Assasi 2016

Appraisal of: Steps toward improving ethical evaluation in health technology assessment: a proposed framework.

Reviewer(s): Sabine Calleja

Full Reference: Assasi N, Tarride J-E, O'Reilly D, Schwartz L. Steps toward improving ethical evaluation in health technology assessment: a proposed framework. BMC Med Ethics. 2016;17(1):34.

Short description: This article describes “a multi-stage study that aimed at construction of a framework for improving the integration of ethics in HTA”. The authors detail the methods of their study which involved a systematic review of the literature, a separate literature search to find main barriers and facilitators of ethical evaluation in HTA, a survey of HTA producing agencies worldwide. The findings from these sources informed the creation of a framework. As described in the Results, the framework consists of an algorithmic flowchart, a stepwise guide, and commonly recommended tools to facilitate the proposed evaluation tasks. The authors describe these components in detail. The framework has been adapted into a guide which is embedded in the article as a Table. The article explains the steps in this framework including the objectives and scope of the evaluation, stakeholder analysis, assessing organizational capacity, framing ethical evaluation questions, ethical analysis, deliberation, and knowledge exchange/translation. In sum, the authors describe that this framework should be used to comprehensively evaluate ethical considerations.

Limitations stated by the author(s): Limitations stated by the authors include that use of the framework may require data, information and expertise and other resources that not every HTA organization might have. The stepwise section of the framework does not include a case study to exemplify how to apply all the steps. The framework also was not validated.

Limitations stated by the reviewer(s): Same as mentioned above. Note that the authors planned to address these concerns in a future study.

Study Type: Single study. 

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