Publisher details
The National Coordinating Centre for Health Technology Assessment (NCCHTA)
located at :
Southampton
Address :
Mailpoint 728 Boldrewood
University of Southampton SO16 7PX Southampton England
Related collections :
|
Available items(s) from this publisher (3)
Add the result to your basket Make a suggestion Refine your search Apply to external sources
‘Early warning systems’ for identifying new healthcare technologies / G. Robert / Southampton [England] : The National Coordinating Centre for Health Technology Assessment (NCCHTA) (1999)
‘Early warning systems’ for identifying new healthcare technologies [printed text] / G. Robert, Author ; A. Stevens, Author ; J. Gabbay, Author . - Southampton [England] : The National Coordinating Centre for Health Technology Assessment (NCCHTA), 1999 . - VI, 108 p. : Ill. ; A4. - (Health Technology Assessment; 13) .
ISSN : 1366-5278 -13 : € 0,00
Languages : English (eng)
Descriptors: Classification
W 82 Biomedical technology (General)
Indexation
Female ; Forecasting ; Great Britain ; Guideline [Publication Type] ; Information Services ; Male ; Technology Assessment, BiomedicalContents note: 1 Aims 1 -- 2 Background and rationale for the study 3 -- The need for an early warning system 3 -- State of the art of early warning 7 -- Some problems in developing methods in EWSs 9 -- Timeliness of this report 10 -- 3 Methods 11 -- Systematic review of the literature on health futures and forecasting exercises 11 -- Telephone enquiry of coordinators of EWSs 12 -- A Delphi study to assess potential sources for identifying new healthcare technologies 12 -- Retrospective case studies of exemplar technologies 12 -- 4 Literature review and telephone enquiry 15 -- Results of literature review 15 -- Results of telephone enquiry of sources and methods used in HTA early -- warning systems 23 -- 5 Delphi study: information sources for identifying new healthcare technologies .. 29 -- Potential information sources 29 -- International Delphi study 29 -- 6 Case studies 39 -- Introduction 39 -- CT scanners (head) 39 -- Biosensor for home glucose monitoring (Medisense ExacTech pen) 41 -- Left ventricular assist devices (LVADs) 43 -- Telemedicine 46 -- Paediatric intensive care units (PICUs) 48 -- IFN-â for multiple sclerosis 50 -- Dornase alfa for cystic fibrosis 51 -- Donepezil 52 -- Laparoscopic cholecystectomy 54 -- 7 Synthesis of results 57 -- Information sources 57 -- Establishment and operation of an EWS 62 -- 8 Conclusions and research recommendations 67 -- Timeliness of this report 67 -- Our methods 67 -- Information sources 67 -- Operating an EWS 67 -- Research recommendations 68 -- Acknowledgements 69 -- References 71 -- Appendix 1 Key concepts 79 -- Appendix 2 Databases 87 -- Appendix 3 Search strategies: case studies 89 -- Appendix 4 Questionnaire to coordinators of existing or planned HTA EWSs 91 -- Appendix 5 Contemporary sources for early warning in the UK 93 -- Appendix 6 New healthcare technologies in the UK 97 -- Appendix 7 Catalogue of World Wide Web sites with information on new healthcare technologies 99 -- Health Technology Assessment reports published to date 101 -- Health Technology Assessment panel membership 105 Link for e-copy: http://www.hta.ac.uk/fullmono/mon313.pdf Format of e-copy: pdf [Open Access] (650 KB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2665 Prioritisation of health technology assessment / J. Townsend / Southampton [England] : The National Coordinating Centre for Health Technology Assessment (NCCHTA) (2003)
Prioritisation of health technology assessment : The Paths model: methods and case studies [printed text] / J. Townsend, Author ; M. Buxton, Author ; G. Harper, Author . - Southampton [England] : The National Coordinating Centre for Health Technology Assessment (NCCHTA), 2003 . - X, 94 p. : Ill. ; A5.
ISSN : 1366-5278 : € 0,00
Languages : English (eng)
Descriptors: Classification
W 82 Biomedical technology (General)
Indexation
Decision Support Techniques ; Great Britain ; Health Priorities ; Humans ; Research ; Research Support ; State Medicine ; Technology Assessment, BiomedicalAbstract: OBJECTIVES:
To develop a method of economic evaluation and triage for research prioritisation, before the funding decision.
DATA SOURCES:
Existing models were researched focusing on MEDLINE, HealthSTAR, IBSS and HEED.
REVIEW METHODS:
Papers of primary relevance that included a proposed model were reviewed in detail, and their models appraised using criteria adapted from the EUR-ASSESS project and the authors' previous experience. From this the PATHS model was developed. It assumes three or more possible alternative outcomes or scenarios in terms of research results: 'favourable' to the technology being assessed, 'unfavourable' or 'inconclusive'. An associated flow of benefits or disbenefits, costs or savings is identified for each potential research outcome depending on the likely implementation of the results as judged by experts. These benefits and costs are weighted and discounted in the model to give an expected incremental cost-effectiveness ratio (EICER). EICERS could be estimated for any number of research areas or proposals to inform funding prioritisation. The model was tested and evaluated on three case studies identified in liaison with the NHS R&D HTA programme and the UK Medical Research Council. These case studies were funded research projects, where full evaluation was underway and where results would be reported during the PATHS project. The studies were selected to include surgery or other invasive procedures, and non-invasive health services projects (a fourth case study did not complete during the course of the study). The three case studies included randomised controlled trials of early surgery or observation for small abdominal aortic aneurysms, infusion protocols for adult pre-hospital care, and postnatal midwifery support.
RESULTS:
Each of the three assessments indicated net clinical benefit or no clinical loss of benefit, in addition to health service cost savings in excess of the cost of the trial. For two case studies, the value of the proposed trial, as evaluated by the model in the prediction, was consistent with the ex post evaluation, thus providing positive tests of the value of the model. In the third case meaningful ex post analysis was not possible as very poor compliance with the trial protocol (indicated in the ex ante evaluation) seriously undermined its conclusions. During the study, at the request of the UK HTA programme, the model was also applied to a funding request for a large randomised trial of beta-interferon for multiple sclerosis treatment.
CONCLUSION:
The PATHS model has a useful part to play in the research prioritisation process. Its strengths lie in its emphasis on the impact of research results on policy and practice (the keystone for NHS research) and net effects on health benefits and costs. It assesses the cost-effectiveness of the research and may identify ways to enhance the research design, endpoints relevant to implementation, analytical methods and dissemination. Further research is recommended to investigate the scope for synthesising the strengths of the PATHS model with other approaches including value of information; to compare ex ante and immediate ex post assessments of implementation with long term follow-up of actual implementation; and to assess the robustness of such approaches to the choice and number of experts used.Contents note: Glossary and list of abbreviations vii -- Executive summary ix -- 1 Background: health technology assessment -- prioritisation 1 -- The PATHS study 1 -- 2 Review of the literature 3 -- Introduction 3 -- Methods 3 -- Commentary 5 -- Conclusions 12 -- Annex to Chapter 2: an application of the -- Townsend–Buxton model to a proposal for -- the evaluation of long-term use of hormone -- replacement therapy 12 -- 3 The synthesised model 17 -- Development 17 -- Conclusions 19 -- 4 Case study 1: the costs and benefits of -- postnatal midwifery support 21 -- Project summary 21 -- Timings of the trial 21 -- Data from experts 21 -- Model parameters, results and -- discussion 23 -- Conclusions 25 -- Actual results of the trial 25 -- Testing of the model 26 -- Modelling ex post predicted outcomes 27 -- 5 Case study 2: an RCT of infusion protocols -- in adult pre-hospital care 29 -- Introduction 29 -- Project summary 29 -- Timings of the trial 29 -- Data from experts 29 -- Model parameters, results and discussion . 30 -- Conclusions 34 -- Actual results of the trial 34 -- Testing the model 35 -- 6 Case study 3: MRC small aneurysm trial of -- early surgery or observation for small -- abdominal aortic aneurysms 39 -- Introduction 39 -- Project summary 39 -- Timing of the trial 40 -- Data from experts 40 -- Model parameters, results and discussion . 41 -- Conclusions 42 -- Actual results of the trial 43 -- Testing of the model 43 -- Modelling ex post predicted outcomes 44 -- 7 An application of the PATHS model: -- an assessment of the likely payback from a -- proposed UK trial of -interferon for the -- treatment of multiple sclerosis 45 -- Background 45 -- Evidence available at the time 45 -- ‘Payback’ analysis and recommendation 45 -- Subsequent research and policy decisions . 48 -- Conclusions 49 -- 8 Conclusions 51 -- Recommendations to HTA funders 53 -- Recommendations for further research 54 -- Acknowledgements 55 -- References 57 -- Appendix 1 Details of the search strategy . 61 -- Appendix 2 Trial of the costs and benefits -- of postnatal midwifery support 63 -- Appendix 3 Trial of the costs and benefits -- of postnatal midwifery support: questions -- to experts (2) 69 -- Appendix 4 An RCT of infusion protocols -- in adult pre-hospital care 71 -- Appendix 5 An RCT of infusion protocols -- in adult pre-hospital care: questions to -- experts (2) 75 -- Appendix 6 The UK small aneurysm trial 77 -- Appendix 7 The UK small aneurysm trial: -- questions to experts (2) 81 -- Health Technology Assessment reports -- published to date 83 -- Health Technology Assessment -- Programme 91 Link for e-copy: http://www.hta.ac.uk/fullmono/mon720.pdf Format of e-copy: PDF [Open Access] (477 KB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2601 The inclusion of reports of randomised trials published in languages other than English in systematic reviews / David Moher / Southampton [England] : The National Coordinating Centre for Health Technology Assessment (NCCHTA) (2003)
The inclusion of reports of randomised trials published in languages other than English in systematic reviews [printed text] / David Moher, Author ; B. Pham, Author ; M.L. Lawson, Author ; T.P. Klassen, Author . - Southampton [England] : The National Coordinating Centre for Health Technology Assessment (NCCHTA), 2003 . - XI, 90 p. : ill. ; A4. - (Health Technology Assessment; Vol.7 N°41) .
ISSN : 1366-5278 : € 0,00
Languages : English (eng)
Descriptors: Classification
W 20.5 Medical research (General)
Indexation
Complementary Therapies ; Great Britain ; Humans ; Publishing ; Randomized Controlled TrialsAbstract: OBJECTIVE:
To assemble a large dataset of language restricted and language inclusive systematic reviews, including both conventional medicinal (CM) and complementary and alternative medicine (CAM) interventions. To then assess the quality of these reports by considering and comparing different types of systematic reviews and their associated RCTs; CM and CAM interventions; the effect of language restrictions compared with language inclusions, and whether these results are influenced by other issues, including statistical heterogeneity and publication bias, in the systematic review process.
DATA SOURCES:
MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and the Centralised Information Service for Complementary Medicine.
REVIEW METHODS:
Three types of systematic reviews were included: language restricted; language inclusive/English language (EL) reviews that searched RCTs in languages other than English (LOE) but did not find any and, hence, could not include any, in the quantitative data synthesis; and systematic reviews that searched for RCTs in LOE and included them in the quantitative data synthesis. Fisher's exact test was applied to compare the three different types of systematic reviews with respect to their reporting characteristics and the systematic review quality assessment tool. The odds ratio of LOE trials versus EL trials was computed for each review and this information was pooled across the reviews to examine the influence that language of publication and type of intervention (CM, CAM) have on the estimates of intervention effect. Several sensitivity analyses were performed.
RESULTS:
The LOE RCTs were predominantly in French and German. Language inclusive/LOE systematic reviews were of the highest quality compared with the other types of reviews. The CAM reviews were of higher quality compared with the CM reviews. There were only minor differences in the quality of reports of EL RCTs compared with the eight other languages considered. However, there are inconsistent differences in the quality of LOE reports depending on the intervention type. The results, and those reported previously, suggest that excluding reports of RCTs in LOE from the analytical part of a systematic review is reasonable. Because the present research and previous efforts have not included every type of CM RCT and the resulting possibility of the uncertainty as to when bias will be present by excluding LOE, it is always prudent to perform a comprehensive search for all evidence. This result only applies to reviews investigating the benefits of CM interventions. This does not imply that systematic reviewers should neglect reports in LOE. We recommend that systematic reviewers search for reports regardless of the language. There may be merit in including them in some aspects of the review process although this decision is likely to depend on several factors, including fiscal and other resources being available. Language restrictions significantly shift the estimates of an intervention's effectiveness when the intervention is CAM. Here, excluding trials reported in LOE, compared with their inclusion, resulted in a reduced intervention effect. The present results do not appear to be influenced by statistical heterogeneity and publication bias.
CONCLUSIONS:
With the exception of CAM systematic reviews, the quality of recently published systematic reviews is less than optimal. Language inclusive/LOE systematic reviews appear to be a marker for a better quality systematic review. Language restrictions do not appear to bias the estimates of a conventional intervention's effectiveness. However, there is substantial bias in the results of a CAM systematic review if LOE reports are excluded from it.Contents note: List of abbreviations vii -- Executive summary ix -- 1 Introduction: assessing the need to evaluate -- systematic reviews with language publication -- restrictions 1 -- Assessing the quality of reporting of -- systematic reviews 1 -- Controlling systematic error 2 -- Summary 4 -- Aim and objectives 4 -- 2 The inclusion of non-English language -- trials in systematic reviews – -- methodology 7 -- Systematic review eligibility criteria 7 -- Literature search strategy 7 -- Quality assessment strategy 10 -- Data extraction strategy 11 -- Data analysis 11 -- 3 Results 15 -- General characteristics of the included -- systematic reviews 15 -- Quality of reporting of systematic -- reviews 19 -- Quality of reporting of RCTs 27 -- ‘Language of publication’ bias and -- location bias are related to the type of -- intervention (CM or CAM) 30 -- The impact of language restriction on -- between-study heterogeneity and -- publication bias 38 -- 4 Discussion 49 -- Quality of reporting of systematic -- reviews 50 -- Quality of reporting of RCTs 51 -- ‘Language of publication’ bias and location -- bias are related to the type of intervention -- (CM or CAM) 52 -- Conclusions 56 -- Acknowledgements 61 -- References 63 -- Appendix 1 Data abstraction form 67 -- Appendix 2 Jadad and allocation -- concealment data collection form 71 -- Appendix 3 Listing and citations of -- systematic reviews included in -- research 73 -- Health Technology Assessment reports -- published to date 79 -- Health Technology Assessment -- Programme 87
Link for e-copy: http://www.hta.ac.uk/fullmono/mon741.pdf Format of e-copy: PDF [Open Access] (528 KB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2600