New PICO Exercises Released: What Can We Learn?

Evoque & PICO: Is One Enough? 🤔
 

This PICOExercise seems straightforward. The intended use of Evoque is to treat patients with severe tricuspid regurgitation who remain symptomatic despite medical therapy and have no other surgical or transcatheter treatment options, as decided by the heart team. 💉

For patients who have failed medical (conservative) therapy and have no other interventional options, the only next step is to optimize their current therapy. 🔄 So, it's no surprise that there’s only one PICO: “Ongoing use of guideline-compliant optimal individualized medical therapy.” 📋

However…

•Optimal individualized therapy can vary depending on national treatment standards. This uniform definition might, in reality, include many different PICOs — meaning the JCA Report based on this PICO might not be relevant for most countries. 🌍💡

•Moreover, this wording for a comparator isn’t fully aligned with the scoping process guidance. ❌

•While the ESC guideline recommendation has a class IIa level (meaning it’s a "should" recommendation), there’s still a lot of room for nuance.

•And what about other surgical therapies currently under development?🔬 How will they influence the intended use (and thus, treatment alternatives)? 💭
 

Given the importance of PICOs for EU HTA, we see a lot that can be learned out of the PICO Exercises. Follow our thoughts in this new series Reflections On Second Wave Of PICO Exercises to Get Ready For EUHTA.

📖 More on how to prepare for EU HTA in our book: EU HTA 101 (updated in October 2024) https://shop.tredition.com/booktitle/EU_HTA_101/W-587-633-024