Med Tech-related health technology assessments from NIHR in September 2024

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 NICE guidance. 

In September 2024, three MedTech-related assessments were published in the NIHR HTA Journal.

A systematic review and cost-effectiveness analysis of hyperthermic intraoperative peritoneal chemotherapy and cytoreductive surgery for people with peritoneal metastases made the following recommendations:

• In people with peritoneal metastases from colorectal cancer with limited peritoneal metastases and who are likely to withstand major surgery, hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy should not be used in routine clinical practice (strong recommendation);
• There is considerable uncertainty as to whether hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy or cytoreductive surgery + systemic chemotherapy should be offered to patients with gastric cancer and peritoneal metastases (no recommendation);
• Hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy should be offered routinely to women with stage III or greater epithelial ovarian cancer and metastases confined to the abdomen requiring and likely to withstand interval cytoreductive surgery after chemotherapy (strong recommendation).

An assessment of resuscitative endovascular balloon occlusion of the aorta in trauma patients with life-threatening torso hemorrhage was based on the pragmatic, multicentre, Bayesian, group-sequential, registry-enabled, open-label, parallel-group randomized controlled trial (UK-REBOA). This was the first randomized trial of the addition of resuscitative endovascular balloon occlusion of the aorta to standard care in the management of exsanguinating hemorrhage. All the analyses suggested that a strategy of standard care plus resuscitative endovascular balloon occlusion of the aorta is potentially harmful. The role (if any) of resuscitative endovascular balloon occlusion of the aorta in the pre-hospital setting remains unclear. Further research to clarify its potential (or not) may be required.

The clinical and cost-effectiveness of clopidogrel resistance genotype testing after ischaemic stroke or transient ischaemic attack was assessed based on a systematic review and economic model. It was concluded that CYP2C19 testing, followed by tailored treatment, is likely to be effective and cost-effective in both populations.

See the full details here.

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