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Technology assessment in medicine.

B Littenberg1

  • 1Dartmouth Medical School, Hanover, New Hampshire.

Academic Medicine : Journal of the Association of American Medical Colleges
|July 1, 1992
PubMed
Summary
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This study introduces a five-level framework for evaluating medical technologies, from biologic plausibility to societal outcomes. This hierarchical scheme aids in comprehensive technology assessment for healthcare advancements.

Area of Science:

  • Health Policy
  • Medical Technology Assessment
  • Biomedical Engineering

Background:

  • Defining medical technology and technology assessment is crucial for systematic evaluation.
  • Existing assessment methods may lack a comprehensive, hierarchical structure.
  • Evaluating new medical interventions requires a structured approach to ensure efficacy and safety.

Purpose of the Study:

  • To present a novel, hierarchical paradigm for the evaluation of medical technologies.
  • To establish a framework encompassing multiple levels of assessment, from basic science to societal impact.
  • To provide a systematic approach for analyzing the value and implications of medical technologies.

Main Methods:

  • Proposing a five-level hierarchical assessment scheme: biologic plausibility, technical feasibility, intermediate outcomes, patient outcomes, and societal outcomes.
Keywords:
Health Care and Public Health

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  • Defining each level with specific criteria for evaluating medical technologies.
  • Illustrating the application of the scheme using hypercholesterolemia screening tests as a case study.

    • Main Results:

    • The proposed five-level scheme offers a structured method for evaluating medical technologies.
    • Level I (biologic plausibility) assesses the scientific basis of the technology.
    • Level II (technical feasibility) evaluates delivery to the target population.
    • Level III (intermediate outcomes) measures short-term physiologic impact.
    • Level IV (patient outcomes) considers medical, psychologic, and financial impacts, including side effects and mortality.
    • Level V (societal outcomes) analyzes resource use, ethical, and social factors.

    Conclusions:

    • The hierarchical assessment scheme provides a robust framework for evaluating medical technologies.
    • This systematic approach facilitates a thorough understanding of a technology's impact on patients and society.
    • The proposed paradigm can guide decision-making in healthcare technology adoption and policy.