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  • Question on Consultation

    Has all of the relevant evidence been taken into account?

  • Question on Consultation

    Are the summaries of clinical and and cost effectiveness reasonable interpretations of the evidence?

  • Question on Consultation

    Are the recommendations sound and a suitable basis for guidance to the NHS?

  • Question on Consultation

    Are there any equality issues that need special consideration and are not covered in the medical technology consultation document?

  • Question on Document

    Could the period while surgeons are learning to use the technologies have a significant impact on the clinical and cost-effectiveness of them?

Evidence generation plan

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5 Minimum evidence standards

The committee heard that the robot-assisted surgery (RAS) technologies may improve patient outcomes and improve surgical efficiencies, although evidence for this is uncertain. All the technologies that have been recommended for use in the NHS while more evidence is generated have some implementation experience in the NHS. The companies did not report any safety concerns for using RAS for knee or hip replacements.

The committee has indicated that it may in the future be able to recommend new technologies in this topic area if there is evidence on: 

  • non-inferiority of the RAS technology compared with conventional surgery for orthopaedic procedures (for primary outcomes including length of hospital stay, complications, patient-reported outcome measures, utilities and revisions)

  • resource use associated with the technologies . 

Companies can strengthen the evidence base by also having qualitative evidence about healthcare professional opinion, procedure-related discomfort, and ergonomics of the RAS technology for the surgeon