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  • Gert Jan van der Wilt (a1), Ansgar Gerhardus (a2) and Wija Oortwijn (a3)


Objectives: A comprehensive health technology assessment (HTA) enables a patient-centered assessment of the effectiveness, economic, ethical, socio-cultural, and legal issues of health technologies that takes context and implementation into account. A question is whether these various pieces of evidence need to be integrated, and if so, how that might be achieved. The objective of our study is to discuss the meaning of integration in the context of HTA and suggest how it may be achieved in a more structured way.

Methods: An analysis of the concept of integration in the context of HTA and a review of approaches that were adopted in the INTEGRATE-HTA project that may support integration.

Results: Current approaches to integration in HTA are mainly methods of commensuration, which are not optimally geared to support public deliberation. In contrast, articulating evaluative frameworks could be an important means of integration which allows for exploring how facts and values can be brought to bear on each other.

Conclusions: Integration is not something that only needs to be addressed at the end, but rather throughout an HTA, right from the start. Integration can be conceived as a matter of accounting for the relevance of empirical evidence in view of a commitment to a set of potentially conflicting values. Various elements of the INTEGRATE-HTA project, such as scoping and the development of logic models, can help to achieve integration in HTA.



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1. Preisler, G, Tvingstedt, AL, Ahlström, M. A psychosocial follow-up study of deaf preschool children using cochlear implants. Child Care Health Dev. 2002;28:403418.
2. Venkatapuram, S. Health justice. An argument from the capabilities approach. Cambridge, UK: Polity Press; 2011.
3. Anand, P. Capabilites and health. J Med Ethics. 2005;31:299303.
4. Coast, J, Smith, RD, Lorgelly, P, Welfarism. Extra-welfarism and capability: The spread of ideas in health economics. Soc Sci Med. 2008;67:11901198.
5. Lorgelly, PK, Lawson, KD, Fenwick, EA, Briggs, AH. Outcome measurement in economic evaluations of public health interventions: A role for the capability approach? Int J Environ Res Public Health. 2010;7:22742289.
6. Canoy, M, Faber, MJ, Munneke, M, et al. Hidden treasures and secret pitfalls: Application of the capability approach to ParkinsonNet. J Parkinsons Dis. 2015;5:575580.
7. Richardson, HS. Democratic autonomy. Public reasoning about the ends of public policy. Oxford: Oxford University Press; 2002.
8. Richardson, HS. Practical reasoning about final ends. Cambridge: Cambridge University Press; 1994.
9. Wahlster, et al. this volume.
10. Brereton, L, Ingleton, C, Gardiner, C, et al. Lay and professional stakeholder involvement in scoping palliative care issues: Methods used in seven European countries. Palliat Med. 2017;31:181 192.
11. Guba, YS, Lincoln, EG. Fourth generation evaluation. Newbury Park, CA: SAGE; 1989.
12. Brereton, et al. this volume.
13. Rohwer, A, Booth, A, Pfadenhauer, L, et al. Guidance on the use of logic models in health technology assessments of complex interventions. (accessed August 18, 2017).
14. Lysdahl, B, et al. this volume.



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