• The technology described in this briefing is NPi-200. It is used to measure pupillary light reflex and pupil diameter in patients in critical care.

  • The innovative aspects are that the neurological pupil index, a proprietary index developed from more than 600,000 normative data sets, allows pupil reactivity and other parameters to be trended over time, like other vital signs.

  • The intended place in therapy would be as an alternative to manually checking pupillary response using a pen torch in critical care units.

  • The main points from the evidence summarised in this briefing are from 6 observational studies including a total of 1,217 people in critical care units. They show that NPi-200 can measure additional parameters compared with standard care and predict poor outcomes in people who are critically ill.

  • Key uncertainties around the evidence or technology are that only 1 comparative observational study was included, which did not report on patient outcomes and none of the studies were conducted in the UK.

  • The cost of NPi-200 is £17.50 per patient, per 7-day stay in a critical care unit, with hourly observations (excluding VAT). The resource impact would be greater than standard care, which is around £1.50 for a pen torch.