Research to meet the needs of the NHS: a review of published NIHR HTA clinical trials

Background The NIHR HTA programme was established in 1993 with the aim of being ‘needs-led’. This was achieved through commissioning trials to address questions specified by the programme rather than by applicants. At the time this was an unusual funding model and the programme has developed experience that is now globally significant. There is dissatisfaction worldwide with the focus of much existing clinical research (the arrival in the USA of Comparative Effectiveness Research is one attempt to address this) and many trials focus on outcomes that are of little relevance to patients [1]. However, apart from early work reviewing the sources of topics suggested to the HTA programme [2], there has been no systematic attempt to review the programme’s success in being needs-led.