MedTech-related assessments from the Scottish Health Technology Group in February 2023


Mar 2023

In February 2023, the Scottish Health Technology Group, SHTG, released three MedTech-related technology assessments.

SHTG released considerations regarding selective internal radiation therapies (SIRT) for treating primary hepatocellular carcinoma (HCC) in Scotland. It was based on Technology Appraisal (TA688) from NICE, which included QuiremSpheres™, SIR-Spheres®, and TheraSphere™. SHTG concluded that adaptation of NICE TA688 in Scotland would not be possible due to specified reasons. However, clinicians in Scotland can use SIRT: SIR-Spheres® and TheraSphere™ are available within NHSScotland to treat selected patients with HCC, based on the NICE TA688 criteria.

SHTG evaluated the Feeling Good app, a set of audio files delivered to provide support in improving mood and well-being. This evaluation is part of an SHTG pilot in assessing the value of digital technologies. It was concluded that the cost-effectiveness of Feeling Good remains highly uncertain due to the limiting model assumptions in the one-linked economic evaluation that was identified. Further research into the effectiveness of the Feeling Good app is required to demonstrate the impact on clinical outcomes and patient benefits.

The evaluation of Store-and-forward teledermatology (SAF TD) to triage referrals from primary to secondary care dermatology was requested by the Accelerated National Innovation Adoption (ANIA) collaborative and the Dermatology AI Consortium.

SHTG concluded that teledermatology for secondary care triage of referrals:

  • Reduces the number of face-to-face secondary care appointments required. Where dermatology specialist triage provided advice or reassurance, published studies reported that in the region of 50% of referrals could be managed in primary care;
  • Facilitates more accurate allocation of referral priority;
  • Reduces waiting time for specialist dermatology input;
  • Reduces time to commencing treatment; and
  • Offers similar clinical outcomes, quality of life, and patient satisfaction as a conventional referral.

The main safety concern is that clinically significant incidental lesions may be missed as a result of fewer in-person examinations. Actions to mitigate this risk will be required. A de novo cost consequence analysis for NHSScotland estimated that increased uptake of a SAF TD referral triage system would likely lead to a reduction in healthcare resource use, decreased travel requirements, and costs for patients, leading to decreased carbon emissions.

ANIA and the Dermatology AI Consortium will use SHTG assessment to inform a value case and subsequent decision-making on the secondary care use of TD triage of referrals from primary care. If approved, this approach will inform a national digital-enabled dermatology pathway across Scotland.

See more details here.

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