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AVALIA-T
avalia-t, Axencia de Avaliación de Tecnoloxías Sanitarias de Galicia Herramienta

PriTec TOOL FOR OBSOLETE HEALTH TECHNOLOGIES

 

In 2008, the Galician Health Technology Assessment Agency (Spain) started a project, under the collaboration framework established by the National Health System Quality Plan, aimed at developing a methodological guideline for the identification, prioritisation and assessment of obsolete health technologies [complete document]. The principal aim of the guideline is to establish the methodological bases for guiding people or institutions that are interested in analysing obsolete health technologies in their respective health-care settings and wish to explore such technologies in depth, e.g., identification, prioritisation or assessment.

To facilitate and promote the prioritisation of obsolete technologies eligible for assessment, a topic specifically addressed in the guideline, the Directorate-General for Health Assurance & Planning of the Galician Health Authority, impelled the development of a prioritisation tool.

The PriTec prioritisation tool developed by avalia-t makes allows for the prioritisation of obsolete health technologies for which undertaking an assessment would be especially relevant. It is an automatically applicable web application, consisting of scoreable criteria grouped in the prioritisation areas (domains) associated with the monitored technology: a) characteristics of the target population/end-users; b) risk/benefit; and, c) costs, organisation and other implications. PriTec enables the simultaneous comparison of up to 50 technologies and generates a prioritisation report that includes the main results and figures.

METHODOLOGY

  1. Work levels

To develop the prioritisation process on which the PriTec tool is based, the following work levels were defined:

  • Technical team: made up of avalia-t technical staff who co-ordinated the prioritisation project. Its functions were to review and analyse the scientific evidence, assess the results and propose prioritisation areas or domains, as well as initial prioritisation criteria (items within each domain).
  • Working group: made up of experts in health technology assessment drawn from various Spanish assessment agencies and units. Its functions were to critically review the prioritisation methodology, the initial prioritisation criteria and the results sent to the panel of experts. They were responsible for proposing the members of the panel of experts within their region.
  • Panel of experts: made up of policy makers (hospital directors and directors of health authority central services, such as health care, health assurance, public health, etc.), clinicians(primary and specialised care) and system end-users (patient associations, consumer and end-user organisations, consultancy groups, community participation groups and other types of users), selected to participate in the obsolete technology prioritisation process. Members of the panel of experts scored and weighted the prioritisation criteria proposed by the working group. To facilitate comprehension of the questionnaire, a specific version adapted for system end-users was drawn up.
  1. Selection of prioritisation criteria and domains

The initial list of domains and prioritisation criteria was drawn up in consensus with the working group. A total of 14 prioritisation criteria classified into 4 domains were included: a) population/end-users; b) technology; c) risk/benefit; and, d) costs, organisation and other implications.

  1. Domain scores and weightings

Each prioritisation criterion was scored by the panel of experts on a scale of 1 to 9 points according to the importance attributed, i.e.: a) score of 7-9, clearly important element, b) score of 4-6, doubts about its importance; and c) score of 1-3, element of no or little importance. The panel of experts allocated domains a partial weight over 100%, in line with the latter's relative relevance for obsolete technologies. The 10 criteria finally included were selected on the basis of the median, with only those criteria having a value of 7 or higher being included. This meant the elimination of the "technology" domain. The final weight allocated to each of the ensuing 3 domains was that which corresponded to the median of the weighting values allocated by the panel of experts, namely: a) population/end-users, 36.66%; b) risk/benefit, 36.66%; and, c) costs, organisation and other implications, 26.67 %.

  1. Tool′s operation

For full information on the tool′s operation, please see the "User Guide" document, which will be found on the menu shown on the left-hand side of the application, containing detailed instructions for the tool's use. Once the data have been entered, PriTec automatically performs all the calculations. Moreover, it furnishes results for each technology and displays these in a comparative manner for the respective pre-selected technologies. For a detailed explanation of how scores are calculated, please see the "Score calculation" document, which will be found on the menu shown on the left-hand side of the application, setting out the score calculation formulae in detail. PriTec enables reports to be generated and any data and results obtained in situ to be stored in the form of tables and figures so that these may be used in subsequent work sessions. No data entered into the application are stored on the web, which guarantees the total confidentiality of any data introduced.


avalia-t, Axencia de Avaliación de Tecnoloxías Sanitarias de Galicia