Article type
Abstract
Background: In 2016 WHO launched the Priority Assistive Product List (APL) which included 50 assistive products (APs) aimed at improving access to assistive technology on a global scale. While this process provided a sound foundation, there is merit in further standardizing and improving transparency in evaluation and ranking APs for the APL.
Objective: To develop a toolbox for prioritizing APs for inclusion in the WHO APL.
Methods: The toolbox was developed in a three-stage process: first a scoping review was performed in MEDLINE, aimed at identifying indicators describing the value of APs. Secondly, a Delphi study was performed amongst expert representing different functional domains, stakeholder groups (e.g. developers, healthcare professionals, AP user representatives), and WHO regions. Experts were asked to comment on indicator definitions, and judge importance using a 5-point Likert scale. The highest scoring indicators were selected, and experts were asked to provide weights for these. In the final stage, a toolbox consisting of an evaluation and ranking tool was developed and piloted using real-world case-studies.
Results: From 682 records identified in the scoping review, 21 studies were selected containing 50 indicators. Fourteen indicators were selected and reviewed by a panel of 51 experts. After careful deliberation, four quantitative indicators were selected and weighted: need, benefits, risks, and costs, with weights of 1.75, 1.5, 1.0 and 1.0 respectively. Each of these indicators should be rated as either ‘very low’, ‘low’, ‘moderate’, ‘high’, or ‘very high’ based on the available evidence. In addition, the level of evidence should be provided for each indicator, including any other considerations. All information is compiled in a summary overview, which can be exported to a score-based ranking tool, serving as the basis for consensus-based ranking.
Conclusion: This toolbox aims to generate a globally representative list of prioritized APs, through a transparent evidence-based process. It is not intended as a final version, but rather as the first of many iterations, expected to adapt with emerging methodological insights.
Relevance and importance to patients: A systematic and transparent evaluation of APs is essential to enhance the trust of AP users and the general public in regulatory processes.
Objective: To develop a toolbox for prioritizing APs for inclusion in the WHO APL.
Methods: The toolbox was developed in a three-stage process: first a scoping review was performed in MEDLINE, aimed at identifying indicators describing the value of APs. Secondly, a Delphi study was performed amongst expert representing different functional domains, stakeholder groups (e.g. developers, healthcare professionals, AP user representatives), and WHO regions. Experts were asked to comment on indicator definitions, and judge importance using a 5-point Likert scale. The highest scoring indicators were selected, and experts were asked to provide weights for these. In the final stage, a toolbox consisting of an evaluation and ranking tool was developed and piloted using real-world case-studies.
Results: From 682 records identified in the scoping review, 21 studies were selected containing 50 indicators. Fourteen indicators were selected and reviewed by a panel of 51 experts. After careful deliberation, four quantitative indicators were selected and weighted: need, benefits, risks, and costs, with weights of 1.75, 1.5, 1.0 and 1.0 respectively. Each of these indicators should be rated as either ‘very low’, ‘low’, ‘moderate’, ‘high’, or ‘very high’ based on the available evidence. In addition, the level of evidence should be provided for each indicator, including any other considerations. All information is compiled in a summary overview, which can be exported to a score-based ranking tool, serving as the basis for consensus-based ranking.
Conclusion: This toolbox aims to generate a globally representative list of prioritized APs, through a transparent evidence-based process. It is not intended as a final version, but rather as the first of many iterations, expected to adapt with emerging methodological insights.
Relevance and importance to patients: A systematic and transparent evaluation of APs is essential to enhance the trust of AP users and the general public in regulatory processes.