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The Article Alert for the week of April 18, 2016 (sample articles)
Wortley S, Tong A, Howard K. Community views and perspectives on public engagement in health technology assessment decision making. Aust.Health Rev. Epub 2016 Apr 7. PMID: 27050156.
Objectives: The aim of the present study was to describe community views and perspectives on public engagement processes in Australian health technology assessment (HTA) decision making.
Methods: Six focus groups were held in Sydney (NSW, Australia) as part of a broad program of work on public engagement and HTA. Eligible participants were aged ≥18 years and spoke English. Participants were asked about their views and perspectives of public engagement in the HTA decision-making process, with responses analysed using a public participation framework.
Results: Fifty-eight participants aged 19-71 years attended the focus groups. Responses from the public indicated that they wanted public engagement in HTA to include a diversity of individuals, be independent and transparent, involve individuals early in the process and ensure that public input is meaningful and useful to the process. This was consistent with the public participation framework. Perceived shortcomings of the current public engagement process were also identified, namely the lack of awareness of the HTA system in the general population and the need to acknowledge the role different groups of stakeholders or 'publics' can have in the process.
Conclusions: The public do see a role for themselves in the HTA decision-making process. This is distinct to the involvement of patients and carers. It is important that any future public engagement strategy in this field distinguishes between stakeholder groups and outline approaches that will involve members of the public in the decision-making process, especially if public expectations of involvement in healthcare decision-making continue to increase.
What is known about this topic? The views and perspectives of patients and consumers are important in the HTA decision-making process. There is a move to involve the broader community, particularly as decisions become increasingly complex and resources more scarce.
What does this paper add? It not been known to what extent, or at what points, the community would like to be engaged with the HTA decision-making process. The present study adds to the evidence base on this topic by identifying features of engagement that may be important in determining the extent of wider public involvement. It is clear that the community expects the system to be transparent, for patients to be involved early in specific processes and the wider community to be able to contribute to the broader vision of the healthcare system.
What are the implications for practitioners? A formalised strategy is needed to include the public voice into health technology decisions. With the current level of reform in the healthcare sector and the focus on creating a sustainable healthcare system, there is a real opportunity to implement an approach that not only informs patients and the community of the challenges, but includes and incorporates their views into these decisions. This will assist in developing and adapting policy that is relevant and meets the needs of the population.
Carman KL, Maurer M, Mangrum R, Yang M, Ginsburg M, Sofaer S, Gold MR, Pathak-Sen E, Gilmore D, Richmond J, et al. Understanding An Informed Public's Views On The Role Of Evidence In Making Health Care Decisions. Health.Aff. 2016 Apr 1;35(4):566-74. PMID: 27044953.
Policy makers and practitioners increasingly believe that medical evidence plays a critical role in improving care and health outcomes and lowering costs. However, public understanding of the role of evidence-based care may be different. Public deliberation is a process that convenes diverse citizens and has them learn about and consider ethical or values-based dilemmas and weigh alternative views. The Community Forum Deliberative Methods Demonstration project, sponsored by the Agency for Healthcare Research and Quality, obtained informed public views on the role of evidence in health care decisions through seventy-six deliberative groups involving 907 people overall, in the period August-November 2012. Although participants perceived evidence as being essential to high-quality care, they also believed that personal choice or clinical judgment could trump evidence. They viewed doctors as central figures in discussing evidence with patients and key arbiters of whether to follow evidence in individual cases. They found evidence of harm to individuals or the community to be more compelling than evidence of effectiveness. These findings indicate that increased public understanding of evidence can play an important role in advancing evidence-based care by helping create policies that better reflect the needs and values of the public.
- DOI: http://dx.doi.org/10.1377/hlthaff.2015.1112
- PubMed: http://www.ncbi.nlm.nih.gov/pubmed/27044953
Doos L, Packer C, Ward D, Simpson S, Stevens A. Past speculations of the future: a review of the methods used for forecasting emerging health technologies. BMJ Open. 2016 Mar 10;6(3):e010479. PMID: 26966060.
Objectives: Forecasting can support rational decision-making around the introduction and use of emerging health technologies and prevent investment in technologies that have limited long-term potential. However, forecasting methods need to be credible. We performed a systematic search to identify the methods used in forecasting studies to predict future health technologies within a 3-20-year timeframe. Identification and retrospective assessment of such methods potentially offer a route to more reliable prediction.
Design: Systematic search of the literature to identify studies reported on methods of forecasting in healthcare.
Participants: People are not needed in this study.
Data Sources: The authors searched MEDLINE, EMBASE, PsycINFO and grey literature sources, and included articles published in English that reported their methods and a list of identified technologies.
Main Outcome Measure: Studies reporting methods used to predict future health technologies within a 3-20-year timeframe with an identified list of individual healthcare technologies. Commercially sponsored reviews, long-term futurology studies (with over 20-year timeframes) and speculative editorials were excluded.
Results: 15 studies met our inclusion criteria. Our results showed that the majority of studies (13/15) consulted experts either alone or in combination with other methods such as literature searching. Only 2 studies used more complex forecasting tools such as scenario building.
Conclusions: The methodological fundamentals of formal 3-20-year prediction are consistent but vary in details. Further research needs to be conducted to ascertain if the predictions made were accurate and whether accuracy varies by the methods used or by the types of technologies identified. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a license) please go to http://www.bmj.com/company/products-services/rights-and-licensing/