Presentation by Dr Junainah binti Sabirin

1. HHEEAALLTTHH
TTEECCHHNNOOLLOOGGYY
AASSSSEESSSSMMEENNTT
((HHTTAA)):: IINNTTEERRPPRREETTIINNGG
AA HHTTAA RREEPPOORRTT
DR JUNAINAH SABIRIN
DATIN DR RUGAYAH BAKRI

2. OOUUTTLLIINNEE
Introduction
MaHTAS HTA products
Checklist for HTA reports
2

3. IINNTTRROODDUUCCTTIIOONN
 Proponent to the MOH’s vision for health:
“A NATION WORKING TOGETHER FOR BETTER HEALTH”
MaHTAS
3
Health Technology Assessment
Unit established under Medical
Dev. Div., Ministry of Health
(MOH) in keeping with the
Ministry’s policy of ensuring
that safe, effective and cost-effective
health technologies
are being used in the MOH
facilities
HTA Unit upgraded to
HTA Section, and
development of
evidence-based CPG
put under HTA
Section’s purview
- to reduce variation in
practice in improving
quality of care
HTA Section
designated as WHO
Collaborating Centre
for Evidence-Based in
Health-Care Practice
for Asia Pacific region

4. IINNTTEERRNNAATTIIOONNAALL
NNEETTWWOORRKKIINNGG
o Member of international
organization/network:
INAHTA
HTAi
G-I-N
ISPOR
HTA AsiaLink
EVIP Net Asia
INAHTA : International Network of Agencies for Health Technology Assessment
HTAi : Health Technology Assessment International
G-I-N : Guidelines International Network
ISPOR : International Society for Pharmacoeconomics and Outcome Research
HTA AsiaLink : Collaboration between HTA agencies in Asia : Singapore, Thailand,
4

5. MMAAHHTTAASS FFUUNNCCTTIIOONN
 Conduct health technology assessment or
rapid assessment
 Coordinate formulation and implementation
of evidence-based CPGs
 Provide training
 Conduct horizon scanning (New activity)
5

6. HHTTAA ……..
 HTA is the systematic evaluation of
properties, effects, and / or impacts of health
care technology. May address the direct,
intended consequences of technologies as
well as their indirect, unintended
consequences.
 Main purpose is to inform technology-related
policy making in health care:
 Acquisition / Adoption / Implementation of new health
technology
 Continued use of existing technology
 Disengage the use of obsolete technology
 Advertisement related to health technology
 Reimbursement 6

7. MAHTAS HHTTAA PPRROODDUUCCTTSS
Information
Brief (Rapid
Review)
Very rapid information response
- Urgent information need or decision problem
-Look for high level of evidence, may restrict the literature
search to 1 or 2 database
-Preparation time: 2 weeks
Technology
review report
(Mini HTA)
Reacting to an existing decision problem
-Less comprehensive report
-Smaller scope of assessment (evaluate safety, effectiveness
issues, costs/financial impact)
-May be externally reviewed
-Preparation time: 2-4 months
Health
Technology
Assessment
(HTA) reports
Traditional assessments (Comprehensive report)
-Anticipating a future decision problem
-Decision can wait (to some extent) based on evidence
-Evaluate safety, effectiveness issues, cost-effectiveness/
financial impact, organizational considerations.
may also address ethical, social and legal implications
-Expert committee and externally reviewed
-Preparation time: 8-18 months after approval by HTA CPG
Council

8. 8

9. 9

10. OUTPUT
6
3
6
No. of HTA, TR, CPG dan IB (1997 - 2013)
1
5
3
4
6
2 2
1
4
3 3
4
3
2
7
8
12
4
6
37
22
27
28
31
30
20
28
0
3
13
10
6
4 4
8
6
7
8
6
5
40
35
30
25
20
15
10
5
0
Number
Year
HTA
TR
CPG
Info brief
TOTAL NO. OOFF PPRROODDUUCCTTSS ((aass ooff 22001133))
 Health Technology Assessment (HTA) reports = 5588 (1997-2013)
 Technology Review (Rapid assessment) reports = 226600 (1997-2013)
 Clinical Practice Guidelines (CPGs) = 8800 (2001-2013)
 Information Brief = 5588 (2009-2013)
MaH
TAS

11. HTA & TR OUTPUT BBYY TTYYPPEESS OOFF HHEEAALLTTHH
TTEECCHHNNOOLLOOGGIIEESS ::11999977--22001133
HTA (1998-2013) TR (2001-2013)

12. HHTTAA RREEPPOORRTTSS
MaH
TAS

13. OONNLLIINNEE
AACCCCEESSSSIIBBIILLIITTYY
13

14. Click
MMAAHHTTAASS MMOOBBIILLEE AAPPPP
((MMYYMMAAHHTTAASS))
e.g. search CPG/HTA by
category or title
14

15. CCHHEECCKKLLIISSTT FFOORR HHTTAA RREEPPOORRTTSS
 Prepared by INAHTA
 Aid to ensure consistent and transparent approach to
HTA
 Clear identification in an HTA report of what has been
done in an assessment and any significant limitation
in the analysis
 Help reader of HTA report to easily obtain information
on purpose, method used, assumptions made and
conclusion reached
GLOBAL NETWORKING FOR 15
EFFECTIVE HEALTHCARE

16. IINNTTEENNDDEEDD AAUUDDIIEENNCCEE
oUSER
• Gives guidance on what to look for in an HTA
report and assess the reliability of the
information
oPRODUCER
• Gives points that should be considered during
the planning, conducting and reporting of the
assessment
• Improve the quality of HTA products
16

17. CCHHAARRAACCTTEERRIISSTTIICCSS OOFF
HHTTAA RREEPPOORRTT
 A clear formulation of the problem
 An explicit methods
 A wide scope of the technology
• Assessments will vary considerably in their depth and
scope of analysis, given differences in the types of problem
being addressed, policy requirements and the time and
resources available for assessment
o Strength relies on transparency in the
assessment process and in the reporting
17

18. HHTTAA RREEPPOORRTTSS
 Variations in the content of HTA reports
 Main content:
- Policy question / issues
- Objective
- Research questions
- Background information
- Methods
- Results
- Conclusions
18

19. CCOONNTTEEXXTT OOFF
MMAATTEERRIIAALL IINN
CCHHEECCKKLLIISSTT
 Checklist contains only brief details of a number
of important points relating to HTA reports (14
questions)
 HTA report may be a valid and useful source of
information even if it does not include a number
of elements in the checklist
 Not essential for an HTA report to include all the
attributes given in the checklist
 The significance of any omissions in an HTA
report will depend on how it is to be used by the
reader 19

20. 20
Copyright INAHTA Secretariat 2007
A checklist for HTA reports
This summary form is intended as an aid for those who wish to make a record of the
extent to which a health technology assessment report meets the 14 questions given in
the checklist.
It is NOT intended as a scorecard to rate the standard of HTA reports — reports may
be valid and useful without meeting all the criteria that have been listed.
Item Yes
Partly
No
Preliminary
1. Appropriate contact details for further information?
2. Authors identified?
3. Statement regarding conflict of interest?
4. Statement on whether report externally reviewed?
5. Short summary in non-technical language?
Why?
6. Reference to the policy question that is addressed?
7. Reference to the research question(s) that is/are addressed?
8. Scope of the assessment specified?
9. Description of the assessed health technology?
How?
10. Details on sources of information and literature search strategies provided?
Search
strategy Databases Year range Language
restriction Primary data
Other kind of
information
resources
O O O O O O
Complete reference
list of included studies
List of excluded
studies Inclusion criteria Exclusion criteria
O O O O
11. Information on basis for the assessment and interpretation of selected data and information?
Method of data
extraction described?
Critical appraisal
method (for quality
assessment of the
literature) described?
Method of data
synthesis described?
Results of the
assessment clearly
presented, e.g. in the
form of evidence
tables?
O O O O
Context? (may or may not apply to each HTA)
(Medico-) legal
implications
considered?
Economic
analysis
provided?
Ethical
implications
considered?
Social
implications
considered?
Other perspectives
(stakeholders,
patients, consumers)
considered?
O O O O O
What then? Yes Partly No
12. Findings of the assessment discussed?
13. Conclusions from assessment clearly stated?
14. Suggestions for further action?

21. PPRREELLIIMMIINNAARRYY IINNFFOORRMMAATTIIOONN
1. Appropriate contact details for further
information?
 Contact person or position with appropriate
address
1. Authors identified?
 Clear indication of persons who were involved
in preparing the report and their roles
 Authors/Committee members
1. Statement regarding conflict of interest?
 Statement of “no conflict of interest”
 Funding
 Non-financial matters
Yes / Partly /No
21

22. PPRREELLIIMMIINNAARRYY IINNFFOORRMMAATTIIOONN
4. Statement on whether report externally
reviewed?
o Measure to improve its quality and credibility
o Names and affiliations of persons who have
provided comment or information during
preparation of report
5. Short summary in non-technical language?
o Executive summary/Abstract – addressed for
policy-makers
o Focused on conclusion and recommendation
Yes / Partly /No 22

23. WWHHYY TTHHEE AASSSSEESSSSMMEENNTT
HHAASS BBEEEENN
UUNNDDEERRTTAAKKEENN
6. Reference to the policy question that is
addressed?
o Why the assessment has been undertaken?
o Who requested?
6. Reference to the research question that is /
are addressed?
o Define the research questions
23 Yes / Partly /No

24. WWHHYY TTHHEE AASSSSEESSSSMMEENNTT HHAASS
BBEEEENN UUNNDDEERRTTAAKKEENN
8. Scope of the assessment specified?
o Indicate the attributes of the technology
addressed and areas that are not included in the
assessment
8. Description of the assessed health
technology?
o Short description of technology – what, how it
works?
24
Yes / Partly /No

25. HHOOWW TTHHEE AASSSSEESSSSMMEENNTT HHAASS
BBEEEENN UUNNDDEERRTTAAKKEENN
10. Sources of information used?
o Search strategy
o Databases
o Year
o Language restriction
o Use of primary data, other kind of information
o Complete reference list of included studies
o List of excluded studies
o Inclusion criteria
o Exclusion criteria
25
√ where
appropriate

26. HHOOWW TTHHEE AASSSSEESSSSMMEENNTT HHAASS
BBEEEENN UUNNDDEERRTTAAKKEENN
11. Information on basis for the assessment and
the interpretation of selected data and
information?
o Method of data extraction described
o Critical appraisal method (quality assessment)
o Method of data synthesis described
o Results of the assessment clearly presented (e.g
evidence table)
26
√ where appropriate

27. CCOONNTTEEXXTT
Information on context (may or may not apply to
each HTA)
 Medico-legal implications
 Economic analysis
 Ethical implications
 Social implications
 Wider perspectives (stakeholders, patients,
consumers)
27
√ where appropriate

28. IIMMPPLLIICCAATTIIOONNSS OOFF TTHHEE
AASSSSEESSSSMMEENNTT
RREESSUULLTTSS AANNDD CCOONNCCLLUUSSIIOONNSS
12. Findings of the assessment discussed?
Discussion should include:
o Relationship of the results obtained to the question
being addressed by the assessment
o Comment on missing or uncertain information
o Basis for the opinion and conclusions in the report
13. Conclusions from the assessment clearly stated?
 Clear conclusion with reference to the policy and
research questions
13. Suggestion for further action?
 Research, information gaps
28
Yes / Partly /No

29. 29
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