BOX 6-1
Brief History of Medical Technology Assessment in the U.S. Federal Government21


Office of Technology Assessment (OTA) was created in 1972 as an analytical arm of Congress and conducted studies in nine areas, one of which was health.


NIH Consensus Development Program was established as a mechanism to judge—in an unbiased, impartial manner—controversial topics in medicine and public health. NIH has conducted 115 consensus development conferences, and 22 state-of-the-science (formerly “technology assessment”) conferences, addressing a wide range of issues.


Office of Medical Applications of Research (OMAR) was established as part of the NIH Consensus Development Program. This is the focal point for evidence-based assessments of medical practice and state-of-the-science on behalf of the medical community and the public. NIH resisted the establishment of this office for many years, but eventually could no longer resist congressional pressure.


National Center for Healthcare Technology was established to advise the Health Care Financing Administration (HCFA, now CMS) on coverage decisions for new medical technologies under the Medicare program.


National Center for Health Care Technology (NCHCT) was eliminated. The American Medical Association (AMA) and Health Industry Manufacturers Association (HIMA) (now known as AdvaMed), led the move. However, the center paved the way for the AHRQ.


Office of Health Technology Assessment (OHTA) of the National Center for Health Services Research assumed the responsibilities of NCHCT following its elimination.


OTA was not funded by Congress during a time of budgetary concerns.


American College of Radiology Network (ACRIN) is the first large-scale collaborative clinical trials group devoted to the development of technologies for medical imaging. Clinical trials were launched in 1999.


National Institute of Biomedical Imaging and Bioengineering (NIBIB) was established. The NIBIB mission statement includes the “translation and assessment of technological capabilities in biomedical imaging…” This is the first NIH institute to include technology assessment in its mission statement.


Intense debate over the value of the AHRQ, the only “official” federal medical technology assessment agency. Some lawmakers were in favor of closing the agency. The AHRQ budget, which was already too small to allow anything beyond very limited funding of clinical technology assessment, was reduced. AHRQ was reauthorized only until 2005.

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