1,721,023 research outputs found
Political analysis of health technology assessment implementation in Iran
No full textBACKGROUND: Health technology assessment (HTA) is a critical tool for evidence-based decision-making in healthcare systems, yet its implementation in low- and middle-income countries such as Iran remains understudied. This study examines the political dynamics of HTA implementation in Iran, focussing on the roles, interests and interactions of key stakeholders. By addressing the gap in understanding the political challenges and opportunities associated with HTA implementation, this study aims to provide actionable insights for policymakers and practitioners. METHODS: A qualitative study design was employed, using in-depth semi-structured interviews with 19 stakeholders from 6 categories: interest groups, political leaders, donors, financial decision-makers, beneficiaries and bureaucracies. Participants were selected through purposive sampling to ensure representation across sectors. Data were analysed using thematic analysis, guided by the political analysis framework of Campos and Reich. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist to ensure methodological rigour. RESULTS: The findings reveal significant barriers to HTA implementation in Iran, including limited political will, competing priorities, inter-agency coordination challenges and concerns about equity and access. Interest groups, such as physicians and pharmacists, expressed concerns about restricted clinical autonomy and limited access to innovative treatments. Political leaders emphasized the difficulty of prioritizing HTA amidst competing healthcare and economic issues, whilst donors highlighted the need for alignment with national priorities and long-term sustainability. Financial decision-makers acknowledged the potential of HTA to improve resource allocation but raised concerns about budgetary constraints. Beneficiaries stressed the importance of transparency and inclusion, and bureaucrats underscored the need for stronger leadership and capacity building. CONCLUSIONS: The study underscores the importance of strong political leadership, stakeholder engagement and institutional capacity building for successful HTA implementation in Iran. Practical steps include strengthening inter-agency coordination mechanisms, ensuring transparent and inclusive decision-making processes, aligning donor support with national health priorities and investing in training programs to build technical capacity within government agencies. By addressing these challenges, policymakers can enhance the integration of HTA into the health system, ensuring efficient and equitable resource allocation
Challenges of using artificial intelligence in Iran's health system: a qualitative study
No full textBackground: Artificial intelligence (AI) is transforming healthcare globally, enhancing diagnostics, treatment, and efficiency. However, low- and middle-income countries (LMICs) like Iran face significant barriers to AI integration. Iran's health system, challenged by an aging population, increasing non-communicable diseases, and limited resources, could benefit from AI-driven, patient-centered care. Yet, its adoption remains limited. Understanding the barriers to AI implementation is critical for informed policymaking. Methods: This qualitative study involved semi-structured interviews with 15 stakeholders from healthcare management, policymaking, and AI sectors in Iran, conducted between January and April 2025. Participants were selected purposively to represent government, academia, healthcare, and technology. Data were analyzed thematically using Braun and Clarke's framework. Rigor was ensured through member checking, triangulation, and adherence to qualitative research standards. Results: Five major barriers to AI adoption emerged: (1) organizational and structural limitations, including poor infrastructure and fragmented governance; (2) legal and policy challenges, marked by regulatory gaps and ethical concerns; (3) data-related issues such as low data quality, lack of standardization, and security risks; (4) shortage of skilled professionals and limited training opportunities; and (5) challenges in integrating AI into policymaking, including concerns about losing human oversight in decision-making. Conclusion: AI implementation in Iran's health system faces complex and interrelated challenges. Addressing these requires a coordinated strategy focused on legal reform, infrastructure investment, capacity building, and cultural adaptation. Balancing technological innovation with ethical and human-centered care is essential for successful and sustainable integration
Mapping the social networks of key actors in the development of health technology assessment in Iran
No full textBackground: Health Technology Assessment (HTA) is vital for evidence-based policymaking and resource allocation. In Iran, HTA development involves diverse actors with varying levels of power, influence, and support. Understanding their interactions is key to strengthening HTA processes. Methods: We applied Social Network Analysis (SNA) to map relationships among 27 stakeholders identified through document review and expert interviews. Data were collected via an online questionnaire completed by 83 experts (response rate: 72.2%), assessing five dimensions: power, position, interest, influence, and support. Network metrics, including degree, closeness, betweenness, and eigenvector centrality, were analyzed using R Version 4.4.1. Results: The Ministry of Health and Medical Education, Food and Drug Administration, Insurance Organizations, and Parliament were perceived as the most influential actors. The Plan and Budget Organization (degree centrality 0.34) and National Institute of Health Research (0.26) emerged as key connectors with high bridging roles. Overall, the network exhibited low density (0.13) and limited clustering (0.11), indicating sparse connectivity. Peripheral actors, such as the Chamber of Commerce, were largely disconnected from the network. Conclusion: HTA development in Iran is shaped by a few central institutions, but weak connectivity and limited engagement of peripheral actors hinder collaboration. Strengthening stakeholder communication, enhancing inclusiveness, and securing sustainable funding are critical for more effective HTA implementation and evidence-informed health policy
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Iran's Health System Transformation Plan: A SWOT analysis
Full text linkBackground: Societies are characterized by evolving health needs, which become more challenging throughout time, to which health system should respond. As such, a constant monitoring and a periodic review and reformation of healthcare systems are of fundamental importance to increase the efficiency and effectiveness of healthcare services delivery, equity, and sustainable funding. The establishment of President Rouhani's government in Iran, on May 5, 2014, the settlement of the new Ministry of Health and Medical Education administration (MoHME) and the need for change in the provision of healthcare services has led to the "Health System Transformation Plan" (HSTP). The aim of the current investigation was to critically evaluate the health transformation plan in Iran. Methods: Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis enables to identify and assess the strengths and weaknesses within an organization or program, as well as the threats and opportunities outside the given organization or program. To identify SWOT of the HSTP in Iran, all articles concerning this program published in scholarly databases as well as in the gray literature were systematically searched. Subsequently, all factors identified at the first round were thematically classified into four categories and for reaching consensus on this classification, the list of points and factors was sent to 40 experts - policy- and decisionmakers, professors and academicians, health department workers, health activists, journalists. Results: Thirty-four subjects expressed comments on classification. Incorporating their suggestions, the SWOT analysis of Iran's HSTP was revised, finalized and then performed. Conclusion: HSTP in Iran, like many of the initiatives that have been recently introduced and not fully implemented, have various challenges, difficulties and pitfalls that health policymakers need to pay attention to. Interacting with criticisms, taking into account public opinion and strengthening the plan can make the project more effective, and it can be anticipated that in the future, better conditions in the health sector will be achieved. © Iran University of Medical Sciences
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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