ECRI Institute identifies 1,000 healthcare technologies to address unmet needs

6 July 2012

The US ECRI Institute has identified nearly 1,000 new and emerging healthcare technologies and services with the potential to address an unmet patient need.

 It conducted a horizon scanning exercise on behalf of the US Agency for Healthcare Research and Quality (AHRQ). These interventions, which cut across scores of diseases and conditions, are described in newly published reports that are free and available to the public on AHRQ’s Effective Health Care website.

One report, Horizon Scanning Status Update, is a compendium of the topics being tracked in the system and includes a short description of each technology or service detailing the unmet need, potential patient population, intervention, developer, phase of development, comparators, and potential health impacts. The Potential High Impact Reports discuss topics within each priority condition that may have potential for high impact based on comments and opinions of various experts with clinical, health systems, health administration, and/or research backgrounds.

“The horizon scanning system is intended to help inform AHRQ’s deliberations for allocating resources for patient-centered outcomes research,” says ECRI Institute’s Karen Schoelles, MD, SM, project director for the Healthcare Horizon Scanning System. “Other groups engaging in comparative effectiveness research may also find these resources useful to identify potential comparators or even technologies or procedures in development that might disrupt current treatment paradigms,” adds Schoelles.

As the nation’s first and only initiative of its kind, the Healthcare Horizon Scanning System is a multi-year project designed to provide a comprehensive, systematic, transparent process for identifying, tracking, and monitoring new healthcare interventions and technologies across 14 priority areas identified by AHRQ. These priority areas include arthritis, cancer, cardiovascular diseases, dementia, depression, developmental delays, diabetes, functional limitations, infectious disease, obesity, peptic ulcer disease, pregnancy, pulmonary disease, and substance abuse. ECRI Institute also added a “cross-cutting” area to track interventions that impact more than 1 of the 14 priority areas identified by AHRQ.

Since December 2010, more than 10,000 leads have been uploaded into the system for consideration, and about 1,400 topics have been identified and moved through the system, according to the procedures outlined in the protocol. Topics in the system must be in development for humans and intended for use in the US healthcare system. Topics that meet criteria for inclusion in the Horizon Scanning System are tracked not only while interventions are in development, but up to 2 years after initial diffusion/commercial availability in the United States.

The criteria and process for identifying interventions to be tracked in the AHRQ Healthcare Horizon Scanning System are described in detail in the Horizon Scanning Protocol and Operations Manual.

An unmet need may arise from a gap in effective ways to screen, diagnose, treat, monitor, manage, or provide or deliver care for a health condition or disease. Interventions might be lacking entirely (eg, treatment for Duchenne muscular dystrophy) or existing options might be less than optimal. Unmet need also arises from conditions for which significant barriers exist to obtaining effective care, such as heart transplantation, or conditions for which availability of certain treatments is limited by location, access, or cultural or ethnic barriers that could cause health disparities.

In the just-published Horizon Scanning Status Update report, five priority areas comprise about 76% of the interventions (including programs) being tracked. Interventions related to cancer account for 30% of identified and monitored topics.

Other areas in descending order of number of topics being tracked are in the priority areas of functional limitations and disability (18%), cardiovascular diseases (11%), infectious diseases (11%), and diabetes (6%). Interventions being tracked in the remaining eight priority conditions (arthritis; dementia; depression and other mental illness; obesity; peptic ulcer disease and dyspepsia; pregnancy and childbirth; pulmonary diseases; substance abuse) account for 4% or less each, or a combined total of almost 24% of the interventions being tracked in the system.

“Overall, more than 84% of topics in the system fall into one of four general categories,” notes program manager Diane Robertson. "About 62% are a pharmaceutical/biotechnology; about 14% are devices—either implanted or used to deliver treatments externally; about 5% are technologies intended to screen, diagnose, and/or monitor a disease state; and about 3% are programs/services/care-delivery innovations.”

The most recent Potential High Impact Reports include 108 topics that are expected to have potential for high impact in the 14 priority areas and a cross-cutting category. The determination of potential impact is made using a systematic process of gathering opinions and impressions about potential impact from a variety of experts. Perspectives of an expert with a conflict of interest (COI) are balanced by perspectives of experts without COIs. No more than two experts with a possible COI are considered out of a total of the seven or eight experts who are sought to provide comment for each topic.

Further information

AHRQ’s Effective Health Care website: http://effectivehealthcare.ahrq.gov/index.cfm

Horizon Scanning Status Update: www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=880

Potential High Impact Reports: www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=1063