PI:
Andrew Dullea (PhD Candidate), supervised by Prof. Susan Smith, Dr. Lydia O’Sullivan, and Dr. Kieran A. Walsh

Collaborators:
Health Information and Quality Authority (HIQA)

Funding:
Health Information and Quality Authority (HIQA); with support from Evidence Synthesis Ireland, TCD’s Bicentenary Award, and the Structured Population health, Policy and Health-services Research Education (SPHeRE) programme.

Objectives

This PhD project aims to identify and address methodological challenges in complex evidence syntheses that inform regulatory and health policy decision-making, particularly in the context of the generic justification of medical exposures to ionising radiation under Irish and European legislation (SI 256 / 2018; Council Directive 2013/59/Euratom).

Key Components:

• Review: To conduct an overview of reviews on the diagnostic accuracy of ¹⁸F-PSMA PET/CT in staging and restaging prostate cancer.
• Embedded Methodological Study: To develop and pilot a structured approach to applying GRADE within overviews of reviews of diagnostic test accuracy.
• Review: To conduct a systematic review on breast cancer screening overdiagnosis to inform potential expansion of Ireland’s BreastCheck programme (ages 45–49 and 70–74) (ongoing).
• Embedded methodological study: examining variation in overdiagnosis estimates (ongoing).
• Study within a Review (SWAR): To evaluate the sensitivity and precision of search strategies developed using a text-mining tool (PubReMiner) compared with conventional librarian-developed strategies.

Impact (Publications to date)

• Diagnostic Accuracy of ¹⁸F-Prostate Specific Membrane Antigen (PSMA) PET/CT Radiotracers in Staging and Restaging of Patients With High-Risk Prostate Cancer or Biochemical Recurrence: An Overview of Reviews – Seminars in Nuclear Medicine (2025)
• Developing an approach for assigning GRADE levels in a systematic overview of reviews of diagnostic test accuracy using general principles identified from current GRADE guidelines: A case study – Research Synthesis Methods (2025)
• Sensitivity and precision of search strategies built using a text-mining word frequency tool (PubReMiner) compared to current best practice for building search strategies: A study within a review (SWAR) – Cochrane Evidence Synthesis and Methods (2026)

Keywords

Evidence Synthesis; Methodological Research; Health Technology Assessment; Clinical Epidemiology; Generic Justification; Ionising Radiation; Radiation Protection

Principal Investigator: Dr Mairin Ryan, Health Information and Quality Authority (HIQA)

Clinical Lead: Professor Susan Smith, Trinity College Dublin

TCD staff: Dr Paul Doody

Collaborators: 

• Health Information and Quality Authority 
• Department of Health 
• National Clinical Effectiveness Committee (NCEC)

Funding: Health Research Board (HRB) (grant reference: ESCG-2024-002, 2024-2028)

Objective: The role of CICER is to independently review evidence and provide scientific support for the development, by guideline development groups, of NCEC National Clinical Guidelines.

Key components: CICER undertakes systematic reviews of the clinical- and cost-effectiveness of interventions included in National Clinical Guidelines in Ireland, as well as estimating the budget impact of implementing the recommendations. CICER further supports guideline development groups by:

• Providing tailored training sessions;
• Assisting in the development of clinical questions and search strategies;
• Performing systematic reviews of national and international clinical guidelines and supporting the assessment of their suitability for adaptation to Ireland; and
• Supporting the use of evidence-to-decision frameworks to develop evidence-based recommendations within National Clinical Guidelines.

Further, CICER aims to build capacity and drive innovation in the evidence synthesis and methodological research communities through national and international collaborations.

Impact:

• Provides evidence synthesis and methodological support for the development of NCEC National Clinical Guidelines.
• Drives innovation in evidence synthesis, National Clinical Guideline development, Patient and Public Involvement, and research methodologies more broadly.
•  

Overall aim: This research project aims to develop and apply a draft HTR and Disinvestment tool to inform health technology disinvestment decision-making in Ireland, with a focus on the medicines on the publicly funded reimbursement list.

PI: David Aluga, Discipline of Public Health & Primary Care

Supervisors:

Professor Susan M. Smith (Trinity College Dublin)

Professor Paddy Gillespie (University of Galway)

Dr. Paula Byrne (University of Galway)

Funding: Health Research Board (HRB) funded Structured Population health, Policy and Health-services Research Education (SPHERE) Scholarship

Key components:

1. Scoping review: This scoping review aimed to synthesise the evidence on tools that address HTR and disinvestment decision-making.
2. Secondary data analysis: A review of minutes of the Health Service Executive-Drugs Group from 2018-2023 to explore the trends of positive/conditional positive recommendations, whether Health Technology Management (HTM) was recommended, and the potential predictors for such recommendations.
3. Qualitative research: To identify and map stakeholders in HTR and disinvestment decision-making in Ireland, focusing on disinvestment in medicines, exploring their views and experiences of disinvestment from medicines and working with these stakeholders to identify current policies/practices and opportunities for HTR and disinvestment in Ireland.
4. Co-design: This study aims to apply the findings from Studies 1-3 to draft an outline HTR and disinvestment tool and present this for co-design work with stakeholders identified in Study 3. This will involve refining the draft tool to inform HTR and disinvestment decision-making in the Irish context.

To find out more about this project, please email PI: alugad@tcd.ie