Abstract
Innovations in health care are growing exponentially, resulting in improved quality
of and access to care, as well as rising societal costs of care and variable reimbursement.
In recent years, digital health technologies and artificial intelligence have become
of increasing interest in cardiovascular medicine owing to their unique ability to
empower patients and to use increasing quantities of data for moving toward personalised
and precision medicine. Health technology assessment agencies evaluate the money spent
on a health care intervention or technology to attain a given clinical impact and
make recommendations for reimbursement considerations. However, there is a scarcity
of economic evaluations of cardiovascular digital health technologies and artificial
intelligence. The current health technology assessment framework is not equipped to
address the unique, dynamic, and unpredictable value considerations of these technologies
and highlight the need to better approach the digital health technologies and artificial
intelligence health technology assessment process. In this review, we compare digital
health technologies and artificial intelligence with traditional health care technologies,
review existing health technology assessment frameworks, and discuss challenges and
opportunities related to cardiovascular digital health technologies and artificial
intelligence health technology assessment. Specifically, we argue that health technology
assessments for digital health technologies and artificial intelligence applications
must allow for a much shorter device life cycle, given the rapid and even potentially
continuously iterative nature of this technology, and thus an evidence base that maybe
less mature, compared with traditional health technologies and interventions.
Résumé
Les innovations dans le domaine de la santé sont en croissance exponentielle, ce qui
se traduit par une amélioration de l'accès aux soins et de leur qualité, mais aussi
par une augmentation des coûts sociétaux des soins et des remboursements variables.
Ces dernières années, les technologies de santé numérique et l'intelligence artificielle
ont suscité un intérêt croissant en médecine cardiovasculaire en raison de leur capacité
unique à responsabiliser les patients et à utiliser des quantités croissantes de données
pour avancer vers une médecine personnalisée et de précision. Les agences d'évaluation
des technologies de santé quantifient les sommes dépensées pour une intervention ou
une technologie de soins de santé en vue d'obtenir une retombée clinique donnée et
formulent des recommandations sur des considérations de remboursement. Cependant,
les évaluations économiques des technologies de santé numériques cardiovasculaires
et de l'intelligence artificielle sont rares. Le cadre d'évaluation actuel des technologies
de la santé n'est pas outillé pour prendre en considération l'aspect original, dynamique
et imprévisible de ces technologies, soulignant la nécessité de mieux aborder le processus
d'évaluation des technologies numériques de la santé et de l'intelligence artificielle.
Dans cette étude, nous comparons les technologies numériques de la santé et l'intelligence
artificielle par rapport aux technologies traditionnelles des soins de santé, nous
examinons les dispositifs d'évaluation des technologies de santé existants et nous
discutons des défis et des possibilités liés à l'évaluation des techno-logies numériques
de la santé et de l'intelligence artificielle dans le domaine cardiovasculaire. Plus
précisément, nous soutenons que les évaluations des technologies de la santé pour
les technologies numériques de la santé et les applications de l'intelligence artificielle
doivent tenir compte d'un cycle de vie des dispositifs beaucoup plus court, étant
donné la nature rapide et même potentiellement itérative et continue de ces technologies,
constituant alors une base de données factuelles peut-être moins mature, en comparaison
avec les technologies et interventions traditionnelles de santé.
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Article info
Publication history
Published online: August 27, 2021
Accepted:
August 3,
2021
Received:
June 22,
2021
Footnotes
See page 264 for disclosure information.
Identification
Copyright
© 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
