EUnetHTA
Issue
The purpose of adaptation is to enable an HTA agency in one country (or region or setting) to make use of an HTA report produced elsewhere, thus saving time and money. This sounds simple but in reality, the adaptation process is complex.
Different types of HTA reports
Not all 'HTA reports' are the same. Some just contain information about technologies, some also contain recommendations about how they should be used (in the English context, these are respectively 'assessment' and 'appraisal'). Of those that contain information, some are reports of new studies and some are a synthesis of research i.e. systematic reviews. Some are produced very quickly, in a few days; some take a year or more to produce.
Adaptation is a part of a spectrum
Making use of all or part of an HTA report from elsewhere could be done in a wide range of ways (see items 1 to 4 below). There is a spectrum, with progressively more of the original report being used and so more possibility of saving time and money through reduced duplication. Items 1 to 3 require further work beyond the use of information from the report to develop your own report.
Summarising: translate the summary and use this for background information
Updating searches: using the original search strategy to identify any more recent evidence or adding to the search strategy and extending it.
Adapting: the systematic extraction of relevant HTA information from an
existing report (from a whole report or from part of a report)
Adopting: making use of the report without making any changes at all
(except perhaps translation into your own language)
Adaptation is a process
The ‘product’ of the adaptation process is information that has been extracted from the report that is (a) relevant to your needs, (b) quality assessed (c) critically appraised and d) is ready to be incorporated into a new framework for an HTA report in your own setting or country. The process of adaptation therefore involves, to varying degrees, the following steps:
a) checking the relevance of the question(s) addressed in the original report to the question you are facing,
b) identifying the information in the report which is relevant and most likely to be transferable to your setting,
c) assessing the reliability of the information under various domains (benefits, harms, cost-effectiveness, organisational domain assessment elements, social and legal issues, etc),
d) identifying and setting out the problems which may occur when the extracted, relevant, quality assessed information is transferred into a local HTA report; and deciding how to deal with them.