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Ethics in Health Technology Assessment (HTA)

HTA is a multidisciplinary process that uses explicit methods to determine the value of a health technology at different points in its lifecycle. The purpose is to inform decision-making in order to promote an equitable, efficient, and high-quality health system (O’Rouke 2020). In order to do so HTA needs theories, methods, perspectives, and approaches from ethics.

About the project

“HTA is a multidisciplinary process that uses explicit methods to determine the value of a health technology at different points in its lifecycle. The purpose is to inform decision-making in order to promote an equitable, efficient, and high-quality health system.” (O’Rouke 2020). In order to do so HTA needs theories, methods, perspectives, and approaches from ethics.

 

Objectives

  • To investigate the role of ethics in HTA.
  • To explore ways to integrate ethics in HTA.
  • To develop, test, and use specific methods for addressing ethical issues in health technology assessment.

Methods

Conceptual, epistemological, and ethical analysis and development.

 

Financing

Partly financed by The Norwegian Knowledge Centre for the Health Services (2002-2013, now at The Norwegian Institute of Public Health NIPH), the INTEGRATE-HTA project (EU) and by the VALIDATE project (EU).

 

Collaborators

Kristin Bakke Lysdahl (USN), members of the INTEGRATE-HTA project (EU) and by the VALIDATE project (EU).

 

Project start and finish

2000 – 2025

 

Topics (issues)

The role of ethics in HTA:

  • Hofmann B. M. Why ethics should be part of health technology assessment. International journal of technology assessment in health care. 2008; 24(4): 423-9.
  • Hofmann B. Why not integrate ethics in HTA: identification and assessment of the reasons GMS health technology assessment. 2014; 10(Doc04): 3-9.
  • Abrishami P., Oortwijn W., Hofmann B. Ethics in HTA: Examining the “Need for Expansion”. International Journal of Health Policy and Management. 2017; 6(10): 551-3.
  • Hviding K., Hofmann B. Fra forskning til helsepolitisk beslutning. Hva er en god metodevurdering i en beslutningsprosess? Michael Quarterly. 2012; 9(2): 165-73.

Facts and values in HTA:

  • Hofmann B., Cleemput I., Bond K., Krones T., Droste S., Sacchini D. et al. Revealing and acknowledging value judgments in health technology assessment. International journal of technology assessment in health care. 2014; 30(6): 579-86.
  • Hofmann B., Bond K., Sandman L. Evaluating facts and facting evaluations: On the fact-value relationship in HTA. Journal of evaluation in clinical practice. 2018; 24(5): 957-65.

Methods for addressing ethical issues in HTA:

  • Hofmann B. Toward a Method for Exposing and Elucidating Ethical Issues with Human Cognitive Enhancement Technologies. Science and engineering ethics. 2017; 23 (2): 413-29.
  • Hofmann B., Droste S., Oortwijn W., Cleemput I., Sacchini D. Harmonization of ethics in health technology assessment: a revision of the Socratic approach. International journal of technology assessment in health care. 2014; 30(1): 3-9.
  • Hofmann B. Toward a Method for Exposing and Elucidating Ethical Issues with Human Cognitive Enhancement Technologies. Science and engineering ethics. 2017; 23(2): 413-29.
  • Saarni S.I., Braunack-Mayer A., Hofmann B., Wilt G. Jvd. Different methods for ethical analysis in health technology assessment: An empirical study. International journal of technology assessment in health care. 2011; 27(4): 305-12.
  • Burls A., Caron L., Langavant G.C., Dondorp W., Harstall C., Pathak-Sen E. et al. Tackling ethical issues in health technology assessment: A proposed framework. International journal of technology assessment in health care. 2011; 27(3): 230-7.
  • Hofmann B., Oortwijn W., Lysdahl K., Refolo P., Sacchini D., Wilt G. Jvd. et al. Integrating ethics in health technology assessment: many ways to Rome. International journal of technology assessment in health care. 2015; 31(3): 131-7.
  • Scott A. M., Hofmann B., Gutierrez-Ibarluzea I., Bakke Lysdahl K., Sandman L., Bombard Y. Q-SEA - a tool for quality assessment of ethics analyses conducted as part of health technology assessments. GMS health technology assessment. 2017; 13: Doc02.
  • Stich A. K., Mozygemba K., Lysdahl K. B., Pfadenhauer L. M., Hofmann B., van der Wilt G. J. et al. Methods Assessing Sociocultural Aspects of Health Technologies: Results of a Literature Review. International journal of technology assessment in health care. 2019; 35(2): 99-105.
  • Lampe K., Mäkelä M., Makela M., Garrido M. V., Anttila H., Autti-Ramo I. et al. The HTA Core Model: A novel method for producing and reporting health technology assessments. International journal of technology assessment in health care. 2009; 25: 9-20.
  • Hofmann B. Etikk i vurdering av helsetiltak. Utvikling av en metode for å synliggjøre etiske utfordringer ved vurdering av helsetiltak. Vitenskapelig artikkel. Nasjonalt kunnskapssenter for helsetjenesten; 2008. Report No.: 978-82-8121-223-7.
  • Hofmann B. Etiske vurderinger.  Slik oppsummerer vi forskning: Nasjonalt kunnskapssenter for helsetjenesten; 2009. p. 63.

Doing ethics in HTA:

  • Hofmann B. Ethical issues with colorectal cancer screening-a systematic review. Journal of evaluation in clinical practice. 2017; 23(3): 631-41.
  • Hofmann B., Haustein D., Landeweerd L. Smart-Glasses: Exposing and Elucidating the Ethical Issues. Science and engineering ethics. 2016; 136(17): 1-21.
  • Hofmann B., Stanak M. Nudging in screening: Literature review and ethical guidance. Patient education and counseling. 2018; 101(9): 1561-9.
  • Alquist R., Grøgaard J., Hellesnes K., Hofmann B. Myr R, Reinar LM, et al. Samsoving, smokk, amming og krybbedød – finnes det en sammenheng? Virkninger av snusbruk. Vitenskapelig artikkel. Nasjonalt kunnskapssenter for helsetjenesten; 2005. Report No.: 82-8121-049-482-8121-051-6.
  • Dahm K. T., Leiknes K. A., Husum T. L., Kirkehei I., Hofmann B., Myrhaug H. T. et al. Effekt av tiltak for å redusere tvangsbruk i psykisk helsevern for voksne. Nasjonalt kunnskapssenter for helsetjenesten 2012. Report No.: 978-82-8121-484-20332-9410 Contract No.: 5.
  • Graff B. A., Have M., Hofmann B., Norderhaug I. N., Haukland H. H., Lingås E. et al. Aldersvurdering av mindreårige asylsøkere. Vitenskapelig artikkel. Oslo: Nasjonalt kunnskapssenter for helsetjenesten; 2006. Report No.: 82-8121-104-082-8121-081-8.
  • Hofmann B. Effekt av fysioterapi ved kneleddsartrose, begrenset til elektroterapi og øvelsesbehandling Medisinsk metodevurdering basert på internasjonal og egen litteraturgranskning Rapport 4/2004: Nasjonalt kunnskapssenter for helsetjenesten Sykehuset Innlandet HF; 2004. p. 104.
  • Movik E., Ringerike T., Linnestad K. K., Hofmann B., Harboe I., Gjertsen M. K. et al. Metylnaltrekson ved forstoppelse i kreftbehandling. Rapport nr.23. Nasjonalt kunnskapssenter for helsetjenesten; 2009. Report No.: 978-82-8121-298-5.
  • Hofmann B. Ethical Considerations in the Use of Technology in the Cardiac Intensive Care Unit. In: Romanò M, editor. Palliative Care in Cardiac Intensive Care Units. Cham: Springer International Publishing; 2021. p. 173-82.
  • Hofmann B, Hjelmesæth J, Søvik TT. Moral challenges with surgical treatment of type 2 diabetes. Journal of diabetes and its complications. 2013; 27(6): 597-603.
  • Hofmann B. Bariatric surgery for obese children and adolescents: a review of the moral challenges. BMC medical ethics. 2013; 14(18).
  • Hofmann B. Parachutes for diabetes: Bariatric surgery beyond evidence? Diabetes Research and Clinical Practice. 2012; 98(3): 406-7.
  • Hofmann B. Ethical aspects of bariatric treatment of adult obesity. Alberta, Canada: Institute of Health Economics; 2011.
  • Hofmann B. Stuck in the Middle: The Many Moral Challenges With Bariatric Surgery. American Journal of Bioethics. 2010; 10(12): 3-11.
  • Hofmann B. The encompassing ethics of bariatric surgery. The American journal of bioethics : AJOB. 2010; 10(12): W1-2

HTA for complex interventions:

  • Pfadenhauer L. M., Gerhardus A., Mozygemba K., Lysdahl K. B., Booth A., Hofmann B. et al. Making sense of complexity in context and implementation: the Context and Implementation of Complex Interventions (CICI) framework. Implementation science : IS. 2017; 12(1): 21.
  • Wahlster P., Brereton L., Burns J., Hofmann B., Mozygemba K., Oortwijn W. et al. An integrated perspective on the assessment of technologies: INTEGRATE-HTA. International journal of technology assessment in health care. 2017:1-8.
  • Lysdahl K. B., Oortwijn W., van der Wilt G. J., Refolo P., Sacchini D., Mozygemba K. et al. Ethical analysis in HTA of complex health interventions. BMC medical ethics. 2016; 17:16.
  • Lysdahl K. B., Hofmann B., Lysdahl K. B., Oortwijn W., Wilt G. Jvd., Refolo P. et al. Complex health care interventions: Characteristics relevant for ethical analysis in health technology assessment Ethical analysis in HTA of complex health interventions. GMS health technology assessment. 2016;12:8.
  • Pfadenhauer L. M., Mozygemba K., Gerhardus A., Hofmann B., Booth A., Lysdahl K. B. et al. Context and implementation: A concept analysis towards conceptual maturity. Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen. 2015; 109(2): 103-14.

Patient involvement in HTA:

  • Wale J., Scott A. M., Hofmann B., Garner S., Low E., Sansom L. WHY PATIENTS SHOULD BE INVOLVED IN HEALTH TECHNOLOGY ASSESSMENT. International journal of technology assessment in health care. 2017:1-4.
  • Scott A. M., Bond K., Gutierrez-Ibarluzea I., Hofmann B., Sandman L. QUALITY ASSESSMENT OF ETHICS ANALYSES FOR HEALTH TECHNOLOGY ASSSESSMENT. International journal of technology assessment in health care. 2016: 1-8.
  • Lysdahl K. B., Oortwijn W., van der Wilt G. J., Refolo P., Sacchini D., Mozygemba K. et al. Ethical analysis in HTA of complex health interventions. BMC medical ethics. 2016;17:16.
  • Lysdahl K. B., Hofmann B., Lysdahl K. B., Oortwijn W., Wilt G. Jvd., Refolo P. et al. Complex health care interventions: Characteristics relevant for ethical analysis in health technology assessment Ethical analysis in HTA of complex health interventions. GMS health technology assessment. 2016;12:8.
  • Pfadenhauer L. M., Mozygemba K., Gerhardus A., Hofmann B., Booth A., Lysdahl K. B. et al. Context and implementation: A concept analysis towards conceptual maturity. Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen. 2015; 109(2): 103-14.
  • Hofmann B., Oortwijn W., Lysdahl K., Refolo P., Sacchini D., Wilt G. Jvd. et al. Integrating ethics in health technology assessment: many ways to Rome. International journal of technology assessment in health care. 2015; 31(3): 131-7.
  • Hofmann B., Droste S., Oortwijn W., Cleemput I., Sacchini D. Harmonization of ethics in health technology assessment: a revision of the Socratic approach. International journal of technology assessment in health care. 2014; 30(1): 3-9.
  • Hofmann B., Cleemput I., Bond K., Krones T., Droste S., Sacchini D. et al. Revealing and acknowledging value judgments in health technology assessment. International journal of technology assessment in health care. 2014; 30(6): 579-86.
  • Hofmann B. Why not integrate ethics in HTA: identification and assessment of the reasons GMS health technology assessment. 2014; 10(Doc04): 3-9.
  • Saarni SI, Braunack-Mayer A, Hofmann B, Wilt GJvd. Different methods for ethical analysis in health technology assessment: An empirical study. International journal of technology assessment in health care. 2011; 27(4): 305-12.
  • Burls A., Caron L., Langavant G.C., Dondorp W., Harstall C., Pathak-Sen E. et al. Tackling ethical issues in health technology assessment: A proposed framework. International journal of technology assessment in health care. 2011; 27(3): 230-7.
  • Wilt G.Jvd., Braunack-Mayer A., Bombard Y., Hofmann B. Emerging and Evolving Methods for Ethics in HTA.  Health Technology Assessment International, 7th Annual Meeting Dublin 2010, Maximising the Value of HTA, Book of Abstracts 2010. p. 22.
  • Alquist R., Grøgaard J., Hellesnes K., Hofmann B., Myr R, Reinar L. M. et al. Samsoving, smokk, amming og krybbedød – finnes det en sammenheng? Virkninger av snusbruk. Vitenskapelig artikkel. Nasjonalt kunnskapssenter for helsetjenesten; 2005. Report No.: 82-8121-049-482-8121-051-6.
  • Dahm K. T., Leiknes K. A., Husum T. L., Kirkehei I., Hofmann B., Myrhaug H. T. et al. Effekt av tiltak for å redusere tvangsbruk i psykisk helsevern for voksne. Nasjonalt kunnskapssenter for helsetjenesten 2012. Report No.: 978-82-8121-484-20332-9410 Contract No.: 5.
  • Graff B. A., Have M., Hofmann B., Norderhaug I. N., Haukland H. H., Lingås E. et al. Aldersvurdering av mindreårige asylsøkere. Vitenskapelig artikkel. Oslo: Nasjonalt kunnskapssenter for helsetjenesten; 2006. Report No.: 82-8121-104-082-8121-081-8.
  • Hofmann B. Effekt av fysioterapi ved kneleddsartrose, begrenset til elektroterapi og øvelsesbehandling Medisinsk metodevurdering basert på internasjonal og egen litteraturgranskning Rapport 4/2004: Nasjonalt kunnskapssenter for helsetjenesten Sykehuset Innlandet HF; 2004. p. 104.
  • Hofmann B. Etikk i vurdering av helsetiltak. Utvikling av en metode for å synliggjøre etiske utfordringer ved vurdering av helsetiltak. Vitenskapelig artikkel. Nasjonalt kunnskapssenter for helsetjenesten; 2008. Report No.: 978-82-8121-223-7.
  • Hofmann B. Etiske vurderinger.  Slik oppsummerer vi forskning: Nasjonalt kunnskapssenter for helsetjenesten; 2009. p. 63.
  • Hofmann B. M. Why ethics should be part of health technology assessment. International journal of technology assessment in health care. 2008; 24(4): 423-9.
  • Hviding K., Hofmann B. Fra forskning til helsepolitisk beslutning. Hva er en god metodevurdering i en beslutningsprosess? Michael Quarterly. 2012; 9(2): 165-73.
  • Lampe K., Mäkelä M., Makela M., Garrido M. V., Anttila H., Autti-Ramo I. et al. The HTA Core Model: A novel method for producing and reporting health technology assessments. International journal of technology assessment in health care. 2009; 25: 9-20.
  • Movik E., Ringerike T., Linnestad K. K., Hofmann B., Harboe I., Gjertsen M. K. et al. Metylnaltrekson ved forstoppelse i kreftbehandling. Rapport nr.23. Nasjonalt kunnskapssenter for helsetjenesten; 2009. Report No.: 978-82-8121-298-5.

Outcomes (selected publications)

  • Refolo, P., Sacchini, D., Bloemen, B., Grin, J., Gutierrez-Ibarluzea, I., Hofmann, B., ... & Spagnolo, A. G. (2023). On the normativity of evidence–Lessons from philosophy of science and the “VALIDATE” project. European Review for Medical and Pharmacological Sciences, 27, 11202-11210.
  • Van Der Wilt GJ, Bloemen B, Grin J, et al. Integrating Empirical Analysis and Normative Inquiry in Health Technology Assessment: The Values in Doing Assessments of Health Technologies Approach. International journal of technology assessment in health care 2022;38(1):7 doi: http://dx.doi.org10.1017/S0266462321001768
  • Grin J, Bloemen B, Gutierrez-Ibarluzea I, et al. Learning and practicing more value-reflective, problem-setting health technology assessment: experiences and lessons from the VALIDATE project. International journal of technology assessment in health care 2022;38(1):7 doi: http://dx.doi.org10.1017/S0266462322000204[published
  • Refolo P, Bond K, Bloemen B, et al. Core competencies for ethics experts in health technology assessment. International journal of technology assessment in health care 2020;36(6):534-39 doi: http://dx.doi.org10.1017/S0266462320001968
  • Hofmann B. Enhancing the value of HTA by addressing the values in HTA. Seminar for the Ludwig Boltzmann Institute for Health Technology Assessment, 2020.
  • Stich A. K., Mozygemba K., Lysdahl K. B., Pfadenhauer L. M., Hofmann B, van der Wilt G. J. et al. Methods Assessing Sociocultural Aspects of Health Technologies: Results of a Literature Review. International journal of technology assessment in health care. 2019;35(2):99-105.
  • Hofmann B., Stanak M. Nudging in screening: Literature review and ethical guidance. Patient education and counseling. 2018;101(9):1561-9.
  • Hofmann B., Bond K., Sandman L. Evaluating facts and facting evaluations: On the fact-value relationship in HTA. Journal of evaluation in clinical practice. 2018;24(5):957-65.
  • Hofmann B. OP101 Do We Need To Extend Health Technology Assessment To Health Enhancement Assessment? International journal of technology assessment in health care. 2018;33(S1):46.
  • Hofmann B. VP142 Assessing Human Enhancements: Exposing And Elucidating Ethical Issues. International journal of technology assessment in health care. 2018;33(S1):214-5.
  • Wale J., Scott A. M., Hofmann B., Garner S., Low E., Sansom L. WHY PATIENTS SHOULD BE INVOLVED IN HEALTH TECHNOLOGY ASSESSMENT. International journal of technology assessment in health care. 2017:1-4.
  • Wahlster P., Brereton L., Burns J., Hofmann B., Mozygemba K., Oortwijn W. et al. An integrated perspective on the assessment of technologies: INTEGRATE-HTA. International journal of technology assessment in health care. 2017:1-8.
  • Scott A. M., Hofmann B., Gutierrez-Ibarluzea I., Bakke Lysdahl K., Sandman L., Bombard Y. Q-SEA - a tool for quality assessment of ethics analyses conducted as part of health technology assessments. GMS health technology assessment. 2017;13:Doc02.
  • Pfadenhauer L. M., Gerhardus A, Mozygemba K, Lysdahl KB, Booth A, Hofmann B, et al. Making sense of complexity in context and implementation: the Context and Implementation of Complex Interventions (CICI) framework. Implementation science : IS. 2017; 12(1): 21.
  • Hofmann B. Ethical issues with colorectal cancer screening-a systematic review. Journal of evaluation in clinical practice. 2017; 23(3): 631-41.
  • Abrishami P., Oortwijn W., Hofmann B. Ethics in HTA: Examining the “Need for Expansion”. International Journal of Health Policy and Management. 2017; 6(10): 551-3.
  • Scott AM, Bond K, Gutierrez-Ibarluzea I, Hofmann B, Sandman L. QUALITY ASSESSMENT OF ETHICS ANALYSES FOR HEALTH TECHNOLOGY ASSSESSMENT. International journal of technology assessment in health care. 2016:1-8.
  • Lysdahl KB, Oortwijn W, van der Wilt GJ, Refolo P, Sacchini D, Mozygemba K, et al. Ethical analysis in HTA of complex health interventions. BMC medical ethics. 2016;17:16.
  • Lysdahl KB, Hofmann B, Lysdahl KB, Oortwijn W, Wilt GJvd, Refolo P, et al. Complex health care interventions: Characteristics relevant for ethical analysis in health technology assessment Ethical analysis in HTA of complex health interventions. GMS health technology assessment. 2016;12:8.
  • Pfadenhauer LM, Mozygemba K, Gerhardus A, Hofmann B, Booth A, Lysdahl KB, et al. Context and implementation: A concept analysis towards conceptual maturity. Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen. 2015;109(2):103-14.
  • Hofmann B, Oortwijn W, Lysdahl K, Refolo P, Sacchini D, Wilt GJvd, et al. Integrating ethics in health technology assessment: many ways to Rome. International journal of technology assessment in health care. 2015;31(3):131-7.
  • Hofmann B, Droste S, Oortwijn W, Cleemput I, Sacchini D. Harmonization of ethics in health technology assessment: a revision of the Socratic approach. International journal of technology assessment in health care. 2014;30(1):3-9.
  • Hofmann B, Cleemput I, Bond K, Krones T, Droste S, Sacchini D, et al. Revealing and acknowledging value judgments in health technology assessment. International journal of technology assessment in health care. 2014;30(6):579-86.
  • Hofmann B. Why not integrate ethics in HTA: identification and assessment of the reasons GMS health technology assessment. 2014;10(Doc04):3-9.
  • Saarni SI, Braunack-Mayer A, Hofmann B, Wilt GJvd. Different methods for ethical analysis in health technology assessment: An empirical study. International journal of technology assessment in health care. 2011;27(4):305-12.
  • Burls A, Caron L, Langavant GCd, Dondorp W, Harstall C, Pathak-Sen E, et al. Tackling ethical issues in health technology assessment: A proposed framework. International journal of technology assessment in health care. 2011;27(3):230-7.
  • Wilt GJvd, Braunack-Mayer A, Bombard Y, Hofmann B. Emerging and Evolving Methods for Ethics in HTA.  Health Technology Assessment International, 7th Annual Meeting Dublin 2010, Maximising the Value of HTA, Book of Abstracts2010. p. 22.
  • Alquist R, Grøgaard J, Hellesnes K, Hofmann B, Myr R, Reinar LM, et al. Samsoving, smokk, amming og krybbedød – finnes det en sammenheng? Virkninger av snusbruk. Vitenskapelig artikkel. Nasjonalt kunnskapssenter for helsetjenesten; 2005. Report No.: 82-8121-049-482-8121-051-6.
  • Dahm KT, Leiknes KA, Husum TL, Kirkehei I, Hofmann B, Myrhaug HT, et al. Effekt av tiltak for å redusere tvangsbruk i psykisk helsevern for voksne. Nasjonalt kunnskapssenter for helsetjenesten 2012. Report No.: 978-82-8121-484-20332-9410 Contract No.: 5.
  • Graff BA, ten Have M, Hofmann B, Norderhaug IN, Haukland HH, Lingås E, et al. Aldersvurdering av mindreårige asylsøkere. Vitenskapelig artikkel. Oslo: Nasjonalt kunnskapssenter for helsetjenesten; 2006. Report No.: 82-8121-104-082-8121-081-8.
  • Hofmann B. Effekt av fysioterapi ved kneleddsartrose, begrenset til elektroterapi og øvelsesbehandling Medisinsk metodevurdering basert på internasjonal og egen litteraturgranskning Rapport 4/2004: Nasjonalt kunnskapssenter for helsetjenesten Sykehuset Innlandet HF; 2004. p. 104.
  • Hofmann B. Etikk i vurdering av helsetiltak. Utvikling av en metode for å synliggjøre etiske utfordringer ved vurdering av helsetiltak. Vitenskapelig artikkel. Nasjonalt kunnskapssenter for helsetjenesten; 2008. Report No.: 978-82-8121-223-7.
  • Hofmann B. Etiske vurderinger.  Slik oppsummerer vi forskning: Nasjonalt kunnskapssenter for helsetjenesten; 2009. p. 63.
  • Hofmann BM. Why ethics should be part of health technology assessment. International journal of technology assessment in health care. 2008;24(4):423-9.
  • Hviding K, Hofmann B. Fra forskning til helsepolitisk beslutning. Hva er en god metodevurdering i en beslutningsprosess? Michael Quarterly. 2012;9(2):165-73.
  • Lampe K, Mäkelä M, Makela M, Garrido MV, Anttila H, Autti-Ramo I, et al. The HTA Core Model: A novel method for producing and reporting health technology assessments. International journal of technology assessment in health care. 2009;25:9-20.
  • Movik E, Ringerike T, Linnestad KK, Hofmann B, Harboe I, Gjertsen MK, et al. Metylnaltrekson ved forstoppelse i kreftbehandling. Rapport nr.23. Nasjonalt kunnskapssenter for helsetjenesten; 2009. Report No.: 978-82-8121-298-5.
Published Sep. 5, 2022 11:50 AM - Last modified Mar. 28, 2024 12:59 PM

Contact

Project leader

Bjørn Hofmann

Participants

Detailed list of participants