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Assessing health technologies: Working for effective healthcare

Few common procedures and interventions used in the NHS have been evaluated rigorously, nor have the majority of the increasing number of new treatments and interventions. We often do not know which are the most effective or which provide best value for money, and in what circumstances.

It is understandable, therefore, that there is growing interest in the clinical and cost effectiveness of treatments and methods of care. The British NHS Health Technology Assessment Programme was not the first to begin to address these issues, but the UK is now acknowledged as having one of the most influential programmes. Other countries are interested in the UK approach of inviting widespread consultation with purchasers, providers and users of health services.

Health Technology Assessment (assessment of the costs, effectiveness and broader impact of any method used by health professionals to promote health, prevent, diagnose or treat disease, or improve rehabilitation and long term care) is the centrepiece of NHS R & D. Priorities for assessment are identified by the Standing Group on Health Technology, chaired by Professor Sir Miles Irving, Director of the Programme, with a remit to ensure a coordinated approach across the whole of health care. The Standing Group was set up by the NHS Central R&D Committee in 1993. At that time Sir Miles Irving commented: "The success of the programme depends on continual input from individual clinicians, managers and consumers to identify the most important topics for assessment and to translate research findings into practice".

1995 Priorities



Attached are the latest top priorities, agreed by the Standing Group in November 1995. These topics will be taken forward through the NHS Health Technology Assessment (HTA) programme. Invitations for research proposals will be advertised in the general and health press shortly. Further details of particular priority areas will be available at that time.

THE SGHT's 1995 TOP PRIORITY AREAS

CODE R&D AREA
95/01 Beta interferon for multiple sclerosis (evaluation and pharmacoeconomic analysis)
95/02 Stenting and other innovative methods of aortic aneurysm repair
95/03 Antimicrobial prophylaxis in surgery: comparative efficacy and co-effectiveness of different regimens in total hip replacement
95/04 Size of group randomised trials (systematic review)
95/05 Various interventions in the management of varicose veins of differing severity
95/06 Health promotion among the UK's South Asian and Afro-Caribbean communities with respect to cardiovascular disease and stroke
95/07 Targeted health visiting of high-risk families
95/08 Efficacy and cost-effectiveness of rhDNase in cystic fibrosis
95/09 Evaluating the effectiveness of discharge arrangements for the elderly
95/10 Effectiveness and cost-effectiveness of different knee prostheses with particular reference to quality of life
95/11 Treatment of established osteoporosis (extended systematic review)
95/12 Publication and other selection biases in systematic reviews (extended systematic review)
95/13 New antiepileptic drugs and existing therapies
95/14 Cross-cutting issues: uptake rates across screening programmes and ethnic/social groups (systematic review)
95/15 High-dependency units in the provision of surgical services
95/16 Image-guided minimally invasive therapy: insertion of central venous catheters under image guidance versus conventional methods
95/17 Diagnosis of endometrial abnormalities
95/18 Diagnostic tests for glaucoma
95/19 Action research: standards for judging its appropriateness
95/20 Evaluation of the use of standardised measurement of outcome in health technology assessment
95/21 Audit in health technology assessment (systematic review)
95/22 Brief psychological treatments for depression in general practice (systematic review)
95/23 Screening for congenital dislocation of the hip (systematic review)
95/24 Use of interferon alpha in the treatment of chronic hepatitis C


WHAT CAN YOU DO?



The SGHT is starting its review of priorities for 1996. Suggestions for consideration are invited by the SGHT's six panels (Acute Sector, Diagnostic and Imaging, Methodology, Primary and Community Care, Pharmaceutical and Population Screening). Respondents are asked to identify areas of uncertainty for the NHS in terms of the effectiveness or cost-effectiveness of an intervention, rather than general development.

Suggestions should be sent in the following format to Sheila Greener, at the address given, to be received by 4 March 1996. Enquiries about the current programme of research into health technologies may be made to Sam Brown at the same address.
Suggestion for research topic for consideration by the Standing Group on Health Technology Advisory Panels Name:

Position:

Address:

Telephone: Fax: Postcode:
Proposed research topic:

Reason: (50-100 words):

Return this form to:
Sheila Greener, R&D, NHS Executive, Quarry House, Quarry Hill, Leeds LS2 7UE
Telephone: 0113 2546186 Fax: 0113 2546174 The results of this programme will begin to become available in 1996. The important thing then will be to ensure that the information has the widest possible audience - so that health professionals can see the evidence and patients begin to benefit, from the understanding gained.



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