Page 14 - A9Rc19d2z_zddyc4_fc0.tmp

Our Research:

Assessment of Technologies

Theme Leader: Dr Graham Scotland

The Assessment of Technologies Technology Management
(AoT) theme aims to apply and
Researchers in the AoT theme are involved in two
develop economic evaluation
new randomised controlled trials funded by the
methods to support decision
NIHR: the ‘REGAL’ study – ‘Recurrence of endometriosis:
making across the life course
GnRH analogues versus laparoscopic surgery trial’ – will
of health technologies
evaluate the clinical and cost-effectiveness of long-
Graham Scotland (Technology Management). term use of GnRH agonists with add-back hormone
Our applied economic
Theme Leader replacement therapy as an alternative treatment
evaluations are based on a
to further laparoscopic surgery for women with
combination of evidence synthesis and decision
recurrent endometriosis; the ‘SCRIPT’ study – ‘Selective
modelling, and analysis of individual patient data
Caries Removal in Permanent Teeth’ – aims to assess
collected alongside randomised controlled trials
the clinical and cost-effectiveness of selective caries
or observational studies. The research theme also
removal with complete caries removal in permanent
recognises the policy emphasis in Scotland and
posterior teeth.
internationally on person-centred care. We reflect
this in our sub-theme of research which focuses on
‘Broader measurement of value in economic evaluation’.
Recurrence of endometriosis: GnRH
analogues versus laparoscopic surgery
trial (REGAL)
Endometriosis is a common, painful condition affecting
one in ten women of childbearing age. It occurs when
cells like those lining the womb grow outside it, causing
internal bleeding, scarring and pain. Key-hole surgery
(laparoscopy) is commonly used to destroy areas of
endometriosis. However, endometriosis returns in up
to half of treated women within five years, and there is
uncertainty about how best to treat women, particularly those who wish to preserve their fertility. Repeat
surgery is invasive, expensive and risky, without guaranteeing a cure. A less invasive treatment is monthly
or three-monthly injections with Gonadotrophin Releasing hormone (GnRH) analogues. While effective in
reducing pain, this type of hormonal treatment has generally only been used for up to a year because of the
risk of side effects (hot flushes and night sweats) and concerns about osteoporosis. However, recent research
suggests that giving small doses of hormone replacement therapy (HRT) with GnRH analogues can reduce the
risk of side effects. Funded by the National Institute for Health Research (NIHR), this new trial will assess the
clinical and cost-effectiveness of long-term GnRH analogues with added HRT compared to conservative key-
hole surgery in women who experience recurrence of pain after surgery but who wish to preserve their fertility.
The research team: L. Saraswat, (NHS Grampian & University of Aberdeen), S. Bhattacharya, K. Cooper
(Obstetrics & Gynaecology, University of Aberdeen), T. J. Clark (Birmingham Women’s NHS Foundation Trust,
A. Horne (University of Edinburgh), C. Becker (University of Oxford), E. Saridogan (University College London
Hospitals NHS Foundation Trust), G. Jones (Leeds Beckett University), G. Scotland (HERU), G. MacLennan, K.
Gillies (Health Services Research Unit (HSRU), University of Aberdeen) and S. Vyas (North Bristol NHS Trust).

14 HERU ANNUAL REPORT 2019