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State of the ART? Two New Tools for Risk Communication in Health Technology Assessments

Author

Listed:
  • Sabine E. Grimm

    (Maastricht University Medical Centre)

  • Xavier Pouwels

    (University of Twente)

  • Bram L. T. Ramaekers

    (Maastricht University Medical Centre)

  • Ben Wijnen

    (Maastricht University Medical Centre)

  • Thomas Otten

    (Maastricht University Medical Centre)

  • Janneke Grutters

    (Radboud University Medical Centre)

  • Manuela A. Joore

    (Maastricht University Medical Centre)

Abstract

Purpose Outcomes of health technology assessments (HTA) are uncertain, and decision-making is associated with a risk. This risk, consisting of the probability of making a wrong decision and its impact, is rarely considered in HTA. This hampers transparent and consistent risk assessment and management. The aim of this study was to develop risk communication tools in the context of health technology decision-making under uncertainty. Methods We performed a scoping review of tools for uncertainty and risk communication within HTA using citation pearl-growing. We developed two tools, drawing on existing publications on risk and uncertainty communication for inspiration. Individual semi-structured interviews with HTA stakeholders were performed to identify potential improvements in usefulness, user-friendliness, and information adequacy. Tools were amended and further evaluated in a real-world HTA and workshop with HTA stakeholders. Results The identified risk communication tools did not include non-quantified uncertainties, and did not link to risk management strategies. We developed two tools: the Assessment of Risk Table (ART), for a summary of quantified and non-quantified uncertainties and the resulting risk assessment, and the Appraisal of Risk Chart (ARCH), for linking net benefit and risk outcomes to appropriate risk management strategies. Stakeholders appreciated the usefulness of the tools. They also highlighted that more information on local policy options was required for optimal risk management use, and HTA processes may need adapting. Conclusion The risk communication tools presented here can help assess risk, facilitate communication between analysts and decision-makers, and guide the appropriate use of available risk management strategies.

Suggested Citation

  • Sabine E. Grimm & Xavier Pouwels & Bram L. T. Ramaekers & Ben Wijnen & Thomas Otten & Janneke Grutters & Manuela A. Joore, 2021. "State of the ART? Two New Tools for Risk Communication in Health Technology Assessments," PharmacoEconomics, Springer, vol. 39(10), pages 1185-1196, October.
    • Handle: RePEc:spr:pharme:v:39:y:2021:i:10:d:10.1007_s40273-021-01060-3
    DOI: 10.1007/s40273-021-01060-3
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    References listed on IDEAS

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    1. Simon Walker & Mark Sculpher & Karl Claxton & Steve Palmer, 2012. "Coverage with evidence development, only in research, risk sharing or patient access scheme? A framework for coverage decisions," Working Papers 077cherp, Centre for Health Economics, University of York.
    2. Michał Jakubczyk & Bogumił Kamiński, 2017. "Fuzzy approach to decision analysis with multiple criteria and uncertainty in health technology assessment," Annals of Operations Research, Springer, vol. 251(1), pages 301-324, April.
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