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Assessment of health care technologies
260
Book
reviews
policy in a European context, or, of course, those specifically interested in health in the Netherlands. Xavier R. Leus, MD MPH MS Pan American Health Organization’ Field Office US/Mexico Border El Pase, Texas USA
Assessment of Wealth Care Techadegies Case Studies, Key Concepts and Strategic Issues, A. Szczepura and J. Kankaanpiia (Eds.). John Wiley and Sons, West Sussex, 247 pp., 1996, g24.95. ISBN O-471-96571-5.
Health care technology assessment is receiving growing interest and is also becoming more necessary in recent years. In an era with ever increasing scientific knowledge, creating ever more possibilities for health care interventions on the one hand and tighter budgetary constraints on the other hand, societies need reliable instruments for setting priorities in health care. Governments all over the world are seeking evidence to decide which interventions it will cover for its citizens, and which not, based on e.g. evidence about effectiveness, safety, costs, ethical, legal and social consequences. Health care technology assessment is one of the instruments that can be used for these purposes. The main aim of the editors of this book was to provide a ‘state of the art’ on health care technology assessment for lay people in the area, i.e. for people who have not yet been involved closely in health care technology assessment. ‘It is aimed at the interested professional or manager who currently has little or no knowledge of how such assessments are performed or how their findings might prove useful in practice, but who would like to know more’. They succeeded very well in achieving this objective. The book starts with a brief introduction to health care technology assessment (definition, history, information, experience in different countries, . ..). written by the editors (A. Szczepura, J. Kankaanpaa). The remainder of the book brings together contributions from key practitioners of technology assessment throughout the world. The first chapters deal with basic concepts; they deal with the process of innovation and diffusion in health care (A. Bonair and J. Persson) and provide a basic methodological toolkit (C. Goodman).
’ This book review presents the personal opinion of the reviewer only, and, as such, does not pngage the Pan American Health Organization or any of its Offices.
Book reviews
261
The important current issues in technology assessment are subsequently analysed by means of case studies. Two chapters explore the factors which influence diffusion in detail by analysing diffusion of a therapeutic intervention-laser technology (D. Banta, H. Vondeling, A. de Wit, H. Rosendal) and of a diagnostic technology-MRI (R. Cranovsky, N. Racoveanu). The next case study focuses on a particular disease and examines the assessment of a range of available treatments (medication, open cholecystectomy, laparoscopic cholecystectomy, . . .) (M. Fendrick). One chapter focuses on one available therapy for a widespread clinical condition-PTCA (C. Goodman). Two chapters deal with low cost, high volume, diagnostic technologiesoffice based pathology testing (D. Hailey and A. Lea) and screening (P. Carlsson, E. Varenhorst). The two subsequent chapters concentrate on the evaluation of drugs, by providing an overview of the development of health care technology assessment in pharmaceuticals (M. Drummond and B. Lute) and on the shortcomings of many of the current assessments, based on the case study of thrombolytic therapy in acute myocardial infarction (L. Ake Levin). Finally, more strategic issues are dealt with. A first chapter focuses on the development of guidelines for pharmacoeconomic studies (AS. Mitchell and D. Menon). The final chapter, written by the editors, explores future directions for health care technology assessment. The editors have achieved their aim-providing a state of the art on health care technology assessment-for a specific audience (i.e. people with very limited experience in this field). For this audience, the book serves its purpose very well. In order not to create false expectations however, it is important to keep this target audience in mind. People who already have quite a lot of expertise with health care technology assessment will not find many new things in this book-although even for them the selected case studies may still contain interesting material. Obviously also those involved in carrying out health care technology assessment studies will not get much support from this book, which focuses only very briefly on methods of health care technology assessment. Only those (with experience in health care technology assessment) with responsibilities in the area of timing of health care technology assessment and implementing the findings will find useful material for futher thinking in this book.
Department
Professor Dr. Katrien Kesteloot of Health Services and Nursing Research Catholic University of Leuven Belgium
Book
reviews
policy in a European context, or, of course, those specifically interested in health in the Netherlands. Xavier R. Leus, MD MPH MS Pan American Health Organization’ Field Office US/Mexico Border El Pase, Texas USA
Assessment of Wealth Care Techadegies Case Studies, Key Concepts and Strategic Issues, A. Szczepura and J. Kankaanpiia (Eds.). John Wiley and Sons, West Sussex, 247 pp., 1996, g24.95. ISBN O-471-96571-5.
Health care technology assessment is receiving growing interest and is also becoming more necessary in recent years. In an era with ever increasing scientific knowledge, creating ever more possibilities for health care interventions on the one hand and tighter budgetary constraints on the other hand, societies need reliable instruments for setting priorities in health care. Governments all over the world are seeking evidence to decide which interventions it will cover for its citizens, and which not, based on e.g. evidence about effectiveness, safety, costs, ethical, legal and social consequences. Health care technology assessment is one of the instruments that can be used for these purposes. The main aim of the editors of this book was to provide a ‘state of the art’ on health care technology assessment for lay people in the area, i.e. for people who have not yet been involved closely in health care technology assessment. ‘It is aimed at the interested professional or manager who currently has little or no knowledge of how such assessments are performed or how their findings might prove useful in practice, but who would like to know more’. They succeeded very well in achieving this objective. The book starts with a brief introduction to health care technology assessment (definition, history, information, experience in different countries, . ..). written by the editors (A. Szczepura, J. Kankaanpaa). The remainder of the book brings together contributions from key practitioners of technology assessment throughout the world. The first chapters deal with basic concepts; they deal with the process of innovation and diffusion in health care (A. Bonair and J. Persson) and provide a basic methodological toolkit (C. Goodman).
’ This book review presents the personal opinion of the reviewer only, and, as such, does not pngage the Pan American Health Organization or any of its Offices.
Book reviews
261
The important current issues in technology assessment are subsequently analysed by means of case studies. Two chapters explore the factors which influence diffusion in detail by analysing diffusion of a therapeutic intervention-laser technology (D. Banta, H. Vondeling, A. de Wit, H. Rosendal) and of a diagnostic technology-MRI (R. Cranovsky, N. Racoveanu). The next case study focuses on a particular disease and examines the assessment of a range of available treatments (medication, open cholecystectomy, laparoscopic cholecystectomy, . . .) (M. Fendrick). One chapter focuses on one available therapy for a widespread clinical condition-PTCA (C. Goodman). Two chapters deal with low cost, high volume, diagnostic technologiesoffice based pathology testing (D. Hailey and A. Lea) and screening (P. Carlsson, E. Varenhorst). The two subsequent chapters concentrate on the evaluation of drugs, by providing an overview of the development of health care technology assessment in pharmaceuticals (M. Drummond and B. Lute) and on the shortcomings of many of the current assessments, based on the case study of thrombolytic therapy in acute myocardial infarction (L. Ake Levin). Finally, more strategic issues are dealt with. A first chapter focuses on the development of guidelines for pharmacoeconomic studies (AS. Mitchell and D. Menon). The final chapter, written by the editors, explores future directions for health care technology assessment. The editors have achieved their aim-providing a state of the art on health care technology assessment-for a specific audience (i.e. people with very limited experience in this field). For this audience, the book serves its purpose very well. In order not to create false expectations however, it is important to keep this target audience in mind. People who already have quite a lot of expertise with health care technology assessment will not find many new things in this book-although even for them the selected case studies may still contain interesting material. Obviously also those involved in carrying out health care technology assessment studies will not get much support from this book, which focuses only very briefly on methods of health care technology assessment. Only those (with experience in health care technology assessment) with responsibilities in the area of timing of health care technology assessment and implementing the findings will find useful material for futher thinking in this book.
Department
Professor Dr. Katrien Kesteloot of Health Services and Nursing Research Catholic University of Leuven Belgium