PUB HLTH 7147 - Health Technology Assessment

North Terrace Campus - Semester 2 - 2019

This course takes a broad view of the impact of health technologies on the health of the population & individual. Health technologies can include medical procedures, medical devices, diagnostic & investigative technologies, pharmaceuticals & public health interventions. In this course emphasis is placed on the methods used to assess these health technologies in order to inform government policy, clinical & public health practice. Methods include the systematic review of literature to assess the safety & effectiveness of a technology, meta-analysis,as well as economic evaluation to determine whether a technology is cost-effective. Attention is also given to the diffusion of technological innovations within their social, cultural & ethical context; addressing particular challenges with the assessment of medical tests; to horizon scanning for new & emerging technologies; & to investment in, & disinvestment from, health technologies. The course has a strong practical focus & is taught by practitioners in the field.

  • General Course Information
    Course Details
    Course Code PUB HLTH 7147
    Course Health Technology Assessment
    Coordinating Unit Public Health
    Term Semester 2
    Level Postgraduate Coursework
    Location/s North Terrace Campus
    Units 3
    Contact 1 week intensive
    Available for Study Abroad and Exchange N
    Incompatible PUB HLTH 7147OL
    Assumed Knowledge PUB HLTH 7075 & PUB HLTH 7074 & PUB HLTH 7081
    Course Description This course takes a broad view of the impact of health technologies on the health of the population & individual. Health technologies can include medical procedures, medical devices, diagnostic & investigative technologies, pharmaceuticals & public health interventions. In this course emphasis is placed on the methods used to assess these health technologies in order to inform government policy, clinical & public health practice. Methods include the systematic review of literature to assess the safety & effectiveness of a technology, meta-analysis,as well as economic evaluation to determine whether a technology is cost-effective. Attention is also given to the diffusion of technological innovations within their social, cultural & ethical context; addressing particular challenges with the assessment of medical tests; to horizon scanning for new & emerging technologies; & to investment in, & disinvestment from, health technologies. The course has a strong practical focus & is taught by practitioners in the field.
    Course Staff

    Course Coordinator: Professor Tracy Merlin

    Telephone: +61 8313 3575
    Email: tracy.merlin@adelaide.edu.au
    Location: Level 9, AHMS Building
    Course Timetable

    The full timetable of all activities for this course can be accessed from Course Planner.

    The full timetable of all activities for this course can be accessed from Course Planner.

    The course timetable is also given in the Health Technology Assessment course handbook.

    The course will be held from September 30 - October 4, 2019.

  • Learning Outcomes
    Course Learning Outcomes
    1 Describe  and critically appraise the conduct of health technology assessment (HTA), in particular the use of systematic literature
    review and economic modelling, to inform the development of health policy
    2 Understand the policy framework for HTA in Australia and internationally
    3 Undertake basic systematic searching for evidence on a health technology
    4 Critically appraise the quality of evidence supporting a health technology
    5 Recognise the range of approaches used in HTA to conduct an economic evaluation
    6 Recognise the role of ethical analysis and public and patient engagement in HTA
    7 Understand the complex issues associated with evaluating diagnostic tests in an HTA
    8 Interpret a meta-analysis and apply meta-analytic statistical techniques
    University Graduate Attributes

    This course will provide students with an opportunity to develop the Graduate Attribute(s) specified below:

    University Graduate Attribute Course Learning Outcome(s)
    Deep discipline knowledge
    • informed and infused by cutting edge research, scaffolded throughout their program of studies
    • acquired from personal interaction with research active educators, from year 1
    • accredited or validated against national or international standards (for relevant programs)
    1-8
    Critical thinking and problem solving
    • steeped in research methods and rigor
    • based on empirical evidence and the scientific approach to knowledge development
    • demonstrated through appropriate and relevant assessment
    1, 3-8
    Teamwork and communication skills
    • developed from, with, and via the SGDE
    • honed through assessment and practice throughout the program of studies
    • encouraged and valued in all aspects of learning
    1, 4, 5, 6, 7
    Career and leadership readiness
    • technology savvy
    • professional and, where relevant, fully accredited
    • forward thinking and well informed
    • tested and validated by work based experiences
    3, 5, 7, 8
    Intercultural and ethical competency
    • adept at operating in other cultures
    • comfortable with different nationalities and social contexts
    • Able to determine and contribute to desirable social outcomes
    • demonstrated by study abroad or with an understanding of indigenous knowledges
    2, 6
    Self-awareness and emotional intelligence
    • a capacity for self-reflection and a willingness to engage in self-appraisal
    • open to objective and constructive feedback from supervisors and peers
    • able to negotiate difficult social situations, defuse conflict and engage positively in purposeful debate
    1-8
  • Learning Resources
    Required Resources
    Please obtain an electronic copy of the Health Technology Assessment Handbook.

    All Required Readings will be available through the University Intranet (MyUni https://myuni.adelaide.edu.au/)



    Recommended Resources
    Refer to Health Technology Assessment Handbook and to the course information on MyUni, https://myuni.adelaide.edu.au/.

    Access to this course will be available through MyUni after enrolment.
    Online Learning
    MyUni will hold copies of recordings of lectures, electronic copies of lecture notes and electronic copies of the readings, along with any other course-related material.

  • Learning & Teaching Activities
    Learning & Teaching Modes
    Teaching in Health Technology Assessment begins from the assumption that the participants have extensive professional and  personal ideas and experience and that our role as teachers is to harness your knowledge and skills and build on them. We assume that you are willing and able to prepare fully for classes, to participate in discussions and to carry your share of the workload.  

    The course is built around examples of health technology assessment. People learn best when they are able to put developing knowledge and skills into practice. We believe that this is the most effective way of learning and the course has a range of lectures, group activities and a major group project to facilitate this process. In addition, we have key concepts and theoretical issues threaded throughout the course. 

    This course is taught as an intensive, over 5 straight days from Monday to Friday. This form of teaching has been chosen instead of a weekly teaching session as it provides immersion in the subject area and facilitates the participation of audit students from policy areas and industry. The course introduces a range of new concepts that are all related to health technology assessment, and teaching in a concentrated format will make it easier to recognise the links and reinforce the concepts as the course progresses. Given the intense form of teaching it will help students if they read the readings prior to each day of the course.

    The teaching comprises a broad mix of lectures, practicals, and small group discussions. This course gives a high priority to interaction between the participant and the academic staff, and amongst participants. It is understood that students may have different learning  styles and may come from different cultural backgrounds, but all students are encouraged to participate actively.
    Workload

    The information below is provided as a guide to assist students in engaging appropriately with the course requirements.

    The information below is provided as a guide to assist students in engaging appropriately with the course requirements.

    As a general rule in any university course, you will need to allow a minimum of three independent study hours for every hour  undertaken in formal class work contact. This time is needed for such activities as reading for the topic, preparation for activities in class and work on assignments. As this course is taught in an intensive mode, there will be a need for revision and preparation in the evening. 

    Award and non-award students will need to complete a group presentation and answer two quizzes during the course. Time is provided for groups to work on their presentation on Tuesday, Wednesday and Thursday afternoons.

    A major assessment task will need to be completed by award and non-award students and submitted electronically by 5pm on Friday, November 1 2019.
    Learning Activities Summary

    MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
    9.10am What is health technology assessment? How is HTA done around the world [TM] Critical appraisal of intervention studies [TM] Economic evaluation – interpretation, uncertainty and critical appraisal
     [JK/HH]
    HTA of medical tests and investigative procedures [TM] Meta-analysis
    [TM]

    Practical - interpretation of meta-analyses [TM & JM]
    HTA in Australia

    Regulatory/TGA, horizon 
    scanning, state-based HTA [JP]
    Practical - assigning level of evidence and critical appraisal of
    intervention studies [TM & JP]
    Quiz - interpreting diagnostic test accuracy Heterogeneity and publication bias [TM]
    10.40-11.00am MORNING TEA MORNING TEA MORNING TEA MORNING TEA MORNING TEA
    11.10am HTA in Australia

    Investment/disinvestment [TM/JP]
    Synthesis in an HTA: communicating to the policy maker [TM] Economic evaluation – interpretation, uncertainty and critical appraisal [JK/HH] Critical appraisal of diagnostic accuracy studies [TM]
    Practical - understanding heterogeneity [TM & JM]

    Role play - relevance of HTA in decision-making Critical appraisal of SRs and HTAs [TM] Practical – critical appraisal of diagnostic accuracy studies (QUADAS-2)
    [TM & JM]
    Computer exercise on meta-analysis in Stata [TM and JM]

    Rm S126, Helen Mayo South Computing Suite 

    HTA methodology - why systematic reviews?  [TM] Practical - critical appraisal of secondary research [TM & JP]
    1.00-1.30 LUNCH LUNCH LUNCH LUNCH LUNCH
    How to conduct an HTA?

    Translating the policy question (PICO) [TM]

    Searching for evidence [SN]

    Selection of evidence and data extraction [TM]


    Practical - applying PICO criteria to the evidence  [TM & SN]
    Economic evaluation of health technologies - the basics [HH/JK] Ethical/ social aspects of HTA [DC]

    Incorporating
    community in HTA decision-making [JS/DC]

    Quiz on pre-readings.


    Group oral presentations and
    evaluation

     

    Ligertwood Rm 113 and Ligertwood Rm 111



    Facilitated discussion about community engagement in Australian HTA [JS/DC]


    Discussion on final
    assignment [TM]


    Video
    3.40-4.00pm AFTERNOON
    TEA
    AFTERNOON TEA AFTERNOON TEA AFTERNOON TEA AFTERNOON TEA
    4.00-5.00pm Online exercise on searching for SRs and HTAs [TM & SN]

    Rm S126, Helen Mayo South Computing Suite
    Independent group work by award and non-award students for Oral Presentation due Friday



    Independent
    group work by award and non-award students for Oral Presentation due Friday



    Independent
    group work by award and non-award students for Oral Presentation due Friday

    4:30pm Searching exercise answers
    5.00-5.30pm Award and non award students meet to discuss assessment
    Unless otherwise specified above, the location of all sessions is the Ligertwood Building Room 113. However, check MyUni to confirm.
    Specific Course Requirements
    None
    Small Group Discovery Experience
    N/A
  • Assessment

    The University's policy on Assessment for Coursework Programs is based on the following four principles:

    1. Assessment must encourage and reinforce learning.
    2. Assessment must enable robust and fair judgements about student performance.
    3. Assessment practices must be fair and equitable to students and give them the opportunity to demonstrate what they have learned.
    4. Assessment must maintain academic standards.

    Assessment Summary
    Assessment Task Task Type Weighting Learning Outcome
    Quiz on interpreting diagnostic test accuracy Summative 10% 7
    Quiz on pre-readings supporting Community Engagement topic Summative 10% 6
    Oral presentation of critical appraisal (in small groups) Summative 20% 4
    Integrated HTA Summative 60% 1-6, 8
    Assessment Related Requirements
    N/A
    Assessment Detail
    Quizzes

    Each student is to complete two short quizzes on Thursday. One quiz will assess individual students’ understanding and  interpretation of diagnostic test accuracy measures. The answers to the quiz will be provided following quiz completion so that you receive immediate feedback on your learning. The other quiz will be open-book and test students’ understanding of the Community Engagement pre-readings available on MyUni.

    ORAL PRESENTATION OF CRITICAL APPRAISAL

    Working in pre-allocated groups of 3 or 4, you are to prepare a 12 minute power point presentation with up to 8 slides, of a critical  appraisal of a published paper (to be allotted to each group on the Monday).  The presentation will be made on Friday afternoon.   A hard copy of the presentation will need to be submitted at that time.

    The presentation should contain the following elements:

    ·  An introductory slide listing the paper to be discussed and the names of members of the presentation team.

    ·  A summary of the paper and the question it addresses

    ·  The level of evidence and design of the study

    ·  Which tools were used to assist with the critical appraisal

    ·  The critical appraisal itself

    · Conclusions regarding the validity of the study’s results


    All group members are expected to contribute equally to the presentation. If individuals have not contributed sufficiently they will
    receive a downgraded individual mark, as opposed to the group mark.



    INTEGRATED HTA

    Each student is to submit an evaluation of a health technology from the selected topics listed below. You need to assume that the  technology is new and has not yet been publicly funded in Australia. The evaluation should contain the following elements.

    · Assessment of the clinical need for this technology in Australia in terms of the mortality and/or morbidity associated with the underlying disease/condition that the technology aims to address.  [10%]

    · PICO criteria for conducting a systematic review to assess the effectiveness and harm/safety of the health technology. [10%]

    · Conduct a PubMed search for randomised controlled trials and systematic reviews based on the PICO criteria developed above.   The PubMed search strategy should be submitted, including the number of citations yielded at each line of the search. The results  of the search (a snapshot of the first page of citations is sufficient) should also be submitted. The search strategy should have  enough detail that it can be replicated. [10%]

    · Search for an HTA report on your topic that includes an economic evaluation. Searches should be conducted using Google, the HTA database (accessible through http://www.crd.york.ac.uk or the Cochrane Library), and/or the UK Health Technology Assessment journal. Identify one HTA report on the topic from your search and
    o  Critically appraise the systematic review component of the HTA using a relevant checklist. You should aim to come to a conclusion regarding the quality of the systematic review. [15%]
    o  Using a structured approach or checklist, critically appraise the economic evaluation presented in the HTA report.  [15%]

    · Identify and evaluate the likely applicability, extrapolation and transformation issues associated with translating the evidence to an economic model that reflects Australian use of the technology (1/2 page). [10%]

    · Apply the ethics framework from Hofman to your topic. [15%]

    · Prepare a 3 page policy brief including a conclusion for your policy maker as to whether the health technology should be publicly funded.  This should be included as the first section of your submission. [15%]



    Topics for integrated HTA

    1.       Laparoscopic cholecystectomy for people with uncomplicated symptomatic gallstones (biliary pain) or cholecystitis

    2.       Cabozantinib for the treatment of renal cell carcinoma in treatment-experienced patients

    3.       Implantable cardioverter defibrillators for use in people at risk of sudden cardiac death

    4.       Testing people with early-onset colorectal cancer for Lynch syndrome


    Submission
    Submission

    In this course, assessment tasks 1, 2 and 3 will be done in class. Assessment task 4 will need to be submitted electronically by  clicking on the relevant ‘Assignments’ link for the Course in MyUni.  Your assignment must be  formatted as a Microsoft Word file and submitted through the Turnitin link.
     
    If for some reason you are unable to upload the assignment to MyUni, please email it to the Course Coordinator. In case we mislay it, you should retain a copy of the assignment submitted.
     
    Extensions

    All extensions for assignments must be requested, at the latest, by the last working day before the due date of submission.  Extensions will generally be granted only on medical or genuine compassionate grounds.  Supporting documentation must be provided at the time a student requests an extension.  Without documentation, extensions will not be granted.  Late requests for extension will neither be accepted nor acknowledged.

    Only the Course Coordinator(s) may grant extensions.

    Supporting documentation will be required when requesting an extension. Examples of documents that are acceptable
    include: a medical certificate that specifies dates of incapacity, a police report (in the case of lost computers, car & household theft etc.), a letter from a Student Counsellor, Education and Welfare Officer (EWO) or Disability Liaison Officer that provides an assessment of compassionate circumstances, or a letter from an independent external counsellor or appropriate professional able to verify the student’s situation.  The length of any extension granted will take into account the period and severity of any incapacity or impact on the student.  Extensions of more than 10 days will not be granted except in exceptional circumstances.


    Late submission

    Marks will be deducted when assignments for which no extension has been granted are handed in late.

    All assignments, including those handed in late, will be assessed on their merits.  In the case of late assignments where no extension has been granted, 5 percentage points of the total marks possible per day will be deducted.  If an assignment that is 2 days late is awarded 65% on its merits, the mark will then be reduced by 10% (5% per day for 2 days) to 55%.  If that same assignment is 4 days late, the mark will be reduced by 20% (5% per day for 4 days) to 45%, and so on.

    The School of Public Health reserves the right to refuse to accept an assignment that is more than 7 days late.

    Assignments submitted after the due date may not be graded in time to be returned on the listed return dates.

    Students submitting examinable written work who request (and receive) an extension that takes them beyond the examination
    period are advised that there is no guarantee that their grades will be processed in time to meet usual University deadlines.

     
    Resubmission

    If a student is dissatisfied with an assessment grade they should follow the Student Grievance Resolution Process
    Students who are not satisfied with a particular assessment result should raise their concerns with Course Coordinator(s) in the
    first instance.  This must be done within 10 business days of the date of notification of the result.  Resubmission of any assignment is subject to the agreement of the Course Coordinator(s) and will only be permitted for the most compelling of reasons. 

    Additional assessment is permitted for students who narrowly fail to achieve a passing grade in the course.
    Eligibility for this will be determined according to the University’s Modified arrangements for coursework Assessment policy.


    Course Grading

    Grades for your performance in this course will be awarded in accordance with the following scheme:

    M10 (Coursework Mark Scheme)
    Grade Mark Description
    FNS   Fail No Submission
    F 1-49 Fail
    P 50-64 Pass
    C 65-74 Credit
    D 75-84 Distinction
    HD 85-100 High Distinction
    CN   Continuing
    NFE   No Formal Examination
    RP   Result Pending

    Further details of the grades/results can be obtained from Examinations.

    Grade Descriptors are available which provide a general guide to the standard of work that is expected at each grade level. More information at Assessment for Coursework Programs.

    Final results for this course will be made available through Access Adelaide.

  • Student Feedback

    The University places a high priority on approaches to learning and teaching that enhance the student experience. Feedback is sought from students in a variety of ways including on-going engagement with staff, the use of online discussion boards and the use of Student Experience of Learning and Teaching (SELT) surveys as well as GOS surveys and Program reviews.

    SELTs are an important source of information to inform individual teaching practice, decisions about teaching duties, and course and program curriculum design. They enable the University to assess how effectively its learning environments and teaching practices facilitate student engagement and learning outcomes. Under the current SELT Policy (http://www.adelaide.edu.au/policies/101/) course SELTs are mandated and must be conducted at the conclusion of each term/semester/trimester for every course offering. Feedback on issues raised through course SELT surveys is made available to enrolled students through various resources (e.g. MyUni). In addition aggregated course SELT data is available.

  • Student Support
  • Policies & Guidelines
  • Fraud Awareness

    Students are reminded that in order to maintain the academic integrity of all programs and courses, the university has a zero-tolerance approach to students offering money or significant value goods or services to any staff member who is involved in their teaching or assessment. Students offering lecturers or tutors or professional staff anything more than a small token of appreciation is totally unacceptable, in any circumstances. Staff members are obliged to report all such incidents to their supervisor/manager, who will refer them for action under the university's student’s disciplinary procedures.

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