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Mapping the Stakeholder’s Opinion of Priori5sa5on Criteria for Early Awareness and Alert System in Brazil
A NASCIMENTO, AT VIDAL, CC OTTO, RT ALMEIDA 1 Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, Rio de Janeiro. 2 Departamento de Gestão e
Incorporação de Tecnologias em Saúde, Secretaria de Ciência, Tecnologia e Insumos Estratégicos, Ministério da Saúde, Brasília, Brasil
INTRODUCTION A Horizon Scanning System (HSS) on new and emerging technologies may help to foresee the most
relevant technologies to be prioriXsed for the Brazilian Unified Health System (SUS, in Portuguese). FiltraXon and prioriXsaXon are two basics steps of a HSS. Therefore, the definiXon of criteria for these two steps should be done with the involvement of different stakeholder to increase transparency and adherence for a HSS.
This paper aimed to map the preferences of the SUS’s stakeholders regarding the filtraXon and prioriXsaXon criteria.
RESULTS
Searching the literature and websites of HSS agencies, four filtraXon and sixteen prioriXsaXon criteria were selected. Those criteria were discussed by 22 strategic stakeholders who were divided into five groups in a workshop. Each parXcipant chose the 10 most relevant prioriXsaXon criteria followed by a group discussion to reach the group opinion. The criteria that were chosen by four of the five groups were taken as the final ones. Finally, all groups decided to combine three of the criteria, remaining only eight. The MulXple Correspondence Analysis (MCA) method was applied to map the preference within and between groups. The method displays the stakeholder`s opinion in a two or more dimensions, which are associated with the criteria that most discriminated their opinions.
METHODS
Figure 1 shows the posiXon of the stakeholders and their groups on a two dimensional map that explains 70.3 % of variability of the opinions. Despite divergent views among the stakeholders, two groups (A and D) showed more coherence and tend to have more influence in the choice of eight final criteria. Other groups did not show a similar opinion between their stakeholders. However, part of the groups B and E considered the cost of the technology one of the most important criterion.
Legend: Group A – blue; Group B – green; Group C – gray; Group D – violet; Group E – orange
Figure 1: Correspondence Map of Stakeholder's Opinions.
-0.1 0.0 0.1 0.2
-0.2
-0.1
0.0
0.1
G1=blue, G2=green, G3=gray, G4=violet, G5=orange
Dim1 (65,94%)
Dim
2 (2
0,56
%)
1
2
3
4
5
67
8
9
10
11
12
13
1415
16 171819
20
21
22
Dimension 1 (variability = 46.8%)
Dimen
sion 2 (variability = 23.5 %)
Figure 2: ContribuXon (%) of the 16 criteria to the total variability of each dimension.
Legend: CP – PotenXal impact on costs for paXents; CS – PotenXal impact on providers' cost; Csoc – PotenXal impact on costs for society; DI – PotenXal for inappropriate diffusion; DS – PotenXal impact on service performance; LES – Legal, ethical and social impact; MB – PotenXal impact on morbidity; MT – PotenXal impact on mortality; PC – Changes in clinical pracXce; Prio – Health policy relevance; QV – PotenXal impact on the quality of life; R – Available evidence. Rep – Epidemiological relevance; Rtec – Clinical pracXce relevance; SB – PotenXal impact on paXent survival; SG – Safety; 0 5 10 15 20
05
1015
20
Dimension 1 (%)
Dim
ensio
n 2
(%)
Rep
PrioMT
MB
QVSB
DS
RTec
DI
CP
CsocCSPC
RSG
LES
Dimension 1 (%)
Dimen
sion 2 (%
)
EPOSTERBOARDS TEMPLATE
RESULTS The MCA was carried out with all 16 prioriXsaXon criteria proposed to the stakeholders in the selecXon process of priorisaXon criteria. Figure 2 shows the contribuXon of those
prioriXsaXon criteria to the total variability of dimension 1 and 2 (axis). The criteria with the greatest contribuXon for the dimension 1 were R and Rtec, reflecXng the importance of the technology anributes related to scienXfic evidence available and the epidemiological relevance, respecXvely. On the other hand, for dimension 2 the criteria with the highest contribuXon reflected anributes concerning the impact of technology on the paXent’s life (SB, QV and LES).
In Brazil, the HSS is in the iniXal stage and the involvement of SUS’s stakeholders is strategic to design an effecXve system, as well as reducing the stakeholder’s resistance. This approach allows the client of the HSS to analyse the stakeholder’s individual opinions and to increase the transparency of the process.
To CoordinaXon for the Improvement of Higher EducaXon Personnel (CAPES) for the first author scholarship and to the grant from Agreement Lener OPAS-‐OMS (SCTIE-‐MS)/Fundação Coppetec BR/LOA/1200120.001.
Mapping the Stakeholder’s Opinion of Priori5sa5on Criteria for Early Awareness and Alert System in Brazil
A NASCIMENTO, AT VIDAL, CC OTTO, RT ALMEIDA 1 Programa de Engenharia Biomédica, COPPE, Universidade Federal do Rio de Janeiro, Rio de Janeiro. 2 Departamento de Gestão e
Incorporação de Tecnologias em Saúde, Secretaria de Ciência, Tecnologia e Insumos Estratégicos, Ministério da Saúde, Brasília, Brasil
CONCLUSIONS ACKNOWLEDGEMENTS
Two filtraXon criteria selected aser the groups discussion:
• Time Horizon from phase II or III of clinical trial;
• Innova5on defined as totally new therapeuXc opXon or when compared to current opXon present a great potenXal of efficacy or reduce side effects.
Eight prioriXsaXon criteria selected by the stakeholders: • Epidemiological relevance (Rep); • Clinical pracXce relevance (RTec); • Health policy relevance (Prio); • PotenXal impact on the SUS´s budget (O);
• PotenXal impact on providers' cost (CS); • PotenXal impact on mortality (MT); • Safety (SG); • Legal, ethical and social impact (LES).
