Saarni 2011

Appraisal of: Different methods for ethical analysis in health technology assessment: An empirical study 

Reviewer(s): Melissa Walter

Full Reference: Saarni S, Braunack-Mayer A, Hofmann B, van der Wilt GJ. Different methods for ethical analysis in health technology assessment: An empirical study. Int J Technol Assess Health Care 2011; 27: 305–312.

Short description: The article first describes, and then models the use of, four different methods of ethical analysis that can be used in health technology assessments (HTAs): the EUnetHTA Model, casuistry, axiology, and principlism. The authors describe their process of working through the case of bariatric surgery using each of the four methods. Their goal is not to recommend a "best method"; rather, they conclude that each method has benefits and that they could even be used together to provide a more thorough analysis. All four methods arrive at a similar conclusion in their case study: that bariatric surgery should be funded in a similar way to other surgical treatments. In the description section of the article, literature searching is explicitly listed as a step in the axiology process but not mentioned as part of any of the other methods. In the results section, their EUnetHTA Model analysis uses preliminary literature searching to define the scope of the project, as well as additional literature searches later in the process based on themes already identified. For the other three analyses, they may have conducted literature searches, for example to determine clinical or cost-effectiveness, but it is not discussed in the article. According to the authors, the literature searches conducted for an HTA by FinOHTA were available to them, but it is not clear how much they were used. In general, literature searching is discussed only briefly and without any details of search methods, terms, databases, etc.

Limitations stated by the author(s): Of the four different analyses conducted by the authors, one (the EUnetHTA model) was more thorough since it was included in a full HTA, while the other three were done post-hoc and in truncated form for this paper. As a result, these three did not have stakeholder participation.

Limitations stated by the reviewer(s): None identified. 

Study Type: Single study. 

Related Chapters: 

Tags: 

• EUnetHTA model

• Casuistry

• Axiology

• Principlism

• Health technology assessment

• Ethical analysis

• Ethics

• Nutritional and Metabolic Diseases