The purpose of independent review organizations is to provide transparent, objective evaluations of new medical devices and to inform the public, physicians and policy makers, Feldman said. Some, like the California Technology Assessment Forum (CTAF), which is profiled in the "Perspectives" article as a case study, have meetings open to the public and populate their review board with experts in medicine, representatives from medical professional societies, technology manufacturers, policy makers and insurance providers, among others. CTAF selects devices for review based on their impact and the availability of relevant clinical data.

The UCSF Division of General Internal Medicine currently subcontracts with CTAF to provide technology assessments.


"In order to be considered in an assessment, CTAF requires that information already be published or accepted by a peer-reviewed journal. This encourages companies to make their trial results available to the public," said Tice, attending physician in the Division of General Internal Medicine at UCSF and co-author of the study. "CTAF also requires improvements in patient-oriented outcomes, not surrogate markers. For example, we want to see improvements in disease-free survival and patient quality of life, not just a reduction in tumor size."

Topics can be brought to the board's attention by all potential stakeholders, including health plans, industry, professional societies and consumer groups. Once findings are presented, the technology's manufacturer has the opportunity to give testimony, and eventually the board makes recommendations based on the body of information presented.

"We cover it all, from evaluating technologies used in genetic testing, radiation treatment for prostate cancer, digital mammography, computerized prosthetics and pre-natal screening to Positron Emission Tomography scans," Tice said.

Eventually, the authors suggest, independent review boards should summarize their findings into uncomplicated take-home messages that patients can easily find on their own.

The analysis was funded by the Blue Shield of California Foundation.

Additional co-authors are Amy J. Petersen, PhD, and Leah S. Karliner, MD, both of the Division of General Internal Medicine at UCSF.

Through CTAF, researchers Feldman, Tice and Karliner have received salary support to contribute to assessments, and Petersen receives salary support to facilitate dissemination of CTAF reviews.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate level education in the life sciences and health professions, and excellence in patient care.

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