NICE has appointed a new external assessment centre to support its Medical Technologies Evaluation Programme.

The new assessment centre, developed by Newcastle upon Tyne Hospitals NHS Foundation Trust Medical Physics Department in partnership with York Health Economics Consortium, will provide independent assessment of the clinical and health economic evidence for medical technologies.

It will also develop and facilitate independent research to assist suppliers when NICE guidance recommends that further research should be carried out on a medical device or diagnostic.

The new assessment centres were selected for their knowledge and expertise in the evaluation of medical technologies.

To date, one more external assessment centre, CEDAR – part of Cardiff and Vale University Local Health Board – has been commissioned.

Professor Carole Longson, Director of the Centre for Health Technology Evaluation at NICE, said: “We’re delighted to welcome the new joint external assessment centre based at Newcastle and York. Their input to the production of NICE medical technology guidance will be essential, providing independent assessment of the evidence available for devices going through the NICE evaluation process.

“Where the relevant NICE advisory committee identifies that a technology has considerable potential but insufficient evidence to support widespread adoption across the NHS, it may make recommendations for further research. In such cases, the external assessment centre will play a key role in facilitating the development of further relevant evidence.

“We look forward to working with the centre, and benefitting from their combined technical and economics expertise in supporting the development of robust guidance for the NHS.”

Established by NICE in 2009, the Medical Technologies Evaluation Programme is focused specifically on innovative medical technologies. Seven NICE medical technology guidance documents have been published to date.

Four new-generation cardiac computed tomography (CT) scanners from leading diagnostic imaging companies are recommended in draft guidance from NICE’s Diagnostics Assessment Programme.

The provisional recommendations support the use of the following CT scanners in the NHS:

• Somatom Definition Flash CT (Siemens Healthcare)
• Aquilion ONE (Toshiba Medical Systems)
• Brilliance iCT (Philips Healthcare)
• Discovery CT750 (GE Healthcare).

The draft NICE guidance recommends the use of these CT scanners for first-line imaging of coronary arteries in people with suspected coronary artery disease who are difficult to image with earlier-generation CT scanners and who are considered at high risk (10–29%) of having the disease.

It also recommends their use in people with known coronary artery disease for first-line evaluation of disease progression to establish the need for surgical intervention where use of earlier-generation scanners is difficult.

Recent NICE guidelines on acute chest pain recommend CT (as well as invasive) coronary angiography to diagnose coronary artery disease in people considered at high risk (10–29%) of the disease.

However, people with complicating factors such as a high calcium score, obesity, arrhythmias, tachycardia or previous coronary stents or grafts, are difficult to image using earlier CT technologies.

The new-generation cardiac CT scanners listed above have superior technical features enabling faster image acquisition, better image quality and lower radiation dose.

Professor Carole Longson, NICE Health Technology Evaluation Centre Director, said: “The independent Diagnostics Advisory Committee concluded that new-generation cardiac CT scanners are good value for money for hard to image patients instead of proceeding directly to initial angiography.

“The Committee acknowledged that, from a patient perspective, a non-invasive cardiac diagnostic test is preferable to invasive coronary angiography because of the risks associated with this type of test.”

The draft guidelines are now open for consultation with healthcare professionals, industry and patient groups. NICE is particularly keen, Professor Longson said, to discuss “this important new technology” in relation to the existing NICE guidelines on the diagnosis and management of angina.

Coronary artery disease caused an estimated 91,000 deaths in the UK in 2007.

NICE has published guidance supporting the use of a patient warming mattress from a Yorkshire company to prevent hypothermia during surgery.

The Medical Technologies Advisory Committee (MTAC) assessed the use of the Inditherm mattress (pictured) from Inditherm Medical, which is designed for use with patients having surgery involving an anaesthetic.

The evidence considered suggests that the device is as effective in maintaining a patient core body temperature above 36°C as forced air warming, which NICE continues to recommend.

MTAC also estimated that the Inditherm mattress offers the NHS an average annual cost saving of £9,800 compared with forced air warming (where heated air is blown into a specially designed blanket).

In addition, MTAC concludes, the Inditherm mattress may have further practical advantages: it is re-usable and can be cleaned in the same way as a normal operating table mattress, as well as minimising waste of energy.

Professor Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said: “We are very pleased to publish guidance today advising that the Inditherm patient warming mattress should be considered for use in patients at risk of inadvertent hypothermia. The evidence examined indicates that as well as benefiting patients by reducing a range of serious complications associated with inadvertent hypothermia, it also benefits the NHS by saving money.”

Longson also noted that the new guidance did not supersede the recommendation of forced air warming – rather, it suggested “that when considering new investment in warming devices, consideration should be given to whether use of Inditherm would be beneficial with respect to local circumstances.”

NICE estimates that there are 2700 theatres in England not currently using any type of patient warming, of which 40% might be expected to purchase the Inditherm mattress.

Inditherm Medical is based in Rotherham.