CONCLUSIONS AND RECOMMENDATIONS

• Location of potentially obsolete health technologies is complex. Current search systems in the most widely used medical literature databases are not geared to detection of these types of technologies.
• There are very useful data sources for detecting potentially obsolete technologies. These data sources are databases containing: health technology assessment reports; new and emerging technologies; obsolete health technology detection networks; and currently prevailing statutory rules and regulations. Once a foreseeable obsolete technology has been detected, a standardised procedure must be established to assess whether it meets the criteria that would define it as a potentially obsolete technology, before being passed through to the prioritisation stage for eventual assessment.
• The existence of a prioritisation tool facilitates the selection of potentially obsolete technologies entailing a greater impact on health care processes or patient safety. A prioritisation system such as that developed in this report enables potentially obsolete technologies to be prioritised, taking into account the points of view of the different actors in the health-care system (administrators/managers, clinicians and end-users).
• Having this tool (PriTec tool) in Spanish and English will make it possible for prioritisation criteria to be unified, and comparisons among different health organisations to be drawn. It is possible that the tool developed may need to be adapted to other health settings or contexts.
• A recommendation for a given health technology or indication to be classified as obsolete must be based on scientific evidence and conclude with a recommendation for its exclusion from the service portfolio, or clearly and exclusively confine the technology’s use to some well-delimited clinical situations.
• The definition of a content structure for obsolete health technology assessment documents renders such a document easier to draft and to read. On this being a novel proposal, it would be of great interest if it were used by all organisations involved in the evaluation of obsolete technologies so as to have a document with a standard structure for health technology assessment.
• The greatest challenge in the assessment of potentially obsolete health technologies is the detection, prioritisation and assessment of technologies which genuinely imply an important impact for health care systems. This is the main objective of this aspect of HTA and the most difficult goal to achieve. It is of little use to appraise and confirm health technologies as obsolete if these are hardly used in clinical practice.
• Knowledge on the part of clinicians, managers and end-users of the health-care system of the existence of obsolete health technologies and the dissemination of reports that assess such technologies are crucial for achieving the necessary impact for this type of assessments.