UK’s NICE Info on Vein Visualisation System Falls Short of Being Guidance

UK Healthcare watchdog NICE has issued what it calls a Medtech Innovation Briefing (MIB) on the AccuVein AV400 for vein visualisation. MIBs differ from guidance by being purely informational. Nonetheless they’re a useful resource for medical professionals seeking impartial advice and information.

Background

The National Institute for Health and Care Excellence (NICE) periodically issues Medtech Innovation Briefings which provide a description of the medical technology, including its likely place in therapy, the costs of using the technology and a critical review of the strengths and weaknesses of the relevant published evidence.

Their purpose is to provide objective information on device and diagnostic technologies to aid local decision-making by clinicians, managers and procurement professionals. By making this information available, NICE helps to avoid the need for NHS organisations to produce similar information for local use.

The subject of this newly issued MIB is the AccuVein AV400, a device which is intended to help find superficial veins for venepuncture and cannulation where venous access is difficult. Superficial veins are detected using an infrared laser light emitted by the device, and an image of the veins in real time is projected back onto the skin surface.

Take a look at the MIB itself, which can be found here, and it becomes even clearer that these things are informational rather than directive. It points to a few clinical studies that report an increase in vein visualisation, although no statistically significant increase was found in first attempt cannulation rates. And while the MIB provides cost information, it also points out that no evidence of cost or resource use is available. 

So it seems that if you need a system to venepuncture or cannulation this is an option that may help to avoid difficulties encountered in people in whom venous access is difficult. As to the incidence of these potential problems no information is made available and neither has an improvement been demonstrated in terms of first attempt cannulation rate. This all leaves the reader being fed the conclusion that the AccuVein AV400 will most likely suit a setting with a higher than average proportion of patients with difficult venous access, for example paediatric and bariatric surgery units.

Sort of damned with faint praise.

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