Innovating Health Technology Assessment Methods: Barriers and Enablers illustrated using Qualitative and Quantitative Methods on Real-World Data

The development and implementation of health technology assessment (HTA) methods is a process needed for improving HTA quality, in response to emerging novel health technologies and the variety in HTA practices. However, some general problems that negatively affected method development or implementation have occurred over time, such as the lack of a clear overview of the needs from HTA stakeholders and lack of expertise on the HTA methods. To address the problems related to HTA method development or implementation, in Chapter 2, we first provided a conceptual framework to facilitate a general understanding of the process of innovating HTA methods and the stakeholder roles involved. Also, in Chapter 3, we explored the applicability of this conceptual framework in three cases of innovating quantitative methods in various disease fields (such as diabetes and head and neck cancer), and improved the framework applicability by designing a roadmap. In addition to providing a conceptual framework, in Chapter 4-8, we investigated specific research questions related to development or implementation of qualitative and quantitative HTA methods using real-world data (RWD). More specifically, in Chapter 4,5, and 6, we focused on methods used for assessing quality of studies using RWD; in Chapter 7 and 8, we focused on methods used for merging randomized-controlled trials and RWD in (network) meta-analyses. This thesis showed that, the use of the framework may lead to increased awareness that not only researchers, but also all HTA stakeholders (e.g. patients, clinician and health technology developers) have the potential to contribute to the development or implementation of HTA methods. Also, in this thesis, we have offered some potential solutions to the challenges of HTA method innovation. For example, given the lack of skills to implement a method in the HTA context, we recommend developers to inform practitioners and beneficiaries of the contexts where using a method is approp