Case study: Mechanical chest compression
What did we do?
We appraised mechanical chest compression devices, to be used by the ambulance service on adults experiencing out-of-hospital non-traumatic cardiac arrest. We published Guidance in February 2018.
The Welsh Ambulance Service NHS Trust proposed the topic and device manufacturers provided information about the devices.
We consulted with clinical leads and methodological experts during the evidence review. We also engaged with the Wales Cardiac Network to ensure wider stakeholders were informed.
What were the reactions?
“In my honest opinion, health services need such high quality health technology appraisals now more than ever in order to develop and deliver clinical and cost effective care.” – Service provider
What did we learn?
The review found high quality studies on the clinical effectiveness of the technology and the costs associated with it.
Based on the evidence, we concluded that cardiopulmonary resuscitation using mechanical chest compression devices was not significantly better at preventing mortality than manual resuscitation. Our economic analysis showed that routinely implementing the devices across the ambulance service would not be cost effective.
What difference did this make?
The Welsh Ambulance Service NHS Trust used our Guidance to inform their commissioning decision.
The Out of Hospital Cardiac Arrest Implementation Group is taking action to improve audit data collection.
We improved efficiency in the use of scarce NHS resources by discouraging investment in a technology that was unsupported by available evidence. By avoiding routine use of these devices, it’s estimated that NHS Wales could save £220,823. This cost saving is based on the assumption that there would be 50% uptake of the technology without HTW Guidance.