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

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

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• 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

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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)

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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

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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

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The Model

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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

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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…

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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

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˗ 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

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˗ 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

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˗ 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

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Core HTA information

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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).

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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

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INF

OR

MA

TIO

N

CollectionsServe also as project platforms

TO

OL

SCore HTA Structure 2012

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Official EUnetHTA

Other

Pool of structured HTA

InformationResult cards (RC) based on

assessment elements

Local products

HTA Core ModelOnline 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

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http://www.eunethta.eu/


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

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

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