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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jacr.2009.01.013 Byline: Ilia L. Ferrusi (a), David Ames (b), Morgan E. Lim (a), Ron Goeree (a)(c) Keywords: Health technology assessment; decision making; medical device industry; biomedical technology Abstract: Health technology assessment has significantly improved the decision-making process via the thorough and systematic evaluation of the clinical utility and cost-effectiveness of new drugs and health technologies. However, the device industry faces a significant challenge in meeting the evidentiary demands of the health technology assessment process, particularly given the small size of the Canadian market and device manufacturers. This is further compounded by the somewhat short-sighted nature of health care budgets, which see medical devices as a cost-driver given the sometimes significant upfront investment required to implement a technology producing downstream benefits in the long-term. Industry is the research and development of the health care system, but innovative development could be stifled unless the health technology assessment process recognizes the risk of manufacturers. The authors propose that health technology assessment can be improved by recognizing the challenges that device manufacturers face and by sharing the risk associated with evaluations of effectiveness. Health technology assessment is a powerful tool that can be used to evaluate new and potentially obsolete technologies alike, with the goal of meeting the needs of patients as customers of both the device industry and the health care system. Author Affiliation: (a) Programs for Assessment of Technology in Health Research Institute, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada (b) Johnson & Johnson Medical Products Canada, Guelph, Ontario, Canada (c) Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada Article Note: (footnote) Funding for this project was provided by a research grant from the Canadian Association for Drugs and Technologies in Health (Ottawa, Ontario, Canada).

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jacr.2009.01.022 Byline: Feng Xie (a)(b), Daria O'Reilly (a)(b), Ilia L. Ferrusi (a), Gord Blackhouse (a)(b), James M. Bowen (a)(b), Jean-Eric Tarride (a)(b), Ron Goeree (a)(b) Keywords: Cost-effectiveness; diagnostic technologies; H. pylori; gastric cancer Abstract: The aim of this paper is to present an economic evaluation of diagnostic technologies using Helicobacter pylori screening strategies for the prevention of gastric cancer as an illustration. Author Affiliation: (a) Programs for Assessment of Technology in Health Research Institute, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada (b) Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jacr.2009.01.018 Byline: Morgan E. Lim (a)(b), Daria O'Reilly (a)(b), Jean-Eric Tarride (a)(b), Natasha Burke (a)(b), Ilia L. Ferrusi (a)(b)(c), Kaitryn Campbell (a)(b), Ron Goeree (a)(b) Keywords: Health technology assessment; economic evaluation; diagnostic efficacy; epidemiology Abstract: Decision makers are faced with the task of allocating health resources to maximize patients' health under budget constraints. To offer structure to the complexity of the decision-making process, the field of health technology assessment (HTA) was developed. This paper offers an introduction to the fundamental aspects of HTA and acts as a guide to the conduct of HTA for radiologists. First, the authors define HTA and describe how it is linked to the field of diagnostics. Second, a basic 11-step framework for the conduct of an HTA is outlined. The framework begins with the identification of the problem and proceeds through to the dissemination and impact of an HTA. Third, the authors provide a real-world example of an HTA in the field of diagnostics. Last, they describe the challenges and barriers faced in HTA. Author Affiliation: (a) Programs for Assessment of Technology in Health Research Institute, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada (b) Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada (c) Centre for Evaluation of Medicines, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada