METHODS

Topics and Data for Priority Setting

To prepare for the pilot test, study staff sampled 11 conditions and technologies from a rank-ordered list of 20 topics produced during the IOM/ CHCT pilot study (IOM, 1990f). Using stratified random sampling, the first- and twentieth-ranked conditions or technologies were sampled first. Nine additional topics were then sampled between the top and bottom of the group using a table of random numbers.

Conditions and technologies were defined more specifically than in the IOM/CHCT study to facilitate data gathering. These definitions required a designation of whether the condition or technology was to include prevention, screening, diagnosis, or treatment; the level of severity; the care settings; and the anatomical site or sites of interest. For instance, ''cardiovascular disease'' in the IOM/CHCT study was further defined for this pilot test as "treatment of coronary artery disease severe enough to consider revascularization but not treatment of post-myocardial infarction." Thus, the individual topics in the pilot test were a subset of the topics listed in the IOM/CHCT report but not strictly comparable to them.

Before the meeting, staff compiled data on each condition and technology and provided the pilot-test group with a summary describing each condition, a list of alternative technologies to be considered, and data relevant to each condition.

Although the groups were small (each had six members), they included clinicians and individuals experienced in quantitative and health services research and technology assessment, and public policymaking.

Criteria

The following six criteria were to be weighted and given criterion scores:

  1. burden of illness (per patient with the disease)

  2. cost (expenditures/person/year)

  3. prevalence (rate/1,000 in the general population)

  4. practice variations (coefficient of variation)

  5. potential of the assessment to improve health outcomes

  6. potential of the assessment to resolve ethical, legal, or social (ELS) issues.



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