Implants are widely used across the NHS, yet for many devices there is limited robust evidence about their long-term outcomes or value for money. When available, clinical trials are often too small to detect rare or delayed complications and may exclude people with complex health needs or from certain minority backgrounds.
‘Recent reports have highlighted the need for stronger systems to monitor implant safety,’ said Daniel Prieto-Alhambra, Professor of Pharmaco- and Device Epidemiology at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS). ‘Our study will develop and test a framework to improve how commonly used implants are monitored and evaluated in the NHS, particularly for patients with complex health needs and those from underserved communities.’
Funded by a NIHR Programme Grant for Applied Research (PGfAR), the programme titled Making Implants safer and more Cost-Effective for patients and the National Health Service (MICE), will firstly identify the most useful healthcare data sources, review the best analytical methods, and apply these approaches to selected examples of implant use.
A collaboration between NDORMS at the University of Oxford, the University of Bristol and Queen Mary University of London, the team will evaluate four types of implants used in different NHS settings: heart valve replacements, hip implants following hip fracture, vaginal mesh, and endoprostheses used in emergency heart surgery for aortic dissection.