A multi scale methodology for technology assessment. A case study on spine surgery

Abstract

This article describes a multi-scale methodology for Health Technology Assessment. Multi-scale means that this method focuses the attention on the needs to be satisfied taken as a whole, by categories and one by one. For this reason a graphic representation has been used to identify the strengths of every technology to be compared. Than an objective function has been established in order to individuate the technology that better fill the needs as whole and by category. In order to establish a scale of satisfaction, it was necessary to define an algorithm that could distinguish parameters in objectivequantitative and subjective-qualitative. These last items have been quantified by auditing an un-polarized sample of experts trough questionnaires. Finally the chosen method was applied to neurosurgery, especially to spine surgery. Two different surgical techniques have been evaluated for different pathologies, each method applying different biocompatible elements: the traditional treatment, which employs rigid fixers (Cage and Titanium bars) and a new procedure, which employs elastic fixers with shape memory (Somafix and Nitinol bars).