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TA101

Introduction to Health Care Technology Assessment

Clifford S. Goodman
The Lewin Group
January 1998

Table of Contents

  • ACKNOWLEDGMENTS
  • ABOUT THE AUTHOR
  • INTRODUCTION
  • Origins of Technology Assessment
  • Early Health Care Technology Assessment
  • FUNDAMENTAL CONCEPTS AND ISSUES
  • Health Care Technology Assessment
  • Purposes of HCTA
  • Basic HCTA Orientations
  • Scope of Health Care Technology
  • Material Nature
  • Purpose
  • Stage of Diffusion
  • Timing of Assessment
  • Properties and Impacts Assessed
  • Measuring Health Outcomes
  • Types of Organizations That Conduct HCTA
  • Expertise for Conducting HCTA
  • Selected Issues in HCTA
  • Quality of Care and HCTA
  • Outcomes Research and HCTA
  • Decentralization of HCTA
  • Barriers to HCTA
  • HCTA and Underused Technologies
  • TEN BASIC STEPS OF HCTA
  • Step One: Identify Assessment Topics
  • Identify Candidate Topics
  • Setting Assessment Priorities
  • Step Two: Specify the Assessment Problem
  • Problem Elements
  • Step Three: Determine Locus of Assessment
  • Step Four: Retrieve Available Evidence
  • Information and Data Sources for HCTA
  • Types of Sources
  • Gray Literature
  • Publication Bias
  • Help for Searchers
  • Step Five: Collect New Primary Data
  • Varying Responsibilities for Primary Data Collection
  • Methods for Primary Data Collection
  • Methods of Cost Analysis
  • RCTs Versus Observational Studies: Tradeoffs of Validity
  • Developments in Primary Data Collection Studies
  • Types of Methodological Validity
  • Step Six: Interpret Evidence
  • Classification of Studies
  • Grading the Evidence
  • Conflict of Interest and Bias
  • Step Seven: Synthesize Evidence
  • Meta-analysis
  • Decision Analysis
  • Consensus Development
  • Variations in Methodological Approach
  • Step Eight: Formulate Findings and Recommendations
  • Step Nine: Disseminate Findings and Recommendations
  • Competing for Attention
  • Dissemination Dimensions
  • Dissemination Plan
  • Mediating Access
  • Step Ten: Monitor Impact
  • Attributing Impact to HCTA Reports
  • Factors Mediating Impact
  • APPENDIX A. CONCEPTS IN ASSESSMENT OF DIAGNOSTIC TECHNOLOGIES
  • APPENDIX B. SUGGESTED READINGS IN HCTA
  • Origins and Evolution of Technology Assessment
  • Overview of HCTA
  • Priority Setting
  • Randomized Controlled Trials
  • HCTA of Diagnostic and Screening Technologies
  • Evidence in HCTA
  • Cost-Effectiveness and Related Economic Analyses
  • Meta-Analysis
  • Decision Analysis
  • Consensus Development
  • Health-Related Quality of Life Measures
  • Ethical, Legal, Social, and Political Issues
  • HCTA and Quality of Care
  • Effectiveness/Outcomes Research and HCTA
  • Searching the HCTA Literature
  • GLOSSARY
  • REFERENCES
    • U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894
    National Institutes of Health
    Department of Health & Human Services
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    Last updated: 14 August 2001