How medical specialists appraise three controversial health innovations: scientific, clinical and social arguments.

Medical specialists play a pivotal role in health innovation evaluation and policy making. Their influence derives not only from their expertise, but also from their social status and the power of their professional organisations. Little is known, however, about how medical specialists determine what makes a health innovation desirable and why.

What medical specialists like and dislike about health technology assessment reports.

Objective: To examine how medical specialists view health technology assessment (HTA) and its role in policy-making.

Methods: Semi-structured interviews with 28 medical specialists practising in Quebec and Ontario (Canada) to examine their views on an HTA report relevant to their specialty (prostate-specific antigen screening, electroconvulsive therapy and prenatal screening for Down's syndrome).

Results: Medical specialists represent a particularly demanding audience for HTA producers because they are knowledgeable about current studies in their field and often contribute to the evidence base that HTA seeks to synthesize.

What leads to better health care innovation? Arguments for an integrated policy-oriented research agenda.

This essay is based on the recognition that the current 'downstream' health services research and policy approach to innovation misses the mark on one crucial point. It has not addressed how to promote the design of innovations that are likely to be more valuable than others. Re-visiting the ways in which health services research could inform innovation processes, this paper suggests that three attributes make innovations especially compelling from a health care system perspective: relevance; usability; and sustainability.

Dissemination of health technology assessments: identifying the visions guiding an evolving policy innovation in Canada.

Health technology assessment (HTA) has received increasing support over the past twenty years in both North America and Europe. The justification for this field of policy-oriented research is that evidence about the efficacy, safety, and cost-effectiveness of technology should contribute to decision and policy making. However, concerns about the ability of HTA producers to increase the use of their findings by decision makers have been expressed.

Use of health technology assessment in decision making: coresponsibility of users and producers?

Objectives: Health technology assessment (HTA) is a policy-oriented form of research designed to inform decision-makers on the introduction, use, and dissemination of health technology. Whereas research on knowledge transfer has focused on knowledge producers, little attention has been given to the user's perspective. This study examines how health-care provider, administrator, and patient associations across Canada use HTA reports and the limitations they encounter when accessing and using scientific knowledge.

International Master's Program in health technology assessment and management: assessment of the first edition (2001--2003).

Background: Despite a clear call for greater input from health technology assessment (HTA) in the areas of clinical practice and policy making, there are currently very few formal training programs. The objectives of our Consortium were to (i) develop a master's level program in HTA, (ii) test its content with a group of Canadian and European students, and (iii) evaluate the Program's strengths and weaknesses.

Objectives: This study presents the results of our evaluation of the first edition of the Master's Program (2001--2003).

Redefining health technology assessment in Canada: diversification of products and contextualization of findings.

Objectives: While strategies for enhancing the dissemination and impact of Health Technology Assessment (HTA) are now being increasingly examined, the characteristics of HTA production have received less attention.

Methods: This study presents the results of a content analysis of the HTA documents (n = 187) produced by six Canadian agencies from 1995 to 2001, supplemented by interviews with chief executive officers and researchers (n = 40). The goal of this analysis was to characterize the agencies' portfolios and to analyze the challenges these agencies face in responding to the increased demand for HTA.