Evidence map›Paper›PMID 41397741›Full record

ArticleBMJ open2025

Developing a national framework for health technology assessment in Iran: a mixed-methods Delphi consensus study.

Meysam Behzadifar, Ahad Bakhtiari, Saeed Shahabi, Samad Azari, Aidin Aryankhesal, Masoud Behzadifar

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Meysam BehzadifarSocial Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran (the Islamic Republic of).
Ahad BakhtiariHealth Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
Saeed ShahabiHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran (the Islamic Republic of).
Samad AzariHealth Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
Aidin AryankhesalSchool of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
Masoud BehzadifarSocial Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran (the Islamic Republic of) masoudbehzadifar@gmail.com.ORCID http://orcid.org/0000-0002-0271-4360

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo develop a context-specific health technology assessment (HTA) framework tailored to the healthcare needs and system of Iran, to improve evidence-based decision-making, optimise resource allocation and support progress towards universal health coverage.

designA mixed-methods Delphi consensus study conducted using a three-phase, sequential approach: document review, qualitative focus group discussions and Delphi consensus rounds. The study reporting follows the Accurate Consensus Reporting Document guideline to ensure transparent reporting of consensus methods.

settingA national-level study conducted in Iran's healthcare system between January 2023 and March 2024, including perspectives from public and academic institutions, policy bodies and patient organisations.

participantsThe study involved 18 purposively selected stakeholders in three focus group discussions, including policymakers, healthcare professionals, researchers and patient representatives. Subsequently, 20 HTA experts participated in three iterative Delphi rounds to refine and reach consensus on the framework components. OUTCOME MEASURES: Identification of core components and operational steps required to develop and implement a comprehensive HTA framework in Iran.

resultsThe final HTA framework includes nine core components: (1) establishing a national HTA body; (2) engaging stakeholders; (3) building capacity through training and research; (4) developing standard HTA methodologies; (5) implementing prioritisation and evaluation processes; (6) ensuring sustainable funding; (7) enhancing transparency and accountability; (8) promoting continuous improvement and (9) fostering innovation. Detailed operational steps and micro-activities were developed for each component. The framework achieved an 84% consensus among Delphi panellists, indicating strong agreement on its content and applicability.

conclusionsThis tailored HTA framework provides a structured roadmap to institutionalise evidence-based decision-making in Iran's healthcare system. Its implementation can strengthen the efficiency, equity and sustainability of healthcare planning and policy. Pilot testing is recommended to assess feasibility and scalability, with potential to serve as a model for other low-income and middle-income countries.

Indexed as

Technology Assessment, BiomedicalConsensusDecision MakingDelphi TechniqueFocus GroupsHumansIranQualitative ResearchStakeholder ParticipationDecision MakingHealth economicsHealth policy

Identifiers

PMID41397741
PMCPMC12706252

What Socratic holds

Textmetadata
LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.