How the role of health technology assessment (HTA) agencies in relation to medical technologies (MedTech) is framed in the literature reflects and influences governance, shaping perceptions and guiding decisions. We identify different academic discourses to advance MedTech policy debates, in light of several factors potentially influencing this role. This is the first time that discourse on the role of HTA agencies in relation to MedTech has been reviewed. We conducted a comprehensive search, screened for eligibility, and synthesised findings using discourse analysis. 119 articles were included, from which 5 discourses were constructed. The first discourse describes the HTA agency as an independent evaluator of appropriate evidence for all health technologies. The second discourse explicitly categorises MedTech as separate from pharmaceuticals and expands the role of evaluator to include encouraging evidence generation for MedTech. The third discourse moves away from the role of independent evaluator and describes the HTA agency as a convenor of all stakeholder perspectives, using an experimental approach. The fourth and fifth discourses critically reflect on the role of HTA agencies, the fourth on their level of normative reflection and the fifth on their level of nuanced, clinical expertise. We conclude with recommendations for policy and research.

Canada has not escaped trends in most liberal democracies with the rapid growth of agencies created by government to deliver public goods, often justified on elements of their mandate—service delivery, adjudication of disputes, regulatory oversight, among others—benefiting from an arm's-length relationship to the government of the day. Yet Canadian studies of this phenomenon remain mostly absent from the robust comparative literature theorizing and documenting the emergence of widespread “agencification” and its relationship to performance. This article draws on the Government of Canada's Public Service Employee Survey (PSES) microdata from 2017 to test key hypotheses advanced by proponents of agencification, specifically that agencies are more innovative, autonomous and efficient public organizations. We discover that those working in agencies generally report less climate of innovation and less work autonomy than those working in departments, though some types of agencies—namely regulatory and parliamentary ones—defy these trends.

A large number of civilian agencies have published guides and recommendations on how to assemble personal and family emergency kits. However, the kits resulting from following these guidelines are impractical, particularly in the event evacuation becomes necessary. This report describes an alternative approach to assembling an emergency kit.

OstrovskiyG, ShemeshAJ. Contents of a Bug-Out Bag. Prehosp Disaster Med. 2018;33(6):647–649.

In recent years, United States (US) policymakers have instituted quadrennial strategy reviews in several major policy areas. In this article, I examine why policymakers have initiated these large strategic reviews, and why a particular model for them has diffused from the US Defense Department to other government agencies. I find that policymakers have initiated the reviews principally to spur organisational change in agencies and influence the relationship between agencies and the Congress, and that policymakers have replicated the Defense Department’s review model because of that department’s strong political support. My findings suggest more generally that formal strategy activities are often driven more by legislative-executive and bureaucratic politics than by a search for new strategic ideas. Commonalities between the diffusion of quadrennial reviews in the US and the diffusion of other strategy and planning processes internationally underscore the broader applicability and significance of these findings.