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20/81 Perioperative Oxygen Therapy: An overview of systematic reviews and meta-analyses

 

Contents

Introduction

The aim of the HTA Programme is to ensure that high quality research information on the effectiveness, costs and broader impact of health technology is produced in the most efficient way for those who use, manage, provide care in or develop policy for the NHS. Topics for research are identified and prioritised to meet the needs of the NHS. Health technology assessment forms a substantial portfolio of work within the National Institute for Health Research and each year about fifty new studies are commissioned to help answer questions of direct importance to the NHS. The studies include both primary research and evidence synthesis.

Research question

For which type of surgery, at which stage of care, in which sub-groups of patients, delivered under what conditions are different types of perioperative oxygen therapy clinically effective?  

  1. Intervention: Oxygen therapy given perioperatively. Applicants should provide a definition of oxygen therapy for this review and justify the inclusion criteria, but the intention is to capture aspects such as the different types of oxygen therapy, dosage, the stage of surgery when it is given, the type of surgery and the method of delivery.  
  2. Patient group: Individuals of any age who are given oxygen therapy at any stage before, during or after any type of surgical procedure – to be defined and justified by applicants.  
  3. Setting: Hospital.
  4. Control: Any control or comparator. 
  5. Study design: An overview of systematic reviews and meta-analyses. Analyses of important sub-groups should be carried out identifying any generic or specific effects.    
  6. Outcomes: Surgical complications, surgical site infections, mortality, morbidity.
    The identification of areas where there is either no evidence or insufficient evidence to inform clinical decision-making.  

Rationale

The Royal College of Anaesthetists estimates that in a given year 1 in 20 people will require an anaesthetic.  As part of this procedure, patients will usually be given additional oxygen both intra-operatively and for a period post-operatively.  Despite its daily and frequent use, there is significant clinical uncertainty about different aspects of perioperative oxygen therapy.

There are mixed views, for example, over the potential benefits and harms of using a higher concentration of oxygen to reduce surgical site infections in certain populations, and around the use of high-flow nasal cannula oxygen therapy.

There are a significant number of systematic reviews and meta-analyses looking at various aspects of perioperative oxygen therapy, but clinical uncertainty remains. A comprehensive ‘panoramic’ overview of these reviews examining the effectiveness of different approaches and what works for whom is needed to aid clinical decision making and the direction of future research. 

The HTA Programme receives lots of applications in perioperative oxygen therapy with different indications and before commissioning further primary research in this area wishes to undertake a scoping exercise of the existing evidence base in order to identify priority topics.

Making an application

If you wish to submit a Stage 1 application for this call, the online application form can be found on the Funding opportunities page.  To select this call, use the filters on the right of the screen or search using the call name and/or number.

Your application must be submitted on-line no later than 1pm on the 23rd September 2020. Applications will be considered by the HTA Funding Committee at its meeting in November 2020.

Guidance notes and supporting information for HTA Programme applications are available by clicking the links.

IMPORTANT: Shortlisted Stage 1 applicants will be given eight weeks to submit a Stage 2 application. The Stage 2 application will be considered at the Funding Committee in March 2021.

Applications received electronically after 1300 hours on the due date will not be considered.

For commissioned topics, the Programme strongly discourages the practice of the same co-applicant joining more than one competing team. There may be unusual circumstances where the same person could be included on more than on application eg a lead from a named charity or a unique national expert in a condition.

For such exceptions (i) each application needs to state the case as to why the same person is included (ii) the shared co-applicant should not divulge application details between teams and (iii) both teams should acknowledge in their application that they are aware that one of their co-applicants is part of a competing application and that study details have not been shared. 

Should you have any queries please contact us

Email:   

htagb@nihr.ac.uk