La evaluación de nuevas tecnologías en salud en hospitales: revisión narrativa
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Resumen
La rápida evolución de la tecnología y con ella la de los diferentes métodos diagnósticos y terapéuticos ha traído consigo un creciente interés por los profesionales de la salud en disponer de los últimos avances y las mejores tecnologías para atender a los pacientes puesto que, a través de estos recursos, se espera reducir la incertidumbre clínica en cuanto a los diagnósticos y tratamientos. Se reconoce que los avances tecnológicos son, en parte, responsables de mejorar la salud de las comunidades y, en consecuencia, de aumentar la expectativa de vida de la población. Sin embargo, el gran número de innovaciones emergentes hace pensar que debe haber un proceso de selección apropiado por parte de los sistemas de salud para garantizar que se logren en la práctica los beneficios y los propósitos planteados. La selección de las nuevas tecnologías debe incluir tanto el análisis de la tecnología en sí como la comparación con otras; este proceso se denomina Evaluación de tecnologías en salud y tiene un enfoque principalmente macro, es decir, desde agencias de evaluación de carácter nacional que evalúan con el objetivo de regular las inclusiones de tecnologías en los sistemas de salud en Colombia. Se trata de un Plan de beneficios; sin embargo, la disponibilidad de las nuevas tecnologías está en las instituciones de salud e implica una evaluación que regule las tecnologías en este nivel. Internacionalmente esto se reconoce como Evaluación de tecnologías basada en hospitales. Este artículo hace una descripción de las evaluaciones de tecnologías, pero con énfasis en metodologías hospitalarias.
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McGregor M, Brophy JM. End-user involvement in health technology assessment (HTA) development: A way to increase impact. Int J Technol Assess Health Care 2005; 21(2):263–267.
Ministerio de la Protección Social de la República de Colombia. Política Nacional de envejecimiento y vejez: 2007-2019. Minsalud, Bogotá; 2009.
Congress US. Office of Technology Assessment. Assessing the efficacy and safety of medical technologies. Publ No OTA-75 Wash DC US Gov Print Off. 1978.
Nobel J. Health Care Technology Assessment, Policy and Practical Integration. ECRI; 1993.
Vivas Consuelo D, Cantó Torán E. Documento sobre Evaluación de Tecnologías en Salud. MinSalud Colombia; Abril, 2010.
McGregor M, Brophy JM. End-user involvement in health technology assessment (HTA) development: a way to increase impact. Int J Technol Assess Health Care 2005; 21(2):263-267.
Samprietro-Colom L, Lach K, Escolar I, Sroka S, Soto M, Cicchetti A, et al. A handbook and a toolkit for hospital-based Health Technology Assessment. Value Health J Int Soc Pharmacoeconomics Outcomes Res 2015; 18(7):A556.
Rettig RA, Harman AJ. The Development of Medical Technology. 1979 [citado 27 de abril de 2016]; Recuperado a partir de: http://www.rand.org/pubs/papers/P6291/.
Committee NH, others. District health board decision-making about new health interventions: a background paper. Wellingt Natl Health Comm. 2006.
Ministerio de Salud y Protección Social. Ley 1438 de 2011. Ene, 2011.
Miniati R, Frosini F, Cecconi G, Dori F, Gentili GB. Development of sustainable models for technology evaluation in hospital. Technol Health Care 2014; 22(5):729-739.
Battista RN. Towards a paradigm for technology assessment. Sci Basis Health Serv Lond BMJ Publ Group 1996;11–18.
Mytton OT, Velazquez A, Banken R, Mathew JL, Ikonen TS, Taylor K, et al. Introducing new technology safely. Qual Saf Health Care 2010; 19(Suppl 2):i9–i14.
Battista RN. Expanding the scientific basis of health technology assessment: A research agenda for the next decade. Int J Technol Assess Health Care 2006; 22(3):275–280.
Battista RN, Banta HD, Jonnson E, Hodge M, Gelband H. Lessons from the eight countries. Health Policy 1994; 30(1):397–421.
Battista RN. Innovation and diffusion of health-related technologies: a conceptual framework. Int J Technol Assess Health Care 1989; 5(2):227–248.
Organization WH, others. Evaluación de tecnologías sanitarias aplicada a los dispositivos médicos. 2012 [citado 4 de mayo de 2016]; Recuperado a partir de: http://apps.who.int/iris/ handle/10665/44824.
Puig-Junoy J. ¿Es la financiación sanitaria suficiente y adecuada? Gac Sanit. Marzo de 2006; 20(S1):96-102.
Vilcahuamán L, Rivas P. Ingeniería Clínica y Gestión de Tecnología en Salud. Avances y Propuestas. 1ed., Lima. OPS/OMS, 2006.
World Health Organization. Evaluación de tecnologías sanitarias aplicada a los dispositivos médicos. 2012.
Relman AS. Assessment and accountability. N Engl J Med 1988; 319(18):1220–1222.
Blanco Moreno Á, Bustos Guadaña A. El gasto sanitario público en España: diez años de Sistema Nacional de Salud. Hacienda Pública Esp 1996; 3–27.
Banta HD, Luce BR. Health care technology and its assessment: an international perspective. 1993 [citado 27 de abril de 2016]; Recuperado a partir de: https://repository.library.georgetown. edu/handle/10822/860433.
Menon D, Marshall D. The internationalization of health technology assessment. Int J Technol Assess Health Care 1996; 12(1):45–51.
Tugwell P, Sitthi-Amorn C, O’connor A, Hatcher-Roberts J, Bergevin Y, Wolfson M. Technology assessment: old, new, and needs-based. Int J Technol Assess Health Care 1995; 11(4):650–662.
Lázaro y de Mercado P. Evaluación de tecnología médica. Papeles Gest Sanit. 1994.
Maynard A. Transparency in health technology assessments. BMJ 2007; 334(7594):594–595.
Mytton OT, Velazquez A, Banken R, Mathew JL, Ikonen TS, Taylor K, et al. Introducing new technology safely. Qual Saf Health Care 2010; 19(Suppl 2):i9–i14.
Moharra M, Kubesch N, Estrada MD, Parada T, Cortés M, Espallargues M. Survey report on HTA organisations. Catalan Agency Health Technol Assess Res Catalan Health Serv Dep Health Auton Gov Catalonia Barc Spain [Internet]. 2008 [citado 28 de abril de 2016]; Recuperado a partir de: http://eunethta.eu/sites/5026.fedimbo.belgium.be/files/Survey%20report%20on%20 HTA%20organisations.pdf.
Pasternack I, Anttila H, Mäkelä M, Ikonen T, Räsänen P, Lampe K, et al. Testing the HTA Core Model: Experiences from two pilot projects. Int J Technol Assess Health Care 2009; 25(S2):21–27.
Centro Nacional de Excelencia Tecnológica en Salud. Evaluación de metodologías para la salud. Documento metodológico. Cenetec, México; 2010.
Buglioli Bonilla M, Pérez Galán A. Evaluación de tecnologías de salud. Rev Médica Urug 2002; 18(1):27–35.
Conde Olasagasti JL. Evaluación de tecnologías médicas basada en la evidencia. Agencia de Evaluación de Tecnologías Sanitarias. Instituto de Salud Carlos III. Ministerio de Sanidad y Consumo. 1998.
Martelli N, Lelong A-S, Prognon P, Pineau J. Hospital-based health technology assessment for innovative medical devices in university hospitals and the role of hospital pharmacists: learning from international experience. Int J Technol Assess Health Care 2013; 29(2):185–191.
Committee MSA, others. Guidelines for the assessment of diagnostic technologies. August; 2005.
Schnell-Inderst P, Mayer J, Lauterberg J, Hunger T, Arvandi M, Conrads-Frank A, et al. Health technology assessment of medical devices: What is different? An overview of three European projects. Z Für Evidenz Fortbild Qual Im Gesundheitswesen 2015; 109(4):309–318.
Pasternack I, de Groot I, Kleijnen S, Polman P. Comparing the HTA core model with a national health technology assessment report. Int J Technol Assess Health Care 2014; 30(5):530–535.
Observatorio Medicamentos de Alto Impacto Financiero (MAIF). Decisiones informadas sobre medicamentos de alto impacto financiero. [Citado 28 de abril de 2016]. http://www.omaif.org/
Ølholm AM, Kidholm K, Birk-Olsen M, Christensen JB. Hospital managers’need for information on health technology investments. Int J Technol Assess Health Care 2015; 31(6):414.
Lampe K, Pasternack I, Saarekas O, Raustia L, Cleemput I, Corio M, et al. Developing the HTA core model for the online environment. Int J Technol Assess Health Care 2014; 30(5):478–487.
Ong BN. The lay perspective in health technology assessment. Int J Technol Assess Health Care 1996; 12(3):511–517.
Burls A, Caron L, de Langavant GC, Dondorp W, Harstall C, Pathak-Sen E, et al. Tackling ethical issues in health technology assessment: a proposed framework. Int J Technol Assess Health Care 2011;27(3):230–237.
Rogers TL. Hospital-Based Technology Assessmen. Journal of Clinical Engineering 2002; 27(4):276-279.
Banta D, Oortwijn W. Conclusion: Health technology assessment and health care in the European Union. Int J Technol Assess Health Care 2000; 16(2):626–635.
Ehlers L, Vestergaard M, Kidholm K, Bonnevie B, Pedersen PH, Jørgensen T, et al. Doing mini– health technology assessments in hospitals: a new concept of decision support in health care? Int J Technol Assess Health Care 2006; 22(3):295–301.
Lehoux P, Denis J-L, Tailliez S, Hivon M. Dissemination of health technology assessments: identifying the visions guiding an evolving policy innovation in Canada. J Health Polit Policy Law 2005; 30(4):603–642.
Radaelli G, Lettieri E, Masella C, Merlino L, Strada A, Tringali M. Implementation of EUnetHTA core model® in lombardia: the VTS framework. Int J Technol Assess Health Care 2014; 30(1):105–112.
Kidholm K, Ølholm AM, Birk-Olsen M, Cicchetti A, Fure B, Halmesmäki E, et al. Hospital managers’ need for information in decision-making–An interview study in nine European countries. Health Policy 2015; 119(11):1424–1432.
Gallego G, Fowler S, van Gool K. Decision makers’ perceptions of health technology decision making and priority setting at the institutional level. Aust Health Rev Publ Aust Hosp Assoc. 2008; 32(3):520-527.
Stevens A, Milne R, Burls A. Health technology assessment: history and demand. J Public Health 2003; 25(2):98–101.
Johnson-Masotti AP, Eva K. A decision-making framework for the prioritization of health technologies. Health Serv Restruct Can New Evid New Dir Beach CM Chaykowski RP Shortt St-Hilaire F Sweetman Eds John Dtsch Inst Queen’s Univ Kingston USA. 2006;59–81.
Noorani HZ, Husereau DR, Boudreau R, Skidmore B. Priority setting for health technology assessments: a systematic review of current practical approaches. Int J Technol Assess Health Care 2007; 23(3):310–315.
Gelijns AC, Banta HD. The future and health care technology: implications of a system for early identification. 1994 [citado 28 de abril de 2016]; Recuperado a partir de: http://apps.who.int/ iris/handle/10665/48583.
Durand-Zaleski I, Leclerq R, Bagot M, Lemaire F, Revuz J, Spetebroodt Y, et al. Making choices in hospital resources allocation: The use of an assessment tool to decide which new projects are financed. Int J Technol Assess Health Care 1996; 12(1):163–171.
De los Monteros JCE, Javier VPR. Actualización de la Guía para la Adquisición de Nuevas Tecnologías (GANT). Madr Plan Nac Para El SNS MSC Agencia Eval Tecnol Sanit Andal AETSA. 2006.
Copenhagen: National Board of Health. Medical devices and health technology assessment [Internet]. 2000 [citado 28 de abril de 2016]. Recuperado a partir de: https://www.google.com/ search?q=go&ie=utf-8&oe=utf-8#q=Medical+devices+and+health+technology+assessmen t+(in+Danish).+Copenhagen:+National+Board+of+Health%3B+2000.
Helene Arentz-Hansen. Helene Arentz-Hansen Mini-HTA to support evidence-based decisions for new health technologies in Norwegian hospitals. [Internet]. Norwegian Knowledge Centre for the Health Services; [citado 28 de abril de 2016]. Recuperado a partir de: https:// www.google.com/search?q=go&ie=utf-8&oe=utf-8#q=Helene+Arentz-Hansen+MiniHTA+to+support+evidence-based+decisions+for+new+health+technologies+in+Norwegia n+hospitals.+Norwegian+Knowledge+Centre+for+the+Health+Services.
Vestergaard M, Ehlers L, Kidholm K, Holt P, Bonnevie B, Jensen M, et al. Introduction to miniHTA–a management and decision support tool for the hospital service. Dan Natl Board HealthCent Eval HTA. 2005.
Garrido MV. Health Technology Assessment and Health Policy-Making in Europe: Current Status, Challenges, and Potential [Internet]. WHO Regional Office Europe; 2008 [citado 4 de mayo de 2016]. Recuperado a partir de: https://books.google.com/books?hl=es&lr=&id=aV3M5uHTev 0C&oi=fnd&pg=PP2&dq=HEALTH+TECHNOLOGY+ASSESSMENT+AND+HEALTH+POLICY+M AKERING+IN+EUROPE&ots=LRR47zsOrm&sig=yXaYthzPOIA0GCwuuQtHleeDqTo
McGregor M. What Decision-Makers Want and What They Have Been Getting. Value Health. 2006; 9(3):181–185.
Bennie M, Dear J, Hems S, Black C, McIver L, Webb DJ. An investigation into the effect of advice from the Scottish Medicines Consortium on the use of medicines in Scotland’s Health Service. Br J Clin Pharmacol 2011; 71(2):283–288.
Hutton J, Trueman P, Facey K. Harmonization of evidence requirements for health technology assessment in reimbursement decision making. Int J Technol Assess Health Care 2008; 24(4):511.
Stafinski T, Menon D, Philippon DJ, McCabe C. Health Technology Funding Decision-Making Processes Around the World. Pharmacoeconomics 2011; 29(6):475–495.
Moharra M, Espallargues M, Kubesch N, Estrada M-D, Parada A, Vondeling H, et al. Systems to support health technology assessment (HTA) in Member States of the European Union with limited institutionalization of HTA. Int J Technol Assess Health Care 2009; 25(S2):75–83.
Tantivess S, Teerawattananon Y, Mills A. Strengthening cost-effectiveness analysis in Thailand through the establishment of the health intervention and technology assessment program. Pharmacoeconomics 2009; 27(11):931–945.
Watt AM, Hiller JE, Braunack-Mayer AJ, Moss JR, Buchan H, Wale J, et al. The ASTUTE Health study protocol: Deliberative stakeholder engagements to inform implementation approaches to healthcare disinvestment. Implement Sci 2012; 7(1):1–12.
Boenink M. Debating the desirability of new biomedical technologies: Lessons from the introduction of breast cancer screening in the Netherlands. Health Care Anal 2012; 20(1):84–102.
Poulin P, Austen L, Kortbeek JB, Lafrenière R. New technologies and surgical innovation five years of a local health technology assessment program in a surgical department. Surg Innov 2012; 19(2):187–199.
Mitchell MD, Williams K, Brennan PJ, Umscheid CA. Integrating local data into hospital-based healthcare technology assessment: two case studies. Int J Technol Assess Health Care 2010; 26(3):294–300.
Goodman C. Toward international good practices in health technology assessment. Int J Technol Assess Health Care 2012; 28(2):169–170.
Lampe K, Mäkelä M. HTA Core Model for Medical and Surgical Interventions. EUnetHTA. 2008.
Lampe K, Pasternack I. HTA Core Model for Medical and Diagnostic Technologies. EUnetHTA. 2008.
Gagnon M-P, Foundation CHSR, others. Opportunities to promote efficiency in hospital decisionmaking through the use of health technology assessment. Canadian Health Services Research Foundation; 2011.
Attieh R, Gagnon M-P. Implementation of local/hospital-based health technology assessment initiatives in low-and middle-income countries. Int J Technol Assess Health Care 2012; 28(4):445–451.
Bodeau-Livinec F, Simon E, Montagnier-Petrissans C, Joël M-E, Féry-Lemonnier E. Impact of CEDIT recommendations: An example of health technology assessment in a hospital network. Int J Technol Assess Health Care 2006; 22(2):161–168.
Elshaug AG, Hiller JE, Tunis SR, Moss JR. Challenges in Australian policy processes for disinvestment from existing, ineffective health care practices. Aust N Z Health Policy 2007; 4(1):23.
Lafortune L, Farand L, Mondou I, Sicotte C, Battista R. Assessing the performance of health technology assessment organizations: A framework. Int J Technol Assess Health Care 2008; 24(1):76–86.
Juzwishin D, Olmstead D, Menon D. Hospital-based technology assessment programmes: two Canadian examples. World Hosp Health Serv Off J Int Hosp Fed 1995; 32(2):2–9.
Mäkelä M, Roine RP. Health technology assessment in Finland. Int J Technol Assess Health Care 2009; 25(S1):102–107.