International Journal of Technology Assessment in Health Care最新文献

{"title":"Inclusion and use of ethical analysis in health technology assessment reports relevant to genomic newborn screening.","authors":"Siun Gallagher, Joanne Scarfe, Ainsley J Newson, Sarah Norris","doi":"10.1017/S0266462326104115","DOIUrl":"10.1017/S0266462326104115","url":null,"abstract":"<p><strong>Objectives: </strong>Advances in the use of genomic technologies in newborn bloodspot screening (NBS) raise ethical challenges that should be systematically and critically considered. We examine how ethical analyses have been incorporated into health technology assessments (HTA) relevant to genomic NBS to inform how ethics might be incorporated in Australian HTAs of genomic NBS.</p><p><strong>Methods: </strong>We conducted an inductive content analysis of publicly available HTA reports and summaries relevant to genomic NBS published between January 2013 and June 2023 across 18 countries. Eligible reports related to genetic or genomic testing or population screening. These reports were screened for inclusion of ethical considerations and coded with NVivo for their presence, structure, and reported influence on decision making. Twelve reports with substantial ethical discussion were examined in-depth through qualitative thematic analysis.</p><p><strong>Results: </strong>One hundred and ninety reports met our inclusion criteria, with Spain, Australia, and the United Kingdom heavily represented. Ethics was mentioned in 39 percent of reports, and ethical analysis appeared to influence recommendations in 13 percent. When present, ethical considerations focused on equity, harm, and autonomy. Consideration of ethical issues was mostly unstructured, descriptive, and lacked normative conclusions.</p><p><strong>Conclusions: </strong>Although a range of ethical considerations were raised in the HTA reports relevant to genomic NBS, ethical analyses were generally inconsistently applied or reported, and the way in which ethics has influenced HTA recommendations was not always clear. Further work is needed to understand how the role of ethics in Australian HTAs of genomic NBS could be strengthened to ensure ethically defensible decisions.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":" ","pages":"e84"},"PeriodicalIF":3.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and use of ecological and economic evaluation of medical devices in healthcare centers: a survey of French hospitals.","authors":"Sophie Bouvet, Sarah Kabani, Manuel Roulaud, Elodie Benhaim, Thierry Chevallier, Virginie Chasseigne, Audrey Cordon, Sihame Chkair","doi":"10.1017/S0266462326104048","DOIUrl":"10.1017/S0266462326104048","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study is to examine current practices regarding the integration of environmental and economic impact assessments in decision making for medical device procurement across French healthcare facilities. These findings will reveal the barriers to environmental criteria integration in Hospital-Based Health Technology Assessment (HB-HTA).</p><p><strong>Methods: </strong>A cross-sectional survey, collected between 21 May and 12 July 2024, explored knowledge and implementation of environmental and economic assessments in hospital-based medical device procurement. Disseminated nationwide through the French Interregional Clinical Research and Innovation Groups (GIRCI), the French National Agency for Support to Healthcare Performance (ANAP) network, and via Territorial Hospital Groups, targeting public and private healthcare centers, the eight-section survey addressed governance, eco-responsible procurement, environmental data accessibility, and experience with joint assessments and certification practices.</p><p><strong>Results: </strong>Twenty-nine healthcare centers were analyzed, mostly regional or university hospitals or community hospitals (88 percent), primarily in the public sector. A structured approach to ecological transition was reported by 76 percent of institutions. Eco-responsible purchasing measures were implemented in nineteen centers (83 percent); however, access to life-cycle assessment data, especially for upstream manufacturing phases, remained limited. Forty-five percent of institutions had conducted joint environmental-economic assessments. Although 70 percent of respondents were aware of responsible procurement certifications schemes, only 36 percent used them.</p><p><strong>Conclusions: </strong>French healthcare institutes demonstrate growing awareness and engagement in sustainable procurement practices. However, limited access to standardized environmental data blocks systematic integration of environmental criteria into procurement practices and thus HB-HTA. Strengthening supplier transparency, harmonizing evaluation frameworks, and embedding environmental metrics into both processes could accelerate sustainable transition.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":" ","pages":"e82"},"PeriodicalIF":3.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prompt-based tutorial for large language model-assisted screening in systematic reviews and meta-analyses.","authors":"Tongyu Qiu, Huangqi Jiang, Mark S Chen, Tao Lin","doi":"10.1017/S0266462326104073","DOIUrl":"10.1017/S0266462326104073","url":null,"abstract":"<p><strong>Objectives: </strong>Title/abstract and full-text screening are among the most time-consuming stages of systematic reviews. Large language models (LLMs) such as ChatGPT can assist in screening, but prior evaluations have largely focused on abstract-level decisions and require coding or application programming interfaces (API) access, limiting practical application. This study developed and evaluated a structured, prompt-based approach that enables LLMs to perform both abstract and full-text screening without programming or API integration.</p><p><strong>Methods: </strong>Using datasets from three completed meta-analyses, we implemented a stepwise training framework involving comprehension checks, criterion-specific feedback, and iterative prompt refinement. Study 1 optimized file format and batch size using 1,000 abstracts and 50 full texts. Studies 2 and 3 validated the approach using independent datasets on teletherapy versus in-person therapy (1,321 abstracts, 82 full texts) and emotion regulation and mental health (1,500 abstracts, 129 full texts), respectively. Human reviewers' decisions served as the reference standard.</p><p><strong>Results: </strong>In Study 1, the LLM achieved 98 percent sensitivity and 80.6 percent specificity at abstract screening, with batches of 50 abstracts in plain-text format performing optimally. In Study 2, sensitivity and specificity were 100 percent and 85.6 percent for abstracts, with 82.1 percent full-text accuracy and all eligible studies retained. In Study 3, abstract screening achieved 100 percent sensitivity and 93 percent specificity, while full-text screening achieved 96.2 percent sensitivity and 90.3 percent specificity.</p><p><strong>Conclusions: </strong>A structured, prompt-based approach enabled LLMs to achieve high sensitivity and specificity across both screening stages without coding or APIs. With human oversight, this accessible workflow can reduce reviewer burden and accelerate evidence synthesis.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":" ","pages":"e83"},"PeriodicalIF":3.0,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demonstrating transportability of real-world evidence: what do HTA bodies and health technology developers need?","authors":"Ashley A Jaksa, Blythe Adamson, Robert Szulkin, Christian Dehlendorff, Emma Hernlund, Vandana Ayyar Gupta, Melinda Hanisch, Jing Wang-Silvanto, Karen M Facey","doi":"10.1017/S0266462326103924","DOIUrl":"10.1017/S0266462326103924","url":null,"abstract":"<p><p>Real-world evidence (RWE) is reshaping how health technology assessment (HTA) bodies evaluate therapies, yet a critical gap persists: while transportability methods enable researchers to adapt treatment effect estimates from RWE studies in another jurisdiction to local contexts, the field remains unclear on when these analyses impact decision-making. This article synthesizes insights from HTA bodies, health technology developers (HTDs), and methodologists to clarify what is missing from today's transportability conversation. We find that methodological progress has outpaced guidance on its utility; HTDs risk investing in transportability analyses without clear evidence that they reduce key uncertainties or affect recommendations. We identify three fundamental gaps: the absence of objective thresholds for determining whether transportability assumptions are adequately met; limited guidance on when quantitative transportability is needed versus qualitative assessment; and variation in HTA bodies' evaluation and application of transported evidence. These gaps create a critical impasse where HTDs must decide whether to invest in such analyses, while HTA bodies lack standardized frameworks for their assessment. We argue that transportability cannot transition from academic exercise to a decision-making tool without explicit early dialogue between stakeholders, transparent reporting standards, and capacity building within HTA bodies. We present actionable recommendations to build HTA expertise, create a case study repository, and define contexts where transported RWE demonstrably impacts patient access. As evidence dossiers increasingly rely on nonlocal data, addressing these strategic and operational gaps becomes essential to help patients.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":"42 1","pages":"e66"},"PeriodicalIF":3.0,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting Gaps for Innovation in HTA: Analysis of Technological Submissions as a Strategy for Translational Research.","authors":"Laís Lopes, Bernardo Soares Fernandes, Alessandro Nakoneczny Schildt, Fernanda Oliveira, Maria Angélica Pires Ferreira","doi":"10.1017/S0266462326104036","DOIUrl":"https://doi.org/10.1017/S0266462326104036","url":null,"abstract":"","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":" ","pages":"1-20"},"PeriodicalIF":3.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing and implementing a protocol for evaluating patient involvement in health technology assessment: the experience of the Spanish HTA network (RedETS).","authors":"Eva Reviriego-Rodrigo, Paula Cantero-Muñoz, Laura Llinàs-Mallol, Begoña Rodríguez-Ortiz de Salazar, Vanesa Ramos-García, Analía Abt-Sacks, Matilde Palma-Ruiz, Anabel Granja-Dominguez, Gustavo Mora-Navarro, Beatriz Fernández-Martín, Celia Juárez-Rojo, Ana Toledo-Chávarri","doi":"10.1017/S0266462326104085","DOIUrl":"10.1017/S0266462326104085","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study is to describe the development and first implementation of a protocol for evaluating patient involvement in health technology assessment (HTA) within the Spanish HTA Network (RedETS), establishing a framework for continuous monitoring across agencies.</p><p><strong>Methods: </strong>A multi-phase process informed protocol development. Indicators were proposed and refined based on international evidence and RedETS experience. Three concise questionnaires were designed for agency leads, HTA coordinators, and patients, and improved through consultation and pilot testing. The first evaluation cycle was conducted in March 2025 via online surveys. Quantitative data were summarized descriptively, and qualitative responses analyzed thematically. A stakeholder meeting reviewed findings.</p><p><strong>Results: </strong>Responses were received from all eight agencies, the coordinators of all forty-nine HTA reports published during the study period, and ten of the thirty-three patients involved in these reports. Twenty reports (41 percent) included patient involvement, mainly through protocol review, draft validation, consultation meetings, or qualitative research. Twenty-nine reports (59 percent) had no patient involvement; among these, six of twenty-nine (21 percent) had attempted recruitment but could not implement it due to recruitment or organizational barriers. In reports with involvement, participation represented a small proportion of assessment time and often relied on a single patient. Patient respondents valued their contribution but noted unclear expectations, technical language, and limited feedback.</p><p><strong>Conclusions: </strong>The protocol proved feasible and valuable for monitoring whether, how, and when patients are involved in HTA. Strengthening planning, recruitment, and feedback will support more meaningful engagement. RedETS provides a scalable model for continuous monitoring in HTA.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":" ","pages":"e76"},"PeriodicalIF":3.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reporting the use of AI in horizon scanning: a brief communication on methodological standards.","authors":"Hannah O'Keefe, Claire Eastaugh, Chris Marshall","doi":"10.1017/S026646232610405X","DOIUrl":"10.1017/S026646232610405X","url":null,"abstract":"<p><strong>Objectives: </strong>The UK is being positioned to become a leader in the field of artificial intelligence (AI), with the government driving the AI Opportunities Action Plan. In line with the government's push for an AI-driven future, horizon-scanning organizations are leveraging AI and embedding it within their methodological practices. To ensure the transparent, reliable, and responsible use of AI, horizon scanning requires a set of tailored reporting items. However, this is a notable gap in the current methodological landscape.</p><p><strong>Methods: </strong>This methods communication discusses the current guidelines, policies, and statements around the use of AI relevant to futures and foresight research for health, social care, and life sciences policy and practice. We include stakeholder positions, research funding applications and writing for publication within the discussion and demonstrate how these guidelines relate to horizon scanning practices, with a focus on the common recommendations for reporting AI.</p><p><strong>Results: </strong>We have utilized the documents to identify and consolidate reporting recommendations into a minimal set of reporting items for AI in horizon scanning. A total of 139 data points were consolidated into 46 reporting items under six categories.</p><p><strong>Conclusions: </strong>Further work is needed to validate these reporting items, but this interim step toward a robust reporting framework fills an immediate methodological need. We encourage those working in the horizon scanning space to continue to explore and embed AI transparently and responsibly in this rapidly adapting field.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":" ","pages":"e68"},"PeriodicalIF":3.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13468941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What we choose to value in the artificial intelligence era of healthcare.","authors":"Jennifer C Goldsack","doi":"10.1017/S0266462326104061","DOIUrl":"10.1017/S0266462326104061","url":null,"abstract":"","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":" ","pages":"e74"},"PeriodicalIF":3.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of health economic evaluations published in Lebanon: summary of current practice, a critical appraisal, and recommendations for future studies.","authors":"Wadih Mina, Rana Rizk, David Burns, Caroline Daccache, Rita Karam, Dwayne Boyers","doi":"10.1017/S0266462326103961","DOIUrl":"10.1017/S0266462326103961","url":null,"abstract":"<p><strong>Introduction: </strong>Health technology assessment is emerging in Lebanon, with an increased interest in health economic evaluations (EEs). Despite the importance of the methodological quality of EEs, no study has examined this issue in Lebanon.</p><p><strong>Objective: </strong>As only methodologically robust health EE can meaningfully inform decision making, this study systematically reviews and critically appraises published full EEs in Lebanon, formulating recommendations to strengthen the quality and consistency of future evaluations within the Lebanese context.</p><p><strong>Methods: </strong>We searched for full model- and trial-based EEs and cost-minimization analyses (CMAs) on NHSEED, Medline, EMBASE, and CINAHL without language or time restrictions. We followed PRISMA guidelines, narratively synthesized the characteristics, methods, and results of studies, and critically appraised them using CHEC for trial-based evaluations and CMA and CHEC-Extended for model-based evaluations.</p><p><strong>Results: </strong>Eight studies, published 2012-2025, were included: five model-based, two trial-based, and one CMA. Assessed technologies included screening/vaccination programs, diagnostic tools, nutrition education, e-mental health interventions, and early versus delayed treatment of hepatitis C. Methodological inconsistencies pertained mostly to discounting rates and willingness-to-pay thresholds. Suboptimal quality pertained mainly to model-based evaluations conducted by Lebanese researchers. Common pitfalls included the perspective being unclear; the identification, measurement, and valuation of costs and outcomes; model validation and calibration; sensitivity analyses; and discounting. The trial-based and CMA met more than 80 percent of the criteria.</p><p><strong>Conclusion: </strong>We identified a limited number of published full EEs in Lebanon and highlighted their major shortcomings. Future work should scale up high-quality EEs in Lebanon, particularly modeling studies, to inform resource allocation.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":" ","pages":"e88"},"PeriodicalIF":3.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the conflict-of-interest reporting practices in published health technology assessment reports.","authors":"Miro Vuković, Filipa Alpeza, Ana Marušić","doi":"10.1017/S0266462326104024","DOIUrl":"10.1017/S0266462326104024","url":null,"abstract":"<p><strong>Background: </strong>Health technology assessment (HTA) informs healthcare policy, reimbursement, and clinical decision making. Transparency in conflict-of-interest (CoI) reporting is critical to ensure the credibility and impartiality of HTA outputs. However, the extent and consistency of CoI disclosures across HTA reports remain unclear.</p><p><strong>Objectives: </strong>To systematically assess the frequency, form, and comprehensiveness of CoI reporting in published HTA reports and to identify possible patterns.</p><p><strong>Methods: </strong>We retrieved and screened 1,215 HTA records from the International HTA Database. After exclusions, 689 English-language reports were analyzed (full and mini HTAs (<i>n</i> = 254), rapid reviews (<i>n</i> = 166), and HTA research studies (<i>n</i> = 269)). CoI statements were categorized as positive (declared CoI) or negative (no CoI). Cross-country comparisons and content analyses of positive statements were conducted distinguishing between the presence of disclosure, its content and granularity, and the transparency of conflict management.</p><p><strong>Results: </strong>CoI statements were present in 71 percent of full/mini HTAs, 60 percent of rapid reviews, and 100 percent of HTA research studies. CoIs were declared in 14, 16, and 83 percent of these categories, respectively. Reporting practices varied widely among agencies, with few providing detailed or standardized disclosures. Financial CoI dominated, while nonfinancial and institutional CoI were less frequently addressed.</p><p><strong>Conclusions: </strong>CoI reporting in HTA remains inconsistent despite its recognized importance for transparency. Disclosure and management of conflicts represent distinct governance functions, both requiring attention. Our findings highlight a need for harmonized, individual-level disclosure policies, and a description of CoI management strategies in HTA processes.</p>","PeriodicalId":14467,"journal":{"name":"International Journal of Technology Assessment in Health Care","volume":" ","pages":"e75"},"PeriodicalIF":3.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}