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Implementing a HTA-Unit in a University-Affiliated Child Welfare Agency: The Challenge of Adapting the Medical Model of HTA to the Social Services Context

Date and Location




Saturday 21 September 2013 - 10:30 - 12:00


Presenting author and contact person

Presenting author

Eve-Line Bussières

Contact person

Eve-Line Bussières
Abstract text
Background. Health technology assessment (HTA)-units has originally emerged from the medical domain, were systematic reviews (SR) of randomized-controlled trials (RCT’s) are commonly done. Recently, HTA-units have started to be implemented in the social services context; in the province of Quebec, Canada, it’s implementation is mandatory for every university-affiliated agencies. This situation appears quite unique and requires different adaptations of the medical model of HTA, in order to meet the specific needs of the social services context. For example, far less RCT’s are performed in the social literature, mainly for ethical reasons, but also because RCT’s cannot answer numerous questions emphasizing more the process than the outcome, a major concern in social sciences. Consequently, SR of observational studies are more common in the social context; but is it possible to perform them using the typical methodology and the usual quality assessment tools? Objective. This presentation addresses the challenges of implementing a HTA-unit in a University-affiliated child welfare agency, and the necessity to adapt the medical model of HTA in at least two ways: 1) the structure of the unit; 2) the way SR are carried out, including the pertinence of quality assessment tools. As an example, we will present the process of doing a meta-analysis (MA) of observational studies in our social HTA-unit, with a particular focus on the available quality assessment tools. Results/Discussion. The challenges of implementing a HTA-Unit in the social services context will be discussed. We propose that the paucity of quality assessment tools available and pertinent for observational studies raises the question of its actual pertinence in this context. As MA allows to do moderator analysis, including methodological variables, we suggest that it can represent an interesting way of doing high quality systematic reviews in social sciences.