Med Tech-related health technology assessments from NIHR in December 2024

The National Institute for Health and Care Research (NIHR) funds valuable independent research for health and social care decision-makers in England. Reports from the Health Technology Assessment (HTA) Programme are published in the NIHR HTA Journal and inform the National Institute for Health and Care Excellence (NICE) guidance. 

In December 2024, four Med Tech-related assessments were published in the NIHR HTA Journal:

• Cervical ripening at home or in the hospital during labor induction, based on the prospective multicenter observational cohort study using routinely collected data (CHOICE cohort), a process evaluation comprising a survey and nested case studies (qCHOICE), and a cost-effectiveness analysis. It was concluded that home cervical ripening using balloon catheters may be as safe for babies as using prostaglandins in hospitals in low- and moderate-risk groups, but there is substantial uncertainty. Home cervical ripening with balloons is likely to be cost-saving. The impacts on workload, service users, and staff experiences were complex.
• A systematic review and economic model concerning hybrid closed-loop systems for managing blood glucose levels in type 1 diabetes. The clinical evidence identified 12 randomized controlled trials of hybrid closed-loop systems compared with continuous subcutaneous insulin infusion + continuous glucose monitoring. The hybrid closed-loop arm showed a statistically significant improvement in glycated hemoglobin percent over time between 3.9 and 10 mmol/l and in hyperglycemic levels. The cost-effectiveness estimate was £179,000 per quality-adjusted life-year.
• Collagenase injection versus limited fasciectomy surgery to treat Dupuytren's contracture in adult patients based on the two-arm, unblinded, randomized, controlled non-inferiority trial with a cost-effectiveness evaluation and nested qualitative and photographic substudies. It was concluded that collagenase delivered in outpatient settings is less effective but more cost-saving than limited fasciectomy among adults with Dupuytren's contracture. Further research is required to establish the longer-term implications of both treatments.
• A systematic review and conceptual economic model concerning point-of-care tests for urinary tract infections to reduce antimicrobial resistance. It was concluded that more research is required to determine whether point-of-care tests for urinary tract infections have the potential to be clinically effective and cost-effective to the NHS. Rapid tests such as the Astrego PA-100 system and Lodestar DX appear promising, but data are very limited.

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