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 (quality-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 KPIs Evaluation space by post-intervention evaluations Evaluation space by 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 – ...