Literature Review of Methods for Evaluating and Selecting Medical Devices at Hospital Level

OBJECTIVES: To conduct a literature review of methods for medical device (MD) evaluation and selection at the hospital level, with particular interest in procedures, processes and tools.

METHODS: We conducted a literature review in PubMed (Medline) in March 2022. Search terms were medical device, hospital, methods, technology assessment and, decision making or decision support or selection (or variants); or Mesh terms Equipment and supplies and technology assessment, biomedical/methods. We defined inclusion and exclusion criteria; papers evaluating only one MD were excluded. We also reviewed the five most relevant cross-link papers and references.

RESULTS: Twenty-four documents were included. Four main models of MD evaluation and selection procedures/organisation at hospital level were identified: ambassador, internal committee, mini health technology assessment (HTA), HTA unit; and 4 models of HTA unit, according to structure and level of integration. In terms of tools, mini-HTA mainly included formularies or questionnaires with requirements and consequences of MD use, considering aspects mainly related to technology, patients, organisation and economy. Other tools combine mini-HTA with multicriteria decision analysis.Regarding processes, different professionals prepare MD assessment reports, sometimes at least partly pharmacists, and decisions are generally taken in multidisciplinary teams. There is heterogeneity regarding decision criteria.

CONCLUSIONS: Different tools and procedures for MD evaluation and selection at hospital level have been identified. One example is mini-HTA, which considers the consequences of an MD at hospital level for technology, patients, organisation and economy, and with multidisciplinary decision. This review at hospital level has not been done before and can help to identify the most appropriate model for each hospital context.