Abstract
Adequate methods are urgently needed to guarantee the good practice of health technology assessment (HTA) for technologies with novel properties. The aim of the study was to construct a conceptual framework to help understand the innovation of HTA methods (IHTAM). The construction of the IHTAM framework was based on two scoping reviews, one on the current practice of innovating methods, that is existing HTA frameworks, and one on theoretical foundations for innovating methods outside the HTA discipline. Both aimed to identify and synthesize concepts of innovation (i.e., innovation processes and roles of stakeholders in innovation). Using these concepts, the framework was developed in iterative brainstorming sessions and subsequent discussions with representatives from various stakeholder groups. The framework was constructed based on twenty documents on innovating HTA frameworks and fourteen guidelines from three scientific disciplines. It includes a generic innovation process consisting of three phases ("Identification," "Development," and "Implementation") and nine subphases. In the framework, three roles that HTA stakeholders can play in innovation ("Developers," "Practitioners," and "Beneficiaries") are defined, and a process on how the stakeholders innovate HTA methods is included. The IHTAM framework visualizes systematically which elements and stakeholders are important to the development and implementation of novel HTA methods. The framework could be used by all stakeholders involved in HTA innovation to learn how to engage dynamically and collaborate effectively throughout the innovation process. HTA stakeholders in practice have welcomed the framework, though additional testing of its applicability and acceptance is essential.
Highlights
We adopted a conceptual framework approach, which defines a network of concepts providing a comprehensive understanding of multidisciplinary phenomena and helping stakeholders understand knowledge from other disciplines [13]. We considered this approach most useful to facilitate understanding of the complexities associated with innovating health technology assessment (HTA) methods
The new framework was developed in two stages: first, identifying and synthesizing concepts of innovating HTA methods in two scoping reviews; and second, drafting the framework based on the concepts and refining the framework by gaining input from
Axial coding was used to identify how the concepts regarding innovation processes and those regarding stakeholder roles interact with each other, in other words, what roles HTA stakeholders could play and how their roles change along different phases of innovation
Summary
HTA methods refer to all qualitative and quantitative methods relevant to the full scope of the HTA process [3], such as methods for evidence generation from clinical or real-world data [4;5], methods for synthesizing HTA evidence and modeling cost-effectiveness [6], and tools for dealing with uncertainty in multi-criteria decision making for health care [7]. These methods vary by function and, if proven robust and implemented successfully, can improve the quality of HTA conducted throughout the HTA process
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