PubMed · 11573299
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B Richart. 2001. A method for collecting Web page usage statistics.. https://pubmed.ncbi.nlm.nih.gov/11573299/
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Health impact assessment (HIA) on a strategic level focuses on the broad determinants of health. However, the evidence with regard to the health impacts is often necessarily 'soft'. The example of a health impact review on national housing policy in the Netherlands shows that HIA can be effective even in the absence of hard data. Strategies used to overcome the problem of not having hard data are outlined. The authors argue that, for HIA to be effective, it does not necessarily have to be limited to easy-to-measure, easy-to-quantify programmes and health effects.
Health impact assessment (HIA) is an approach that has experienced increased activity and wide support within England. This is reflected in the large number of HIAs being undertaken at local and regional levels, by the advocacy of HIA in many national policy documents, and by the setting up of specialized HIA posts and centres. To continue this level of support, and to justify any increase, the approach of HIA must show whether and how the HIA approach informs the decision-making process and, in particular, whether it improves health and reduces health inequalities. The first steps in answering these questions have been taken by the partial evaluation of some completed HIAs within England. A description of these evaluations is presented. Work is also progressing on promising practice guidance for practitioners on the topic of evaluating HIAs. The further development of evaluation within HIA is required, at both a practitioner and research level, and provides an exciting opportunity for people and groups to advance the evidence base for HIA, while also proving its place as an effective public health intervention.
BACKGROUND: The objective of this study was to assess the current level of intensity-modulated radiation therapy (IMRT) use in the United States. METHODS: Three-hundred thirty-three randomly selected radiation oncologists were sent a 13-question survey regarding IMRT use. IMRT users were asked about the number of patients and sites treated, their reasons for adopting IMRT, and future plans for its use. Physicians who did not use IMRT were asked about their reasons for not using IMRT; whether they intended to adopt it in the future; and, if so, their reasons. RESULTS: One-hundred sixty-eight responses (50.5%) were received. Fifty-four respondents (32.1%) stated that they currently used IMRT. Most IMRT users (79.6%) had adopted IMRT since 2000. Academic physicians were more likely to use IMRT (P = 0.003) compared with private practitioners. The percent of physicians using IMRT in practices comprised of 1 physician, 2-4 physicians, or > 4 physicians were 15.4%, 28.4%, and 44.2%, respectively (P = 0.02). The most common sites treated were head and neck malignancies and genitourinary tumors. Of the 114 IMRT nonusers, 96.5% planned to use IMRT in the future, with 91.8% planning to use IMRT within 3 years. Among IMRT nonusers, the most common reason cited for not using IMRT was lack of necessary equipment. The most common reasons for adopting IMRT (users) or wanting to adopt IMRT (nonusers) were to improve delivery of conventional doses and to escalate dose. CONCLUSIONS: Approximately one-third of radiation oncologists in the United States use IMRT. However, this number appears to be growing rapidly. Efforts to ensure the safe and appropriate application of this new technology are warranted.