Information on new and innovative technologies

Medical science is constantly evolving. New treatments and methods of delivery regularly appear at pace. Given this, it is important that patients on the NHS are able to access the benefits of innovation – an aspiration set out for the NHS by the government in its Five Year Forward View.

Our medtech innovation briefings offer fast, responsive information on new or novel medical technologies, devices, and diagnostics tests. The briefings aim to help clinicians, managers and those with procurement responsibilities with local decision-making.

Medtech innovation briefings differ from NICE guidance since they do not contain judgments on the value of a technology or act as guidance recommendations. They include a description of the medical technology, the costs of its use and a critical review of the strengths and weaknesses of the relevant published evidence.

By providing objective information on new technologies, the briefings can help avoid the need for NHS organisations to produce similar information for local use.

This year we published 23 MIBs on a range of devices covering topic areas such as bone marrow biopsy, prostate cancer, and chronic kidney disease.

How do we develop our briefings?

Our medtech innovation briefings are developed as part of the NICE Medical Technologies Evaluation Programme. Topics are identified from a range of sources such as NHS England, through engagement with manufacturers, and partner organisations.

Each briefing is authored by an external assessment centre that searches for and sifts the evidence, before critically appraising it. The centre then develops a draft briefing and involves specialist commentators. Each briefing takes around 12 weeks to develop.

Software to automate gas control during general anaesthesia

General anaesthesia is essential for certain procedures where it is safer for patients to be unconscious. Around 2.4 million people had general anaesthesia in the UK in 2007, with most having a combination of agents delivered through the vein or inhalation to induce and maintain the anaesthesia.

Maintaining manually controlled inhalational anaesthesia carries certain risks such as oxygen deprivation (known as hypoxia) and abnormally large carbon dioxide levels (known as hypercapnia). Mistakes with dosage levels can also lead to patients regaining consciousness mid-procedure.

End-tidal control software for use with Aisys closed circuit anaesthesia systems

The End-tidal Control is a gas delivery software system that avoids manual delivery by helping to automate the amount of anaesthesia that is delivered to patients. It is an option that can be used with the GE Healthcare Aisys Carestation and Aisys CS2 anaesthesia delivery systems.

The system costs between £5,000 and £5,500 depending on whether it is added to an existing system or purchased with a new system. If a new system is purchased, the initial cost is approximately £40,000 per system. There are no additional consumable costs for using the system.

Of five studies on the system’s effectiveness, one randomised trial reported the End-tidal Control resulted in anaesthetic consumption compared with manual gas control.

It also reported that target anaesthetic concentration was reached faster using the system than with manual gas control.

One observational study reported that there no complications associated with the system. An audit study also reported advantages of the system that include better control of end‑tidal anaesthetic agent concentrations, allowing attention to be directed to other aspects of care.

A UK service evaluation reported that using the system for 20-40 minutes reduced costs of anaesthesia by between 41 and 53 per cent.

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Haemodialysis system for renal replacement therapy in chronic kidney disease

Chronic kidney disease (CKD) is the loss of kidney function. It is classified clinically into 5 stages. At stage 5 the kidneys have lost all of their function, which is known as established renal failure.

Haemodialysis is a procedure used for people with CKD at this stage to remove metabolic waste products from the blood. The blood is passed into a dialysis machine with a semi-permeable membrane, and waste products in the blood then diffuse across the membrane into a solution.

NxStage System One NX1000-1 home haemodialysis device

The NxStage System One is a haemodialysis system for renal replacement therapy to be used at home or while travelling. The system can run from standard home electricity and water supplies, and is smaller than conventional home haemodialysis systems.

Evidence from 4 studies confirms at least the same safety and effectiveness between standard usage in healthcare settings and daily home dialysis using the system.

Furthermore, 2 studies showed an improvement in health-related quality of life and modest improvements in survival compared with standard in‑centre haemodialysis 3 times per week.

While limited cost information is available on the system, the manufacturer claims that the average price per treatment across all programmes is approximately 60 per cent of the NHS tariff price for home dialysis.