Research in this area considers how technologies/services can be developed to meet the needs of the healthcare system. Through involvement in the earlier phases of technology/intervention development and testing, we can provide important insights into cost-effective and sustainable delivery models, guiding questions on the value of further research.
Recently Completed Projects
- A model-based cost-effectiveness analysis of opportunistic screening for identifying (undetected) atrial fibrillation (AF)
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A model-based cost-effectiveness analysis was undertaken of opportunistic screening for identifying (undetected) atrial fibrillation (AF) with a single-lead handheld electrocardiogram (ECG) monitor compared to standard practice (i.e. usual case finding) in general practitioner practices in Scotland.
Outcome and Translation
The results of this study will help inform the potential cost-effectiveness of opportunistic AF screening (using a hand-held single-lead ECG device) versus alternative scenarios of standard case finding. Whilst conclusions are subject to uncertainty owing to a lack of comparative data on case finding under routine clinical practice, ultimately the results may help inform the decision on whether or not to roll out a national AF screening programme in primary care in Scotland (using a single-lead ECG monitor screening strategy/technology) in a QOF chronic disease population.
HERU researchers involved in this research project: Aileen Neilson, Graham Scotland and Emma Tassie
- Vitamin K supplementation to reduce falls in older people - a multicentre trial
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Vitamin K is involved in a wide range of biological processes, including vascular, bone, neurological and muscle function. Studies in osteoporosis suggest beneficial effects on bone mineral density, and pilot data suggest that vitamin K supplementation may be able to reduce postural sway in older people – a key risk factor for falls.
This pilot randomised controlled trial tested the optimum dose (200mcg and 400mcg vs placebo) of vitamin K given for one year to improve postural sway in a group of 96 older people at high risk of falls; tested recruitment rates for a large, community-based falls trial; and collected preliminary data on falls rates to inform the sample-size calculation for a full-scale trial. The economic analysis focused on the estimation of the worth of future additional research to reduce decision uncertainty, using pre-trial modelling, and calculated the optimal sample size for a future study.
Outcome and Translation
We found that costs were lower amongst participants in the low dose Vitamin K2 group, relative to high dose Vitamin K2 (£896-£902 versus £1033-£1044). Neither dose of vitamin K2 produced any improvement relative to placebo. The optimal sample size for a future trial would be 131 participants per group, and such a trial would remain cost-effective up to a sample size of 1100 per group.
The trial is regsitered with the ISRCTN registry: ISRCTN18436190
The project was discussed in a HERU Blog post - Vitamin K2 has no effect on reducing the risk of falls.
HERU researchers involved in this research project: Paul McNamee
External collaborators: M. Witham, M. McMurdo, P. Donnan, (Ninewells Hospital); R. Soiza (Applied Medicine, University of Aberdeen) and V. Cvoro (Department of Geriatric Medicine, Victoria Hospital).