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Health technology assessment in obstetrics and gynaecology. Part 1: an overview of the process

^1. Birmingham Women's Hospital, Metchley Park Road, Edgbaston, Birmingham B15 2TG, UK Email: Pabedin{at}doctors.org.uk (corresponding author)
^2. Birmingham Women's Hospital, UK
^3. Birmingham Women's Hospital, UK

Key content:

• A health technology is any method used to promote health; diagnose, prevent or treat disease; or improve long-term rehabilitation and care.
  
• Systematic reviews are summaries of the total evidence on a defined subject, using explicit techniques and critical appraisal of the relevant primary research to generate recommendations for practice and policy.
  
• ‘Bias’ exaggerates or underestimates the true effect of an intervention or exposure. There are several possible types of bias such as selection, performance, measurement and attrition.
  

Learning objectives:

• To learn about the role of health technology assessments (HTAs) in the formulation of health policy and the adoption of new technologies.
  
• To understand the methodology involved in conducting systematic reviews and economic evaluations in HTA.
  
• To learn about the role of institutions (for example, NICE) in utilising HTA to formulate health policy.
  

Ethical issues:

• Systematic reviews are the highest level of evidence as they incorporate the results of multiple studies but can be biased if individual studies are not published.
  
• Meta-analysis should only be conducted when there is sufficient heterogeneity (decided by statistical tests) between the studies under consideration in a systematic review.
  
• The investigators in a clinical trial should be transparent in any shortcomings of conduct or design that can question the conclusions.
  

Please cite this article as: Abedin P, Daniels JP, Khan KS. Health technology assessment in obstetrics and gynaecology. Part 1: an overview of the process. The Obstetrician & Gynaecologist 2007;9:109–115.

Keywords bias / clinical trials / health technology assessment / meta-analysis / systematic reviews