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Health technology assessment for digital technologies that manage chronic disease: a systematic review

Published online by Cambridge University Press:  26 May 2021

Amy von Huben*
Affiliation:
School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
Martin Howell
Affiliation:
School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
Kirsten Howard
Affiliation:
School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
Joseph Carrello
Affiliation:
School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
Sarah Norris
Affiliation:
School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
*
Author for correspondence: Amy von Huben, E-mail: amy.vonhuben@sydney.edu.au

Abstract

Objective

A growing number of evaluation frameworks have emerged over recent years addressing the unique benefits and risk profiles of new classes of digital health technologies (DHTs). This systematic review aims to identify relevant frameworks and synthesize their recommendations into DHT-specific content to be considered when performing Health Technology Assessments (HTAs) for DHTs that manage chronic noncommunicable disease at home.

Methods

Searches were undertaken of Medline, Embase, Econlit, CINAHL, and The Cochrane Library (January 2015 to March 2020), and relevant gray literature (January 2015 to August 2020) using keywords related to HTA, evaluation frameworks, and DHTs. Included framework reference lists were searched from 2010 until 2015. The EUNetHTA HTA Core Model version 3.0 was selected as a scaffold for content evaluation.

Results

Forty-four frameworks were identified, mainly covering clinical effectiveness (n = 30) and safety (n = 23) issues. DHT-specific content recommended by framework authors fell within 28 of the 145 HTA Core Model issues. A further twenty-two DHT-specific issues not currently in the HTA Core Model were recommended.

Conclusions

Current HTA frameworks are unlikely to be sufficient for assessing DHTs. The development of DHT-specific content for HTA frameworks is hampered by DHTs having varied benefit and risk profiles. By focusing on DHTs that actively monitor/treat chronic noncommunicable diseases at home, we have extended DHT-specific content to all nine HTA Core Model domains. We plan to develop a supplementary evaluation framework for designing research studies, undertaking HTAs, and appraising the completeness of HTAs for DHTs.

Type
Assessment
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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