Health technology assessment in musculoskeletal care: A narrative review of evolving methodologies, clinical evidence, and research gaps
Các tác giả
DOI: https://doi.org/10.59294/HIUJS20250118Từ khóa:
HTA, EUnetHTA core model, patient outcomesTóm tắt
Introduction: Health Technology Assessment (HTA) is a systematic, evidence-based process for evaluating healthcare technologies and guiding resource allocation. It plays a vital role in clinical decision-making and hospital management, especially in Musculoskeletal (MSK) medicine, ensuring interventions are appropriate, effective, and cost-efficient. Methods: This review applies the EUnetHTA Core Model® version 3.0, which standardizes assessments across nine domains, including safety, effectiveness, economics, and ethics. Rapid HTA approaches are also examined to highlight methodological diversity. Data on achievements and research gaps were synthesized from evaluations of advanced diagnostic systems (e.g., EOSedge™) and digital health tools (e.g., telemedicine). Results: HTA has enabled safer, higher-quality technology adoption. The EOSedge system achieved 3 - 6-fold dose reductions in full-spine imaging without sacrificing image quality. Evaluations of telemedicine show outcomes equivalent or superior to traditional care in Patient-Reported Outcome Measures (PROMs) and consistently lower costs. Discussion: Major research gaps persist, particularly the limited focus on patient-centered outcomes. Methodological quality in digital health HTAs remains critically low, with inadequate integration of Patient-Reported Experience Measures (PREMs) and economic evaluations. Addressing biological variability and embedding sex and gender analysis are essential for equity and validity. Conclusion: HTA structures complex healthcare decisions beyond costs and technology metrics. Future research should strengthen evidence linking technology to patient outcomes and incorporate equity and experience dimensions.
Abstract
Introduction: Health Technology Assessment (HTA) is a systematic, evidence-based process for evaluating healthcare technologies and guiding resource allocation. It plays a vital role in clinical decision-making and hospital management, especially in Musculoskeletal (MSK) medicine, ensuring interventions are appropriate, effective, and cost-efficient. Methods: This review applies the EUnetHTA Core Model® version 3.0, which standardizes assessments across nine domains, including safety, effectiveness, economics, and ethics. Rapid HTA approaches are also examined to highlight methodological diversity. Data on achievements and research gaps were synthesized from evaluations of advanced diagnostic systems (e.g., EOSedge™) and digital health tools (e.g., telemedicine). Results: HTA has enabled safer, higher-quality technology adoption. The EOSedge system achieved 3 - 6-fold dose reductions in full-spine imaging without sacrificing image quality. Evaluations of telemedicine show outcomes equivalent or superior to traditional care in Patient-Reported Outcome Measures (PROMs) and consistently lower costs. Discussion: Major research gaps persist, particularly the limited focus on patient-centered outcomes. Methodological quality in digital health HTAs remains critically low, with inadequate integration of Patient-Reported Experience Measures (PREMs) and economic evaluations. Addressing biological variability and embedding sex and gender analysis are essential for equity and validity. Conclusion: HTA structures complex healthcare decisions beyond costs and technology metrics. Future research should strengthen evidence linking technology to patient outcomes and incorporate equity and experience dimensions.
Tài liệu tham khảo
[1] R. Tomaiuolo, G. Banfi, C. Messina, D. Albano, S. Gitto, and L. M. Sconfienza, “Health technology assessment in musculoskeletal radiology: the case study of EOSedge™,” La Radiologia Medica, vol. 129, no. Suppl 2, pp. 1076-1085, 2024, doi: 10.1007/s11547-024-01832-9.
[2] G. Boissonnat et al., “Performance of automatic exposure control on dose and image quality: comparison between slot-scanning and flat-panel digital radiography systems,” Med. Phys., vol. 50, no. 2, pp. 1162-1184, Sep. 2022, doi: 10.1002/mp.16227.
[3] S. Bargeri et al., “Effectiveness of telemedicine for musculoskeletal disorders: umbrella review,” J. Med. Internet Res., vol. 26, p. e50090, Feb. 2024, doi: 10.2196/50090.
[4] K. Hayashi et al., “Utilization of telemedicine in conjunction with wearable devices for patients with chronic musculoskeletal pain: a randomized controlled clinical trial,” Sci. Rep., vol. 15, Art. no. 1396, Jan. 2025, doi: 10.1038/s41598-025-01396-8.
[5] M. Mchenga, L. Vijayasingham, R. RamPrakash et al., “Value is Gendered: The Need for Sex and Gender Considerations in Health Economic Evaluations,” Appl. Health Econ. Health Policy, vol. 23, pp. 171-181, 2025. doi:10.1007/s40258-024-00930-z.
[6] C. Hartig, S. Horstmann, K. Jacke et al., “A deeper consideration of sex/gender in quantitative health research: a checklist for incorporating multidimensionality, variety, embodiment, and intersectionality throughout the whole research process,” BMC Med. Res. Methodol., vol. 24, art. 180, 2024. doi:10.1186/s12874-024-02258-7.
[7] P. Kumar et al., “The changing landscape of health technology assessment (HTA) in the Asia-Pacific (APAC) region: advances, challenges and future goals,” ISPOR Europe Conf. Proc., 2024.
[8] R. R. Nugraha, C. Suharlim, R. Prawiranegara et al., “A framework for improved collaboration on HTA in the Asia-Pacific region: a role for HTAsiaLink,” Int. J. Technol. Assess. Health Care, vol. 41, e30, 2025. doi:10.1017/S0266462325000236.
[9] L. Ferrante di Ruffano et al., “Health technology assessment of diagnostic tests: a state of the art review of methods guidance from international organizations,” Int. J. Technol. Assess. Health Care, vol. 39, p. e14, Feb. 2023, doi: 10.1017/S0266462323000095.
[10] S. K. C. Sarin et al., “What, Where, and How to Collect Real-World Data and Generate Real-World Evidence to Support Drug Reimbursement Decision-Making in Asia: A reflection Into the Past and A Way Forward,” Int. J. Health Policy Manag., vol. 12, art. 6858, 2023. doi:10.34172/ijhpm.2023.6858.
[11] S. Setia et al., “Integrated Real-World Data Warehouses Across 7 Evolving Asian Health Care Systems: Scoping Review,” J. Med. Internet Res., vol. 26, 2024. doi:10.2196/ (pending).
[12] A. Pisapia, G. Banfi, and R. Tomaiuolo, “The novelties of the regulation on health technology assessment: a key achievement for the European Union health policies,” Clin. Chem. Lab. Med., vol. 60, no. 7, pp. 1160-1163, May 2022, doi: 10.1515/cclm-2022-0408.
Tải xuống
Tải xuống: 0




