Article type
Abstract
"Background: Health Technology Assessment (HTA) is a multidisciplinary approach that uses explicit methods to estimate the value of health technologies throughout its life cycle. The goal of HTA is to help decision-makers achieve an equitable, efficient and high-quality healthcare system. The approach is formal, systematic, and transparent, and uses state-of-the-art methods to consider the best available evidence. HTA has played an essential role in improving the quality and efficiency of health resource utilization. As the field evolved, there were numerous efforts to evaluate, improve and harmonize the science, methodologies, and practices of HTA. Evidence grading is an indispensable tool and process in helping decision-makers obtain the best evidence. However, no study has yet systematically analyzed the evidence grading system used in HTA evidence production.
Objective: To conduct a cross-sectional survey on the use of the evidence grading systems in HTA.
Methods: Web of Science and CNKI databases were systematically searched to collect complete HTA reports. The search was limited to Chinese or English language publications and covered articles published from inception to January 2023. Studies were selected manually and coded by two reviewers independently, and any conflicts were discussed with a third reviewer. Data extraction included but not limit to year of publication, corresponding author’s country, source of funding, subject of the study, purpose of the study, content (safety, efficacy, economy and social adaptation) of HTA, and evidence grading system.
Results: Of the 4119 articles identified, 214 met the inclusion criteria. Considering the content of the assessment, 200 assessed the effectiveness of health innovations, 184 assessed safety, 184 assessed economic viability, and 37 assessed social adaptability. Only 9 HTAs used the evidence grading systems, with three using GRADE (Grading of Recommendations, Assessment, Development and Evaluations), one using the evidence grading system developed by David Sackett et.al in 1986, and the remaining five used other evidence grading systems.
Conclusion: Evidence grading systems were not widely used in HTAs, while the most commonly used evidence grading systems were GRADE. Evidence grading systems applicable to HTAs need to be developed."
Objective: To conduct a cross-sectional survey on the use of the evidence grading systems in HTA.
Methods: Web of Science and CNKI databases were systematically searched to collect complete HTA reports. The search was limited to Chinese or English language publications and covered articles published from inception to January 2023. Studies were selected manually and coded by two reviewers independently, and any conflicts were discussed with a third reviewer. Data extraction included but not limit to year of publication, corresponding author’s country, source of funding, subject of the study, purpose of the study, content (safety, efficacy, economy and social adaptation) of HTA, and evidence grading system.
Results: Of the 4119 articles identified, 214 met the inclusion criteria. Considering the content of the assessment, 200 assessed the effectiveness of health innovations, 184 assessed safety, 184 assessed economic viability, and 37 assessed social adaptability. Only 9 HTAs used the evidence grading systems, with three using GRADE (Grading of Recommendations, Assessment, Development and Evaluations), one using the evidence grading system developed by David Sackett et.al in 1986, and the remaining five used other evidence grading systems.
Conclusion: Evidence grading systems were not widely used in HTAs, while the most commonly used evidence grading systems were GRADE. Evidence grading systems applicable to HTAs need to be developed."