MedTech-related health technology assessments from NIHR in November 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 November 2021, three MedTech-related assessments were published in the NIHR HTA Journal:

• Unicompartmental compared with a total knee replacement (TKR) for patients with multimorbidities, an assessment based on a cohort study using propensity score stratification and inverse probability weighting. There were two stages of the study. At the first stage, the Total or Partial Knee Arthroplasty Trial (TOPKAT) was replicated using propensity score and instrumental variable methods. The aim of the second stage was to compare the risk benefits and cost-effectiveness of unicompartmental knee replacement with TKR surgery in patients with severe systemic morbidity who would have been ineligible for TOPKAT using the validated methods from the first stage. It was concluded that unicompartmental knee replacement was safer and more cost-effective than TKR for patients with severe comorbidity and should be considered the first option for suitable patients;
• Surgery versus conservative management of stable thoracolumbar fracture, based on feasibility randomized controlled trial (PRESTO), qualitative study, and national survey. Surgical fixation (open spinal surgery with or without spinal fusion or minimally invasive stabilization surgery) was compared with initial conservative management of stable thoracolumbar fractures without spinal cord injury. This study concluded that a full trial is unlikely to be feasible, mainly because of the small number of patients meeting the eligibility criteria;
• Feasibility and design of a trial regarding the optimal mode of delivery for preterm birth, based on the CASSAVA multiple methods study. This study confirmed evidence was lacking about the optimal mode of delivery for women in preterm labor and found agreement that a trial should be conducted. The CASSAVA project could inform the design of the future randomized trial and indicate how such a trial could be carried out.

See the full details here.

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