MedTech-related health technology assessments from NIHR in June 2021

The National Institute for Health 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 NICE guidance.

In June 2021, six MedTech-related assessments were published in the NIHR HTA Journal:

• Multimodal imaging interpreted by graders to detect re-activation of diabetic eye disease in previously treated patients: the EMERALD diagnostic accuracy study. For the ophthalmic grader pathway, trained ophthalmic graders reviewed the spectral-domain optical coherence tomography scans to detect diabetic macular oedema and seven-field Early Treatment Diabetic Retinopathy Study or ultra-widefield fundus images to detect proliferative diabetic retinopathy. It was concluded that the ophthalmic grader pathway is safe and saved resources in the surveillance of people with previously treated and stable diabetic macular oedema and proliferative diabetic retinopathy;
• High-sensitivity troponin assays for early rule-out of acute myocardial infarction in people with acute chest pain: a systematic review and economic evaluation. It was concluded that high-sensitivity cardiac troponin testing might be cost-effective compared with standard troponin testing, and strategies involving multiple tests are likely to be more effective than a single test;
• Modelling tool to support decision-making in the NHS Health Check programme: workshops, systematic review and co-production with users. The aim was to develop a validated open-access flexible web-based model that enables local commissioners to quantify the cost-effectiveness and potential for equitable population health gain of the NHS Health Check program. The workHORSE (working Health Outcomes Research Simulation Environment) model was developed and tested. It was concluded that the model could be used to estimate the health, economic, and equity impact comprehensively at the local authority level. It has the potential for further development as a commissioning tool and to stimulate broader discussions on the role of these tools in real-world decision-making;
• Tibial nerve stimulation compared with sham to reduce incontinence in care home residents: ELECTRIC RCT, the multicenter, pragmatic, participant, and outcome assessor-blind, randomized placebo-controlled trial. Transcutaneous posterior tibial nerve stimulation is a non-invasive, safe, low-cost intervention that effectively reduces urinary incontinence in adults. Residents were randomized (1:1) to receive 12 30-minute sessions of transcutaneous posterior tibial nerve stimulation or sham stimulation over six weeks. It was concluded that in the care home context (with a high proportion of residents with poor cognitive capacity and limited independent mobility), transcutaneous posterior tibial nerve stimulation was not effective in reducing urinary incontinence;
• Testing strategies for Lynch syndrome in people with endometrial cancer: systematic reviews and economic evaluation. The aim was to systematically review the evidence on the test accuracy of immunohistochemistry- and microsatellite instability-based strategies to detect Lynch syndrome and the clinical effectiveness and the cost-effectiveness of testing for Lynch syndrome in people who have been diagnosed with endometrial cancer. The economic model suggests that testing women with endometrial cancer for Lynch syndrome is cost-effective, but that should be treated with caution because of uncertain model inputs;
• Modelling of hypothetical SARS-CoV-2 point of care tests for routine testing in residential care homes: rapid cost-effectiveness analysis. SARS-CoV-2 point-of-care tests have considerable potential for benefit for use in residential care facilities, but whether or not this materializes depends on the diagnostic accuracy and costs of forthcoming SARS-CoV-2 point-of-care tests.

See the full details here.

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