For our technology assessments and various other assignments, we use the EUnetHTA methodology. It was developed in cooperation with European HTA institutions and it offers guidance on how to answer challenging medical questions in a scientific way using evidence-based medicine. For example:
- What current technology can we compare the new technology with? In other words, how to choose a suitable comparator?
- How to choose relevant studies and information from the vast amount of published research?
- How to choose appropriate indicators of clinical effectiveness and safety?
- How to assess whether the results of clinical studies are relevant, thorough, and reliable?
- How to assess whether the new technology offers value for money?
- How to take the ethical, legal, social, and organizational aspects into account in the assessment?
- How to pay attention to distorted perception, interpretation, and information on the side of scientists, experts, patients, and ourselves in the assessment?
Our main outputs – comprehensive assessments of health technologies – are structured according to the so-called methodological framework of the HTA Core Model:
The model defines the basic areas that a comprehensive technology assessment should include:
- Health problem and current use of technology
- Description and technical characteristics of the technology
- Clinical effectiveness and safety of the technology
- Economic assessment of the technology
- Ethical, organizational, social/patient and legal aspects of the technology
At the same time, the model offers:
- A set of questions an HTA institution can address in its assessment
- Guidance in answering these questions
- A common reporting structure to present the entire assessment
Example of the method used in the assessment of a new medicine:
- NIHO collects all available studies, data, technical specifications, and scientific articles on the medicine. Medical and other scientific databases are full of scientific work on various topics. However, they also contain thousands of poor quality and methodologically flawed studies. The task of NIHO is to sieve through this huge amount of data and find the essential, relevant, and high-quality data for the Slovak system. For a true result, it is important to minimize the amount of misrepresentation of information as much as possible.
- From the collected data, NIHO determines whether and how the medicine works; who should use it and how; how effective and safe it is, and whether it is more effective than the standard treatment.
- NIHO then asks professionals who are to administer the medicine about how this affects their way of working. NIHO also asks patients if the medicine is relevant for them at all. In fact, this may be a situation where the medicine improves only some laboratory parameter, but patients will basically not feel any subjective improvement.
- NIHO also determines whether other aspects of administration of the medicine should be taken into account, such as legal (consent to the administration of the medicine in a patient with dementia), ethical (whether the treatment will prolong life, but with greater pain) or social (whether other types of care besides health care will be needed) aspects.
- Since the EUnetHTA Core Model is a highly practical multidisciplinary scientific tool, it also includes a chapter on how to convert everything into a common, well understood unit that everyone understands – money.