Table 3.

Evidence for effectiveness standards for Tier A: system impact DHTs.

Evidence category	Minimum evidence standard	Best practice standard
Credibility with UK health and social care professionals.	Be able to show that the DHT has a plausible mode of action that is viewed as useful and relevant by professional experts or expert groups in the relevant field. Either: •  show that relevant clinical or social care professionals working within the UK health and social care system have been involved in the design, development or testing of the DHT, or • show that relevant clinical or social care professionals working within the UK health and social care system have been involved in signing-off the DHT, indicating their informed approval of the DHT.	Published or publicly available evidence documenting that the DHT has a plausible mode of action that is viewed as useful and relevant by professional experts or expert groups in the relevant field. Either: •  show that relevant clinical or social care professionals working within the UK health and social care system have been involved in the design, development or testing of the DHT, or • show that relevant clinical or social care professionals working within the UK health and social care system have been involved in signing-off the DHT, indicating their informed approval of the DHT..
Relevance to current care pathways in the UK health and social care system.	Evidence to show that the DHT has been successfully piloted in the UK health and social care system, showing that it is relevant to current care pathways and service provision in the UK. Also, evidence that the DHT can perform its intended function to the scale needed (for example, having servers that can scale to manage the expected number of users).	Evidence to show successful implementation of the DHT in the UK health and social care system.
Acceptability with users.	Be able to show that representatives from intended user groups were involved in the design, development or testing of the DHT. Provide data to show user satisfaction with the DHT.	Published or publicly available evidence to show that representatives from intended user groups were involved in the design, development or testing of the DHT and to show that users are satisfied with the DHT.
Equalities considerations.	Evidence, if relevant, that the DHT: • Contributes to challenging health inequalities in the UK health and social care system, or improving access to care among hard-to-reach populations. •  Contribute to promoting equality, eliminating unlawful discrimination and fostering good relations between people with protected characteristics (as described in the 2010 Equalities Act) and others.	Show evidence of the DHT being used in hard-to-reach populations, or that its use reduces health inequalities.
Accurate and reliable measurements (if relevant).	Data or analysis which shows that the data generated or recorded by the DHT is: •  accurate • reproducible • relevant to the range of values expected in the target population. Also data showing that the DHT is able to detect clinically relevant changes or responses.	As for the minimum evidence standard, but with quantitative data.
Accurate and reliable transmission of data (if relevant).	Technical data showing that numerical, text, audio, image-based, graphic-based or video information is: •  not changed during the transmission process • not biased by the data ‘value’ expected from the target patient population.	As for the minimum evidence standard, but with quantitative data.