Swedish Agency for Health Technology Assessment and Assessment of Social Services
Questions addressed by SBU include:
- How good is a treatment or a procedure?
- How best to determine need?
- How should resources be allotted to provide the greatest possible benefit?
SBU provides the knowledge needed to provide better health and medical care
Society provides support for people in different ways – in the form of medical care, aged care and care of the disabled, or special care in cases of substance abuse. A child who is vulnerable or has difficulties at school can also need support from society through healthcare or social services. But what type of treatment, care or support is safest and most effective? These are the issues SBU assesses.
Scrutinising and collating research
Researchers study the effect of different treatments. Their results are published as articles in scientific journals. However, such huge numbers of articles are published that it is impossible for the individual professional to keep abreast of developments. SBU provides an overview by critical assessment and collation of research results on a specific topic or question.
SBU is a government authority, commissioned by the government to evaluate the scientific evidence supporting both new and established measures within health, medical, dental and social services. The assessments cover clinical, social, ethical and health economic perspectives.
SBU started in 1987 and is one of the oldest organisations in the world in the field of Health Technology Assessment, HTA. HTA involves systematic independent assessment of a method, including side effects, cost-effectiveness and ethical implications.
Helping society to provide the best possible care SBU’s assessments can serve as support for decision-makers, for those working in medical or social services and other involved parties. SBU also identifies areas where there is inadequate knowledge about the effect of different measures.
How an assessment is conducted
Suggestions for topics warranting assessment, e.g. treatment methods or other procedures, are received from many sources, for example from professionals working in the health and medical services, social services, government authorities or from SBU’s scientific advisory committees or board.
The main reason for undertaking an assessment is to determine whether a measure is effective. SBU also prioritises ethically controversial topics or methods which have important implications for organisations and personnel.
The starting point: research conducted to date
SBU collects, evaluates and compares the results of research published to date. This means that we systematically search the scientific literature to find the answer to one or more questions. For example, to determine which treatment is best for a certain disease, the best diagnostic method or, within social services, which supportive measures are effective. Relevant studies, i.e. those which address the question, are selected and graded according to quality.
Large and small projects
Our assessments are run as projects. For every major project we recruit an interdisciplinary working group, comprising experts in the particular field. The working group helps to assess the collected scientific material. Health economic and ethical assessments are usually also undertaken.
Figure 1. How an assessment is conducted
SBU identifies scientific uncertainties
In an assessment, SBU scrutinises the research published on a specific topic. Sometimes, on the basis of the available evidence, it is not possible to determine whether a measure is effective. Information about research topics in which knowledge gaps, or scientific uncertainties, have been identified, is stored in a database on SBU’s website.
When can more research be required?
- When there is no research at all on the measure in question
- When there are not enough studies or the available studies are too small
- When the research studies are of inadequate quality
- When the results of different studies are contradictory.
The effect of a measure is unclear
The lack of research does not necessarily mean that the measure is ineffective, just that we don’t know. Scientific uncertainties are fields where more research is needed.
Scientific uncertainties
- Indicate to researchers and research funding bodies where there is a need for more research.
- Are taken into account by decisionmakers when prioritising measures to be applied in healthcare and social services.
- Alert patients, clients and professionals in a certain field that there is uncertainty about the effect of a measure.
