Hofmann 2014

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

Reviewer(s): Sabine Calleja

Full Reference: Hofmann B, Droste S, Oortwijn W, Cleemput I, Sacchini D. Harmonization of ethics in health technology assessment: A revision of the Socratic approach. Int J Technol Assess Health Care 2014; 30(1): 1–7.

Short description: The article describes the revisions made to the Socratic approach, an HTA-specific ethics method used in a wide range of health technologies. The Socratic approach “poses a set of morally relevant questions to highlight overt and covert value issues with regard to a health technology”. Its purpose is to “inform decision makers (on various levels) about values, viewpoints, and arguments…”. Revisions were believed necessary to “promote its usability and the transferability of its results”. A panel of ethics experts involved in HTA revised the Socratic approach to make it broader and clearer. The revised version is comprised of a procedure of 6 steps, 7 main questions and 33 explanatory/guiding questions. The authors describe the main limitations of the former Socratic approach, as explained by the experts who revised the method. After detailing the revised version, the authors describe the information retrieval and selection process of this approach and how to apply the approach. Their discussion explains the justification for the revision, its impact on policy making, and methodological limitations.

Limitations stated by the author(s): The authors describe the limitations to include the consensus not being all-encompassing, that some limitations in the original approach were ignored in the revision process, and that the new version might not be the perfect and final version.

Limitations stated by the reviewer(s): As mentioned above, the revisions were created only by a select number of experts (11 people from 9 countries). As the new revised approach is used, it is possible that new issues will emerge from it that will require further revision. 

Study Type: Single study. 

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