Objective To investigate the health technology assessment reports, analyze publication characteristics and report quality, and explore hot topics in health technology assessment. Methods Web of Science and CNKI databases were searched to collect complete health technology assessment reports from inception to January 2023. SPSS 26.0 software was used to analyze the publication journals, countries, number of authors, assessment types and assessment contents of the assessment reports. The report quality was assessed based on International Network of Agencies for Health Technology Assessment (INAHTA) report criteria (2007 edition). VOSviewer 1.6.11 was used to analyze keywords clustering. Results A total of 216 papers were included, with 158 published by Chinese authors, and a rapid growth trend in the number of reports over past four years. The rate of reports on health technology social adaptability assessment was only 17.13%. Among the Chinese reports, 25 were general health technology assessments, 35 were rapid assessments, and 3 were mini assessments. Among the English reports, 4 were rapid assessments, and 54 were regular healthcare technology assessments. For the 14 items in the INAHTA reporting criteria, the reporting rates were high for the brief summary (98.61%), problem description (94.91%), and results discussion entries (97.69%). However, the reporting rates were low for criteria such as personnel responsibilities, conflict of interest statements, and peer review statements, at 31.94%, 19.44%, and 3.24% respectively. English literature generally exhibited higher report quality. Conclusion In recent years, the volume of health technology assessment reports in China has been increasing, with developments in assessment types and application fields. However, there are also problems with standardization of reporting.
The reporting checklist of health technology assessment (HTA) was a tool developed by the International Network of Agencies for Health Technology Assessment (INAHTA) to be used to guide the reporting of HTA. Experiential evidence showed that the tool was effective to improve the reporting quality of HTA and also could be used as a reference in performing HTA and translating the research evidence into decision-making. This paper introduced the background, developing process and main contents of the checklist, so as to improve the reporting quality of HTA in China.
Objective To assess the effectiveness and safety of nine lipid-lowing agents in the national essential drug list (2000) and provide evidence for the adjustment and selection of essential drugs. Methods Based on principles of health technology assessment (HTA) and evidence-based medicine, we searched for all published clinical studies about these drugs from the following databases: MEDLINE (1966-2002.8), The Cochrane Library, EMBASE (1974-2002), CBMdisk (1979-2002.8) and VIP (1989-2002.8), the database of National Center for Adverse Drug Reaction(ADR) Monitoring of China and the database of WHO Uppsala drug monitoring center. Included studies were appraised, analyzed and compared for the reduction of triglyceride (TC) or low density lipoprotein (LDL-C), the prevention for the coronary events and the incidence of ADR. Results The results from comparative trials for lipid-lowing agents showed that the equivalent dose of statins for 25% reduction of LDL-C was atorvastatin 10 mg/d, simvastatin 20 mg/d, pravastatin 40mg/d, lovastatin 40 mg/d, cerivastatin 0.3 mg/d and fluvastatin 80 mg/d. It was difficult to compare fenofibrate with gemfibrozil, acipimox with statins or fibrates based on available data. The study on the primary and secondary prevention of cardiovascular events showed that pravastatin and lovastatin were effective in primary prevention, and long-term use could reduce the incidence of cardiovascular disease.Gemfibrozil could reduce the mortality from coronary heart disease (CHD) but the overall mortality was not changed. Pravastatin, simvastatin, atorvastatin, fluvastatin, gemfibrozil and fenofibrate had a confirmed effect in secondary prevention. Data from large-scale clinical trials and the reports from ADR monitoring center of England, America, Canada and Australia suggested that the statins which had rare ADR were safe and tolerated. Rhabdomyolysis was rare but had a serious adverse reaction associated with statins. The rate of fatal rhabdomyolysis related to cerivastatin was the highest among 6 statins. The safety of simvastatin, lovastatin and atorvastatin was lower than cerivastatin but higher than simvastatin and atorvastatin. The number of ADR reports of fenofibrate was fewer than that of gemfibrozil. Conclusions At present, the best evidence focused on pravastatin, simvastatin and lovastatin are widely used and have a confirmed safety and efficacy. Atorvastatin, fluvastatin and fenofibrate still need more data to confirm their effects on coronary heart disease prevention. The drugs which were shown to be inferior or insufficient evidence are cerivastatin, gemfibrozil and acipimox.
ObjectiveTo construct rapid health technology assessment (RHTA) reporting norms, with a view to providing methodological references for RHTA research and reporting. MethodsBased on the preliminary pool of entries constructed by the literature research results, and taking into account the characteristics of RHTA, a Delphi expert correspondence questionnaire was designed, and 25 experts in the field of HTA were selected to conduct multiple rounds of expert correspondence. By calculating the expert authority coefficient and opinion coordination coefficient, combined with the average value of the entry score, coefficient of variation and full score ratio, the entries were selected to form the list of RHTA report specifications. ResultsThe positive coefficient of experts in both rounds of investigation was 100%, the expert authority coefficient in the first round was 0.858, and the expert authority coefficient in the second round was 0.838. The Kendall coordination coefficient in the first round was 0.169, and in the second round it was 0.081. According to the correspondence of 2 rounds of investigation, the final formation included 8 aspects, 26 first-level entries and 18 second-level entries in the list of RHTA report specifications. ConclusionThis study constructed the RHTA report specification, which is both scientific and operable, providing a reference for RHTA report writing.
Objective To investigate present status of health care in peri-brain-death and analyze its effectiveness and health economic characteristics. Method Retrospective analysis of case series was conducted and a total of 940 patients from surgical intensive care unit (SICU) were reviewed on treatment and part of direct medical expenditure. The patients admitted from Jun. 1999 to Dec. 2000 and Nov. 2001 to Jun. 2002 were included in this study. Data were processed by SPSS 10.0. Results Patients were included if they had two of the three symptoms for at least one hour: deep coma, pupillar light reflex disappear, and no autonomic respiratory. Ultimately 115 patients were included, with a total cost of ￥2 515.9 per day for each case, whereas mortality was 99.10%. Mortality increased with the state of peri-brain-death prolonged. Eighty percent of patients included were dead within 72 hours after admission. Conclusions Attempts to resuscitate patients of peri-brain-death have been the most widely applied in China, however, it resulted in great unnecessary consumption of health resources. It is of great importance to promote legislation of brain death in China.
ObjectiveTo investigate the construction strategy of a knowledge base for health technology assessment (HTA) indicators based on a multi-granularity knowledge representation model, in order to meet the users' diverse demands for HTA knowledge services. MethodsFirstly, we constructed a multi-granularity HTA indicator knowledge representation model based on systematically analyzing the content and structure of the HTA indicator system in literature. Secondly, we extracted multi-granularity HTA indicator knowledge from literature and conduct subject indexing in a human-computer collaborative way. Finally, based on the HTA knowledge service requirements, a prototype of the HTA indicator knowledge base-HTA Indicators was designed and developed. ResultsA multi-granularity HTA indicator knowledge representation model was constructed, covering 5 core knowledge units (indicator systems, indicator items, formulas, measurement variables, and subjects), 20 types of attributes, and 12 types of relationships. This model represented the intrinsic characteristics and connections between multi-granularity indicator knowledge units. Knowledge extraction and subject indexing of multi-grain HTA indicators were conducted based on 227 HTA indicator documents, forming instance data. Finally, a prototype of the HTA indicator knowledge base, named HTA Indicators, was developed. HTA Indicators provides services such as multi-granularity HTA indicator knowledge retrieval, navigation, and linking. ConclusionThe construction strategy of the HTA indicator knowledge base based on the multi-granularity knowledge representation model is feasible. The indicator knowledge base can achieve multi-dimensional semantic organization of indicator knowledge, provide multi-level and multi-dimensional indicator knowledge retrieval and discovery services, and meet the users' demand for precise HTA knowledge. In the future, we will explore the use of cutting-edge technologies such as large language models to achieve the automated construction of large-scale HTA knowledge, thereby enhancing the efficiency and intelligence level of knowledge base construction.
Health insurance system has been proved to be an effective way to promote the quality of health service in many countries. However, how to control health expenditure under health insurance system remains a problem to be resolved. Some developed countries like UK, Canada and Sweden linked their health technology assessment results with decision making and health insurance management, and made prominent achievements in both expenditure control and quality improvement. China is carrying out its health system reform and running a new health insurance project. Using the experiences of other countries is undoubtedly of great importance in developing and managing our health insurance system.
ObjectiveTo investigate the health technologies on diabetes prevention and management used in rural China and the assessment results of these health technologies, and to provide references for the selection and using of health technologies on diabetes prevention and management in rural China. MethodsWe searched VIP, CNKI, CBM and WanFang Data to collect survey studies and assessment reports of health technologies on diabetes prevention and management in rural China. The search date was up to July 15th, 2014. Two reviewers independently screened literature, and then the qualitative analysis was performed for the included studies. ResultsA total of 15 studies were included. The results of qualitative analysis showed that:the targeted populations were patients and ordinary villagers who had received the service or treatment of diabetes health technology in rural, as well as the grassroots medical technical personnel and promotion staffs who had developed the health technologies. Diabetes health technology studies in rural mainly included medical personnel health technology related knowledge training. The contents of health technology assessment involved effectiveness, acceptability, economic characteristics, requirements and technical specific property. ConclusionThere was limited researches on the investigation and analysis of health technologies on diabetes prevention and management in rural China, and evaluation content remains insufficient.
Health technological innovation has helped to improve health care delivery and patient outcomes. However, the proliferation of health care technology has accompanied burgeoning health care costs and evoked social, ethical, legal, and political concerns. Health technology assessment (HTA) is the systematic evaluation of properties, effects and/or other impacts of health care technology. The main purpose of HTA is to inform persons of technology-related policy making in health care. There is great variation in the scope, selection of methods and level of detail in the practice of HTA. This paper will introduce the basic concepts and methods of HTA in order to help those who are interested in conducting HTA.
ObjectiveCapsule endoscopy (CE) has been widely used in the diagnosis of small bowel disease (SBD) in the world. To bring CE into the national health insurance directory, and intensify its popularization in primary hospitals, the government needs high quality health technology assessment (HTA) evidence for decision making. This study was aimed to comprehensively evaluate the effectiveness, safety, applicability and economics of CE in the diagnosis of SBD based on global review, to providing the best currently-available evidence for decision making. MethodsWe electronically searched The Cochrane Library (Issue 8, September 2013), PubMed, EMbase, INAHTA, VIP, CBM, CNKI and WanFang Data. We screened studies, extracted data, and evaluated quality independently, according to inclusion and exclusion criteria; and then we made final conclusion after comprehensive analysis. ResultsWe finally included 4 HTAs, 11 systematic reviews (SRs)/ Meta-analyses, 2 randomized controlled trials (RCTs), 5 guidelines, and 10 economics studies for assessment. The results of HTAs, SRs/ meta-analyses and RCTs all showed that, the disease detection rate of CE was higher than that of many other traditional technologies, and that the main adverse event for CE was retention (0.7% to 3.0%), which were consistent with those of the guidelines' recommendations. Besides, the comprehensive results of economics studies showed the superiority of CE compared with other technologies. As the first choice, CE could significantly decrease potential costs, especially when used in outpatients. Conclusiona) Compared with similar technologies, CE indeed has advantages in diagnostic yield, safety and potential costs in the diagnosis of SBD. However, its application has certain limitations, which still needs to be verified by more high quality evidence about CE diagnosis accuracy. b) It is sug gested that, when the government approves the introduction of CE to hospitals, many factors must be considered, such as local disease burden, clinical demands, ability to pay, and staff configuration. At the same time, it is necessary to standardize training for medical technicians, to reduce economic loss caused by poor technical abilities of medicaltechnicians.