The study Fawsitt C, Thom H, Hunt L. Choice of prosthetic implant combinations in total hip replacement: cost-effectiveness analysis using UK and Swedish hip joint registries data. Value Health 2019;22:303-12. This study was funded by the NIHR Research for Patient Benefit Programme (project number PB-PG-0613-31032). To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000771/a-traditional-hip-implant-is-as-effective-as-more-expensive-newer-types-for-older-people

The studyTaylor RS, Walker S, Ciani O, et al. Exercise-based cardiac rehabilitation for chronic heart failure: the EXTRAMATCH II individual participant data meta-analysis. Health Technol Assess 2019;23:1-98.This project was funded by the NIHR Health Technology Assessment Programme (project number 15/80/30).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000803/cardiac-rehabilitation-for-heart-failure-can-improve-quality-of-life-and-fitness

The talent development processes in youth football are both complex and multidimensional. The purpose of this two-fold study was to apply a multidisciplinary, machine learning approach to examine: (a) the developmental characteristics of under-9 to under-16 academy players (n = 98; Study 1), and (b) the characteristics of selected and deselected under-18 academy players (n = 18; Study 2). A combined total of 53 factors cumulated from eight data collection methods across two seasons were analysed. A cross-validated Lasso regression was implemented, using the glmnet package in R, to analyse the factors that contributed to: (a) player review ratings (Study 1), and (b) achieving a professional contract (Study 2). Results showed non-zero coefficients for improvement in subjective performance in 15 out of the 53 analysed features, with key findings revealing advanced percentage of predicted adult height (0.196), greater lob pass (0.160) and average dribble completion percentage (0.124), more total match-play hours (0.145), and an older relative age (BQ1 vs. BQ2: −0.133; BQ1 vs. BQ4: −0.060) were the most important features that contributed towards player review ratings. Moreover, PCDEQ Factor 3 and an ability to organise and engage in quality practice (PCDEQ Factor 4) were important contributing factors towards achieving a professional contract. Overall, it appears the key factors associated with positive developmental outcomes are not always technical and tactical in nature, where coaches often have their expertise. Indeed, the relative importance of these factors is likely to change over time, and with age, although psychological attributes appear to be key to reaching potential across the academy journey. The methodological techniques used here also serve as an impetus for researchers to adopt a machine learning approach when analysing multidimensional databases.

Background: Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy (TMA), characterized by ADAMTS-13 activity <10%.ADAMTS-13 activity assays are typically performed in reference laboratories with a turnaround time of several days. First-line treatment for TTP, therapeutic plasma exchange (TPE), typically starts while results are pending. The automated, on-demand HemosIL AcuStar ADAMTS-13 Activity assay provides results in under an hour, which could reduce unnecessary TPE use and associated costs.Objectives: To estimate the hospital budget impact in the United States, United Kingdom, and France of using a rapid ADAMTS-13 activity assay. Methods:We compared routine use of a rapid assay in adults with TMA with a scenario in which results take 3 days. Model structure and variables were based on published literature, plus survey and interviews of five clinicians from the three countries.Costs for the ADAMTS-13 activity assays and TPE were included.Results: Model results suggest that if an on-demand, rapid ADAMTS-13 activity

The study Palmer R, Dimairo M, Cooper C, et al. Self-managed, computerised speech and language therapy for patients with chronic aphasia post-stroke compared with usual care or attention control (Big CACTUS): a multicentre, single-blinded, randomised controlled trial. Lancet Neurol 2019;18:821-33. This project was funded by the NIHR Health Technology Assessment Programme (project number 12/21/01) and the Tavistock Trust for Aphasia. To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000864/after-a-stroke-computerised-speech-and-language-therapy-can-help-people-find-words