Alberta Innovates- Health Solutions

IS THE WORK ON METHODS FOR ASSESSMENT OF RESEARCH BENEFITS INTERNATIONALLY GENERALIZABLE OR IS AHFMR OR ITS CONTEXT DIFFERENT?

Introduction
There appears to be a cycle of interest in establishing the benefits of research. At one point in time those who assert that research is unarguably beneficial in the long-term, and an undeniable public good, may be in the ascendant. At another point of time those who argue that spending on research needs to be justified in terms of its contribution to specific shorter-term benefits have a stronger pull on the public purse-strings. In reviewing some of the international literature, it is interesting to see how the concerns of the US academics in the late 1960's about the stance of President Lyndon Johnson. His statement that basic science needed to be more targeted and the time from laboratory discovery to useful application reduced (14) are mirrored in the recent concern expressed by the Federation of American Societies for Experimental Biology (17). Their concern was that the 1993 Government Performance and Results Act might disadvantage basic research through failing to recognize its long-term benefits.

In drawing on this international literature, it is tempting to presume that method for the assessment of benefits or value derived from research might be internationally generalizable. While the earlier Buxton/Hanney work was developed specifically in the UK context, it certainly drew on lessons from studies undertaken elsewhere. For example, its consideration of the policy impact was informed by a stream of work undertaken elsewhere in Canada reviewing the policy impact of the Quebec Council on Health Care Technology Assessment (22-25). This work appears to reflect very similar policy concerns to those in the UK. It comes to rather similar conclusions about the difficulty of precisely estimating impact but the systematic descriptive analysis of impact is both feasible and worthwhile.

But such presumptions need to be checked for in Health Services Research there is a frequent concern that research findings may not be geographically generalizable. For example, a new technology may be cost-effective in one country or context but not in another, or a particular form of incentive may be powerful in one health care system but ineffective in another. Generally, however, methods of analysis are transferable, although even these may be culturally influenced. For example, willingness-to-pay as a way of obtaining individuals' valuations of health states has tended to be much more readily accepted and practically valid in the USA. There, patients are more used to making direct payments for health care, than in the UK, where patients have different cultural expectations and experience.

Thus, it was a reasonable precaution to consider as a first step whether there was evidently any reason why the nature and objectives of the AHFMR, or the health care and health research systems in Alberta, should make the Buxton/Hanney approach invalid or inappropriate in this new context.

This section begins by very briefly reviewing a number of characteristics of the local context but focuses principally on analysis of the explicit and implicit objectives of health research in Alberta. It highlights a number of ways in which the work of the AHFMR does differ from that in the UK for which the model was originally created.