Yanara Marks, Jeffrey S. Hoch, Anna Heath, Petros Pechlivanoglou
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引用次数: 0
摘要
背景与目标卫生技术评估 (HTA) 的决策模型大多使用商业软件提交给 HTA 机构,而商业软件具有已知的局限性。有人建议使用开源编程语言 R,因为它高效、透明、可重现,并能考虑复杂的分析。然而,它在 HTA 中的使用仍然有限。本定性研究旨在探讨 R 语言在 HTA 中应用缓慢的主要原因,并找出切实的促进因素。方法我们与来自政府机构、咨询公司、制药公司和学术界的 24 位主要利益相关者进行了两次半结构化焦点小组讨论。两次讨论历时 1.5 小时,对之前研究中发现的障碍进行了反思,并强调了其他障碍。对讨论进行了记录和半誊写,并将数据整理和归纳为关键主题。结果 人力资源限制被认为是一个关键障碍,包括缺乏培训、优先排序和协作,以及对变革的抵制。另一个主要障碍是 HTA 机构对 R 中的提交缺乏认可或明确的指导。与会者还强调,在接受的软件包和决策模型结构方面缺乏沟通,HTA 机构之间也缺乏关于标准决策模型结构的沟通。编制培训材料和举办有针对性的研讨会被认为是一个关键的短期促进因素。加强利益相关者的沟通和参与也可以通过确定需求和机会、鼓励 HTA 机构解决结构性障碍以及提高使用 R 的积极性来促进 R 的使用。
Barriers and Facilitators of Using R for Decision Analytic Modeling in Health Technology Assessment: Focus Group Results
Background and Objective
Decision models for health technology assessment (HTA) are largely submitted to HTA agencies using commercial software, which has known limitations. The use of the open-source programming language R has been suggested because of its efficiency, transparency, reproducibility, and ability to consider complex analyses. However, its use in HTA remains limited. This qualitative study aimed to explore the main reasons for this slow uptake of R in HTA and identify tangible facilitators.
Methods
We undertook two semi-structured focus group discussions with 24 key stakeholders from government agencies, consultancy, pharmaceutical companies, and academia. Two 1.5-hour discussions reflected on barriers identified in a previous study and highlighted additional barriers. Discussions were recorded and semi-transcribed, and data were organized and summarized into key themes.
Results
Human resources constraints were identified as a key barrier, including a lack of training, prioritization and collaboration, and resistance to change. Another key barrier was the lack of acceptance, or clear guidance, around submissions in R by HTA agencies. Participants also highlighted a lack of communication around accepted packages and decision model structures, and between HTA agencies on standard decision modeling structures.
Conclusions
There is a need for standardization, which can facilitate decision model sharing, coding homogeneity, and improved country adaptations. The creation of training materials and tailored workshops was identified as a key short-term facilitator. Increased communication and engagement of stakeholders could also facilitate the use of R by identifying needs and opportunities, encouraging HTA agencies to address structural barriers, and increasing incentives to use R.
期刊介绍:
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