CONSIDERING EQUITY IN HEALTH TECHNOLOGY ASSESSMENT: AN EXPLORATORY ANALYSIS OF AGENCY PRACTICES.

Objectives: Equity is one of the founding principles in most healthcare systems. Financial constraints entail an increased risk of exacerbating inequities and a greater need for evidence-based decisions. It is, therefore, both important and timely to enquire how equity can be addressed in health technology assessment (HTA) practice.

How health technology assessment agencies address the issue of unpublished data.

Objectives: Reporting bias potentially threatens the validity of results in health technology assessment (HTA) reports. Our study aimed to explore policies and practices of HTA agencies regarding strategies to include previously unpublished data in their assessments, focusing on requests to industry for unpublished data.

Methods: We included international HTA agencies with publicly available methods papers as well as HTA reports.

Public engagement in health technology assessment and coverage decisions: a study of experiences in France, Germany, and the United Kingdom.

In the United States and internationally, the trend for public engagement in health policy and practice is increasing, particularly regarding health technology assessment (HTA), which informs often controversial coverage decisions. However, there is no consensus about which members of the public should be involved in which processes or what the respective rationales and benefits of public engagement are. This article explores operational processes and underlying rationales of public engagement at HTA agencies in France, Germany, and the United Kingdom.

Formatting modifications in GRADE evidence profiles improved guideline panelists comprehension and accessibility to information. A randomized trial.

Objective: To determine the effects of formatting alternatives in Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence profiles on guideline panelists' preferences, comprehension, and accessibility.

Study Design And Setting: We randomized 116 antithrombotic therapy guideline panelists to review one of two table formats with four formatting alternatives. After answering relevant questions, panelists reviewed the other format and reported their preferences for specific formatting alternatives.

Consumer involvement in systematic reviews of comparative effectiveness research.

Background: The Institute of Medicine recently recommended that comparative effectiveness research (CER) should involve input from consumers. While systematic reviews are a major component of CER, little is known about consumer involvement.

Objective: To explore current approaches to involving consumers in US-based and key international organizations and groups conducting or commissioning systematic reviews ('organizations').

From evidence assessments to coverage decisions?: the case example of glinides in Germany.

In Germany, coverage decisions in the statutory health insurance (SHI) system are based on the principles of evidence-based medicine. Recently, an evidence assessment by the Institute for Quality and Efficiency in Health Care (IQWiG) of the oral antidiabetics of the glinide class showed that their long-term benefit is not proven. Accordingly, the responsible Federal Joint Committee (G-BA) decided to exclude glinides from prescription in the SHI system.

Application of GRADE: making evidence-based recommendations about diagnostic tests in clinical practice guidelines.

Background: Accurate diagnosis is a fundamental aspect of appropriate healthcare. However, clinicians need guidance when implementing diagnostic tests given the number of tests available and resource constraints in healthcare. Practitioners of health often feel compelled to implement recommendations in guidelines, including recommendations about the use of diagnostic tests.

Population-based screening of children for specific speech and language impairment in Germany: a systematic review.

Objective: The study was aimed at evaluating the effectiveness of a systematic population-based screening programme for specific language impairment (SLI) in preschool children in Germany.

Methods: The study question was divided into a review of (1) evidence from studies evaluating screening programmes, (2) diagnostic instruments in the German language, and (3) studies evaluating speech and language interventions. A systematic database search was conducted between June and October 2007 and was updated in January and again in May 2008.

Reporting bias in medical research - a narrative review.

Reporting bias represents a major problem in the assessment of health care interventions. Several prominent cases have been described in the literature, for example, in the reporting of trials of antidepressants, Class I anti-arrhythmic drugs, and selective COX-2 inhibitors. The aim of this narrative review is to gain an overview of reporting bias in the medical literature, focussing on publication bias and selective outcome reporting.

Work-related health monitoring in Europe from a public health perspective.

Background: In contrast to the enormous importance of work to the life of humans and societies, the working environment has so far played only a minor role in health monitoring. However, increasingly it is realized that work has a strong public health impact and therefore is also a cost factor to modern societies. The aim of the project WORKHEALTH, which is currently being carried out under the EU health monitoring programme, is the establishment of indicators for work-related health monitoring in Europe from a public health perspective.