Ethical challenges for Health Technology Assessment (HTA) in the evolving evidence landscape.

Autor: Refolo P; Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy.; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Duthie K; John Dossetor Health Ethics Centre, University of Alberta, Edmonton, AB, Canada., Hofmann B; Department of Health Science, Norwegian University of Science and Technology, Gjøvik, Norway., Stanak M; National Institute for Value and Technologies in Healthcare (NIHO), Bratislava, Slovak Republic., Bertelsen N; Health Technology Assessment international (HTAi) Patient & Citizen Involvement, Neil Bertelsen Consulting, Berlin, Germany., Bloemen B; Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands., Di Bidino R; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Oortwijn W; Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands., Raimondi C; Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy.; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Sacchini D; Department of Healthcare Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy.; Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., van der Wilt GJ; Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands., Bond K; Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.
Jazyk: angličtina
Zdroj: International journal of technology assessment in health care [Int J Technol Assess Health Care] 2024 Nov 04; Vol. 40 (1), pp. e39. Date of Electronic Publication: 2024 Nov 04.
DOI: 10.1017/S0266462324000394
Abstrakt: Since its inception, Health Technology Assessment (HTA) has typically determined the value of a technology by collecting information derived from randomized clinical trials (RCTs), in line with the principles of evidence-based medicine (EBM). However, data from RCTs did not constitute the sole source of information, as other types of evidence (such as primary qualitative research) have often been utilized. Recent advances in both generating and collecting other types of evidence are broadening the landscape of evidence, adding complexity to the discussion of "robustness of evidence." What are the consequences of these recent developments for the methodology and conduct of HTA, the HTA community, and its ethical commitments? The aim of this article is to explore some ethical challenges that are emerging in the current evolving evidence landscape, particularly changes in evidence generation and collection (e.g., diversification of data sources), and shifting standards of evidence in the field of HTA (e.g., increasing acceptability of evidence that is thought of as lower quality). Our conclusion is that deciding how to best maintain trustworthiness is common to all these issues.
Databáze: MEDLINE