{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:03:30Z","timestamp":1790075010026,"version":"4.0.1"},"reference-count":65,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Mark. Access Health Policy","JMAHP"],"abstract":"<jats:p>Introduction: Different from established clinical guideline workstreams, the participation of general practitioners (GPs) in the health technology assessment (HTA) process at the European level is new. There is a research gap in this domain. The European Union of General Practitioners (UEMO) is the political association of GPs in Europe and has been collaborating as a stakeholder in the creation of the European Regulation on HTA since 2017. The aim of our research is to provide a framework for GPs\u2019role in EU HTA. Methods: Mixed methods: questionnaire and focus groups. Participants: Representatives of national medical\/GP associations of 17 Member States of the EU and five EU non-member countries. Results: Most respondents supported GP involvement in the development of clinical recommendations relevant to general practice. Respondents emphasized that UEMO must turn to WONCA-Europe, the academic society of GPs, when scientific input is required. Among the ten priority topics for HTA in oncology, four emerged as most relevant for the GPs: 1. Conscientious prescription of interventions considering over- and under-medicalization, 2. establishing a system for continuity of care integrating palliative care, 3. ensuring evidence-based medicine, and 4. promoting collaborative care and considering workload. Discussion and Conclusions: The GP can contribute to the debate by defending these four priorities. Presenting the difficulties in this debate can contribute to a better understanding of the implementation of new technology in the real world.<\/jats:p>","DOI":"10.3390\/jmahp14030057","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:04:17Z","timestamp":1790067857000},"page":"57","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of General Practitioners in European Health Technology Assessment, EU-HTA Innovation in Oncology as an Example"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0207-0136","authenticated-orcid":false,"given":"Daniel","family":"Widmer","sequence":"first","affiliation":[{"name":"European Union of General Practitioners (UEMO), 1000 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7004-1975","authenticated-orcid":false,"given":"Hermenegildo","family":"Marcos Carrera","sequence":"additional","affiliation":[{"name":"European Union of General Practitioners (UEMO), 1000 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"J\u00f6rg","family":"Ruof","sequence":"additional","affiliation":[{"name":"Secretariat of the European Access Academy (EAA), 4059 Basel, Switzerland"},{"name":"Institute for Epidemiology, Social Medicine and Health System Research, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2689-7306","authenticated-orcid":false,"given":"Gunasekara Vidanamestrige Chamath","family":"Fernando","sequence":"additional","affiliation":[{"name":"Special Interest Group on Cancer and Palliative Care, World Organisation of Family Doctors (WONCA), 1210 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Patrick","family":"Ouvrard","sequence":"additional","affiliation":[{"name":"European Union of General Practitioners (UEMO), 1000 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"given":"Marie-Christine","family":"Bonnamour","sequence":"additional","affiliation":[{"name":"European Union of General Practitioners (UEMO), 1000 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Mary","family":"McCarthy","sequence":"additional","affiliation":[{"name":"European Union of General Practitioners (UEMO), 1000 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Shrikant","family":"Atreya","sequence":"additional","affiliation":[{"name":"Special Interest Group on Cancer and Palliative Care, World Organisation of Family Doctors (WONCA), 1210 Brussels, Belgium"},{"name":"Tata Medical Center, Newtown, Kolkata 700160, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Galbraith, K., Ward, A., and Heneghan, C. (2017). A Real-World Approach to Evidence-Based Medicine in General Practice: A Competency Framework Derived from a Systematic Review and Delphi Process. BMC Med. Educ., 17.","DOI":"10.1186\/s12909-017-0916-1"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e062158","DOI":"10.1136\/bmjopen-2022-062158","article-title":"Barriers and Enablers to Implementing Clinical Practice Guidelines in Primary Care: An Overview of Systematic Reviews","volume":"13","author":"Wang","year":"2023","journal-title":"BMJ Open"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1016\/j.jacc.2025.06.013","article-title":"2025 ACC\/AHA Clinical Practice Guidelines Core Principles and Development Process: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"87","author":"Otto","year":"2026","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"863","DOI":"10.7326\/M18-3290","article-title":"The Development of Clinical Guidelines and Guidance Statements by the Clinical Guidelines Committee of the American College of Physicians: Update of Methods","volume":"170","author":"Qaseem","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.jclinepi.2020.07.022","article-title":"Supporting Effective Participation in Health Guideline Development Groups: The Guideline Participant Tool","volume":"130","author":"Piggott","year":"2021","journal-title":"J. Clin. Epidemiol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Mikkola, I., Komulainen, J., Hagn\u00e4s, M., and Sipil\u00e4, R. (2025). Importance, Facilitators and Barriers for Finnish General Practitioner Involvement in Clinical Practice Guideline Panels: A Survey. BMC Prim. Care, 26.","DOI":"10.1186\/s12875-025-03017-3"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"499","DOI":"10.46747\/cfp.6707499","article-title":"Endorsement of Clinical Practice Guidelines: Criteria from the College of Family Physicians of Canada","volume":"67","author":"Allan","year":"2021","journal-title":"Can. Fam. Physician"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1093\/fampra\/cmad015","article-title":"A Scoping Review of Evidence-Based Guidance and Guidelines Published by General Practice Professional Organizations","volume":"41","author":"Duffy","year":"2024","journal-title":"Fam. Pract."},{"key":"ref_9","first-page":"CD003030","article-title":"Continuing Education Meetings and Workshops: Effects on Professional Practice and Healthcare Outcomes","volume":"9","author":"Forsetlund","year":"2021","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e058453","DOI":"10.1136\/bmjopen-2021-058453","article-title":"Understanding How and Why Quality Circles Improve Standards of Practice, Enhance Professional Development and Increase Psychological Well-Being of General Practitioners: A Realist Synthesis","volume":"12","author":"Rohrbasser","year":"2022","journal-title":"BMJ Open"},{"key":"ref_11","first-page":"CD001431","article-title":"Decision Aids for People Facing Health Treatment or Screening Decisions","volume":"3","author":"Stacey","year":"2024","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1017\/S0266462304000832","article-title":"View of Health Technology Assessment from the Swampy Lowlands of General Practice","volume":"20","author":"Heath","year":"2004","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e719","DOI":"10.3399\/bjgp14X682309","article-title":"Primary Care Evidence in Clinical Guidelines: A Mixed Methods Study of Practitioners\u2019 Views","volume":"64","author":"Abdelhamid","year":"2014","journal-title":"Br. J. Gen. Pract. J. R. Coll. Gen. Pract."},{"key":"ref_14","unstructured":"NICE (2025, September 01). Healthcare Professionals. Available online: https:\/\/www.nice.org.uk\/shaping-our-work."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e69","DOI":"10.1017\/S0266462325100494","article-title":"Engaging Stakeholders along Health Technology Assessment Pathways: A Scoping Review of International Practice","volume":"41","author":"Carter","year":"2025","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"ref_16","unstructured":"(2025, September 01). UEMO. Available online: https:\/\/uemo.be."},{"key":"ref_17","unstructured":"(2025, September 01). EU Regulation on HTA 2021\/2282. Available online: https:\/\/eur-lex.europa.eu\/eli\/reg\/2021\/2282\/oj\/eng."},{"key":"ref_18","unstructured":"(2025, September 01). UEMO Strengthens Cooperation with EMA, EFPC and WONCA. Available online: https:\/\/uemo.be\/news-uemo\/stronger-primary-care-in-the-eu-uemo-strengthens-cooperation-with-ema-efpc-and-wonca-europe\/."},{"key":"ref_19","unstructured":"(2025, September 01). WONCA Europe. Available online: https:\/\/www.woncaeurope.org."},{"key":"ref_20","unstructured":"(2025, September 01). SIG WONCA Cancer and Palliative Care. Available online: https:\/\/www.globalfamilydoctor.com\/groups\/SpecialInterestGroups\/CancerandPalliativecare.aspx."},{"key":"ref_21","unstructured":"(2025, September 01). EAA. Available online: https:\/\/www.euaac.org."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e026383","DOI":"10.1136\/bmjopen-2018-026383","article-title":"Involving the General Practitioner during Curative Cancer Treatment: A Systematic Review of Health Care Interventions","volume":"9","author":"Perfors","year":"2019","journal-title":"BMJ Open"},{"key":"ref_23","first-page":"e13594","article-title":"Roles of General Practitioners in Shared Decision-Making for Patients with Cancer: A Qualitative Study","volume":"31","author":"Abma","year":"2022","journal-title":"Eur. J. Cancer Care"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Druel, V., Gimenez, L., Paricaud, K., Delord, J.-P., Grosclaude, P., Boussier, N., and Bugat, M.-E.R. (2020). Improving Communication between the General Practitioner and the Oncologist: A Key Role in Coordinating Care for Patients Suffering from Cancer. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-06993-0"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e067896","DOI":"10.1136\/bmj-2021-067896","article-title":"Using Illness Trajectories to Inform Person Centred, Advance Care Planning","volume":"384","author":"Murray","year":"2024","journal-title":"BMJ"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1007\/s11764-016-0545-4","article-title":"The Role of the GP in Follow-up Cancer Care: A Systematic Literature Review","volume":"10","author":"Meiklejohn","year":"2016","journal-title":"J. Cancer Surviv. Res. Pract."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1007\/s00432-017-2343-4","article-title":"The Role of the General Practitioner in Cancer Care: A Survey of the Patients\u2019 Perspective","volume":"143","author":"Lang","year":"2017","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1146\/annurev-publhealth-032013-182440","article-title":"Combining the Power of Stories and the Power of Numbers: Mixed Methods Research and Mixed Studies Reviews","volume":"35","author":"Pluye","year":"2014","journal-title":"Annu. Rev. Public Health"},{"key":"ref_29","first-page":"285","article-title":"The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers","volume":"34","author":"Bartlett","year":"2018","journal-title":"Educ. Inf."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated Criteria for Reporting Qualitative Research (COREQ): A 32-Item Checklist for Interviews and Focus Groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int. J. Qual. Health Care"},{"key":"ref_31","unstructured":"(2025, September 01). WONCA, Dublin. Available online: https:\/\/www.globalfamilydoctor.com\/Conferences\/29thWONCAEuropeConference2024.aspx."},{"key":"ref_32","unstructured":"(2025, September 01). UEMO Presentation at WONCA Dublin. Available online: https:\/\/padlet.com\/patrickouvrard1\/hta-uemo-wonca-j8mzxli3xfpa1yic."},{"key":"ref_33","unstructured":"Pope, C. (2009). Qualitative Research in Health Care, Blackwell. [3rd ed.]."},{"key":"ref_34","unstructured":"Boers, M., Boer, A., and Harmsen, R. (2020). Governance of European Cooperation Processes in Health Technology Assessment: Networking, Paving the Way to Convergence of Practices?, Erasmus University Rotterdam. Available online: https:\/\/www.eur.nl\/sites\/corporate\/files\/2020-11\/magali-boers-digitaal-proefschrift.pdf."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Smith, V., Warty, R., Nair, A., Krishnan, S., Sursas, J.A., Costa, F.d.S., Vollenhoven, B., and Wallace, E.M. (2019). Defining the Clinician\u2019s Role in Early Health Technology Assessment during Medical Device Innovation\u2014A Systematic Review. BMC Health Serv. Res., 19.","DOI":"10.1186\/s12913-019-4305-9"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/j.jval.2022.03.021","article-title":"Involvement of Patients and Medical Professionals in the Assessment of Relative Effectiveness: A Need for Closer Cooperation","volume":"25","author":"Lips","year":"2022","journal-title":"Value Health"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2217543","DOI":"10.1080\/20016689.2023.2217543","article-title":"The Role of Stakeholder Involvement in the Evolving EU HTA Process: Insights Generated through the European Access Academy\u2019s Multi-Stakeholder Pre-Convention Questionnaire","volume":"11","author":"Ruof","year":"2023","journal-title":"J. Mark. Access Health Policy"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"E576","DOI":"10.1503\/cmaj.109-5595","article-title":"Low Awareness about CADTH among Practising Doctors in Canada","volume":"190","author":"Rich","year":"2018","journal-title":"Can. Med. Assoc. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1136\/bmj.319.7220.1292","article-title":"Linking Health Technology Assessment to Practice","volume":"319","author":"Rosen","year":"1999","journal-title":"BMJ (Clin. Res. Ed.)"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s40900-023-00433-6","article-title":"Key Issues for Stakeholder Engagement in the Development of Health and Healthcare Guidelines","volume":"9","author":"Petkovic","year":"2023","journal-title":"Res. Involv. Engagem."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1017\/S0266462324000370","article-title":"Outcomes of Guidelines from Health Technology Assessment Organizations in Community-Based Primary Care: A Systematic Mixed Studies Review","volume":"40","author":"Baradaran","year":"2024","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Julian, E., Belleman, T., Garcia, M.J., M\u00f6lken, M.R.-V., Doeswijk, R., Giuliani, R., W\u00f6rmann, B.J., Widmer, D., Tilleul, P., and Arroyo, R.C. (2025). Avoiding Error and Finding the Right Balance in European Health Technology Assessments: Insights Generated by the European Access Academy. J. Mark. Access Health Policy, 13.","DOI":"10.3390\/jmahp13010006"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.yrtph.2005.06.016","article-title":"Modern Regulatory Impact Analysis: The Experience of the European Union","volume":"44","author":"Ballantine","year":"2006","journal-title":"Regul. Toxicol. Pharmacol. RTP"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1136\/jech.2009.094300","article-title":"Is the Increasing Policy Use of Impact Assessment in Europe Likely to Undermine Efforts to Achieve Healthy Public Policy?","volume":"64","author":"Smith","year":"2010","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Dufour, G., Weeks, L., De Angelis, G., Marchand, D.K., Kaunelis, D., Severn, M., Walter, M., and Mittmann, N. (2022). How We Might Further Integrate Considerations of Environmental Impact When Assessing the Value of Health Technologies. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191912017"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.1017\/S0266462322003282","article-title":"Incorporating Environmental and Sustainability Considerations into Health Technology Assessment and Clinical and Public Health Guidelines: A Scoping Review","volume":"38","author":"Yoo","year":"2022","journal-title":"Int. J. Technol. Assess. Health Care"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.jclinepi.2017.09.023","article-title":"Decision-Making Frameworks and Considerations for Informing Coverage Decisions for Healthcare Interventions: A Critical Interpretive Synthesis","volume":"94","author":"Morgan","year":"2018","journal-title":"J. Clin. Epidemiol."},{"key":"ref_48","first-page":"CD011085","article-title":"Governance Arrangements for Health Systems in Low-Income Countries: An Overview of Systematic Reviews","volume":"9","author":"Herrera","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1111\/risa.13714","article-title":"Accounting for Health Risk Inequality in Regulatory Impact Analysis: Barriers and Opportunities","volume":"41","author":"Levy","year":"2021","journal-title":"Risk Anal."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e108446","DOI":"10.1136\/bmjopen-2025-108446","article-title":"The Carbon Footprints of Single-Use and Reusable Medical Devices: A Systematic Review","volume":"15","author":"Booth","year":"2025","journal-title":"BMJ Open"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"ckaf262","DOI":"10.1093\/eurpub\/ckaf262","article-title":"Mapping the Regulatory Landscape for Environmental Sustainability of Medical Device Practices within the European Union","volume":"36","author":"Zarro","year":"2026","journal-title":"Eur. J. Public Health"},{"key":"ref_52","unstructured":"Fraser, N., Honneth, A., Golb, J., and Golb, J.D. (2003). Redistribution or Recognition? A Political-Philosophical Exchange, Verso."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e70558","DOI":"10.1111\/jep.70558","article-title":"Bringing Regulatory-Style Benefit-Risk Assessment to the Bedside: A Structured Evidence Synthesis Methodology for Shared Decision-Making","volume":"32","author":"Labudovic","year":"2026","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_54","first-page":"3","article-title":"What Is the Carbon Footprint of Primary Care Practices? A Retrospective Life-Cycle Analysis in Switzerland","volume":"21","author":"Nicolet","year":"2022","journal-title":"Environ. Health Glob. Access Sci. Source"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1111\/jep.12156","article-title":"For Every Complex Problem, There Is an Answer That Is Clear, Simple and Wrong: And Other Aphorisms about Medical Statistical Fallacies","volume":"20","author":"Sturmberg","year":"2014","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e70153","DOI":"10.1111\/eci.70153","article-title":"Real-World Evidence and Observational Studies: Methodological Challenges in Clinical Research","volume":"56","author":"Zoccali","year":"2026","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Kympouropoulos, S. (2023). Real World Evidence: Methodological Issues and Opportunities from the European Health Data Space. BMC Med. Res. Methodol., 23.","DOI":"10.1186\/s12874-023-02014-3"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Fricker, M. (2007). Epistemic Injustice: Power and the Ethics of Knowing, Oxford University Press.","DOI":"10.1093\/acprof:oso\/9780198237907.001.0001"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1111\/jep.13370","article-title":"What Is \u201cShared\u201d in Shared Decision-making? Philosophical Perspectives, Epistemic Justice, and Implications for Health Professions Education","volume":"26","author":"Thomas","year":"2020","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"119040","DOI":"10.1016\/j.socscimed.2026.119040","article-title":"Epistemic Injustice in Healthcare Professional Practice: A Scoping Review","volume":"394","author":"Thomas","year":"2026","journal-title":"Soc. Sci. Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1016\/S0140-6736(03)14576-X","article-title":"The Need for Research in Primary Care","volume":"362","author":"Green","year":"2003","journal-title":"Lancet"},{"key":"ref_62","unstructured":"Rochoy, M. (2026). The European Atlas of General Practice, Congr\u00e8s WONCA Europe."},{"key":"ref_63","unstructured":"Balint, M. (2000). The Doctor, His Patient and the Illness, Churchill Livingstone."},{"key":"ref_64","unstructured":"Gadamer, H.-G. (1996). The Enigma of Health: The Art of Healing in a Scientific Age, Stanford University Press."},{"key":"ref_65","unstructured":"Good, B.J. (2008). Medicine, Rationality, and Experience: An Anthropological Perspective, Cambridge University Press. 10th Print; The Lewis Henry Morgan Lectures 1990."}],"container-title":["Journal of Market Access &amp; Health Policy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2001-6689\/14\/3\/57\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:20:16Z","timestamp":1790072416000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2001-6689\/14\/3\/57"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":65,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jmahp14030057"],"URL":"https:\/\/doi.org\/10.3390\/jmahp14030057","relation":{},"ISSN":["2001-6689"],"issn-type":[{"value":"2001-6689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]}}}