Health Research Policy and Systems | |
Knowledge mobilization in the context of health technology assessment: an exploratory case study | |
Monique F Fournier1  | |
[1] Institut national d'excellence en santé et en services sociaux (INESSS), 2021 rue Union, Montréal, QC H3A 2S9, Canada | |
关键词: Decision-makers; Health technology assessment; Implementation; Dissemination; Production; Transfer; Knowledge mobilization; | |
Others : 810026 DOI : 10.1186/1478-4505-10-10 |
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received in 2011-10-26, accepted in 2012-04-03, 发布年份 2012 | |
【 摘 要 】
Background
Finding measures to enhance the dissemination and implementation of their recommendations has become part of most health technology assessment (HTA) bodies' preoccupations. The Quebec government HTA organization in Canada observed that some of its projects relied on innovative practices in knowledge production and dissemination. A research was commissioned in order to identify what characterized these practices and to establish whether they could be systematized.
Methods
An exploratory case study was conducted during summer and fall 2010 in the HTA agency in order to determine what made the specificity of its context, and to conceptualize an approach to knowledge production and dissemination that was adapted to the mandate and nature of this form of HTA organization. Six projects were selected. For each, the HTA report and complementary documents were analyzed, and semi-structured interviews were carried out. A narrative literature review of the most recent literature reviews of the principal knowledge into practice frameworks (2005-2010) and of articles describing such frameworks (2000-2010) was undertaken.
Results and discussion
Our observations highlighted an inherent difficulty as regards applying the dominant knowledge translation models to HTA and clinical guidance practices. For the latter, the whole process starts with an evaluation question asked in a problematic situation for which an actionable answer is expected. The objective is to produce the evidence necessary to respond to the decision-maker's request. The practices we have analyzed revealed an approach to knowledge production and dissemination, which was multidimensional, organic, multidirectional, dynamic, and dependent on interactions with stakeholders. Thus, HTA could be considered as a knowledge mobilization process per se.
Conclusions
HTA's purpose is to solve a problem by mobilizing the types of evidence required and the concerned actors, in order to support political, organizational or clinical decision-making. HTA relies on the mediation between contextual, colloquial and scientific evidence, as well as on interactions with stakeholders for recommendation making. Defining HTA as a knowledge mobilization process might contribute to consider the different orders of knowledge, the social, political and ethical dimensions, and the interactions with stakeholders, among the essential components required to respond to the preoccupations, needs and contexts of all actors concerned with the evaluation question's issues.
【 授权许可】
2012 Fournier; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20140709031731497.pdf | 299KB | download |
【 参考文献 】
- [1]Gauvin FP, Abelson J, Giacomini M, Eyles J, Lavis JN: "It all depends": conceptualizing public involvement in the context of health technology assessment agencies. Social science & medicine 2010, 70:1518-1526.
- [2]Battista RN, Hodge MJ: The "natural history" of health technology assessment. International journal of technology assessment in health care 2009, 25(Suppl 1):281-284.
- [3]Sorenson C, Drummond M, Kristensen FB, Busse R: How can the impact of health technology assessments be enhanced?. Copenhagen: World Health Organization (WHO) Regional Office for Europe, European Observatory on Health Systems and Policies; 2008.
- [4]Banta HD, Perry S: A history of ISTAHC. A personal perspective on its first 10 years. International Society of Technology Assessment in Health Care. International journal of technology assessment in health care 1997, 13:430-453. discussion 454-462
- [5]Hanney S, Buxton M, Green C, Coulson D, Raftery J: An assessment of the impact of the NHS Health Technology Assessment Programme. Health technology assessment 2007, 11:iii-iv. ix-xi, 1-180
- [6]Frønsdal KB, Facey K, Klemp M, Norderhaug IN, Morland B, Rottingen JA: Health technology assessment to optimize health technology utilization: using implementation initiatives and monitoring processes. International journal of technology assessment in health care 2010, 26:309-316.
- [7]Straus SE, Tetroe J, Graham I: Defining knowledge translation. CMAJ 2009, 181:165-168.
- [8]Mitton C, Adair CE, McKenzie E, Patten S, Waye-Perry B: Knowledge transfer and exchange (KTE): a systematic review, key informant interviews and design of a KTE strategy. In Effective dissemination of findings from research. Edited by Institute of Health Economics (IHE). Edmonton, AB: IHE; 2008:25-55.
- [9]Bowen S, Zwi AB: Pathways to "evidence-informed" policy and practice: a framework for action. PLoS medicine 2005, 2:e166.
- [10]Lavis JN, Robertson D, Woodside JM, McLeod CB, Abelson J: How can research organizations more effectively transfer research knowledge to decision makers? Milbank quarterly 2003, 81:221-248.
- [11]Dobbins M, Ciliska D, Cockerill R, Barnsley J, DiCenso A: A framework for the dissemination and utilization of research for health-care policy and practice. Online journal of knowledge synthesis for nursing 2002, 9:7.
- [12]Straus SE, Tetroe J, Graham ID: Knowledge translation in health care: moving from evidence to practice. Chichester, UK; Hoboken, NJ: Wiley-Blackwell BMJ/Books; 2009.
- [13]Agence d'évaluation des technologies et des modes d'intervention en santé (AETMIS): Utilisation des lasers de classe 3b et 4 et de la lumière intense pulsée à des fins esthétiques dans un contexte non médical. Rapport préparé par Sylvie Beauchamp, Alicia Framarin et Jean-Marie R. Lance. ETMIS 2008, 4:1-77.
- [14]Agence d'évaluation des technologies et des modes d'intervention en santé (AETMIS): Introduction des soins médicaux avancés dans les services préhospitaliers d'urgence au Québec. Rapport préparé par Reiner Banken, Brigitte Côté, François de Champlain et André Lavoie. ETMIS 2005, 1:1-82.
- [15]Agence d'évaluation des technologies et des modes d'intervention en santé (AETMIS): Le syndrome de fatigue chronique: état des connaissances et évaluation des modes d'intervention au Québec. Rapport préparé par Guylaine Rouleau, Ugo Ceppi, Vibe Hjelholt Pedersen et Pierre Dagenais. ETMIS 2010, 6:1-185.
- [16]Lambert L, Bogaty P, Carroll-Bilodeau C, Giguère M, Boothroyd L, Morin J: L'évaluation terrain sur l'infarctus aigu du myocarde avec élévation du segment ST (IAMEST). Portrait des délais du cheminement des soins. Montréal, Qc: Agence d'évaluation des technologies et des modes d'intervention en santé (AETMIS); 2008.
- [17]Agence d'évaluation des technologies et des modes d'intervention en santé (AETMIS): Infarctus aigu du myocarde avec élévation du segment ST (IAMEST): enjeux organisationnels et économiques de la prise en charge. Rapport préparé par Peter Bogaty, Lucy J. Boothroyd, Laurie Lambert, Jean-Marie R. Lance et Daniel Paquette. ETMIS 2008, 4:1-114.
- [18]Ministère de la Santé et des Services sociaux (MSSS), Société de l'assurance automobile du Québec (SAAQ): Orientations ministérielles pour le traumatisme craniocérébral léger 2005-2010. Québec, Qc: MSSS, SAAQ; 2005.
- [19]Patton MQ: Qualitative research and evaluation methods. 3rd edition. Thousand Oaks, CA: Sage Publications; 2002.
- [20]Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N: Lost in knowledge translation: time for a map? Journal of continuing education in the health professions 2006, 26:13-24.
- [21]Grimshaw J, Eccles MP: Knowledge translation of research findings. In Institute of Health Economics (IHE). Effective dissemination of findings from research. Edmonton, AB: IHE; 2008:8-24.
- [22]Denis J-L, Lehoux P, Champagne F: A knowledge utilization perspective on fine-tuning dissemination and contextualizing knowledge. In Using knowledge and evidence in health care: Multidisciplinary perspectives. Edited by Lemieux-Charles L, Champagne F. Toronto, ON: University of Toronto Press; 2004:18-40.
- [23]Jacobson N, Butterill D, Goering P: Development of a framework for knowledge translation: understanding user context. Journal of health services research & policy 2003, 8:94-99.
- [24]Straus SE, Tetroe J, Graham ID: Knowledge to action: what it is and what it isn't. In Knowledge translation in health care: moving from evidence to practice. Edited by Straus SE, Tetroe J, Graham ID. Chichester, UK; Hoboken, NJ: Wiley-Blackwell BMJ/Books; 2009:3-9.
- [25]Lomas J, Culyer T, McCutcheon C, McAuley L, Law S: Conceptualizing and combining evidence for health system guidance. Ottawa, ON: Canadian Health Services Research Foundation; 2005.
- [26]Varvasovszky Z, Brugha R: A stakeholder analysis. Health policy and planning 2000, 15:338-345.
- [27]Thompson GN, Estabrooks CA, Degner LF: Clarifying the concepts in knowledge transfer: a literature review. Journal of advanced nursing 2006, 53:691-701.
- [28]Patton MQ: Utilization-focused evaluation. 4th edition. Thousand Oaks, CA: Sage Publications; 2008.
- [29]Lambert L, Brown K, Segal E, Brophy J, Rodes-Cabau J, Bogaty P: Association between timeliness of reperfusion therapy and clinical outcomes in ST-elevation myocardial infarction. JAMA 2010, 303:2148-2155.
- [30]Ward V, House A, Hamer S: Developing a framework for transferring knowledge into action: a thematic analysis of the literature. Journal of health services research & policy 2009, 14:156-164.
- [31]Straus SE, Tetroe JM, Graham ID: Knowledge translation is the use of knowledge in health care decision making. Journal of clinical epidemiology 2011, 64:6-10.
- [32]Davison CM: Knowledge translation: implications for evaluation. New directions for evaluation 2009, 124:75-87.
- [33]Banken R: Role of HTA and good governance in the health system. In Human Development Learning Week, The World Bank, November 11th, 2008. Washington, DC: The World Bank; 2008.
- [34]Dobrow MJ, Goel V, Lemieux-Charles L, Black NA: The impact of context on evidence utilization: a framework for expert groups developing health policy recommendations. Social science & medicine 2006, 63:1811-1824.
- [35]Best A, Holmes B: Systems thinking, knowledge and action: towards better models and methods. Evidence and policy 2010, 6:145-159.
- [36]Elissalde J, Renaud L: Les démarches de circulation des connaissances: mobilisation et valorisation des connaissances. In Les médias et la santé: de l'émergence à l'appropriation des normes sociales. Edited by Renaud L. Québec, Qc: Presses de du Québec; 2010:409-429.
- [37]Lemire N, Souffez K, Laurendeau M-C: Animer un processus de transfert des connaissances: bilan des connaissances et outil d'animation. Québec, Qc: Institut national de santé publique du Québec (INSPQ); 2009.
- [38]Phipps DJ, Shapson S: Knowledge mobilisation builds local research collaborations for social innovation. Evidence and policy 2009, 5:211-227.
- [39]Lehoux P, Blume S: Technology assessment and the sociopolitics of health technologies. Journal of health politics, policy and law 2000, 25:1083-1120.
- [40]Lehoux P, Williams-Jones B: Mapping the integration of social and ethical issues in health technology assessment. International journal of technology assessment in health care 2007, 23:9-16.
- [41]Lavis JN, Wilson MG, Grimshaw JM, Haynes RB, Ouimet M, Raina P, Gruen RL, Graham ID: Supporting the use of health technology assessments in policy making about health systems. International journal of technology assessment in health care 2010, 26:405-414.
- [42]Gauvin FP, Abelson J, Giacomini M, Eyles J, Lavis JN: Moving cautiously: public involvement and the health technology assessment community. International journal of technology assessment in health care 2011, 27:43-49.
- [43]Lehoux P: The problem of health technology: policy implications for modern health care systems. New York: Routledge; 2006.
- [44]Abelson J, Giacomini M, Lehoux P, Gauvin FP: Bringing 'the public' into health technology assessment and coverage policy decisions: from principles to practice. Health policy 2007, 82:37-50.
- [45]Gagnon MP, Desmartis M, Lepage-Savary D, Gagnon J, St-Pierre M, Rhainds M, Lemieux R, Gauvin FP, Pollender H, Légaré F: Introducing patients' and the public's perspectives to health technology assessment: A systematic review of international experiences. International journal of technology assessment in health care 2011, 27:31-42.
- [46]Menon D, Stafinski T: Role of patient and public participation in health technology assessment and coverage decisions. Expert review of pharmacoeconomics & outcomes research 2011, 11:75-89.