DECISION-COMPONENTS OF NICE'S TECHNOLOGY APPRAISALS ASSESSMENT FRAMEWORK.

Area of Science:

• Health technology assessment
• Health economics
• Text analysis

Background:

• Value assessment frameworks are increasingly important in U.S. healthcare for funding decisions.
• The UK's National Institute of Health and Care Excellence (NICE) is a leading health technology assessment (HTA) agency.
• NICE's Technology Appraisals involve a series of decision factors.

Purpose of the Study:

• To apply text analysis to characterize NICE's Technology Appraisals.
• To present NICE's decision factors within newer assessment frameworks.
• To visualize the hierarchical structure of these decision factors.

Main Methods:

• Analysis of 243 NICE medicines guidance documents (2007-2016).
• Text analysis to identify hierarchical decision factors and their frequencies.
• Association analysis of factors with terms related to uncertainty.
• Creation of visual representations of hierarchical factors.

Main Results:

• Identification and hierarchical grouping of 125 decision factors into eight domains (Clinical Effectiveness, Cost Effectiveness, Condition, Current Practice, Clinical Need, New Treatment, Studies, Other Factors).
• Consistent appearance of all domains in guidance documents.
• Frequent association of many factors with terms indicating uncertainty.
• Development of visual representations.

Conclusions:

• NICE's decision-making is complex and consistent, utilizing criteria beyond cost-effectiveness.
• The study emphasizes the need for methodologies accommodating both quantitative and qualitative data.
• Visualizations are crucial for communicating complex decision-making information to stakeholders.