Newton001: Brazil-UK collaboration in Health Technology Assessment of diagnostic strategies for infectious diseases

This project is primarily about improving the number of people with good research skills through a scientific partnership between the University of Exeter and the Oswaldo Cruz Foundation (Fiocruz). Together we will do this by passing on established methods of health technology assessment, particularly health economic modelling. Health technology assessment involves identifying the benefits and harms of any new approach to health care, particularly whether the costs of introducing the new technology seem justified. We will also attempt to improve health technology assessment in an area of common interest, new diagnostic tests for the identification of infectious disease and complications arising from them. In contrast to disease treatments, approaches to evaluating the effectiveness and cost-effectiveness of tests designed to improve our ability to identify whether someone has a particular disease such as hepatitis are at an earlier stage of development. From the perspective of the UK, this project will help the University of Exeter appreciate the challenges of doing health technology assessment outside the UK. As well teaching the techniques of health technology assessment, we will improve research skills by jointly working on a specific assessment comparing the impact of two different non-invasive diagnostic methods - AST to Platelet Ratio Index (APRI) and transient elastography (FibroScan) - to monitor whether liver scarring is beginning, getting worse or better in people living with Hepatitis C. There will be reciprocal visits and regular communication between both centres to these ends during 2015.

The University of Exeter has a huge experience in health technology assessment (HTA), especially as applied in economic evaluation of diagnostic tests, while Fiocruz has an emerging HTA group with experience in infectious diseases. There will be a great opportunity of exchanges in a collaborative research project developed by both institutions.
The activities will consider a two-way process that will benefit all researchers and students involved. After a short preparatory period, two workshops will be held in Brazil with an interval of six months for teleworking and a scientific meeting in the UK in the intervening period to advance the specific HTA on surveillance of fibrosis in Hepatitis C and to develop new specific proposals going forward.
The post-graduate students of Fiocruz's programs will be invited to participate actively in the two workshops. There will be open training and discussion including students and researchers not-directly involved in the project, followed by a closed meeting to develop the research proposal. Similarly there will be open sessions at the UK scientific meeting to encourage wider engagement with junior researchers.
The workshops in Brazil will be based on programmes previously developed by PenTAG to pass on skills in HTA. The first will focus on standard skills required for carrying out HTA; the second will reinforce areas identified as rate limiting in the intervening specific HTA project. It will also reflect on problems, lessons learnt and identifying areas for further methodological development. The speakers will be drawn from experts in Exeter, amplified by experts from the InterTASC network of HTA units in the UK. The inclusion of researchers from other universities will further strengthen the aim of Fiocruz being part of an international network.

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