The future of health research in the UK.

摘要

Richard Horton (July 8, p 93)1 asks whether the UK National Health Service (NHS) Research and Development (R&D) programme provides evidence for decision-making by policymakers and others. For technologies (ie, anything that the health service or its staff might do or use in the care of patients), the answer is an emphatic yes. For instance, the Health Technology Assessment (HTA) programme, part of NHS R&D, has delivered more than 100 projects for the National Institute for Health and Clinical Excellence, and the National Screening Committee identifies 33 HTA studies, from the past 4 years alone, of direct relevance in setting policy.The HTA programme is appropriately "NHS nee'Hs-led": it asks the NHS to identify problem technologies, andthen commissions research into the most important to the NHS. The research commissioned includes clinical trials (Horton cites three recently published in The Lancet) as well as evidence synthesis, to consider effectiveness, cost-effectiveness, and likely NHS impact. Many trials fill important gaps identified through our previous evidence synthesis, a link which other funderslack.Horton chooses to ignore "future promises" for NHS R&D but these are already bearing fruit-for instance, the HTA programme launched a reactive funding stream for clinical trials earlier this year, which attracted 255 applications.