2020 Virtual Workshops

Platforms, Baskets, and Umbrellas: HTA and Novel Clinical Trial Designs

Part 1: Methods for Novel Clinical Trial Study Designs

Date: Wednesday, November 25, 2020

Time: 11:00 am – 1:00pm

What you’ll learn: Discussion on the Past, Present, and Future of novel clinical trials

Part 2: Issues around Health Technology Assessments of Novel Therapeutics

Date: Wednesday, December 2, 2020

Time: 11:00 am – 1:00pm

What you’ll learn: Discussion on the elements required for health technology assessments including clinical evidence methods, clinical evidence outcomes, economics, ethics, implementation

Part 3: Stakeholder Perspectives        

Date: Wednesday, December 9, 2020

Time: 11:00 am – 1:00pm

What you’ll learn: Discussion from a clinician, patients, industry, public and private payers

Audience: Of interest to HTA producers.

Level: Introductory
Abstract: Advancements in genomics have changed the paradigm of clinical trial design in oncology. Master protocols in which multiple parallel drug studies are conducted under one overarching protocol are increasingly used to test multiple hypotheses. A 2019 systematic review (Park et al., Trials, 2019) identified 83 master protocols, most of them in the field of oncology (N = 76/83) and ongoing (N = 68/83) at the time of the review. Master protocols are often classified as basket trials (N = 49/83), umbrella trials (N = 18/83), and platform trials (N = 16/83). 

Compared to traditional clinical trials, basket trials test therapies for a specific genetic marker regardless of the anatomical location, whereas umbrella trials test multiple targeted therapies for a single tumour type that is stratified into subgroups by molecular alteration. Platform trials, which test several interventions against a common control group, allow interventions to enter and exit the trial under a Bayesian decision rule framework based on the demonstration of efficacy or futility. These trial designs have their own advantages and limitations. Methods to understand clinical evidence, patient values and need, ethics and implementation are increasingly being considered as part of health technology management (HTM).

This series of three workshops will present broad perspectives and considerations when assessing the evidence generated by these new study designs from an HTM perspective.

Register: https://cadth.zoom.us/meeting/register/tJApdO2qrjgvEtSyjvmBckzmocaEdS86yFp5

 

Delving into the Literature: What Does the Evidence Really Say?

Date: Wednesday, January 20, 2021

Time: 11:00 am – 1:00pm

Audience: Of interest to health care professionals.

Level: Introductory
What you’ll learn: Participants will appreciate the importance of critical appraisal, understand potential sources of bias in published literature, and learn practical methods for evaluating some of the most common types of publications to assist their decision-making.

  • Dr. Britt Cooper-Jones, CADTH
  • Sarah Garland, CADTH
  • Dr. Joanne Kim, CADTH

Note: Attendance is limited to 30 participants.
Abstract:
“Clinical trials show…”
“A clinical practice guideline recommends…”
“Statistically significant results demonstrate…”
Health care professionals, policy-makers, and patients alike are bombarded with information and statements like this on a daily basis. With limited time but an abundance of studies, how can we make sense of it all? Do you turn to various interpretations of the literature, but wonder if they are truly relevant to your setting? Do you wish you could assess published papers for yourself, but don’t know where to start or what questions to ask? Join CADTH for an introductory hands-on workshop that will enhance your knowledge of, and confidence with, critical appraisal. This session will explain several different types of published research and highlight the most important things to look for when determining the quality of studies. A significant portion of the workshop will be dedicated to applying and practicing critical appraisal skills in small groups. Sample papers will be circulated in advance, and participants will need to pre-read the papers in preparation for interactive discussions. Geared to health care professionals, decision-makers, and patients needing quick-assessment skills to evaluate scientific papers, this workshop will appeal to anyone who wants to gain an introductory comfort in interpreting medical literature.

Register: https://cadth.zoom.us/meeting/register/tJcrc–vqTkpGtKvEwKPZXRS5mwj-7LoltVL

 

Designing Research to Inform Decision-Making Using Value of Information Analyses

Date: Wednesday, January 27, 2021

Time: 11:00 am – 1:00pm

Audience: Of interest to policy-makers.

Level: Intermediate.
What you’ll learn: This workshop introduces four value of information (VoI) measures and highlights how VoI can determine research priorities that support decision-making. The assumptions of a VoI analysis and methods to display results graphically will also be presented.

  • Dr. Anna Heath, The Hospital for Sick Children (SickKids)

Note: Attendance is limited to 25 participants.
Abstract: VoI is a concept from decision analysis that considers whether the current evidence base for a health economic decision model is sufficient to make policy decisions. VoI can then be used to inform future research allocation. Furthermore, Vol measures can direct future research by determining the model inputs with the greatest influence on decision uncertainty. Finally, VoI methods can determine the optimal design for a research study that reduces decision uncertainty as efficiently as possible. Despite this versatility, VoI has rarely been used in practice because of a lack of familiarity, difficulties interpreting these measures, concerns about the assumptions underpinning them, and computational complexity. This workshop aims to address these issues by introducing the general concepts behind VoI, presenting key VoI measures and highlighting where they can be most useful in directing future research. It also demonstrates graphical presentations of these measures and discusses how to critically evaluate VoI analyses and their underlying assumptions. The workshop is a mixture of lectures, computer-based examples, and discussion sessions. Excel worksheets and R code to calculate VoI measures and highlight a Web-based interface for VoI calculations will be provided. Participants will then discuss and interpret examples of VoI analysis from the literature. Participants should have some knowledge of health economic evaluation/HTA and probabilistic sensitivity analysis (PSA).

Register: https://cadth.zoom.us/meeting/register/tJYtduGqrzgtH9wW9SoHUzKXwMyLsc_z1RFL

 

Conducting Economic Evaluations in Child Health

Date: Wednesday, February 3, 2021

Time: 11:00 am – 1:00pm

Audience: Of interest to HTA producers and users, especially those working in child health who produce or consider pediatric health economic evidence.

Level: Intermediate
What you’ll learn: Participants will gain a deeper understanding of the application of economic evaluation methods to child health.

  • Dr. Wendy Ungar, SickKids Research Institute
  • Dr. Myla Moretti, The Hospital for Sick Children (SickKids)
  • Kate Tsiplova, SickKids Research Institute

Abstract:  Background: With the growth in using economic evaluation to inform budget decisions, challenges in applying standard methods to special populations are increasingly apparent. This is especially true for pediatric economic evaluation. Compared to adults, children display unique patterns of morbidity and mortality, unique patterns of health resource use, and depend on a parent or caregiver to act as gatekeeper and reporter. Moreover, valid methods to measure health state utilities in newborns, infants, and toddlers do not exist. These issues create challenges for the conducting of economic evaluation in children.

Description: Specific challenges include capturing the full spectrum of social and physiological impacts, defining outcome measures for the very young, taking developmental change into account, separating parent and child preferences, extending costing beyond the health care system to include school and community resources, determining productivity costs for children and their parents and caregivers, using life-long time horizons, costing stages of development, developing valid and reliable instruments for assessing utility and quality of life in children, using parent proxy measures for costs and outcomes, and choosing the appropriate unit of analysis.

Objectives: to provide a basic understanding of conducting health economic evaluations in children

  • to identify and discuss key methodological challenges in the areas of:
    • defining and selecting health outcomes
    • costing
    • measurement
    • modelling and analysis
  • to share examples of pediatric economic evaluations used in decision-making
  • to gain hands-on experience by working in small groups to solve a pediatric costing exercise.

Register: https://cadth.zoom.us/meeting/register/tJwodeiqqTwjGNQ8rMebhGq2jT-iwt6TkBue

 

Plain Language and Clearer Communication: Making Health Research Make Sense

Date: Wednesday, February 10, 2021

Time: 11:00 am – 1:00pm

Audience: Of interest to anyone who needs to explain research and complex health topics clearly to people who may not have a research background.

Level: Introductory.
What you’ll learn: Participants will learn why plain language is necessary and worth the effort, and will discover the steps and skills needed to write well in plain language. Helpful resources will be identified throughout the workshop.

  • Barbara Greenwood Dufour, CADTH

Abstract: Health care decision-making involves everyone. But the information for making these decisions is often not accessible by everyone. That is, when medical research information is made available, it is often not communicated in a way that is understandable or useful to a lay audience. This is where “plain language” comes in. You may have heard about plain language as a way to more effectively communicate information from specialized fields to the general public. According to Plain Language Association International (PLAIN), plain language is when “wording, structure, and design are so clear that the intended audience can easily find what they need, understand what they find, and use that information.” But how do we put plain language principles into practice? This workshop will provide you with tips and tools to help you write documents that are understandable and useful to any stakeholder group. Attendees will learn the about specific challenges of communicating research to a non-research audience, gain practical tips for addressing those challenges and developing reader-focused content, and work through a step-by-step approach to planning a plain language communication project. By the end, attendees will be able to make research-related information resonate with anyone they wish to reach.

Register: https://cadth.zoom.us/meeting/register/tJAtdu6grTMuHdJUv7AXBpcAHGwS4X0jE7Jn

 

From Lingo to Application: The Use of Confounder Summary Scores (Propensity Scores and Disease Risk Scores) in Health Technology Assessment Based on Real-World Data

Date: Wednesday, February 17, 2021

Time: 11:00 am – 1:00pm

Audience: Of interest to HTA producers.

Level: Introductory
What you’ll learn: Participants will: (i) better understand confounding and confounder summary scores; (ii) be able to estimate propensity scores and disease risk scores; (iii) know their strengths and limits; (iv) have discussed their application within HTA.

  • Dr. Jason, Guertin, Université Laval
  • Dr. Mina Tadrous, Women’s College Hospital

Abstract: Interest in real-world evidence (RWE) using real-world data (RWD) for HTAs has recently skyrocketed. RWD can provide researchers and decision-makers insights on the utilization, effectiveness, and cost of technologies; such studies are often referred to as observational studies. Despite their strengths and value, observational studies are prone to numerous types of biases, namely confounding bias. These biases, if uncontrolled for, may lead to erroneous results and mislead researchers and decision-makers. The purpose of this workshop is to introduce participants to two methodologies, propensity scores and disease risk scores, which are frequently used to adjust for confounding within observational studies. Although both methodologies were developed more than 30 years ago, their use and applications remain unclear. Using practical examples based on empirical and simulated data, participants will be exposed to the strengths and weaknesses of the two methodologies and will learn when and how to use them within comparative effectiveness studies and economic evaluations based on RWD.

Register: https://cadth.zoom.us/meeting/register/tJMqfu2qqz8uG9BAaYDA1e8gqu0ypg9LPerL

 

Survival Analysis and Decision Modelling in R

Date: Wednesday, February 24, 2021

Time: 10:00 am – 1:00pm

Audience: Of interest to HTA producers.

Level: Intermediate.
What you’ll learn: This is an introduction to survival analysis methods for model-based economic evaluations through practical examples in R. The advantages and disadvantages of each method will be discussed.

  • Dr. Petros Pechlivanoglou, The Hospital for Sick Children (SickKids)

Note: Attendance is limited to 20 participants.
Abstract: Economic evaluations often rely on input from time-to-event or survival data. The unique characteristics of such data (i.e., right skewness, non-negative values, competing risks, censoring) require the use of more advanced statistical modelling techniques. Consequently, incorporating input from such statistical models into a model-based economic evaluation can be challenging. This course will teach participants how to appropriately integrate survival analysis data in decision models using R. We will provide an overview of the available methods (e.g., partitioned survival analysis, multi-state models, Markov/semi-Markov models, mixture cure models) and the advantages and disadvantages of each. The implementation of these methods in R will be outlined. Course participants will be asked to complete simple survival analysis exercises in the context of decision modelling to familiarize themselves with the main concepts. Finally, more advanced examples will be presented using different types of data (patient-level, life tables, digitized data from published curves). Participants will also discuss propagating parameter uncertainty from a parametric survival model to the outcomes of the decision model. By the end of the course the participants will be able to:

  • understand the advantages and limitations of the different survival analysis methods when used in an economic evaluation context
  • fit different parametric forms to survival data using R
  • fit competing risks model and multi-state models in R
  • integrate the results of different survival analysis models in a decision-modelling framework
  • conduct probabilistic sensitivity analysis using survival models in R.

All R code used in the short course will be provided to participants for future use.

Register: https://cadth.zoom.us/meeting/register/tJMld-6qqj8qHtETULoopPIBjTnwKic4jA2g

 

Supporting Decision-Making in an Uncertain Future: A Hands-On Introduction to Horizon Scanning in Health Technology Management

Date: Wednesday, March 3, 2021

Time: 11:00 am – 1:00pm

Audience: Of interest to HTA producers.

Level: Introductory
What you’ll learn: By the end of this workshop, you will understand the role horizon scanning plays in health technology management (HTM), know about sources and processes to identify and prioritize horizon scanning topics, and be able to apply processes to real-world examples.

  • Jeff Mason, CADTH
  • Kristen Moulton, CADTH

Note: Attendance is limited to 25 participants.
Abstract: Thousands of new medical devices are approved for use in Canada each year and many more enter the health care system without requiring approval. Often promoted through marketing and media hype, decision-makers face uncertainty about the potential value and impact these technologies may have on the health care system. Horizon scanning — “the systematic identification of health technologies that are new, emerging or becoming obsolete and that have the potential to effect health, health services and/or society” — is an essential component of the HTM toolkit that can be used to support decision-making across the technology life cycle. Using examples from CADTH’s medical devices and clinical interventions horizon scanning service, this half-day, hands-on workshop will teach attendees:

  • what horizon scanning is
  • the role of horizon scanning in HTA
  • common sources of horizon scanning topics
  • a process and framework for horizon scanning topic identification and prioritization.

Register: https://cadth.zoom.us/meeting/register/tJIlde-prT4vGt1YWxpFactaFi77YpHGRNTW

 

Diagnostic Test Accuracy Meta-Analysis

Date: Wednesday, March 10, 2021

Time: 9:00 am – 12:00 pm

Audience: Of interest to HTA producers.

Level: Intermediate
What you’ll learn: Knowledge of methods needed to carry out a meta-analysis of diagnostic test accuracy, including the methods needed to correct for imperfect reference standard.

  • Dr. Nandini Dendukuri, McGill University
  • Ian Schiller, McGill University Health Centre‒Research Institute

Note: Attendance is limited to 20 participants.
Abstract:  The goal of this workshop is to provide participants with an overview of models used for diagnostic test accuracy (DTA) meta-analyses. Bivariate meta-analysis models are necessary as two parameters are involved — sensitivity and specificity. We will also show how these models can be extended to correct for the bias that arises when the reference test is not perfect. Examples from a Cochrane review will be used. R Shiny apps which implement the models will be introduced.

Register: https://cadth.zoom.us/meeting/register/tJwlcOupqzgqGdMuUhmpiTVIqwlyN5hA3HA2

 

Reducing Uncertainty: The Need for Qualitative Research in Evidence-Informed Decision-Making

Date: Wednesday, March 17, 2021

Time: 11:00 am – 1:00pm

Audience: Of interest to policy-makers.

Level: Introductory
What you’ll learn: Participants will become familiar with qualitative research principles, common methods used, and when and how qualitative research can be practically used to influence health policy and practice.

  • Andrea Smith, CADTH
  • Brendalynn Ens, CADTH
  • Dr. Deidre DeJean, CADTH
  • Sarah Garland, CADTH

Note: Attendance is limited to 30 participants.
Abstract: Qualitative evidence enables insights into the contexts that shape the use of, and therefore the effectiveness of, health care interventions and helps to understand their acceptability and feasibility, and their perceived value to health service users. Within HTA, an interest in qualitative evidence reflects a policy imperative to ensure that the needs, preferences, and experiences of patients are central to decisions on technologies, treatments, or service redesign. Using illustrative examples from past HTAs, the workshop will provide an overview of qualitative research principles, common qualitative methods used in HTA, and describe and address some common misconceptions regarding these methods. A focus will be on the appropriate use of qualitative evidence in HTA to practically influence health policy and practice. First, the types of policy questions that qualitative evidence can (or cannot) inform will be identified, and what makes a “good” research question. Next, a review of common approaches to qualitative research in HTA, focusing on qualitative evidence synthesis as the predominant method, will be conducted. An introduction on how to interpret a qualitative evidence synthesis, including how to appraise its quality, illustrating the unique insights offered through qualitative evidence, and how qualitative evidence can help inform interpretations and understandings of other HTA evidence will end the workshop. Each part of this workshop involves a short presentation followed by interactive small-group exercises in which participants will gain hands-on experience.

Register: https://cadth.zoom.us/meeting/register/tJAudOyvrzsrH9UdjzwKxZyS0wymXfwtOHm4