Med Tech-related technology assessments from NICE in the second half of June 2017

The following technology assessments were released by National Institute for Health and Care Excellence in second two weeks of June 2017:

• Medtech Innovation Briefings for RIDASCREEN (tests for monitoring infliximab in inflammatory bowel disease).

• Four Interventional Procedure Guidance for treatment of vaginal vault prolapse and uterine prolapse, including Infracoccygeal sacropexy using mesh to repair vaginal vault prolapse (IPG581), Infracoccygeal sacropexy using mesh to repair uterine prolapse (IPG582), Sacrocolpopexy using mesh to repair vaginal vault prolapse (IPG583), Uterine suspension using mesh (including sacrohysteropexy) to repair uterine prolapse (IPG584).

Several different types of meshes or grafts have been used for this procedures, different types of mesh may have different safety profiles. Current evidence on the safety of these procedures shows there are serious but well-recognised safety concerns. The evidence on efficacy is adequate in quantity and quality. Therefore, these procedures can be used provided that standard arrangements are in place for clinical governance, consent and audit.

• Diagnostic Guidance for Multiple frequency bioimpedance devices to guide fluid management in people with chronic kidney disease having dialysis (DG29).

Multiple frequency bioimpedance devices send small, painless electrical signals through the body by way of electrodes. The electrodes also measure the opposition to the flow of the electric current from body tissues (bioimpedance) to calculate parameters relating to hydration, such as volumes of extracellular, intracellular and total body water. Each of the devices included in this assessment are portable and could be used by a healthcare professional in either a clinic or the patient's home. The assessment compared 3 intervention devices with 1 comparator. The comparator is clinical assessment to determine fluid status and set, or adjust, target weights for people with chronic kidney disease who are on dialysis. The following devices have been evaluated:

• BCM – Body Composition Monitor (Fresenius Medical Care)
• InBody S10 (InBody)
• MultiScan 5000 (Bodystat)

There is currently not enough evidence to recommend the routine adoption of the BCM – Body Composition Monitor to guide fluid management in people with chronic kidney disease having dialysis in the NHS. Further research is recommended to show the effect of using the BCM – Body Composition Monitor on clinical outcomes. Centres that are currently using the BCM – Body Composition Monitor to guide fluid management are encouraged to take part in research and data collection. Centres that do not currently use the BCM – Body Composition Monitor to guide fluid management should only do so as part of a research study, such as the BISTRO trial.

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