Health Impact Evaluation & HTA in FI-STAR Shahryar Eivazzadeh - PowerPoint PPT Presentation

Health Impact Evaluation & HTA in FI-STAR Shahryar Eivazzadeh

The Situation of Evaluation in Literature ● Aspects – Efficacy – Efficiency – Safety ● Indicators – Objective ● M&M ● KPIs – Subjective ● QALY (q uality-adjusted life year) – Method based – Template based ● EQ-5D ● SF-36 ● HTA – Favors RCT but also includes cohort studies – Decision oriented

eHealth Evaluation Situation ● Absence of QALY (research gap) – Too deep? – What about others DALY, WTP, CUA, CER, …? ● Other KPIs

HTA ● Beginning 70s ● Originated in the US, but left there there later ● Sweden was a pioneer in EU ● Future: “It is likely that HTA of the future will move more closely to the idea of comparative effectiveness ”

Two approaches ● Subjective: – Patient related (such as) ● QALY – Method based – Template based ● EQ-5D ● SF-36 – Other stakeholders ... ● Objective: – KPIs – …

Assessing Health Technologies ● Limitations: – Years after the intervention – The impacts cannot be attributed solely to the intervention ● Solution: – Focusing on leading indicators instead of lagging ones – Utilizing Bayesian methods, such as: ● EVSI (Expected Value of Sample Information) ● EVIU (Expected Value of Including Uncertainty )

HTA “It is likely that HTA of the future will move more closely to the idea of comparative effectiveness ” (Banta & Jonsson 2009)

… therefore changes in the KPIs are in focus ● change in Waiting times ● change in Average length of stay ● change in Number of patients in sections – Bed occupancy – ● change in Hospital acquired infections (HAI) ● change in Inpatient mortality rate ● …

Mixing in levels 1. High level (such as QALY) 2. Health KPI level 3. Software KPIs

Using Leading KPIs instead of Post- Intervention Evaluations Evaluation space by Evaluation space by Evaluation space by KPIs post-intervention evaluations post-intervention evaluations

Safety in FI-STAR – Avoiding mis-information – Avoiding unreliable substitution – Being resilient in its critical mission ● To user input ● To environmental situations – Be replaceable – ...