tailieunhanh - Báo cáo y học: "Combining multicriteria decision analysis, ethics and health technology assessment: applying the EVIDEM decisionmaking framework to growth hormone for Turner syndrome patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Combining multicriteria decision analysis, ethics and health technology assessment: applying the EVIDEM decisionmaking framework to growth hormone for Turner syndrome patients. | Goetghebeur et al. Cost Effectiveness and Resource Allocation 2010 8 4 http content 8 1 4 COST EFFECTIVENESS AND RESOURCE ALLOCATION RESEARCH Open Access Combining multicriteria decision analysis ethics and health technology assessment applying the EVIDEM decisionmaking framework to growth hormone for Turner syndrome patients 1 1 1 1 23 Mireille M Goetghebeur Monika Wagner Hanane Khoury Donna Rindress Jean-Pierre Grégoire Cheri Deal Abstract Objectives To test and further develop a healthcare policy and clinical decision support framework using growth hormone GH for Turner syndrome TS as a complex case study. Methods The EVIDEM framework was further developed to complement the multicriteria decision analysis MCDA Value Matrix that includes 15 quantifiable components of decision clustered in four domains quality of evidence disease intervention and economics with a qualitative tool including six ethical and health system-related components of decision. An extensive review of the literature was performed to develop a health technology assessment report HTA tailored to each component of decision and content was validated by experts. A panel of representative stakeholders then estimated the MCDA value of GH for TS in Canada by assigning weights and scores to each MCDA component of decision and then considered the impact of non-quantifiable components of decision. Results Applying the framework revealed significant data gaps and the importance of aligning research questions with data needs to truly inform decision. Panelists estimated the value of GH for TS at 41 of maximum value on the MCDA scale with good agreement at the individual level retest value 40 ICC and large variation across panelists. Main contributors to this panel specific value were Improvement of efficacy Disease severity and Quality of evidence . Ethical considerations on utility efficiency and fairness as well as potential misuse of GH had mixed effects on the .