Methods

Identification

 

 The NIHR HSRIC identification process uses two principal approaches:

 

  • focussed routine scanning – an ongoing ‘horizontal scan’ designed to identify significant and urgent advances regardless of clinical specialty,

  • in-depth scanning and reviews – ‘vertical scans’ to focus on areas with known multiple or complex developments, or in patient groups with significant or unmet needs.

 

Focused routine scanning includes regular contacts with industry to discuss pipeline developments, routine scanning of media and other information sources, collaboration with clinical and technology experts and expert groups. The process for drugs enables pipeline developments from the major pharmaceutical companies to be identified in late phase II or phase III clinical trials and tracked through the final trial and licensing stages.

In-depth scanning reviews can be requested by our national customers and collaborators, or chosen by the NIHR HSRIC team.

Health professionals, researchers and patients are welcome to propose technologies that may need our attention.

 

Filtration

 

Once technologies have been identified there is an elimination and filtration process. This initially discards minor or incremental developments and those not of relevance to the NHS. A search for additional information may be required prior to filtration and may involve contact with relevant commercial developers and/or clinical or technological experts in the field.

The criteria for final selection are dependent on our agreements with each national decision making body, but will generally include filtration around time to licence or availability, the level of innovation, and potential for impact on patients and/or health services.

 

Outputs

 

Information from the NIHR HSRIC is provided in various formats including:

 

  • Technology briefings (mainly drugs and ATMPs)

  • Technology alerts (mainly medical devices, diagnostic and imaging techniques)

  • In-depth horizon scanning review reports

 

Technology briefings and alerts

 

If a technology is selected for further investigation, information is generally provided in the form of short technology briefings or alerts. Technology briefings and alerts vary in length and detail but may include:

 

  • a description of the technology,

  • a description of the related patient group with estimated patient numbers,

  • the current diagnostic or treatment alternatives,

  • the current research evidence of clinical effectiveness,

  • details of any ongoing or related research activities,

 

and in some instances

  •  an overview of the possible clinical, service and financial impact.

 

NIHR HSRIC technology briefings are based on information available at the time of research, a limited literature search and information from the commercial developer. Briefings are not intended to be a definitive statement on the safety, efficacy or effectiveness of the health technology covered, and the NIHR HSRIC makes no recommendations concerning the use of the particular technology.

 

Technology alerts are shorter, non-technical summaries on new and emerging medical devices, in vitro diagnostics, imaging techniques and procedures. They are written with a broad readership in mind – including commissioners, hospital and community providers, health professionals, procurement staff and patients. Alerts are not intended to be a definitive statement on the safety, efficacy or effectiveness of the health technology covered, and the NIHR HSRIC makes no recommendations concerning the use of the particular technology.

 

Timeframe for technology briefings and alerts

 

The NIHR HSRIC aims to notify NICE and NHS England (specialised services) about emerging drugs and ATMPs and new indications for already licensed products and ATMPs, around 20 months and 15 months, respectively, before launch into the English health service.

The NIHR HSRIC aims to provide information on innovative medical devices and diagnostics up to 24 months prior to commercial availability in the English health service.

 

In-depth horizon scanning review reports

 

Horizon scanning reviews generally aim to identify techniques and technologies in clinical development for specific patient groups or indications. The exact inclusion and exclusion criteria and sources to be searched are agreed with a small group of topic experts at the protocol development stage.

 

Reviews are published in the form of a detailed identification report and accompanied by a short summary document. The NIHR HSRIC aims to write up in-depth reviews for peer-reviewed publication wherever possible.