The effectiveness and cost-effectiveness of biomarkers for the prioritisation of patients awaiting coronary revascularisation: a systematic review and decision model

NIHR), was set up in 1993.It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS.'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC).HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'.The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS.There are three routes to the start of projects.First is the commissioned route.Suggestions for research are actively sought from people working in the NHS, from the public and consumer groups and from professional bodies such as royal colleges and NHS trusts.These suggestions are carefully prioritised by panels of independent experts (including NHS service users).The HTA programme then commissions the research by competitive tender.Second, the HTA programme provides grants for clinical trials for researchers who identify research questions.These are assessed for importance to patients and the NHS, and scientific rigour.Third, through its Technology Assessment Report (TAR) call-off contract, the HTA programme commissions bespoke reports, principally for NICE, but also for other policy-makers.TARs bring together evidence on the value of specific technologies.Some HTA research projects, including TARs, may take only months, others need several years.They can cost from as little as £40,000 to over £1 million, and may involve synthesising existing evidence, undertaking a trial, or other research collecting new data to answer a research problem.The final reports from HTA projects are peer reviewed by a number of independent expert