Managing uncertainty within NICE technological appraisals: the nature and impact of the 'social features' of decision-making

Calnan, Michael and Brown , Patrick (2017). Managing uncertainty within NICE technological appraisals: the nature and impact of the 'social features' of decision-making. [Data Collection]. Colchester, Essex: UK Data Archive. 10.5255/UKDA-SN-851764

The National Institute for Health and Clinical Excellence is emblematic of the 'neutral' and 'objective' approach of modern regulatory institutions. Through systematic appraisals of the cost-effectiveness of drugs for the NHS, it aims to overcome the inconsistencies of the previously discretionary decisions of medical professionals.

Cost-effectiveness recommendations ensure a more standardised access to medication across the NHS, as well as regulating the imperfections of the market in terms of over-priced medication. These regulatory roles have important ethical implications for access and resource use, yet the neutrality and objectivity referred to is not straightforward. The volume, contestability and complexity of information which is processed within these appraisals means that a number of decision mechanisms for coping with uncertainty are inevitably invoked. Uncertainty appears to be inherent in this decision making process.

The proposed study will investigate the nature of uncertainties faced within appraisal decisions, the social mechanisms applied in dealing with these, and the impact this has on decision outcomes. This ethnographic study will involve:

non-participant observation of committee meetings

Interviews with committee members, analysts from NICE’s project team, a range of representatives from the various interest groups, and experts involved in the process and documentary outputs from committee processes.

Data description (abstract)

Qualitative methods using a combination of non participatory observation,informal interviews and documentary analysis.
The study set out to explore and describe the various aspects of uncertainty faced by the NICE appraisal committee, the social mechanisms applied for coping with these and the influence of these processes on the outcomes of decisions. These aims were explored through an ethnographic study that was based on primary data collected using a prospective design to follow three distinctly different pharmaceutical products through the single technology appraisal process (STA) involving three different NICE technological appraisal committees This involved documentary analysis, observation of the open and closed sessions of the committee (9 observational sessions) and interviews (N=41) with committee members = 23, analysts from the NICE project teams =3, drug manufacturers representatives = 5, patient organisations =3, members of the assessment group = 4 and clinical experts = 3. Telephone interviews (N=26) were used in tandem with face-to-face interviews (N=15).These data were collected between 2012-2014.

Data creators:

Creator Name	Affiliation	ORCID (as URL)
Calnan Michael	University of Kent
Brown Patrick	University of amsterdam

Contributors:

Name	Affiliation	ORCID (as URL)
hashem ferhana	CHSS, University of Kent

Sponsors:

ESRC

Grant reference:

RES-000-22-4236

Topic classification:

Science and technology
Health

Keywords:

trust in people, pharmaceutical enterprises, trust in government

Project title:

Managing uncertainty within NICE technological appraisals: the nature and impact of the 'social features' of decision-making

Grant holders:

Michael Calnan, Patrick Brown

Project dates:

From	To
1 September 2011	31 August 2014

Date published:

20 Mar 2015 15:35

Last modified:

14 Jul 2017 10:08

Coverage and Methodology

Access and Administration

Data sourcing, processing and preparation:

Transcribing of interview data and pooled with observation data and themtically coded and analysed aided by NVIVO Data preparation: A new NVIVO database was created for the study. For this, two types of data (n=41 interview; n=9 non-participant observations) were prepared before uploading onto the NVIVO database. For the face-to-face / telephone interviews, the data was transcribed first, anonymised and then the text uploaded onto the NVIVO database. For the non-participant observations, the observation notes were written up by the two observers, anonymised and then the two sets of observations notes were combined into one word document. The non-participant observation text was then uploaded onto the study’s NVIVO database. Data analysis: The researchers began detailed coding in three stages: (a) reading the transcripts / non-participant observations (b) spending time reflecting upon the data and thinking about potential codes (c) then coding up the transcripts. Once a new code was identified, a new node name was created and the requisite data was selected into the node file. New codes were added as they emerged. Once a full set of nodes had been identified, the researcher started to create a coding frame / hierarchy of codes. The data were coded separately by two of the research team into NVIVO, and samples of the data were double coded and discussed to advance reliability and construct validity.

Rights owners:

Name	Affiliation	ORCID (as URL)
Calnan Michael	University of Kent

Contact:

Name	Email	Affiliation	ORCID (as URL)
Calnan, MIchael	m.w.calnan@kent.ac.uk	University of Kent	Unspecified

Notes on access:

The Data Collection only consists of metadata and documentation as the data could not be archived due to legal, ethical or commercial constraints. For further information, please contact the contact person for this data collection.

Publisher:

UK Data Archive

Last modified:

14 Jul 2017 10:08