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From page 1... ... Further, it examines how the proposed pnority-setting process might be used or adapted by other organizations and for purposes other than technology assessment. RATIONALE Clinicians, payers, and policymakers turn to technology assessment to help provide better information for clinical decision making, to guide coverage decisions, and to set national health policy. Read the entire page →
From page 2... ... In the legislation establishing AHCPR, the IOM was asked to develop a process and criteria for setting priorities for health care technology assessment and reassessment to assist OHTA in its expanded role within that agency. The establishment of AHCPR itself can be seen as recognition of the need to look systematically at the value of health care services in improving health. Read the entire page →
From page 3... ... The committee concluded that any analytic model must include a process to review its product, and a way to include issues of equity, as well as unusual ethical and legal dimensions presented by health care technologies. Nevertheless, priority rankings established by means of an analytic model should be understood as inputs to a final decision process, not the final product of the process itself. Read the entire page →
From page 4... ... _ r 3. Reduce a large list of nominees to those on which to obtain the data set needed for priority ranking . Read the entire page →
From page 5... ... Because the committee believes that OHTA has a special obligation to consider previously assessed topics as candidates for reassessment, it also believes that the agency should maintain a process for monitoring the published literature on previously assessed topics and should place candidates for reassessment on the same competitive footing in the priority-setting process as candidates for first-time assessment. The Priority-Setting Cycle The committee envisions priority setting as occurring in a cycle. Read the entire page →
From page 6... ... assigning objective criterion scores would require experts in epidemiology and health statistics to review the data collected by OHTA staff and to develop estimates when necessary. Publicly Available Products The committee envisions two products of the priority-setting process that would be publicly available: a list of the pnority-ranked technologies and the data base used to construct the list. Read the entire page →
From page 7... ... RECOMMENDATION 6 The committee recommends a specific quantitative method to calculate a priority score for each candidate topic using the following formula: Prionty Score = W~lnS, + W21rlS2 + . Read the entire page →
From page 8... ... . Similarly, priority setting should address clinical conditions. Read the entire page →
From page 9... ... Recommendation 3 OHTA technology assessments should compare the alternative technologies for managing a clinical condition. Similarly, the priority-setting process should include alternative technologies for managing a clinical condition. Read the entire page →
From page 10... ... The committee also recommends the following subjective criteria: � burden of illness imposed by the clinical condition; � potential of the results of the assessment to change health outcomes; � potential of the results of the assessment to change costs; and � potential of the results of the assessment to inform ethical, legal, or � e socla Issues. Although objective data may exist with which to characterize a candidate topic, integration of these data often requires a subjective estimate. Read the entire page →
From page 11... ... Its first task would be to establish the criterion weights through one of several possible procedures that are detailed in the full report. Once established, these criterion weights remain constant for the entire priority-setting process (i.e., across all candidate topics) Read the entire page →
From page 12... ... A change in the nature of the condition, expanded professional knowledge, a shift in clinical practice, or publication of a new, conflicting assessment might Digger consideration of a condition and technology for reassessment. Recommendation 10 OHTA should maintain a data base on each topic that has been previously assessed and should catalog information pertaining to the topic. Read the entire page →
From page 13... ... ADOPTION OF THE IOM'S PRIORITY-SETTING PROCESS BY OTHER ORGANIZATIONS Many organizations evaluate health technology, although the major categories of such organizations are third-party payers, such as the Health Care Financing Administration (HCFA) and the Blue Cross and Blue Shield Association (BCBSA) Read the entire page →
From page 14... ... Technology Assessment and Clinical Practice Guidelines The committee's priority-setting process may also be useful in setting priorities for developing practice guidelines. Clinical practice guidelines, according to another IOM committee's definition, are "systematically devel oped statements to assist the practitioner and patient in decisions concerning appropriate health care for specific clinical circumstances." Clinical practice guidelines are one vehicle for disseminating the results of technology assessment, and technology assessment is one method of producing information for a practice guideline. Read the entire page →
From page 15... ... In the case of OHTA, satisfying the first principle will require determining which assessments are most likely to result in improvement in the health of the public, reduction of inappropriate health care expenditures, reduction of inequities in access to effective health care services or of maldis~bution across equally needy populations, and the informing of other ethical, legal, and social issues. OHTA and other organizations may wish to modify some of the components of the process as proposed. Read the entire page →
From page 16... ... The committee views its report as a strategic effort to look ahead to reasonable goals for AHCPR and OHTA and to create a process that will be credible, sound, and defensible. During the process of compiling data for the quantitative model, OHTA will create a valuable data base and a ranking of priorities; bow will be important resources for other organizations as well as for OHTA itself. Read the entire page →

From page 1...

... Further, it examines how the proposed pnority-setting process might be used or adapted by other organizations and for purposes other than technology assessment. RATIONALE Clinicians, payers, and policymakers turn to technology assessment to help provide better information for clinical decision making, to guide coverage decisions, and to set national health policy.

SUMMARY Pages 1-16

SUMMARY
Pages 1-16