Health Technology Assessment is indexed in Index Medicus/MEDLINE and Excerpta Medica/ EMBASE. NHS R&D HTA Programme T he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS. Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme. This has meant that the HTA panels can now focus more explicitly on health technologies ('health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care) rather than settings of care. Therefore the panel structure was replaced in 2000 by three new panels: Pharmaceuticals; Therapeutic Procedures (including devices and operations); and Diagnostic Technologies and Screening.

The following abstracts are from publications produced by the Health Technology Assessment Programme in the United Kingdom. This is a national program of government-funded research that publishes over 40 reports every year. The overall aim of the program is to ensure that high-quality research information on the costs, effectiveness, and broader impact of health technologies is produced in the most efficient way for those who use, manage, and work in the National Health Service in England and Wales. Access to the full reports can be made free of charge on the HTA website http://www.ncchta.org http://www.ncchta.org A fully searchable CD-ROM containing the full text of all HTA reports is also available via the HTA website free of charge worldwide. Printed versions of the reports cost £20 (plus post and packing: free in the UK; £2 in Europe; £3 for Rest of the world). See website for details. Objectives: This study aimed to determine the costeffectiveness of influenza vaccination in people 65-74 years of age in the absence of comorbidity. Design: Primary research: randomized controlled trial. Setting: Primary care. Participants: People without risk factors for influenza or contraindications to vaccination were identified from twenty general practitioner (GP) practices in Liverpool in September 1999 and invited to participate in the study. There were 5,875 of 9,727 (60.4 percent) people 65-74 years of age identified as potentially eligible, and of these, 729 (12 percent) were randomized. Intervention: Participants were randomized to receive either influenza vaccine or placebo (ratio, 3:1), with all individuals receiving pneumococcal vaccine unless administered in the previous 10 years. Of the 729 people randomized, 552 received vaccine and 177 received placebo; 726 individuals were administered pneumococcal vaccine. Main outcome measures and methodology of economic evaluation: GP attendance with influenza-like illness (ILI) or pneumonia (primary outcome measure); or any respiratory symptoms; hospitalization with a respiratory illness; death; participant self-reported ILI; quality of life (QoL) measures at 2, 4, and 6 months poststudy vaccination; adverse reactions 3 days after vaccination. A cost-effectiveness analysis was undertaken to identify the incremental cost associated with the avoidance of episodes of influenza in the vaccination population, and an impact model was used to extrapolate the cost-effectiveness results obtained from the trial to assess their generalizability throughout the National Health Service (NHS). Results: In England and Wales, weekly consultations for influenza and ILI remained at baseline levels (less than 50 per 100,000 population) until week 50/1999 and then increased rapidly, peaking during week 2/2000 with a rate of 231/100,000. This rate fell within the range of "higher than expected seasonal activity" of 200-400/100,000. Rates then quickly declined, returning to baseline levels by week 5/2000. The predominant circulating strain during this period was influenza A (H3N2). Five (0.9 ...

Children are a uniquely vulnerable population, yet there is an overwhelming need to test safety and efficacy of therapies and preventions in the pediatric population. Results from studies in adults do not provide sufficient or accurate information. Recently, the need for research involving children has been recognized and action has been taken at the federal level to address both the need for pediatric research and the protection of the welfare and rights of children as research subjects. Other ethical and legal issues such as privacy and confidentiality of information are being addressed as well.

Nutritional requirements of mechanically ventilated, critically ill trauma patients are to estimate because of the variety of injuries and many variables that must be considered in making an accurate nutrition assessment. The Harris‐Benedict predictive equation is often cited in the literature as an overestimation of caloric requirements in the critically ill when compared with indirect calorimetry, and, additionally, studies examining critically ill populations are inconsistent with the application of two important variables: physical activity and fasting. For this study, measurements of resting energy expenditure were compared with the predicted basal energy expenditure (BEE) using the Harris‐Benedict equation with the addition of a selected injury correction factor (ICF), and potential relationships were evaluated for their agreement. When the elements of routine intensive care unit physical activity (which increases energy expenditure by approximately 10%) and the patient's fasting state (the specific dynamic action of food which increased energy expenditure by 10%) are accounted for by the addition of 20% to the measured resting energy expenditure (MREE), the predicted BEE with ICF was in moderate significant agreement with MREE.