EUnetHTA Training course for Stakeholders - Introduction to the HTA Core Model® and core HTA information

European network for Health Technology Assessment | JA2 2012-2015 | www.eunethta.eu
Introduction to
the HTA Core Model® and core
HTA information
EUnetHTA Training Course for Stakeholders
Rome, 29 Oct 2014
Kristian Lampe, THL/FINOHTA

European network for Health Technology Assessment | JA2 2012-2015 | www.eunethta.euEuropean network for Health Technology Assessment | JA2 2012-2015 | www.eunethta.eu
Background and purpose
2

• To capture the shareable ”core” of HTA
• To enable production of structured HTA
information and sharing the acquired knowledge
• To support joint HTA production
• To support local HTA production
Key aims of the HTA Core Model
3

How do we perceive HTA,
i.e. how to split the onion?

What is the Core?
- Two options for splitting the onion
Technology assessment in health care is a
multidisciplinary field of policy analysis. It studies the
medical, social, ethical, and economic implications of
development, diffusion, and use of health technology.
(INAHTA 2005)
5

What is TA / HTA? – back to basics
“The Congress hereby finds and declares that:
(a) As technology continues to change and expand rapidly, its
applications are
1. large and growing in scale; and
2. increasingly extensive, pervasive, and critical in their impact,
beneficial and adverse, on the natural and social environment.
(b) Therefore, it is essential that, to the fullest extent possible, the
consequences of technological applications be anticipated,
understood, and considered in determination of public policy on
existing and emerging national problems.”
Office of Technology Assessment Act, 1972
http://www.princeton.edu/~ota/ns20/act_f.html
6

E Draborg et al. International
comparison of the definition and the
practical application of health
technology assessment. Int J
Technol Assess Health Care. 2005
Winter;21(1):89-95.
433 HTA reports published 1989-
2002 by 11 agencies in 9 countries
Great variation in
HTA practice
7

The Model
8

European network for Health Technology Assessment | JA2 2012-2015 | www.eunethta.eu 9

Health problem and current use of
technology
Technical characteristics
Ethical analysis
Organisational aspects
Legal aspects
Clinical effectiveness
Costs and economic evaluation
Safety
Domains of HTA
• Identified in previous EU projects,
particularly
EUR-ASSESS and ECHTA/ECAHI
• Promote the multidisciplinary nature
of HTA
Social aspects
10

Topics
Health problem and current use of
technology
Technical characteristics
Ethical analysis
Organisational aspects
Social aspects
Legal aspects
Costs and economic evaluation
Safety
Topic 1: Mortality
Topic 2: Morbidity
Topic 3 etc…
Issue 1: What is the effect of the
intervention on overall
mortality?
Issue 2: What is the effect of the
intervention on mortality caused
by the target disease?
Issue 3: etc…
11

Three components of the HTA Core Model
HTA QUESTIONS
(ONTOLOGY)
Questions that an HTA
should answer
METHODOLOGICAL
GUIDANCE
How to answer
the questions
REPORTING
STRUCTURE
How to present
the answers
12

˗ A formal representation of the information contents of an HTA (e.g.
”the effect of technology on reduction of symptoms”) and
relationships between various parts of the content
˗ Assessment elements as building blocks (each provides information
on certain aspect of technology)
˗ Assessment elements are defined by
˗ 9 domains (wider angle of viewing, e.g. clinical effectiveness),
˗ topics within domains (more specific areas of investigation, and
˗ issues within topics (practical questions)
HTA Questions / Ontology
13

˗ Assists in finding answers to questions defined by the ontology
˗ Different levels: domains, assessment elements, whole model / whole
HTA
˗ Domain-level guidance mostly as reviews of state-of-the-art
methodology and links to detailed guidance
˗ Different strengths of guidance: tips, recommendations, standards
Methodological guidance
14

˗ Standardized format for output of HTA information production
˗ In the form of collections containing
˗ General texts, e.g. introduction, summary
˗ Domain-level content, e.g methodology, discussion
˗ Result cards, each containing an answer to question (or answers to questions)
defined by one assessment element (=combination domain-topic-issue)
˗ Appendices
˗ Core HTA information = any HTA information produced using the HTA Core Model
and published within the HTA Core Model Online
˗ Different types of collections (EUnetHTA/Other)
˗ EUnetHTA Core HTA = Extensive assessment, all domains included
˗ EUnetHTA Rapid HTA = Fast assessment, a selection of domains included
˗ Other = Based on users needs, e.g. single AE, single domain
˗ EUnetHTA collections do not contain recommendations
Reporting structure
15

Core HTA information
16

Production process in brief
1. Select the assessment elements to be included in the collection.
2. Translate the included issues each into one or more practical research
question(s).
3. Answer the questions using guidance within the Model.
4. Organise and present the answers according to the common reporting
structure.
5. RESULT: a structured collection of HTA information in which
information on a particular issue can be found at a standard location
(whether in paper or electronic form).
17

Core HTAs
• One type of core hta information collection
• Five pilot core HTAs produced until now within EunetHTA, sixth
will be ready soon. One further pilot commenced within WP4 of
EUnetHTA JA2.
• Intentionally built to “not look like a European HTA report”
• Serve primarily as a scientific basis for local (national, regional)
reports
• Do not contain recommendations regarding the use (or non-use)
of technologies
• Enable distributed production of HTA (e.g. different domains by
separate research groups)
• Easy sharing of produced information
• Easier than before to update only a selection of information
18

INFORMATION
Collections
Serve also as project platforms
TOOLS
Core HTA Structure 2012
19
Official EUnetHTA
Other
Pool of structured HTA
Information
Result cards (RC) based on
assessment elements
Local products
HTA Core Model
Online Tool & Service
Local Tools
RC RC RC RC RC
RC RC RC RC RC
RC RC RC RC RC
RC RC RC RC RC
RC RC RC RC RC
Core HTA
Rapid HTA
Core HTA
Rapid HTA
Full domain
Free set (≥ 1)
My collection
Full domain
Free set (≥ 1)
My collection
Primarily EUnetHTA
jurisdiction
Primarily local
jurisdiction
AUTOMATIC
L HTA
L RHTA
L HTA
L HTA
VOLUNTARY
L
RHTA
Primarily EUnetHTA
jurisdiction
Primarily local
jurisdiction
L HTA
L RHTA
TAILORED

• Currently published through the EUnetHTA main site at www.eunethta.eu
• Select ”Output” and filter by activity JA2-WP5 for most recent rapid HTAs
• Work in progress to include rapid HTAs in the HTA Core Model Online
Rapid assessments
24

Thank you
This presentation arises from the EUnetHTA
Joint Action 2 which has received funding
from the European Union, in the framework of
the Health Programme

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