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Health Technology Assessment Programme-Improving diagnosis of Urinary Tract Infection in older adults

National Institute for Health and Care Research

Research question: Can diagnosis of Urinary Tract Infection (UTI) in older adults be improved based on a combination of clinical factors and rapid testing?

Patient group: Older people (over 65 years old) with suspected UTI, including those who are frail and those experiencing delirium. Applicants to define and justify levels of frailty included and to consider the importance of gaining informed consent from any patients who fall within the more vulnerable groups and how to ensure ease of recruitment.
Applications are encouraged which include recruitment from populations with high disease burden which have been historically underserved by research activity in this field, e.g., Care homes.
Technology: A combination of clinical assessment and diagnostic technologies modalities to best define probability of patient having a UTI/may be the most effective means of testing this and we are testing what combination. Applications are expected that investigate multiple technologies within the study. Applicants should specify and justify the diagnostic tests of their choice, which should have a demonstrated signal of efficacy for detecting Urinary Tract Infection (UTI) and be suitable for use in the NHS.
Outcomes and outputs: Correct diagnosis of UTI/no UTI; accuracy of diagnostic tests (including, but not limited to, sensitivity and specificity); time to results/time to decision making; estimates of cost-effectiveness; service metrics (e.g., hospitalisations, length of stay); clinician and patient acceptability and usability/accessibility.
Existing Core Outcomes should be included amongst the list of outcomes unless a good rationale is provided to do otherwise. Applicants are encouraged to report recruitment and findings disaggregated by sex (and other demographic factors where relevant).
Setting: Urgent care in any relevant setting where this presentation is likely to occur e.g., hospitals, virtual wards, care homes, GP practices, pharmacies. The study could examine the performance of tests in different clinical and community settings as applied in routine practice.
Study design: Comparison of diagnostic tests.
Longer-term follow-up: If appropriate, researchers should consider obtaining consent to allow potential future follow-up through efficient means (such as routine data) as part of a separately funded study.

Specialties

Geriatrics & Gerontology

Nephrology

Urology

Medical Devices

Technology Development

Eligibility Requirements

The HTA Programme will support

evidence synthesis including systematic reviews, modelling studies and meta-analyses
randomised controlled trials (blinded and unblinded)
non-randomised trials, where appropriate
network meta-analysis and expected Value of Information studies
cohort studies (retrospective or prospective)
complex and innovative trials including adaptive designs and platform studies
modelling studies and health economic models
international studies

Remit

To be within remit for the HTA researcher-led workstream:

the primary outcome of a study should be a health- or social care-related outcome. It must also have the potential to directly benefit the wider NHS, social care, or those who use these services
applications for primary research must be within the scope of the Programme and provide robust evidence for the importance and the efficacy or effectiveness of the intervention(s)
- robust evidence is evidence published in a peer reviewed journal demonstrating the efficacy or effectiveness of the intervention and reporting clinically important findings based on point estimates and associated confidence intervals
- feasibility studies showing the acceptability of the intervention or the ability to recruit participants do not alone constitute evidence of efficacy
- on rare occasions, new primary research may be required urgently. Applicants will need to convince HTA of the urgency of the research and if accepted, we may accept unpublished findings supported by datasets that allow the analysis to be replicated
if robust peer reviewed evidence of efficacy or effectiveness has not been published, HTA may accept evidence that the intervention is widely used in, or is available to, the NHS or social care and is likely to diffuse into widespread practice

We will screen all researcher-led applications to ensure they are in remit. Applications that are not in remit will not be considered by a Funding Committee.