Level of health technology assessment process-related skills among doctors in Croatia: a cross-sectional survey study

The European Union's Health Technology Assessment Regulation (HTAR) and its implementing acts foresee various forms of clinician involvement, such as joint clinical assessment or Joint Scientific Consultation. However, considering the varying preparedness levels for HTAR, as well as the understanding of the health technology assessment (HTA) principles and processes, this study aimed to evaluate the levels of HTA-related skills among medical and dental doctors in Croatia.

A cross-sectional survey study was conducted among medical and dental medicine doctors in Croatia. The survey recorded respondents' relevant experience with HTA processes along with skill levels across the entire HTA process, mainly for acting as individual clinical experts or on behalf of their professional organizations, as well as potential HTA doers. Skill levels were evaluated using a 5-point scale (1 - no knowledge to 5 - full expertise).

Among the 376 respondents included, only 6.1 percent had previous involvement in HTA, and 2.2 percent were familiar with HTAR. Related to the HTA process, the highest scores were observed in the understanding of key concepts and results of searching for studies, critical appraisal, study synthesis preparation, and ethics. The lowest scores were recorded in health economics, evidence grading, qualitative synthesis, and public/patient involvement. Respondents with prior research experience and those who reported frequent research use had significantly higher HTA skill scores.

A significant gap in HTA-related skills highlights the need for targeted professional development programs and long-term educational reforms to build the capacity for various modes of involvement in HTA processes and their implementation.