Published health technology assessments in Wales in Q2 of 2022

Health Technology Wales (HTW) is a national body working to improve the quality of care in Wales. It is funded by Welsh Government and hosted within NHS Wales but independent of both. HTW covers medical devices, diagnostics, procedures, psychological therapies, model of care, and social care support, excluding pharmaceuticals.

HTW uses a staged process of assessment by developing three types of documents. Anyone can suggest a topic, and HTW also performs active horizon scanning. The topic exploration report (TER) aimed to assess whether there is enough available evidence to proceed with a full appraisal and whether the topic meets the appraisal selection criteria. Based on the TER conclusions, HTW's Assessment Group decides whether to progress this topic further. If yes, the following two documents are developed: Evidence Appraisal Report (EAR) and Guidance (GUI). Recommendations are not mandatory; the status of HTW guidance is "adopt or justify", meaning that the local health board and other relevant bodies are expected to report on how they have considered the appraisal and guidance. If they have chosen not to adopt HTW guidance, they are asked to outline their rationale and justify their decision.

Four topics were completed in the second quarter of 2022 with the publication of EAR and Guidance. The following key conclusions were made:

• Extreme HypoFractionated Radiotherapy (EHFRT) was recommended for routine adoption to treat localized prostate cancer;
• The evidence supports the routine adoption of electronic blood management systems (EBMS) to support blood transfusions. EBMS reduces rates of sample rejection and blood wastage compared with paper-based systems;
• The routine adoption is recommended for stereotactic ablative radiotherapy (SABR) to treat people with primary kidney cancer who are not suitable for surgery or other ablative techniques;
• Evidence does not support the routine adoption of video laryngoscopy for people who require intubation in a pre-hospital setting. Economic analysis estimates that the routine adoption would be cost incurring and not cost-effective.

In Q2 of 2022, HTW's Assessment Group decided to progress the following topics to full appraisals:

• Topical oxygen therapy (NATROX) for the treatment of non-healing wounds;
• Photobiomodulation for the prevention and treatment of oral mucositis and radiation dermatitis associated with cancer treatment;
• Video feedback interventions to improve communication within family relationships and support children at risk.

Nine TERs were published in Q2 of 2022, for which HTW's Assessment Group decided not to proceed with full appraisal:

• Colourimetry interventions to support people with visual stress;
• Tumour profiling tests that guide treatment decisions for early breast cancer;
• DeltaScan Brain State Monitor for the diagnosis of acute encephalopathy and/or delirium;
• Bed monitoring and alarm systems to prevent falls and pressure injury in care homes;
• Hospital discharge services (Hospital to a Healthier Home) to help make housing safe and accessible for older people;
• Prescription delivery tracking application;
• Remote patient monitoring (RPM) with the robotic-assist knee balancing system for people undergoing total knee replacement arthroplasty;
• Interactive therapeutic devices (doll therapy) in advanced dementia care;
• Powered lower limb exoskeletons to support the musculoskeletal system in adults and children with complex neurological impairments or spinal cord injuries.

See the full details here.

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