Point of care tests for sexually transmitted infections (STIs)

A number of clinical/disease areas have been prioritised by the Technology Strategy Board (TSB) and Department of Health (DH) for the DIIA Innovation Platform. To support commissioning of technology development for detection of sexually transmitted infections (STIs) in humans, a scoping review has been undertaken to help identify the specific requirements for new diagnostic test development and likely economic payback for point of care (POC) tests for STIs in the UK

Point of care tests for tuberculosis (TB) : economic analysis report

A number of clinical/disease areas have been prioritised by the TSB and DH for the DIIA Innovation Platform. To support commissioning of technology developments in the area of tuberculosis detection in humans, a scoping review has been undertaken to help identify the specific requirements for new diagnostic test development and likely payback in the area of point of care (POC) tuberculosis tests in the UK. There has been a gradual rise in the number of tuberculosis (TB) cases observed in the UK over the last 20 years, with a 4.2% rise in 2009 giving an overall 9,040 TB cases diagnosed or 15 cases per 100,000 population [1]. The aims of this economic review are to identify available information on the following for tuberculosis (TB): - economic burden of disease in the UK; - current NHS cost of TB detection and cost of treating identified TB cases; - evidence on cost-effectiveness of current tests for detection of active and latent TB infection; and - estimates of the economic benefits which new POC tests might provide in the UK

Point of care tests for hospital-acquired infections (HAIs) : economic analysis report

A number of clinical/disease areas have been prioritised by the Technology Strategy Board (TSB) and Department of Health (DH) for the DIIA Innovation Platform. To support commissioning of technology development for detection of hospital acquired infections (HAIs) in humans, a scoping review has been undertaken to help identify the specific requirements for new diagnostic test development and likely economic payback for point of care (POC) tests for HAIs in the UK. This report presents economic analysis findings for the following HAIs: - Methicillin-resistant Staphylococcus aureus (MRSA) - Clostridium difficile (C. difficile) - Extended-spectrum beta-lactamase (ESBL) infections

Providing nursing support within residential care homes

This study examines a joint NHS-Local Authority initiative providing a dedicated nursing and physiotherapy team to three residential care homes in Bath and North East Somerset. The initiative aims to meet the nursing needs of residents where they live and to train care home staff in basic nursing. * Hospital admissions and nursing home transfers were prevented. Care home staff and managers preferred residents to be able to stay in their home when they were ill, as did residents themselves. * Enhancing health-orientated education and training of care home staff was challenging at first but relationships improved, and the confidence and professionalism of care staff grew. * Residents’ nursing needs cannot simply be equated with their level of dependency. For example, a resident with dementia can be functionally independent yet have major, often un-communicated health needs. * The early detection of illness and resulting opportunity for early intervention was a major part of the team’s work. Residents were likely to benefit from improved quality of life. * Overall, estimates of costs and savings ranged from a 'worst case' scenario of £2.70 extra to a more likely scenario of £36.90 saved per resident per week. Savings were mainly in reduced use of NHS services, while the Primary Care Trust and Adult Social Services both funded the intervention, highlighting the need for partnership working to sustain funding. * The researchers conclude that any increase in cost should be measured against the benefits of promoting long-term quality of life, quality of care and providing a firm foundation for future workforce development

Emerging prenatal genetic tests : developing a health technology assessment (HTA) framework for informed decision-making

Delphi Process In preparation for the first Delphi exercise, a list of questions was produced from the academic literature, webbased sources and interviews with experts. These questions were structured into broad dimensions and a draft questionnaire piloted. A final list of 73 questions formed the basis of the first Delphi survey. Participants were asked to grade the perceived importance of each question for inclusion in HTA reports on new prenatal genetic tests (4 = Essential; 3 = Desirable, but not essential; 2 = Useful but should not be required; 1 = Of little/ no importance; 0 = I have no basis for judgement). Secondly, they were asked to indicate whether a question should be addressed during test development or whether the question could be addressed later once the technology is ready for implementation. Finally, Panel members were encouraged to identify any other questions which appeared to be missing from the initial list. For copy of questionnaire, see Annex 1: Delphi Round 1 Questionnaire. Respondents were also asked to provide personal details to give some indication of their HTA experience and specialist expertise. Analysis of responses demonstrated that SAFE Delphi panel members represent a highly experienced, multidisciplinary international group of experts with the knowledge required to define which key questions should be addressed in HTA reports on new prenatal genetic tests. Delphi Responses Responses were received from 77/90 (86%) of Panel members. These were analysed with a cut-off of 75% (±3%) applied as an indicator of Panel consensus for all questions. Thus, any question which three out of four respondents rated as essential or desirable was retained, whilst those not achieving this level of agreement were provisionally excluded. In addition, mean scores were also calculated (excluding 0 = I have no basis for judgement) for each question. A mean score >3.25 ± 0.05 was taken as an indication that the Panel had identified a particular question as being of the highest priority to address in HTA