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Syst Rev. 2018 May 23;7(1):79. doi: 10.1186/s13643-018-0743-4.

Health technology assessment of public health interventions: an analysis of characteristics and comparison of methods-study protocol.

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Institute for Research in Operative Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
AQUA Institute for Applied Quality Improvement and Research in Health Care, Maschmuehlenweg 8-10, 37073, Goettingen, Germany.
Institute for Research in Operative Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
Faculty of Health Science, Bielefeld University, Universitätsstr. 25, 33615, Bielefeld, Germany.
Institute of Ethics, History and Theory of Medicine, LMU Munich, Lessingstr. 2, 80689, Munich, Germany.
AOK-Bundesverband, Rosenthaler Str. 31, 10178, Berlin, Germany.
Department of Nursing and Health Sciences, University of Applied Sciences, Leipziger Straße 123, 36037, Fulda, Germany.
Department for Health Services Research, Institute for Public Health and Nursing Research, University of Bremen, Grazer Str. 4, D-28359, Bremen, Germany.
Health Sciences Bremen, University of Bremen, Bremen, Germany.



Conducting a health technology assessment (HTA) of public health interventions (PHIs) poses some challenges. PHIs are often complex interventions, which affect the number and degree of interactions of the aspects to be assessed. Randomized controlled trials on PHIs are rare as they are difficult to conduct because of ethical or feasibility issues. The aim of this study is to provide an overview of the methodological characteristics and to compare the applied assessment methods in HTAs on PHIs.


We will systematically search HTA agencies for HTAs on PHIs published between 2012 and 2016. We will identify the HTAs by screening the webpages of members of international HTA organizations. One reviewer will screen the list of HTAs on the webpages of members of international HTA organization, and a second review will double-check the excluded records. For this methodological review, we define a PHI as a population-based intervention on health promotion or for primary prevention of chronic or non-chronic diseases. Only full HTA reports will be included. At maximum, we will include a sample of 100 HTAs. In the case that we identify more than 100 relevant HTAs, we will perform a random selection. We will extract data on effectiveness, safety and economic as well as on social, cultural, ethical and legal aspects in a priori piloted standardized tables. We will not assess the risk of bias as we focus on exploring methodological features. Data extraction will be performed by one reviewer and verified by a second. We will synthesize data using tables and in a structured narrative way.


Our analysis will provide a comprehensive and current overview of methods applied in HTAs on PHIs. We will discuss approaches that may be promising to overcome the challenges of evaluating PHIs.


Health promotion; Health technology assessment; Methodology review; Public health

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