Are Health Technology Assessment (HTA) funded trials using systematic reviews to inform their design? A retrospective cohort

Article type
Authors
Bhurke S1, Cook A2, Tallant A1, Young A1, Williams E1, Raftery J3
1National Institute for Health Research Evaluation, Trials and Studies Co-ordinating Centre (NETSCC), United Kingdom
2University of Southampton and University Hospital Southampton NHS Foundation Trusts, United Kingdom
3Wessex Institute, University of Southampton, United Kingdom
Abstract
Background: Limited evidence exists on how systematic reviews are used in the design of new trials. Jones and colleagues (2013) investigated this using a cohort of randomised controlled trials (RCTs) funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme during the period 2006 to 2008. Their study found that 11 (23%) of 48 applications made no reference to a systematic review. Twenty (54%) of the 37 applications referenced a systematic review and reported their use in designing of the proposed trial.
Objectives: To replicate and validate Jones’ study, to explore the reasons for applications not referencing a systematic review. The study also investigated a cohort of NIHR HTA trials funded during 2013 to identify if there were improvements over time.
Methods: Two cohorts of NIHR HTA-funded RCTs were included. Cohort I included the same trials as Jones et al (except for one trial that has been discontinued) and cohort II included all trials funded during 2013. Two reviewers undertook data extraction independently. Descriptive statistics were used and no formal statistical comparisons were conducted.
Results: Nine trials were identified in cohort I (19%) and three in cohort II (9%) that did not reference a systematic review, but each had a justifiable reason for this. Systematic reviews were referenced in 85% of NIHR HTA trials and nearly 62% referenced more than one systematic review. In total 108 systematic reviews were referenced, 43 of which were Cochrane systematic reviews.
Conclusions: Systematic reviews were referenced in 85% of NIHR HTA trials. Fifteen per cent of trials that did not reference a systematic review had justifiable reasons. NIHR requires that proposals for primary research are justified by existing evidence and our study confirms that this was true for all NIHR HTA trials that could do so.