Health Technology Assessment (HTA) & Economic Modelling

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Group Lead(s) Pelham Barton and David Moore

Overview

This cross school theme has a strong track record in evidence synthesis and economic modelling. It combines applied and methodological work to support decision making in healthcare, using techniques to minimise bias and make explicit uncertainties. Applied work has conducted NICE technology assessments, contributed to NIHR funded research and identified emerging public health topics. 

Methodological research includes work on statistical approaches to combining and comparing data. The theme includes the Horizon Scanning Centre which supplies timely information about emerging health technologies. 

Our Research Group

The aim of this research group is to provide the best evidence to address a given question through the comprehensive assimilation of relevant information, using techniques to minimise bias and make explicit uncertainties. These are key principles underpinning evidence based medicine and healthcare decision making.

The group has experience in undertaking research to inform national and international healthcare decision making, aid the development of new healthcare technologies, and improve methodologies to advance evidence synthesis. This includes systematic reviews, statistical methods for combining data, and economic modelling to estimate clinical and cost-effectiveness.

Examples of clinical areas in which the group has worked include, but are not limited to: cardiovascular medicine, chronic obstructive pulmonary disease, medical devices, rare diseases.

The group also contains the information support unit for the School, which has a pivotal position in devising, undertaking and educating on advanced strategies to identify published, grey and unpublished research literature.

Current Projects

This research group encompasses a wide variety of projects a variety of which are presented below:

Horizon Scanning

The National Institute for Health Research (NIHR) Horizon Scanning Centre is a research programme funded to provide advanced notice to the NIHR, Department of Health and NHS policy makers in England of key emerging health interventions that may require further research or consideration of their clinical and cost impact on patients and health services.

Supporting the National Institute for Health and Care Excellence (NICE)

The research group continues its long standing engagement with NICE. This currently includes:

In partnership with Brunel University the School is an External Assessment Centre for the NICE Medical Technologies Evaluation Programme, providing a variety of research outputs to support national decision making on medical devices.

Professor Andrew Stevens is Chair of a NICE technology appraisals committee and is also chairing the NICE appraisals methods working party.

National Institute for Health Research (NIHR) funded projects

The research group has a successful track record of gaining funding for both researcher led and specifically commissioned projects from the NIHR. Current projects include:

National Institute for Health Research – HTA (2012-2014) – Ref: 11/27/01

  • The cost-effectiveness of community based non-invasive ventilation (NIV) in patients with stable end stage COPD with hypercapnic respiratory failure. A systematic review and economic evaluation.
  • £212,104

National Institute for Health Research – HTA (2012-2014) – Ref: 10/94/02 

  • The development and evaluation of a prognostic model and clinical decision rule to help decide on cessation of anticoagulant therapy in patients with idiopathic venous thromboembolism.
  • £226,482

National Institute for Health Research – HTA (2011-2013) – Ref: 10/36/02 

  • Diagnostic and prognostic utility of tests for the detection of aspirin resistance in patients with established cardiovascular/cerebrovascular disease
  • £ 200,529

National Institute for Health Research – HTA (2012-2013) – Ref: 10/44/01

  • Supported self-management for patients with moderate to severe chronic obstructive pulmonary disease (COPD): an evidence synthesis and economic analysis
  • £ 241,472

National Institute for Health Research – HTA (2013-2020) – Ref: 12/35/45

  • BASIL2 study: Multi-centre randomised controlled trail to compare the clinical and cost-effectiveness of ‘vein bypass first’ with an ‘best endovascular first’ vascularisation strategy for sever limb ischaemia due to infrageniculate arterial disease (Bypass vs Angioplasty in severe Ischaemia of the leg)
  • £ 2,246,400

National Institute for Health Research – HTA (2013-2025) – Ref: 11/36/16

  • The Low Risk DCIS (ductal carcinoma in situ) Trial
  • £ 3,378,501

National Institute for Health Research – HTA (2013-2021) – Ref: 11/92/15

  • Outcome after Selective Early Closure of Ductus Arteriosus in Extremely Preterm Babies (Baby-OSCAR trial)
  • £ 2,412,174

National Institute for Health Research – HTA (2012-2016) – Ref: 10/57/32

  • A randomised controlled trial of intra-operative cell salvage during caesarean section in women at risk of haemorrhage.
  • £ 1,770,794

National Institute for Health Research – HTA (2011-2015) – Ref: 09/55/38

  • Antiepileptic drug (AED) management in Pregnancy: An evaluation of effectiveness, cost effectiveness and acceptability of dose adjustment strategies
  • £ 1,779,269

National Institute for Health Research – HTA (2011-2015) – Ref: 09/22/50

  • Can magnetic resonance imaging scan replace, or triage the use of laparoscopy in establishing diagnosis among women presenting in secondary care with chronic pelvic pain?
  • £ 1,255,998

National Institute for Health Research – HTA (2011-2015) – Ref: 09/22/122

  • Accuracy of Bladder Ultrasound (BUS) in the diagnosis of Detrusor Overactivity (DO): a study to evaluate if ultrasound can reduce the need for urodynamics
  • £ 1,161,076.20

Medical Research Council (2013-2016) – Ref: MR/J009792/1

  • The AIMS (Antibiotics In Miscarriage Surgery) Trial
  • £ 1,495,567

NIHR Programme Grants for Applied Research (2010-2015)

  • Improving the prevention and treatment of Venous Thromboembolism in Hospital and the Community
  • £ 1,826,823

 NIHR Programme Grants for Applied Research (2012-2016)

  • Optimising the diagnosis and management of hypertension in primary care through self monitoring of blood pressure
  • £2,000,000

The Health Foundation

The group is a preferred supplier for evidence synthesis reports for the Health Foundation

CLAHRC

The group has made a substantial contribution to the Birmingham and Black Country Collaborations for Leadership in Applied Health Research and Care project, running from 2009-2013. This is funded by the National Institute for Health Research and matched NHS funds. The project includes the following main themes

  •  Health service redesign
  •  Evaluation of paediatric outreach services
  •  Early detection and interventions in psychosis
  •  Housing and health
  •  Redesigned maternity support services
  •  Investment in prevention of cardiovascular disease in primary care
  •  Optimisation of the management of stroke and transient ischaemic attack
  •  Effective community care for diabetes
  •  Improving patient safety

Recent Publications

Hemming K, Pinkney T, Futaba K, Pennant M, Morton DG, Lilford RJ. A Systematic Review of Systematic Reviews and Panoramic Meta-Analysis: Staples versus Sutures for Surgical Procedures. PLoS One. 2013 Oct 7;8(10):e75132. doi: 10.1371/journal.pone.0075132. PMID:24116028

Hemming K, Bowater RJ, Lilford RJ. Pooling systematic reviews of systematic reviews: a Bayesian panoramic meta-analysis. Stat Med. 2012 Feb 10;31(3):201-16. doi: 10.1002/sim.4372. Epub 2011 Oct 3.

Lovibond K, Jowett S, Barton P, Caulfield M, Heneghan C, Hobbs FDR, Hodgkinson J, Mant J, Martin U, Williams B, Wonderling D, McManus RJ. Modelling the cost-effectiveness of different options for the diagnosis of high blood pressure in primary care. Lancet. 2011. 378; 1219-1230.

Honest H, Forbes C, Duree K, Norman G, Duffy S, Tsourapas A, Roberts T, Barton P, Jowett S, Hyde C, Khan K. Screening to prevent pre-term birth - systematic reviews of accuracy and effectiveness literature with economic modelling. Health Technology Assessment 2009; 13(43).

Dretzke J, Riley R, Lordkipanidzé M, Jowett S, O’Donnell J, Ensor J, Moloney E, Price M, Raichand S, Hodgkinson J, Bayliss S, Fitzmaurice D, Moore D. The prognostic and diagnostic utility of tests of platelet function for the detection of “aspirin resistance” in patients with established cardiovascular or cerebrovascular disease: A systematic review and economic evaluation. Health Technology Assessment 2014 In press

Orlando R, Pennant M, Rooney S, Khogali S, Bayliss S, Hassan A, Moore D, Barton P. Cost effectiveness of Transcatheter Aortic Valve Implantation (TAVI) for Aortic Stenosis in patients who are high risk or contraindicated for surgery. Health Technology Assessment 2013;17(33) doi: 10.3310/hta17330

Lane D, Raichand S, Moore D, Connock M, Fry-Smith A, Fitzmaurice D. Combined anticoagulation and antiplatelet therapy for high-risk patients with atrial fibrillation: a systematic review. Health Technology Assessment 2013;17(30) doi: 10.3310/hta17300

Malottki K, Barton P, Tsourapas A, Uthman A, Liu Z, Routh R, Connock R, Jobanputra P, Moore D, Fry-Smith A, Chen Y. Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor: a systematic review and economic evaluation. Health Technology Assessment: 2011;15(14)

Connock M; Hyde C, Moore D. Cautions regarding the fitting and interpretation of survival curves: examples from NICE Single Technology Appraisals of drugs for cancer. PharmacoEconomics: 2011 29(10):827-37. doi: 10.2165/11585940-000000000-00000.

Chen Y-F, Jowett S, Barton P, Malottki K, Hyde C, Gibbs JSR, Pepke-Zaba J, Fry-Smith A, Roberts J, Moore D. Clinical and cost-effectiveness of epoprostenol, iloprost, bosentan, sitaxentan and sildenafil for pulmonary arterial hypertension within their licensed indications: a systematic review and economic evaluation. Health Technology Assessment 2009;13(49)Clinical and cost-effectiveness of epoprostenol, iloprost, bosentan, sitaxentan and sildenafil for pulmonary arterial hypertension within their licensed indications: a systematic review and economic evaluation. Health Technology Assessment 2009;13(49)

Moore D, Aveyard P, Connock M, Wang D, Fry-Smith A, Barton P. Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis. BMJ 2009;338:b1024

Aveyard P, Wang D, Connock M, Fry-Smith A, Barton P, Moore D. Assessing the outcomes of prolonged cessation-induction and aid-to-cessation trials: Floating prolonged abstinence. Nicotine & Tobacco Research 2009; doi: 10.1093/ntr/ntp035

Wang D, Connock M, Barton P, Fry-Smith A, Aveyard P, Moore D. ‘Cut down to quit’ with nicotine replacement therapies in smoking cessation: a systematic review of effectiveness and economic analysis. Health Technology Assessment 2008;12(2)

Aubin HJ, Farley A, Lycett D, Lahmek P, Aveyard P (2012) Weight gain after smoking cessation: meta-analysis BMJ 2012;345:e4439

Farley AC, Hajek P, LycettD, Aveyard P (2012) Interventions for preventing weight gain after smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 1. Art. No.: CD006219. DOI: 10.1002/14651858.CD006219.pub3.

Parsons A, Daley A, Begh R, Aveyard P (2010) Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: a systematic review of observational studies with meta-analysis BMJ 340:b5569 doi:10.1136/bmj.b5569

Staff

Pelham Barton
David Moore
Lazaros Andronis
Jon Deeks
Alan Girling
Karla Hemming
Jonathan Ives
Sue Jowett
Richard Lilford
Lesley Roberts
Andrew Stevens
Andrew Sutton

Postdocs
Chen, Dretzke, Bayliss, Jordan, Jolly, Hodgkinson, Fitzmaurice, Monahan, Goranitis, Sanghera, Jackson

Students
Ensor, Olakareem