To enhance the project’s internal and external validity, it was decided that the collaboration of other Spanish HTA agencies or units be sought. A technical working group was thus formed to develop, discuss, agree upon and make different contributions to the guide’s various goals. Involvement of a number of health technology assessment agencies via members of their technical staff has helped lend the project greater visibility in each of its three aspects (identification, prioritisation and assessment). The working group acted both as consultant and as reviewer of the project, and acknowledges the content as being its own.
The agencies involved were: Galician Health Technology Assessment Agency (Agencia de Evaluación de Tecnologías Sanitarias de Galicia/Axencia de Avaliación de Tecnoloxías Sanitarias de Galicia - avalia-t), which co-ordinated the project; Health Technology Assessment Agency (Agencia de Evaluación de Tecnologías Sanitarias), Carlos III Institute of Health; Basque Office for Health Technology Assessment (Osteba); Unidad de Evaluación de Tecnologías Sanitarias de la Comunidad de Madrid, Laín Entralgo Agency; and Servicio de Evaluación del Servicio Canario de Salud, Canary Islands. These agencies or units expressed interest in the project after its presentation for funding under the Quality Plan of the Ministry of Health & Consumer Affairs (Ministerio de Sanidad y Consumo). The collaboration of a hospital health technology assessment unit was likewise deemed relevant, with the Barcelona Clinical Hospital Innovation & New Technology Assessment Unit (Unidad de Avaluació d’Innovació i Noves Tecnologies de la Fundació Clínic per a la Recerca Biomèdica/Hospital Clínic de Barcelona) being included as an integral part of the working group.
Communication between the working group and the avalia-t technical group was conducted by telephone and e-mail. Similarly, a face-to-face meeting was held in February 2008 to present the project to the working group, along with various avenues and ideas for its development, designed to enable progress to be made on the methodological guide, and agreement was reached on the guide’s goals and potential end-users. At this meeting, agreement was also reached on a work schedule and system for completing the project. These agreements were subsequently implemented by the avalia-t technical team, with the collaboration of Osteba.
Each of the guide’s sections was developed in parallel: the obsolete technology identification section was drawn up, taking available data sources into account; the prioritisation section followed a consensus-based methodology using external panellists; and the section dealing with assessment of potentially obsolete technologies was drafted on the understanding that the goal of a report would be to highlight a technology’s obsolescence by means of an easily comprehensible and rigorous technical assessment document.
The basis for the entire guide’s sections was the completion of a very thorough systematic review. Multiple data sources were reviewed, with those of interest for the respective sections of the guide being included.
This guide contains 3 sections which can be used independently, namely: 1) identification; 2) prioritisation; and, 3) obsolete health technology assessment. Each section follows a different methodology, and the general introduction to the guide is common to all three sections. Each section contains the following structure: Introduction; Objectives; Methods; Results; Discussion; and Conclusions. In the Discussion section, stress is laid on the advantages and limitations of the recommendations made. Appendix I shows the systematic search conducted in a number of databases to locate information published on obsolete health technologies. The aim of this comprehensive search was to locate any type of document on obsolete HT, or comments or reflections on the importance of ascertaining and detecting these types of technologies. This search followed the standard work system routinely used by HTA agencies, with a certain degree of additional emphasis on the location of documents of other government agencies or institutions.
The proposed guide is targeted at all professionals who are interested in health technology assessment, at a national or international level, and who may be interested in the identification and assessment of obsolete technologies. This guide may also be used by hospital institutions, health services, insurance companies and other health-care bodies and institutions. Throughout the guide, standard HTA terminology has been used, and some specific aspects of health-database searching are discussed. This guide is proposed as a dynamic document which will be adapted and developed as the contexts of health-care information vary in line with the continuous improvement strategy pursued by the working group.