快速與迷你醫療科技評估：理想與現實的鴻溝

在上一篇貼文中，我們回顧了 Merlin et al. (2014) 為醫療科技評估報告所訂定的「黃金標準」。按照定義，一份合格的「迷你醫療科技評估」必須包含成本與財務衝擊資訊，且必須具備嚴謹的系統性文獻回顧。但十年過去了，我們真的有照著做嗎？為了準備 HTAi 主辦的線上研討會，我深入研讀了即將在會中被探討的最新重磅實證研究——McLaughlin et al. (2026)。

一場全球規模的「現實體檢」

McLaughlin et al. (2026) 針對過去十年間全球 203 份快速與迷你醫療科技評估報告進行了大規模的「現實體檢」，結果揭露了巨大的理論與現實落差。

經濟與預算評估大缺席

最令人震驚的發現是：

  • 僅有 23.2% 的報告包含經濟評估
  • 預算衝擊分析更是低至 10.8%
  • 在省略這些關鍵步驟的報告中，有高達 90.6% 完全沒有解釋省略的原因

這代表絕大多數機構在面臨時間壓力時，根本沒有向決策者透明說明自己抄了哪些捷徑。

方法學的捷徑

近 38% 的報告承認僅依賴「一般文獻檢索」，而非定義中要求的系統性文獻回顧。這是最令人擔憂的發現之一，因為方法學的嚴謹性直接影響報告的可信度與通用性。

重臨床、輕其他

幾乎所有報告都優先確保了臨床有效性（99%）與安全性（82.3%），但倫理、社會與法律層面的評估大多被犧牲。這反映出在緊急評估情境下，醫療科技評估機構傾向於「聚焦於最直接的臨床證據」。

為什麼這很重要？

在醫療資源有限且決策時間緊迫的當下，醫療科技評估機構為了「求快」而抄捷徑是無可厚非的妥協。但如果我們沒有在報告中「透明地交代這些限制」，決策者極有可能將這些縮水版的報告過度解讀，甚至誤當成「完整醫療科技評估」來做出長期的健保給付承諾。這對醫療衛生系統的永續性將帶來潛在風險。

往前走的兩個關鍵問題

我們該放寬對迷你醫療科技評估的定義嗎？

還是應該建立更嚴格的「透明度與報告標準」，強迫機構交代抄了哪些捷徑？這正是本次 HTAi 線上研討會（主題：『Beyond the “Full HTA Report”』）要直擊的核心與痛點。

邀請社群的聲音

這篇文獻的作者 Barbara Clyne 應該也會分享她的第一手觀點。強烈建議所有關注醫療政策與醫療科技評估發展的夥伴們一起上線參與這場「繼往開來」的精彩對話。

反思：你的機構的妥協點在哪？

您的機構在面臨緊急評估壓力時，最常「妥協」的是哪一個環節？是經濟評估的深度？是文獻回顧的系統性？還是倫理與社會影響的考量？歡迎在底下留言交流！

English version below

Rapid and Mini Health Technology Assessments: The Gap Between Ideal and Reality

In a previous post, we reviewed the ‘gold standard’ set by Merlin et al. (2014) for health technology assessment reports. According to the definition, a qualified ‘mini health technology assessment’ must include cost and financial impact information and be supported by rigorous systematic reviews. But has the industry actually followed these standards over the past decade? To prepare for an online seminar hosted by HTAi, I delved into the latest evidence-based research that will be explored during the event—McLaughlin et al. (2026).

A Global-Scale ‘Reality Check’

McLaughlin et al. (2026) conducted a large-scale ‘reality check’ of 203 rapid and mini health technology assessment reports published over the past decade, revealing a significant gap between theory and practice.

Economic and Budget Assessments Are Largely Missing

The most striking findings include:

  • Only 23.2% of reports included economic evaluation
  • Budget impact analysis was even lower at 10.8%
  • Of the reports that omitted these critical steps, 90.6% provided no explanation for the omission

This suggests that most institutions, facing time pressure, fail to transparently communicate which corners they cut to their decision-makers.

Methodological Shortcuts

Nearly 38% of reports relied solely on ‘generic literature searches’ rather than the systematic reviews required by definition. This is one of the most concerning findings, as methodological rigor directly impacts the credibility and generalisability of the report.

Emphasis on Clinical Evidence, Downplay of Other Aspects

Almost all reports prioritized clinical efficacy (99%) and safety (82.3%), but ethical, social, and legal assessments were largely sacrificed. This reflects a tendency in urgent evaluation contexts for health technology assessment institutions to ‘focus on the most direct clinical evidence.’

Why This Matters

Given limited healthcare resources and tight decision-making timelines, it is understandable that health technology assessment institutions compromise to ‘speed up’ the process. However, if these limitations are not ‘transparently disclosed in the report,’ decision-makers may easily overinterpret these abbreviated versions, potentially treating them as ‘complete health technology assessments’ and making long-term reimbursement commitments. This poses a potential risk to the sustainability of health systems.

Two Critical Questions Moving Forward

Should We Relax the Definition of Mini Health Technology Assessments?

Or should we establish stricter ‘transparency and reporting standards’ that force institutions to disclose which corners they cut? This is precisely what the HTAi online seminar (topic: ‘Beyond the “Full HTA Report”’) aims to address.

Inviting Community Voices

Barbara Clyne, one of the authors of this research, is expected to share her firsthand insights. We strongly encourage all stakeholders interested in health policy and health technology assessment development to join this forward-looking dialogue.

Reflection: Where Is Your Institution’s Compromise Point?

When facing emergency evaluation pressure, which aspect does your institution most often compromise on? The depth of economic evaluation? The systematic nature of literature review? Or consideration of ethical and social impacts? Feel free to share your thoughts in the comments below!