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Volume3 Issue1
|
I
ssues and
P
eople
McGILLPROFESSORAPIONEER
in the field of oral health technology assessment
Early inhis career, beforeDr. ShahrokhEsfandiari becameMcGillUniversity’s “evidence-basedguy,”associatedean
academicaffairs, andassociateprofessor in the facultyof dentistry, hewas curious abouthowbigdecisionsweremade in
dentistry—decisions thatmighthavean impact onadental practice, a community, or thedental professionas awhole.
Shahrokh
Esfandiari
DMD,PhD
The annualNCOHRworkshops provide dental
undergraduate studentswithan opportunity tomeet
andbe inspiredby clinicianswhoare in research.
His interest inevidence-baseddecision-
making sharpenedwhenhewas considering
thepurchaseof aCBCTmachine for his
practice. “I basicallywanted to know if Iwas
gettinga ‘bang for everybuck’ I spent ona
CBCTmachine,” he says. “Dentists spenda
hugeamount ofmoneyon technologies that
maynot beasuseful as they think theyare.”
Technology ismore than
just tools andgadgets
Whenhediscovered thefieldofHealth
TechnologyAssessment (HTA), Dr. Esfandiari
foundexactlywhat hehadbeen looking
for. HTA, according to the International
Networkof Agencies forHealthTechnology
Assessment (INAHTA), is the “systematic
evaluationof properties, effects, and/or
influencesof healthcare technology. It
mayaddressboth thedirect, intended
consequencesof technologies and their
indirect, unintendedoutcomes.”Dr. Esfandiari
explains that peopleoftenhave trouble
understandingwhat the “technology” part
ofHTA refers to. “Essentially, anythingyou
canpossibly thinkof that involvesproviding
health toanumber of constituents—that
mediumcanbe interpretedas a technology,”
heexplains. AnMRI scanner,water
fluoridation, or adental handpiece—theseall
fit thisbroaddefinition. “It’snot necessarilya
digital gadget likeamobilephoneor tablet.”
HTA is a relativelynewfieldbut has
increasing influence indecision- and
policy-making inCanadaandaround
theworld.
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“Therearemanycountries
that putHTA reportsup front, and they
make their decisions about healthcare
mechanismsbasedon these reports,”
explainsDr. Esfandiari. Hecites anAustralian
government reviewofwater fluoridation
as anexampleof thecomplexity that can
be involved inproducinganHTA. “You
can imagine the social, ethical and legal
bearingof these kindsof technologies. The
fluoridation report tookacoupleof years
but theAustraliangovernment had solid
evidence in their handand felt confident
that implementing theprogramwouldbe
beneficial to thepopulation.”
McGill
University
Facultyof
Dentistry
