Selection of new health technologies for assessment aimed at informing decision making: A survey among horizon scanning systems
Uncertainty is pervasive in decision making on new health technologies; therefore, some countries have put systems in place to support decision makers with timely information. An important, but as yet undocumented, determinant of the potential value for decision making of these so-called horizon scanning systems (HSSs) is how the most significant health technologies are selected.
All thirteen member organizations of EuroScan, a collaborative network for HSSs, were surveyed and interviewed on how they prioritize technologies for assessment.
The majority of HSSs directly serves a customer. Some customers actively request early assessments of new health technologies, thereby diminishing the need for priority setting for the HSSs. All systems express a concern to miss an important technology and/or to select an unimportant technology. Almost all HSSs use explicit selection criteria, but these criteria hardly ever are operationalized. The number of criteria used varies, but costs and health benefit of the technology are always taken into account. The process of reaching a final decision is implicit, undocumented in all but one system, and is based on agreement by consensus.
The process of making the final decision on which technologies to assess can be improved by applying existing criteria more consistently and transparently. Current practice does not safeguard against missing an important technology. This finding is probably most important to act upon for systems with customers that do not actively request assessment of specific technologies.
Available from: David N. Bengston
- "Day and Schoemaker (2006) emphasize that scanning activities should begin with scoping to determine how broadly to search. Horizon scanning sometimes focuses on a particular domain considered to be most important, such as emerging technologies (Douw and Vondeling 2006), competitive or competitor intelligence (Ghoshal and Westney 1991), or a particular issue or set of issues. But scanning that is too focused will fail to detect signals of change in other domains, raising the risk of being blindsided by unexpected developments (Harris 2002). "
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ABSTRACT: Natural resource management organizations carry out a range of activities to examine possible future conditions and trends as part of their planning process, but the distinct approach of formal horizon scanning is often a missing component of strategic thinking and strategy development in these organizations. Horizon scanning is a process for finding and interpreting early indications of change in the external environment of an organization or field. Effective horizon scanning serves as an early warning system to identify potential opportunities and threats, enable decisionmakers to plan accordingly and take timely action, and foster a culture of foresight throughout an organization. This paper reviews and discusses the key items needed to create an effective horizon scanning system: conceptual frameworks, organizational approaches, design principles, techniques to improve effectiveness, and techniques for analyzing and interpreting scanning results.
Available from: Christopher P Price
- "Although criteria have been developed for priority setting of new health technologies for early assessment, these are generally applied to novel therapeutic agents and interventions . Selection criteria also differ significantly depending on the early awareness programme, and prioritisation is frequently implicit and undocumented [13,14]. "
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ABSTRACT: Currently there is no framework for those involved in the identification, evaluation and prioritisation of new diagnostic technologies. Therefore we aimed to develop prioritisation criteria for the assessment of new diagnostic technologies, by gaining international consensus on not only which criteria should be used, but also their relative importance.
A two-round Delphi process was used to generate consensus amongst an international panel of twenty-six experts on priority criteria for diagnostic health technology assessment. Participants represented a range of health care and related professions, including government, industry, health services and academia.
Based on the responses to the first questionnaire 18 criteria were placed into three categories: high, intermediate and moderate priority. For 16 of the 18 criteria, agreement with the categorisation of the criteria into the high, intermediate and moderate categories was high at > or = 70% (10 had agreement > or = 80%). A further questionnaire and panel discussion reduced the criteria to 16 and two categories; seven were classified as high priority and nine intermediate.
This study proposes an objective structure of prioritisation criteria to use when assessing new diagnostic technologies, based on an expert consensus process. The value of these criteria is that no one single component should be used as the decisive driver for prioritisation of new diagnostic technologies for adoption in healthcare settings. Future studies should be directed at establishing the value of these prioritisation criteria across a range of healthcare settings.
Available from: C. Wild
- "Despite the seemingly facile intention, several obstacles had to be faced. In comparison with the conclusions of Douw et al. in 2006 (5) on priority setting methods used in horizon scanning, it was concluded that the method for priority setting developed for the EUnetHTA newsletter is now the only formal priority setting method, or at least the only one published in this field. What this method adds, as opposed to an informal method, is that it addresses the same criteria for each potentially significant technology, it measures these criteria (i.e., major, moderate, minor impact), it scores the criteria, and it uses the final score to determine if a technology will be included in the newsletter (i.e., if it is prioritized). "
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