Article: Public and patient involvement in health technology assessment: a framework for action


My fellowship is methodological, so I am interested in examples of public and patient involvement (PPI) in methodological work. This 2016 article isn't specifically about methodological work, but it is about PPI in HTA, which has methodological components, so is relevant to my work.

As the title suggests, the objective of this work is to develop a framework to allow patients and members of the public to be involved in HTA. Evidence was identified via three sources: a systematic literature review, searching the websites of HTA organisations, and 'stakeholder dialogue'. Outputs included six guiding principles for PPI, it should be:

  • Purposeful
  • Pragmatic
  • Fair and equitable
  • Proportional
  • Evidence-informed
  • Transparent

More details on these principles may be found here.

In addition, PPI was broken-down into three mechanisms of involvement:

  • Communication: such as dissemination of results. For this, PPI is usually passive.
  • Consultation: to gain input, such as on preferences or attitudes. PPI is then seen as an input to a process, for example via focus groups, surveys or interviews.
  • Participation: which is a two-way exchange of ideas. This includes representation on advisory groups and steering committees, as well as co-production.

Whilst not specific to PPI in methodological work (the focus remains on people with experience of a specific technology or condition), I believe that the guiding principles and mechanisms of involvement are of use to any PPI work.

A further interesting finding: the website search identified 53 HTA agencies from 34 countries with an English website (including translations). Of these, only five described the reasons for public involvement. Two of these 5 were UK agencies (the others were from US, Canada, and South Korea). This suggests that PPI in UK HTA is relatively advanced compared to other countries.

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