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Technology Assessment

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Technology assessment provides crucial information for clinical decisionmaking

Physicians should be active users of medical technology and technology assessments, according to John M. Eisenberg, M.D., Director of the Agency for Healthcare Research and Quality. He believes clinicians should seek out and use such evidence each and every day as they work with their patients to make health care decisions. Health care technologies will not reach their full potential to improve patient care unless they are translated, used, and continuously evaluated, notes Dr. Eisenberg. His views were presented in November at a meeting of the British Medical Association in London and published as a commentary in the November 17, 1999, issue of the Journal of the American Medical Association.

Most people would agree that health care technology has advanced physicians' ability to improve their patients' health and quality of life, yet there continues to be disagreement about which technologies they should use, how much technology is too much, and whether the technologies clinicians use are cost effective. These questions are particularly relevant today, in a health care system that is dominated by intense competition between clinicians and organizations competing for a greater share of the market, whether for hospital beds, ambulatory services, drugs, or devices. Dr. Eisenberg says the proliferation of new and sometimes expensive health care technologies in a period of constrained health care spending is spurring demand for more of the information needed to make decisions that affect both patients' lives and the bottom line of health care costs.

Over the past 10 years, the Agency for Health Care Policy and Research (AHRQ's predecessor agency), sponsored and carried out research on the outcomes and use of medical technology. Dr. Eisenberg points to 10 lessons that stand out from that body of work:

  • Innovation and flexibility should guide assessment.
  • Technology is more than devices.
  • Research and assessments should be linked with coverage.
  • Technology assessment is not a one-time exercise.
  • New measures of outcomes should be developed.
  • The community of practice is a laboratory for technology assessment.
  • Training and capacity-building in technology assessment should be emphasized.
  • Better international collaboration will result in global synergy.
  • National resources on technology assessment should be linked.
  • Technology assessments should be translated into improved practice.

Technology is rarely inherently good or bad; nor is it always or never useful. The challenge is to evaluate when in the course of an illness it is effective, for whom it will enhance outcomes, and how it should be implemented or interpreted. Continued development of medical technologies has brought enormous benefits to patients, but at the same time, these advances bring with them a collective responsibility to ensure that technologies are deployed appropriately, concludes Dr. Eisenberg.

For more information, see Dr. Eisenberg's commentary, "Ten lessons for evidence-based technology assessment," in the November 17, 1999, issue of the Journal of the American Medical Association 282(19), pp. 1865-1869.

Reprints (AHCPR Publication No. 00-R008) are available from AHRQ's Publications Clearinghouse.

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