6 Conclusions

6 Conclusions

6.1 The Committee concluded that the available clinical evidence, together with expert clinical advice, showed that the Sherlock 3CG Tip Confirmation System (TCS) is an effective method of placement for peripherally inserted central catheters (PICCs). The Committee concluded that the main benefit of the technology for patients who would otherwise have blind insertion is avoidance of a confirmatory chest X‑ray. Patients for whom the Sherlock 3CG TCS was used would not need to make journeys to an X‑ray department, would not be exposed to radiation and their PICC could be used without the associated delay. The Committee was advised by a clinical expert that avoidance of chest X‑rays also saves staff time (porters, nurses and sometimes radiologists). The Committee further concluded that use of the technology increases the confidence of both staff and patients during PICC insertion.

6.2 The Committee accepted modelling using revised parameters and sensitivity analyses and concluded that use of the Sherlock 3CG TCS could generate cost savings of about £106 per patient compared with using fluoroscopy as a guide to PICC insertion. The Committee also accepted the estimate of a cost saving of £41 per patient in an intensive care setting when the Sherlock 3CG TCS and confirmatory chest X‑ray are used in place of blind insertion and confirmatory chest X‑ray. The Committee concluded that in other settings, the cost of using the Sherlock 3CG TCS is similar to that of blind PICC insertion with a subsequent chest X‑ray.

Andrew Dillon
Chief Executive
December 2014

  • National Institute for Health and Care Excellence (NICE)