Hogervorst MA, Møllebæk M, Vreman RA, Lu TA, Wang J, De Bruin ML, Leufkens HGM, Mantel-Teeuwisse A, Goettsch W. Perspectives on how to build bridges between regulation, health technology assessment and clinical guideline development: a qualitative focus group study with European experts.
BMJ Open 2023;
13:e072309. [PMID:
37640462 PMCID:
PMC10462958 DOI:
10.1136/bmjopen-2023-072309]
[Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/10/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE
Improving synergy among regulation, health technology assessment (HTA) and clinical guideline development is relevant as these independent processes are building on shared evidence-based grounds. The two objectives were first to assess how convergence of evidentiary needs among stakeholders may be achieved, and second, to determine to what extent convergence can be achieved.
DESIGN
Qualitative study using eight online dual-moderator focus groups.
SETTING
Discussions had a European focus and were contextualised in four case studies on head and neck cancer, diabetes mellitus, multiple sclerosis and myelodysplastic syndromes.
PARTICIPANTS
Forty-two experienced (over 10 years) European regulators, HTA representatives and clinicians participated in the discussion.
INTERVENTIONS
Participants received information on the case study and research topic in advance. An introductory background presentation and interview guide for the moderators were used to steer the discussion.
RESULTS
Convergence may be achieved through improved communication institutionalised in multistakeholder early dialogues, shared definitions and shared methods. Required data sets should be inclusive rather than aligned. Deliberation and decision-making should remain independent. Alignment could be sought for pragmatic clinical trial designs and patient registries. Smaller and lower-income countries should be included in these efforts.
CONCLUSION
Actors in the field expressed that improving synergy among stakeholders always involves trade-offs. A balance needs to be found between the convergence of processes and the institutional remits or geographical independence. A similar tension exists between the involvement of more actors, for example, patients or additional countries, and the level of collaboration that may be achieved. Communication is key to establishing this balance.
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