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Centre for Health Economics and Policy Analysis


Seminar to look at developing a values-based framework for decision-making in health technology assessment

06 Nov 2018

Dr. Murray Krahn,  the Tier 1 Canada Research Chair in Health Technology Assessment and the Director of the Toronto Health Technology Assessment Collaborative, will present CHEPA’s next seminar on Wednesday, Nov. 14.  Please note the change of date from the original schedule.

Dr. Krahn will present a seminar entitled “Developing a values-based Framework for Decision Making in Health (Technology Assessment)”,  which will draw on a research paper that several CHEPA and HEI members also contributed to. The paper is titled “Development of the Ontario decision framework: A values based framework for health technology assessment” and it can be found by clicking here

While the Ontario Decision Framework is similar in some respects to frameworks used in HTA worldwide, it has some distinctive characteristics:
  • it is based on an explicit set of social values;
  • HTA paradigms (evidence-based medicine, economics and bioethics/social science) are used to aggregate decision attributes, and
  • it is rooted in a theoretical framework of optimal decision-making, rather than one related to broad social goals, such as health or welfare maximization

Dr. Krahn will discuss the development of the framework and its implications for HTA.

In addition to his responsibilities at THETA, Dr. Krahn is a Senior Scientist and Director of the Division of Support, Systems, and Outcomes at the Toronto General Research Institute and Adjunct Scientist at the Institute for Clinical Evaluative Sciences. He is also a Professor in the Department of Medicine at the University of Toronto and an attending physician in the division of General Internal Medicine at the University Heath Network.

The seminar will be held on Wednesday November 14, 2018 from 12:30 pm to 1:30 pm in CRL-B119. All are welcome to attend.

If you are unable to attend in person, you are welcome to participate remotely online, using WebEx. To join the seminar online, copy and paste this link into your browser:

The password is CHEPAseminar.

Background:  In 2007, the Ontario Health Technology Advisory Committee (OHTAC) developed a decision framework to guide decision making around nondrug health technologies. In 2012, OHTAC commissioned a revision of this framework to enhance its usability and deepen its conceptual  and theoretical foundations.

The committee overseeing this work used several methods:

  • a priori consensus on guiding principles
  • a scoping review of decision attributes and processes used globally in health technology assessment
  • presentations by methods experts and members of review committees, and
  • committee deliberations over a period of 3 years

As a result, the committee adopted a multi-criteria decision-making approach, but rejected the formal use of multi-criteria decision analysis. Three broad categories of attributes were identified:

  1. context criteria attributes incuded factors such as stakeholders, adoption pressures from neighbouring jurisdictions, and potential conflicts of interest
  2. primary appraisal criteria attributed included (1) benefits and harms, (ii) economics, and (iii) patient-centre care
  3. feasibility criteria attributes included budget impact and organizational feasibility.


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