Development, application, and assessment of two methodological approaches to evaluate new healthcare technologies: A research program
Background: As new healthcare technologies are developed, tensions arise about efficacy, safety, costs and optimal timing of their implementation into routine clinical care. We need methodologies that could avoid the pitfalls of premature adoption of a new technology and facilitate a more deliberate consideration of evolving evidence, particularly among different information sources, such as media reports. ^ Methods: I conducted 3 studies to explore 2 methodological issues related to new healthcare technologies: (1) use of conference abstracts as a source of original research data to inform clinical or policy decisions, and (2) contextual representation of original research documents. I used psychometric methods to develop, test, and apply a reliable, 14-item scale to measure the completeness of reporting in observational study conference abstracts. I studied the natural history of a cohort of original research studies from conference abstract to subsequent publication and identified predictors of peer-review publication. Finally, I developed the systematic bibliometric review, a new methodology to conceptualize, interpret, and visualize the quantity, quality, relevance, and context of original research. My clinical exemplar was rituximab for non-Hodgkin's lymphoma, an expensive, first-in-class cancer drug. ^ New Discoveries: In this thesis, I identified incomplete reporting of essential elements in conference abstracts that cannot be justified by limitations in space alone. With 6.8 years follow-up, the publication rate of a 5-year cohort of conference abstracts was 52.3%, and median time to publication, 1.4 years. Independent predictors of peer-review publication included presentation type (oral or poster versus publication in conference proceedings only) and any author affiliation with industry. In the systematic bibliometric review, systematic evaluation and visual representation of a cohort of 757 documents including original research reports, review articles, guidelines, editorials, and media reports identified a dearth of high-quality evidence to inform clinical decisions, high ratio of review articles to original research, and infrequent citations of original research by media reports. ^ Contribution to Literature: (1) Development of a new psychometrically sound instrument to assess the completeness of reporting in observational study conference abstracts. (2) In-depth case study of a cohort of investigations from conference abstract to full publication for one population, intervention, and disease. (3) Development of a new methodology, the systematic bibliometric review, which helps evidence consumers conceptualize, interpret, and visualize the quantity, quality, relevance, and context of original research. ^
Health Sciences, Epidemiology|Health Sciences, Health Care Management|Health Sciences, Oncology
Michelle Elisabeth Kho,
"Development, application, and assessment of two methodological approaches to evaluate new healthcare technologies: A research program"
(January 1, 2010).
ETD Collection for McMaster University.