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How guidance on the use of interventional procedures is produced in different countries: An international survey

  • Jonathan Plumb (a1), Bruce Campbell (a1) and Georgios Lyratzopoulos (a1)


Objectives: Technology assessment systems for interventional procedures (including surgical operations, minimally invasive procedures, and others) have lagged behind those for pharmaceutical treatments. Such systems have been introduced in some countries during the past decade amid debate about how they should be organized, but there is no collated information about where they exist or how they work. This study was designed to provide hitherto unavailable information about the existence, organization, methods, and outputs of systems aimed at influencing the use of interventional procedures in different countries.

Methods: Data were gathered from a questionnaire survey of key informers associated with healthcare technology assessment (HTA) organizations in different countries.

Results: Responses were received from key informers working for twenty-eight HTA organizations in twenty-five countries (response rate 83 percent). Information about a national system for assessing interventional procedures was obtained for fifteen countries. There was substantial variability in the type and funding of these organizations, the systems used for the selection of procedures, the types and sources of evidence used, the personnel involved in the appraisal of the evidence, the arrangements for consultation on the draft assessment, the format of assessment recommendations, the status of the guidance, and the use of guidance from other countries.

Conclusion: Guidance on interventional procedures is produced variably in different countries—and not at all in some. Greater international collaboration in the assessment of new interventional procedures could help to optimize the efficiency of existing systems as well as the quality of the assessments, by capitalizing on the outputs from scarce (international) resources and expertise.



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1. Campbell, WB, Barnes, SJ, Kirby, RA et al. , Association of study type, sample size, and follow-up length with type of recommendation produced by the National Institute for Health and Clinical Excellence Interventional Procedures Programme. Int J Technol Assess Health Care. 2007;23:101107.
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3. Lyratzopoulos, G, Hoy, AR, Veeramootoo, D, Shanmuganathan, NV, Campbell, B. Influence of expert clinical adviser characteristics on opinions about interventional procedures. Int J Technol Assess Health Care. 2008;24:166169.
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5 National Institute for Health and Clinical Excellence. Interventional Procedures Guidance 233: Endovascular stent insertion for intracranial atherosclerotic disease. 24 October 2007. (accessed December 2008).
6. National Institute for Health and Clinical Excellence. Interventional Procedures Guidance 251. Liposuction for chronic lymphoedema. February 2008. (accessed December 2008).
7. National Institute for Health and Clinical Excellence. Interventional Procedures Guidance 413: Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal metastases. 27 February 2008. (ac-cessed December 2008).
8. National Institute for Health and Clinical Excellence: The Interventional Procedures Programme–Programme Manual. (accessed December 2008).
9. Wilson, CB. Adoption of new surgical technology. BMJ. 2006;332:112114.



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