The process described above centered on a stakeholder engagement framework that included targeted engagement activities to solicit a wide range of perspectives and expertise. These activities included the formation of a Scientific Board to serve in the role of advisors to the ASSIST project, interviews with Key Informants to gather information on the scope of use of PGHD captured via mHealth for SSI surveillance, and bringing together a broad group of participants as a PGHD Stakeholder Advisory Group at a workshop designed to facilitate discussion around the use of PGHD in SSI surveillance. Stakeholder engagement iterated with other HTA activities, providing guidance and refinement at each step of the process.
Scientific Board
Our HTA process called for the formation of a Scientific Board to guide the HTA process, refine the topic areas the HTA addresses, and provide expert review and refinement of project outputs. The Scientific Board is composed of biomedical researchers with expertise in surgical infectious disease, infection control, antimicrobial stewardship, clinical informatics, clinical protocol implementation, and quality improvement. Preference for longstanding active participation in surgical societies engaged in these content areas was emphasized during selection of individuals invited to serve on the Scientific Board.
The Scientific Board met in person at the commencement of the project. In alignment with the transparency espoused in Drummond’s principles of HTA structure11, we oriented the Scientific Board to HTA methods and work plan so members were able to anticipate the timing and format of the deliverables. At this initial meeting, we also crafted the framework for conducting the specific HTA activities by topic and stakeholder point of view. The Scientific Board identified five overarching topic areas to guide the landscape analysis and stakeholder engagement activities carried out during the HTA process (Table 2). Each of the five areas were assigned Scientific Board and project team members as topic leads to serve as content area experts.
Following the initial Scientific Board in-person meeting, the Scientific Board met monthly by teleconference to review and advise on the activities of the project team, guide development of project outputs, participate in the synthesis of data generated through the landscape review and stakeholder engagement activities, and to draft the recommendations included in this HTA report. An additional in-person Scientific Board meeting was held at the end of year 1 of the project, at which Scientific Board members refined the draft recommendations and guided identification of priority areas for future work. Members of the Scientific Board will provide editorial review of the draft HTA report and participate in dissemination activities throughout year 2.
Key Informants
We sought to understand stakeholder perspectives on the value, opportunities, and challenges PGHD bring to SSI diagnosis and surveillance by conducting key informant interviews. Key informants were identified by project team and Scientific Board members; through initial landscape analysis activities, including review of publications and product websites; and through existing relationships with researchers and vendors who currently use or are implementing the use of PGHD via mobile technologies. Additional key informants were identified through snowball sampling following the initial round of interviews. These interviews informed the HTA process by providing insights on how PGHD captured via mHealth is currently used in clinical, research, and public health settings, and identifying open issues in the field (see Methods/Results for full details of Key Informant Interviews).
PGHD Stakeholder Advisory Group
The PGHD Stakeholder Advisory Group (PSAG) was comprised of engaged key informants as well as other leaders in the field. Solicitation of involvement in the PSAG was intended to ensure broad stakeholder input from researchers, providers, industry, and healthcare administration in the HTA process. Importantly, this engagement framework addressed the system-level disconnect that exists between research, healthcare delivery, and technology design through an explicitly community-driven approach. These stakeholders helped to inform and further refine the HTA process by providing feedback on ASSIST project work, initial results, and informing the development of recommendations (see Methods/Results for full details of the PSAG).