Abstract
BackgroundPublic engagement in health technology assessment (HTA) is increasing worldwide. There are several forms of public engagement and it is not always possible to determine which stakeholders participate in the HTA process and how they contribute. Our objective was to investigate which types of social representatives contributed to the public consultation on the incorporation of Trastuzumab for early-stage breast cancer treatment within the public health system in Brazil, held in 2012 by the National Committee for Health Technology Incorporation (CONITEC).MethodsA mixed methods approach was used to analyze social representativeness and the composition of the corpus from the public consultation, which consisted of 127 contributions. Three types of analysis were performed using IRaMuTeQ software: classic lexical analysis, descending hierarchical classification and specificities analysis. The contributions were clustered according to the main categories of discourse observed, into four social representation categories: 1) patient representation/advocacy; 2) pharmaceutical industry/advocacy; 3) healthcare professionals; and 4) individual contributions.ResultsCategory 1 contained words related to increased survival due to use of the drug and a low score for words pertaining to studies on Trastuzumab. The word “safety” obtained a positive score only in category 2, which was also the only category that exhibited a negative score for the word “risk”. Category 3 displayed the lowest scores for “diagnosis” and “safety”. The word “efficacy” had a negative score only in category 4.ConclusionsEach category exhibited different results for words related to health systems and to key concepts linked to HTA. Our analysis enabled the identification of the most prominent contributions for each category. Despite the promising results obtained, further research is needed to validate this software for use in analyzing public contributions.
Highlights
Public engagement in health technology assessment (HTA) is increasing worldwide
We carried out a grounded theoryinspired case study to describe the types of discourses that could be identified by deploying IRaMuTeQ as a tool to transparently and systematically analyse complex corpus linguistics from questionnaires and forms used in public consultations, as this developed by the HTA agency of Ministry of Health of Brazil
Characteristics of the Corpus The corpus consisted of 114 texts, separated into 685 text segments (TS), 542 of which were used, corresponding to 79.12% of the total
Summary
Public engagement in health technology assessment (HTA) is increasing worldwide. There are several forms of public engagement and it is not always possible to determine which stakeholders participate in the HTA process and how they contribute. The outcomes of determining and assessing patient engagement in HTA can be difficult to identify, quantify and qualify because of the social participation strategies implemented by HTA agencies [4]. Available publications on examples of experiences of public engagement in HTA indicate that the perspective of health system users can add important dimensions to the decision-making process within HTA [8]. In Brazil, society can be present in several stages of the process of evaluating and incorporating technologies into the National Health System (SUS), acting as consumers of technology incorporation, participating in public consultations or hearings, or taking part in CONITEC (National Committee for Health Technology Incorporation) board meetings as patient representatives [9, 10]. In 2015, CONITEC adopted a strategy aiming at improving the understanding of general public on HTA evidence by means of plain-language summaries called report to society (relatório para sociedade in Portuguese)
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