Med Tech-related health technology assessments from NIHR in May 2025

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 May 2025, five Med Tech-related assessments were published in the NIHR HTA Journal:

• High-flow nasal cannula therapy versus continuous positive airway pressure for non-invasive respiratory support in pediatric critical care, based on a master protocol comprising two pragmatic, multicenter, parallel-group, non-inferiority randomized controlled trials (step-up and step-down). It was concluded that among critically ill children requiring non-invasive respiratory support, high-flow nasal cannula met the criterion for non-inferiority compared with continuous positive airway pressure for time to liberation from respiratory support. In contrast, the non-inferiority of high-flow nasal cannula could not be demonstrated in critically ill children requiring non-invasive respiratory support following extubation.
• Effectiveness of biomarker-guided duration of antibiotic treatment in children hospitalized with confirmed or suspected bacterial infection based on a randomized controlled trial, a qualitative study, and health economic evaluations. The analysis showed that in children hospitalized with confirmed or suspected bacterial infection, adding a procalcitonin-guided algorithm to usual care is non-inferior in terms of safety, but it does not reduce the duration of intravenous antibiotics and is not cost-effective. A procalcitonin-guided algorithm may offer little added value in the presence of robust antimicrobial stewardship programs to reduce antibiotic use.
• Rapid tests to inform triage and antibiotic prescribing decisions for adults presenting with suspected acute respiratory infection based on a rapid evidence synthesis of clinical effectiveness and cost-utility studies. The findings indicate that the C-reactive protein point-of-care test may reduce the number of patients given an antibiotic prescription, but could increase the re-consultation rate. There was very limited or an absence of evidence for other point-of-care tests.
• Sputum colour charts (Bronkotest by London) to guide antibiotic self-treatment of acute exacerbation of chronic obstructive pulmonary disease based on the Colour-COPD RCT, which was terminated early due to low recruitment. Given that hospital admissions were frequent and sputum color was an unreliable indicator of bacterial infection, the Bronkotest sputum color chart is unlikely to be effective for self-managing COPD. However, further research is warranted due to the limited number of participants recruited.
• Clinical and cost-effectiveness of detailed anomaly ultrasound screening in the first trimester: a mixed-methods study. The research indicated that with standardization and training, first-trimester ultrasound screening for fetal anomalies at 11–14 weeks’ gestation in addition to usual practice is clinically effective, with over 90% detection for eight major conditions and low false-positive rates. Adding first-trimester anomaly screening to the current screening likely represents a cost-effective use of resources and is acceptable to parents.

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