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Institute of Medicine (US) Council on Health Care Technology; Goodman C, editor. Medical Technology Assessment Directory: A Pilot Reference To Organizations, Assessments, and Information Resources. Washington (DC): National Academies Press (US); 1988.

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Medical Technology Assessment Directory: A Pilot Reference To Organizations, Assessments, and Information Resources.

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Congress of the United States Office of Technology Assessment Health Program

Washington, D.C. 20510

202-228-6590

Contact: Clyde J. Behney, Program Manager for Health.

Overview: The Office of Technology Assessment (OTA) is a nonpartisan analytical support agency that serves the U.S. Congress. The Office was authorized in 1972, funded in late 1973, and began full operations in 1974. The Health Program was established in 1975.

OTA has three operating divisions: the Energy, Materials, and International Security Division; the Science, Information and Natural Resources Division; and the Health and Life Sciences Division. Within the Health and Life Sciences Division are three programs: the Food and Renewable Resources Program; the Biological Applications Program; and the Health Program. This profile deals primarily with assessment activities of the Health Program.

OTA is governed by a 12-member bipartisan Congressional board of six senators and six representatives. The board is advised by an Advisory Council of 10 public members eminent in science, technology, and education, appointed by the board. The Comptroller General of the United States and the director of the Congressional Research Service of the Library of Congress are also members. The OTA director is appointed by the board and serves as a nonvoting member.

Purpose: To help Congress anticipate and plan for the consequences of technological applications, and to examine the ways, expected and unexpected, in which technology affects people's lives. The OTA clarifies for Congress both the range of policy options and the potential impacts of adopting each option, but it makes no formal recommendations. The OTA also provides advice to Congressional committee members and staff, presents testimony at hearings, and conducts workshops with committees. Although the OTA is responsible to the needs of the Congress and its products are designed for use by the Congress, they have a wider applicability as well.

Primary intended users: Legislators, government regulators, public policy-makers.

Technologies: Drug, device, medical or surgical procedure, support system, organizational or administrative system, personnel.

The OTA focuses its evaluation efforts on broad policy technological issues or on case studies from which further research questions or generalizable lessons can be gained.

Intervention: Prevention, diagnosis, treatment, rehabilitation.

Stage: New, established or widespread practice, emerging, obsolete.

Properties: Safety; efficacy; cost-effectiveness; effectiveness; cost; acceptance/adoption level; system impact; economic implications; ethical, legal, social implications.

The scope of OTA assessments is quite broad, reflecting the extent to which legislative policy issues are influenced by technological developments.

Selection process: Under OTA statute, studies may be initiated by a request from a Congressional committee chairman. The OTA will also respond formally to requests for information from any member of Congress or any Congressional committee. OTA staff members screen the proposed study to determine what resources and time it might require and what modifications it might need to suit the OTA's resources and Congressional needs. The staff then presents a formal study proposal to the OTA Board, which makes the final decision on whether to undertake it.

Methods: Information syntheses, expert opinion, modeling, cost analysis.

The OTA generally does not support original research, but synthesizes existing knowledge from the medical and health policy literature with the help of expert advisors.

The OTA staff develops an initial draft with advice from an expert advisory panel appointed for each main report. The draft is then circulated for review and comment to groups and experts both in the government and in the private sector. Advisory panel assistance includes review and comment, although its consensus is not sought for report content or findings and reports are not formally approved by the panel. OTA staff are responsible for drafting the final report. Case studies of specific technologies have been used often in conjunction with reports dealing with broad issues such as studies of cost-effectiveness and cost-benefit analyses of technologies. Such case studies usually are prepared by experts under commissions from the OTA and occasionally by OTA staff.

The bulk of OTA's work involves comprehensive, in-depth assessments that may take 18 months or more to complete. It is also provides shorter responses to meet Congressional needs, largely based on information in past and current assessments. OTA can structure longer-range assessments so that the results, in various stages, can be sent to Congress in the form of interim reports.

Assessors: OTA multidisciplinary staff teams plan, direct, and draft all assessments. Staff members have expertise in such areas as medicine, law, sociology, epidemiology, statistics, public health, public policy, and biology. The Health Program has about 13 permanent staff and 12 to 14 other in-house staff on temporary appointments. Outside contract work is usually for special material to be included in OTA reports. OTA uses expert advisory panels as a way of ensuring that reports are objective, fair, and authoritative. The Health Program is advised regarding overall planning by a standing 15-member Health Program Advisory Committee composed of experts in a variety of fields relevant to health care technology assessment. This committee generally is not involved directly in specific studies. The staff rely extensively on the broad technical and professional resources of the private sector, including universities, research organizations, industry, and public interest groups.

Assessment reports include: Abstract; the purpose of the assessment; relationship of this assessment to prior or concurrent assessments of the technology or other technologies intended for similar purposes; who sponsored/commissioned/supported the assessment; who conducted the assessment; description of the technology; stage of lifecycle of technology when assessed; properties assessed; procedure used for the assessment; sources of data/information; methods for collecting data/information; results; findings or conclusions; limitations of findings; implications of findings for practice; recommendations for practice, future assessments, technology development, research; how the technology works, including theory, principles; development of the technology; where technology is in use.

Dissemination: Printed reports; journal articles; press conferences/news releases; TV/ radio broadcasts, video products; briefings to Congressional committees and staff.

Reports approved by the OTA Director are sent to the Technology Assessment Board and to the requesting Congressional committee(s). Summaries are also sent to all members of Congress and then the report and summary are released to the public. Summaries of all OTA reports are available free of charge from the OTA. OTA studies are also available from the U.S. Government Printing Office or the National Technical Information Service.

Budget: $1.6 million (fiscal year 1987). The approximate cost per assessment is $400,000 to $700,000. Funding source: 100 percent parent organization.

Use: OTA reports have generally been well-received by Congress and the various sectors of the health care industry. Because of the nature of congressional decisions, it is difficult to attribute legislative change or other congressional actions to any one factor. However, in several instances Congress has based funding and policy decisions on OTA report findings.

The OTA Health Program is described in: Institute of Medicine, Committee on Evaluating Medical Technologies in Clinical Use. Assessing medical technologies. Washington, DC: National Academy Press, 1985.

Related activities: The OTA was mandated by Congress to select and appoint the members of the Prospective Payment Assessment Commission (ProPAC), which advises the Secretary of DHHS regarding the hospital prospective payment system used for Medicare. The OTA acts as an observer and evaluator of ProPAC, reports annually to Congress on the functioning of the Commission, and appoints replacement commissioners each year. The OTA has similar responsibilities for the Physician Payment Review Commission.

Completed Reports

CU1 Congress of the United States, Office of Technology Assessment. Assessing the quality of medical care. Washington, D.C.: U.S. Government Printing Office. To be completed in Spring 1988.

CU2 ______. Diagnostic and predictive medical tests. Washington, D.C.: U.S. Government Printing Office. To be completed in Spring 1988.

CU3 ______. Drug labeling in developing countries. Washington, D.C.: U.S. Government Printing Office. To be completed in Winter 1988/89.

CU4 ______. Nontraditional methods of cancer management. Washington, D.C.: U.S. Government Printing Office. To be completed in Summer 1988.

CU5 ______. Carcinogen regulatory policy. Washington, D.C.: U.S. Government Printing Office. To be completed Spring 1987.

CU6 ______. Clinical staffing issues in the Indian Health Service. Washington, D.C.: Office of Technology Assessment. Special report. To be released in Spring 1987.

CU7 ______. Effectiveness and costs of ambulatory tocodynamometry. Washington, D.C.: U.S. Government Printing Office. To be completed in Spring 1987.

CU8 ______. Immuno-augmentative therapy. Washington, D.C.: U.S. Government Printing Office. To be completed in Winter 1987/1988.

CU9 ______. Mammography screening for the Medicare population. Washington, D.C.: Office of Technology Assessment. To be completed in Summer 1987.

CU10 ______. Mental health services for children. Washington, D.C.: U.S. Government Printing Office, January 1987.

CU11 ______. Review of study comparing inpatient hospital costs in the Veterans Administration to those in non-VA facilities. Washington, D.C.: Office of Technology Assessment. To be completed in February 1987.

CU12 ______. Technology and child health. Washington, D.C.: U.S. Government Printing Office. To be completed in Spring 1987.

CU13 ______. Extracorporeal shock-wave lithotripsy. Washington, D.C.: U.S. Government Printing Office, May 1986. (Health technology case study series #36)

CU14 ______. Indian health care. Washington, D.C.: U.S. Government Printing Office, April 1986.

CU15 ______. Nurse practitioners, certified nurse-midwives, and assistants: a policy analysis. Washington, D.C.: U.S. Government Printing Office, December 1986. (Health technology case study series #37)

CU16 ______. OTA's second report on the Prospective Payment Assessment Commission (special report). Washington, D.C.: Office of Technology Assessment, March 1986.

CU17 ______. Passive smoking in the workplace: selected issues. Washington, D.C.: Office of Technology Assessment, May 1986.

CU18 ______. Payment for physician services: strategies for Medicare. Washington, D.C.: U.S. Government Printing Office, February 1986.

CU19 ______. Technologies for detecting heritable mutations in human beings. Washington, D.C.: U.S. Government Printing Office, September 1986.

CU20 ______. Blood policy and technology. Washington, D.C.: U.S. Government Printing Office, January 1985.

CU21 ______. Evaluation of HCFA's Part A data base. Washington, D.C.: Office of Technology Assessment, July 1985.

CU22 ______. Medical devices and the Veterans Administration. Washington, D.C.: U.S. Government Printing Office, February 1985.

CU23 ______. Medicare's prospective payment system: strategies for evaluating cost, quality, and medical technology. Washington, D.C.: U.S. Government Printing Office, October 1985.

CU24 ______. OTA's first report on the Prospective Payment Assessment Commission (special report). Washington, D.C.: Office of Technology Assessment, March 1985.

CU25 ______. Preventing illness and injury in the workplace. Washington, D.C.: U.S. Government Printing Office, April 1985.

CU26 ______. Replacing the Rosebud Sioux Hospital: number of beds and whether a surgical suite is needed. Washington, D.C.: Office of Technology Assessment, August 1985.

CU27 ______. Review of the Public Health Service's response to AIDS. Washington, D.C.: U.S. Government Printing Office, February 1985.

CU28 ______. Status of biomedical research and related technology for tropical diseases. Washington, D.C.: U.S. Government Printing Office, September 1985.

CU29 ______. Technologies for managing urinary incontinence. Washington, D.C.: U.S. Government Printing Office, July 1985. (Health technology case study series #33)

CU30 ______. The cost effectiveness of digital subtraction angiography in the detection of cerebrovascular disease. Washington, D.C.: U.S. Government Printing Office, May 1985. (Health technology case study series #34)

CU31 ______. The effectiveness and costs of continuous ambulatory peritoneal dialysis. Washington, D.C.: U.S. Government Printing Office, September 1985. (Health technology case study series #35)

CU32 ______ The hemodialysis equipment and disposables industry. Washington, D.C.: U.S. Government Printing Office, December 1984. (Health technology case study series #32)

CU33 ______. Federal policies and the medical devices industry. Washington, D.C.: U.S. Government Printing Office, October 1984.

CU34 ______. Intensive care units: costs, outcome, and decisionmaking. Washington, D.C.: U.S. Government Printing Office, October 1984. (Health technology case study series #28)

CU35 ______. Medical technology and costs of the Medicare program. Washington, D.C.: U.S. Government Printing Office, July 1984.

CU36 ______. Nuclear magnetic resonance imaging technology: a clinical, industrial, and policy analysis. Washington, D.C.: U.S. Government Printing Office, September 1984. (Health technology case study series #27)

CU37 ______. The Boston elbow. Washington, D.C.: U.S. Government Printing Office, November 1984. (Health technology case study series #29)

CU38 ______. The contact lens industry. Washington, D.C.: U.S. Government Printing Office, December 1984 (Health technology case study series #31)

CU39 ______. The health effects of fish oil. Washington, D.C.: Office of Technology Assessment, February 1984.

CU40 ______. The market for wheelchairs: innovations and public policy. Washington, D.C.: U.S. Government Printing Office, November 1984. (Health technology case study series #30)

CU41 ______. The use of immunosuppressive drugs in kidney transplantation. Washington, D.C.: Office of Technology Assessment, March 1984.

CU42 ______. Update of Federal activities regarding the use of pneumococcal vaccine. Washington, D.C.: U.S. Government Printing Office, May 1984.

CU43 ______. Assistive devices for severe speech impairments. Washington, D.C.: U.S. Government Printing Office, December 1983. (Health technology case study series #26)

CU44 ______. Diagnosis-related groups (DRGs) and the Medicare program: implications for medical technology, Washington, D.C.: U.S. Government Printing Office, July 1983.

CU45 ______. Quality and relevance of research and related activities at the Gorgas Memorial Laboratory. Washington, D.C.: U.S. Government Printing Office, August 1983.

CU46 ______Technology and learning disabilities. Washington, D.C.: U.S. Government Printing Office, December 1983. (Health technology case study series #25)

CU47 ______. The effectiveness and costs of alcoholism treatment. Washington, D.C.: U.S. Government Printing Office, March 1983. (Health technology case study series #22)

CU48 ______. The impact of randomized clinical trials on health policy and medical practice. Washington, D.C.: U.S. Government Printing Office, August 1983.

CU49 ______. The safety, efficacy, and cost effectiveness of therapeutic apheresis. Washington, D.C.: U.S. Government Printing Office, July 1983. (Health technology case study series #23)

CU50 ______. Variations in hospital length of stay: their relationships to health outcomes. Washington, D.C.: U.S. Government Printing Office, August 1983. (Health technology case study series #24)

CU51 ______. Assessment of four common X-ray procedures. Washington, D.C.: U.S. Government Printing Office, April 1982. (Health technology case study series # 19)

CU52 ______. Cardiac radionuclide imaging and cost-effectiveness. Washington, D.C.: U.S. Government Printing Office, May 1982. (Health technology case study series #13)

CU53 ______. MEDLARS and health information policy. Washington, D.C.: U.S. Government Printing Office, September 1982.

CU54 ______. Mandatory passive restraint systems in automobiles. Washington, D.C.: U.S. Government Printing Office, September 1982. (Health technology case study series #20)

CU55 ______. Medical technology under proposals to increase competition in health care. Washington, D.C.: U.S. Government Printing Office, October 1982.

CU56 ______. Postmarketing surveillance of prescription drugs. Washington, D.C.: U.S. Government Printing Office, November 1982.

CU57 ______. Selected telecommunications devices for hearing-impaired persons. Washington, D.C.: U.S. Government Printing Office, December 1982. (Health technology case study series #21)

CU58 ______. Strategies for medical technology assessment. Washington, D.C.: U.S. Government Printing Office, September 1982.

CU59 ______. Technology and handicapped people. Washington, D.C.: U.S. Government Printing Office, May 1982.

CU60 ______. Technology transfer at the National Institutes of Health. Washington, D.C.: U.S. Government Printing Office, March 1982.

CU61 ______. The artificial heart: cost, risks, and benefits. Washington, D.C.: U.S. Government Printing Office, May 1982. (Health technology case study series #9)

CU62 ______. Allocating costs and benefits in disease prevention: an application to cervical cancer screening. Washington, D.C.: U.S. Government Printing Office, May 1981. (Health technology case study series #7)

CU63 ______. Assessing selected respiratory therapy modalities: trends and relative costs in the Washington, D.C. area. Washington, D.C.: U.S. Government Printing Office, July 1981. (Health technology case study series #12)

CU64 ______. Benefit and cost analysis of medical interventions: the case of cimetidine and peptic ulcer disease. Washington, D.C.: U.S. Government Printing Office, September 1981. (Health technology case study series #11)

CU65 ______. Cost-benefit/cost-effectiveness of medical technologies: a case study of orthopedic joint implants. Washington, D.C.: U.S. Government Printing Office, September 1981. (Health technology case study series #14)

CU66 ______. Cost-effectiveness of automated multichannel chemistry analyzers. Washington, D.C.: U.S. Government Printing Office, April 1981. (Health technology case study series #4)

CU67 ______. Cost-effectiveness of influenza vaccination. Washington, D.C.: U.S. Government Printing Office, December 1981.

CU68 ______. Elective hysterectomy: costs, risks and benefits. Washington, D.C.: U.S. Government Printing Office, October 1981. (Health technology case study series #15)

CU69 ______. Formal analysis, policy formulation, and end-stage renal disease. Washington, D.C.: U.S. Government Printing Office, April 1981. (Health technology case study series #1)

CU70 ______. Periodontal disease: assessing the effectiveness and costs of the Keyes technique. Washington, D.C.: U.S. Government Printing Office, May 1981. (Health technology case study series #5)

CU71 ______. Policy implications of computed tomography (CT) scanners: an update. Washington, D.C.: U.S. Government Printing Office, January 1981.

CU72 ______. Screening for colon cancer. Washington, D.C.: U.S. Government Printing Office, April 1981. (Health technology case study series #3)

CU73 ______. Surgery for breast cancer. Washington, D.C.: U.S. Government Printing Office, October 1981. (Health technology case study series # 17)

CU74 ______. Technologies for determining cancer risks from the environment. Washington, D.C.: U.S. Government Printing Office, June 1981.

CU75 ______. The cost-effectiveness of bone marrow transplant therapy and its policy implications. Washington, D.C.: U.S. Government Printing Office, May 1981. (Health technology case study series #6)

CU76 ______. The cost-effectiveness of upper gastrointestinal endoscopy. Washington, D.C.: U.S. Government Printing Office, May 1981. (Health technology case study series #8)

CU77 ______. The costs and effectiveness of neonatal intensive care. Washington, D.C.: U.S. Government Printing Office, August 1981. (Health technology case study series #10)

CU78 ______. The costs and effectiveness of nurse practitioners. Washington, D.C.: U.S. Government Printing Office, July 1981. (Health technology case study series #16)

CU79 ______. The feasibility of economic evaluation of diagnostic procedures: the case of CT scanning. Washington, D.C.: U.S. Government Printing Office, April 1981. (Health technology case study series #2)

CU80 ______. Compensation for vaccine-related injuries. Washington, D.C.: U.S. Government Printing Office, November, 1980.

CU81 ______. Methodological issues and literature review. Washington, D.C.: U.S. Government Printing Office, September 1980. (Background paper #1 of the Series on implications of cost-effectiveness analysis of medical technology)

CU82 ______. The efficacy and cost effectiveness of psychotherapy. Washington, D.C.: U.S. Government Printing Office, October 1980. (Health technology case study series #18)

CU83 ______. The implications of cost-effectiveness analysis of medical technology. Washington, D.C.: U.S. Government Printing Office, August 1980.

CU84 ______. The management of health care technology in ten countries. Washington, D.C.: U.S. Government Printing Office, October 1980. (Background paper #4 of the Series on implications of cost-effectiveness analysis of medical technology)

CU85 ______. A review of selected federal vaccine and immunization policies. Washington, D.C.: U.S. Government Printing Office, September 1979.

CU86 ______. Computer technology in medical education and assessment. Washington, D.C.: U.S. Government Printing Office, September 1979.

CU87 ______. Assessing the efficacy and safety of medical technologies. Washington, D.C.: U.S. Government Printing Office, September 1978.

CU88 ______. Policy implications of computed tomography (CT) scanners. Washington, D.C.: U.S. Government Printing Office, August 1978.

CU89 ______. Cancer testing technology and saccharin. Washington, D.C.: U.S. Government Printing Office, October 1977.

CU90 ______. Policy implications of medical information systems. Washington, D.C.: U.S. Government Printing Office, November 1977.

CU91 ______. Development of medical technology: opportunities for assessment. Washington, D.C.: U.S. Government Printing Office, August 1976.

CU92 ______. Drug bioequivalence. Washington, D.C.: U.S. Government Printing Office, July 1974.

Copyright © 1988 by the National Academy of Sciences.
Bookshelf ID: NBK218464

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