) processes on health technologies of different types and life cycles targeted toward diverse HTA users and facilitators, as well as the barriers of these collaborations. ⋯ Timely and efficient, different collaborative HTA processes on relative efficacy/effectiveness and safety on different types and life cycles of health technologies, targeted toward diverse HTA users in Europe are possible. There are still barriers to overcome.
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Int J Technol Assess Health Care · Jul 2013
Review Meta AnalysisEpidural steroid injection therapy for low back pain: a meta-analysis.
The aim of this study was to systematically assess the long-term (≥ 6 months) benefits of epidural steroid injection therapies for patients with low back pain. ⋯ A long-term benefit of epidural steroid injections for low back pain was not suggested at 6 months or longer. Introduction of selection bias in the majority of injection studies seems apparent. Baseline adjustment is essential when we evaluate pain as a main outcome of injection therapy.