Specialist commentator comments

Comments on this technology were invited from clinical experts working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.

All 3 commentators were familiar with this technology and 2 stated they had used it before. None of the commentators thought that the technology was in widespread use within the NHS.

Level of innovation

The specialist commentators generally thought that the technology was innovative and could represent a variation to current standard care particularly for people having lung volume reduction surgery. One expert thought its ability to detect FI was also novel. None of the commentators thought the device had been superseded but they were aware of other competing software with a similar function.

Potential patient impact

The specialist commentators cited the following as potential benefits to patients:

  • The ability to quickly and accurately identify people whose emphysema may be suitable for ELVR surgery.

  • An improvement in phenotyping patients with COPD by distinguishing between patients with predominant airway disease and emphysema.

They stated the treatment pathway could improve if there were future evidence that validated the accuracy of FI analysis for improving selection of patients for ELVR and avoiding the need for bronchoscopy, which is a more invasive treatment. The introduction of VIDAvision could also lead to fewer hospital appointments.

Potential system impact

The specialist commentators indicated that VIDAvision could remove the need to use bronchoscopy to confirm visual estimation of a CT scan. This could help to identify people whose disease may be suitable for ELVR surgery at an earlier stage. It would also provide an objective measure of emphysema progression.

They thought that the costs to implement the technology would be low because CT scans are already part of standard care in this patient population. The software could be loaded onto a computer terminal in a radiology or medical department and the need for training would be minimal; it could possibly be provided through online learning or by the company. Savings would be seen by reducing the need for bronchoscopy. One commentator thought that quantitative ventilation and a perfusion scan before video-assisted thoracoscopy may no longer be needed.

Existing picture archiving, communication system archives and CT viewing systems could all be potential barriers for use would be the integration of these systems with.

None of the commentators were aware of any safety concerns or regulatory issues surrounding the use of VIDAvision.

General comments

Views were split on whether this technology would replace, or be an addition to, the current standard care. One commentator said it might replace standard care if there were further evidence to validate the findings.

There was uncertainty about whether VIDAvision would be able to replace invasive measures of collateral ventilation but commentators thought it could be useful in providing additional information and could have a broader uses. However, using this type of technology to define and quantify emphysema is not in any national or international guidelines. One commentator noted that currently very few patients have LVRS and they estimated that the software would only be useful for about 1% of patients with COPD.