Using research synthesis in medical technology assessment

This article describes the use of research synthesis procedures (e.g., meta-analysis) in evaluating medical technologies. The synthesis process involves retrieval, extraction, and analysis of pertinent information from a set a research studies. There are several advantages of research synthesis: determining overall effectiveness, explaining seemingly contradictory findings, providing a standard measure of effect, and increasing statistical power. In addition, such syntheses provide timely results that can assist various policy decisions such as initiating clinical trials at NIH, reimbursement at HCFA, and answering NIH consensus conference questions. The authors' synthesis of the research literature on coronary artery bypass graft surgery (CABGS) illustrates how this method can address the various elements of a technology assessment such as safety, efficacy, and cost-effectiveness. The paper concludes by noting how research synthesis can be particularly advantageous in assessing technologies that are rapidly evolving (e.g., lytic agents for acute myocardial infarction).