Evaluation of Health Technologies in Biomedical Engineering
Introduction
The evaluation of health technologies is to analyze different aspects such as safety, efficacy and methodology in economic, social and ethical contexts, being carried out in a transparent process in order to generate a reliable report. Health technologies include all knowledge and skills, devices, drugs, vaccines, and procedures or systems that are put into practice to improve the health or quality of life of patients. This work summarizes some procedures used to evaluate health technologies.
Developing
The process for the evaluation of health technologies (ETES) is dynamic and includes different types of evaluation that will allow us to take a position with respect to a new or existing technology according to their risk-benefits or social and individual costs. This process can be divided into 7 stages:
- Research questions approach
A literature review and the search for questions that will guide the investigation is carried out. Determining the study approach and the dimensions of a specific case. For this it is required that the research question must precisely identify the problem for decision making that motivates the performance of the evaluation. To have this approach, the acronym Pico (Patient-Internion-Comparison-Outcom) which means objective population, intervention, buyer and desired result are used.
- Study protocol design
Once the objectives and scope of the study are considered the local work context to define a methodology, tasks are assigned to responsible and a work schedule is created. The ETES makes use of other studies that have produced primary data and therefore clinical or epidemiological studies are rarely carried out. Relevant studies are identified by valuing its quality and a qualitative or quantitative synthesis of the results is generated.
- Research
The aspects that are evaluated are the security of technology, clinical effectiveness, possible economic implications and the evaluation of the social, organizational and ethical context involved in the use or incorporation of these technologies. It tends to be an iterative process to find as many related studies as possible and those that best fit the objectives of the study are selected. From time to time it is an indefinite activity, because it will never be sure to have found all available references.
- Information synthesis and results discussion
All previous analysis information is compiled and synthesized by the entire work team to discuss the results until reaching the conclusions of the study and making the recommendations. The quality that these studies possess can be diverse, so a second selection of articles found based on quality must.
- Compilation and reporting report
The final report consists of evaluations findings, the main discussion issues and the conclusions and recommendations. Subsequently, the observations by supervisors will be incorporated into the document. Developed synthesis can take different forms: statistical synthesis, narrative synthesis, conceptual synthesis, among others. For the elaboration of the synthesis, an extraction table designed for each particular research must be generated, collecting the statistics of the studies. On some occasions the samples of individual studies will be small and insufficient and will not show inferences about effectiveness. For these cases there is a meta-analysis, that is, a statistical synthesis that combines the results of individual studies.
- Response to the applicant and dissemination of results.
At this point the results must be clear and from this study its validity. The final report is sent to the applicant through a trade in addition to being published on the Internet, specialized magazines, in INAHTA databases, CENENEC or some other.
- Monitoring and feedback
Developers should receive feedback regarding the decision -making process in order to determine whether the conclusions and recommendations they provide are based on an informed decision making. Allowing at the same time that the ETES developer support an implementation of technology by contrasting health technology in the context where it is used. In order for the evaluation of health technologies to work as a decision -making instrument, it is necessary to be inclusive and have a broad perspective. This is why technology is traditionally considered as neutral and free of values;Consequently, it demands objective and quantifiable results by reducing questions to clinical effectiveness, security and economic effectiveness.
conclusion
The analysis provided by the evaluations of health technologies is an important tool that allows an efficient allocation of resources and help in the regulation and organization of health services, while allowing the incorporation of new technologies. It is important to highlight that a good planning must be created that provides a well structured methodology to achieve the objectives of the evaluation that you want to perform. The good evaluation of health technologies will facilitate the comparison of results and encourage better decision making.
References
- WHO, "Health Technology Assessment of Medical Devices," Who, Switzerland, 2011.
- CENECET «Evaluation of Health Technologies: Methodological Document,» Ministry of Health, Mexico, D.F., 2010.
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