Bridges/Jones Diary

  • by: |
  • 02/16/2007
That's John F.P. Bridges and Christopher Jones, both of the Johns Hopkins Bloomberg School of Public Health.

Their new paper, "Patient-based health technology assessment: A vision of the future," is a timely discussion of how HTA and EBM can and must be used to advance patient health and reduce long-term health care costs -- rather than how it is currently being used -- as a way to reduce short-term, transitory health care spending.

Here's a link to the paper:

Download file

Some snippets to entice your appetite for real reform:

"Objective: The aim of this study was to develop a working definition of patient-based HTA, to identify the current barriers to adopting a patient-based model, and to formulate a vision of how a patient-based HTA could be used to promote patient empowerment and patient-centered care."

"Whereas EBM categorizes and ranks all types of medical evidence by the quality of the results provided, the randomized controlled trial (RCT) is given preferential recognition because of its ability to identify (average) treatment effects. Unfortunately, RCTs are costly, frequently underpowered, and too often not representative of the broader population of patients who must receive treatments in different settings. In addition, RCTs may not adequately reflect values of patients, as they so often are focused solely on outcomes defined by the scientific and medical community, without consideration of the patient's needs and desires."

This paper delves into the doctines so often treated as dogma, shines a bright light on faulty assumptions, and calls into question the methods of EBM and HTA that have been hijacked to justify limited formularies and price controls.

It's based on a presentation given at the Third Annual Meeting of Health Technology Assessment International, held July 2-5, 2006 in Adelaide, Australia.

And it's worth a careful read.

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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