Social Value Judgements - principles for the development of NICE guidance (2nd edition) (July 2008)
This document describes the principles that NICE should follow in designing the processes it uses to develop its guidance (recommendations), and in developing individual pieces of guidance. It is mainly about the judgements that NICE and its advisory bodies should apply when making decisions about the effectiveness and cost effectiveness of interventions, especially where such decisions affect the allocation of NHS resources.
Click here for the Document
Report on NICE Citizens Council meeting - Quality Adjusted Life years (QALYs) and the severity of illness 31st January - 2nd February 2008 (18th July 2008)
This is the Council's report of its January 2008 meeting, at which it was asked by NICE's Board to discuss the following question: Should NICE and its advisory bodies take into account the severity of a disease when making decisions? If yes, should the advisory committees: take severity "into consideration" alongside the cost and clinical effectiveness evidence; or should severity be included in the calculation of the QALY? The Council's report on this question will be presented to the Board in September 2008. In the meantime, comments on the report are invited from stakeholders in NICE's work, members of NICE advisory bodies and members of the wider public. If you should have any comments, please send them to Clifford Middleton at clifford.middleton@nice.org.uk or NICE, MidCity Place, 71 High Holborn, London WC1V 6NA by 5pm on Friday, 15 August 2008.
Click here for the Report
The diagnosis and acute management of stroke and transient ischaemic attacks Clinical Guideline CG68 (23rd July 2008)
The advice in the NICE guideline covers: how healthcare professionals should recognise the symptoms of a stroke or transient ischaemic attack (TIA) and make a diagnosis quickly; when people should have a brain scan and other types of scan; specialist care for people in the first 2 weeks after a stroke; drug treatments for people who have had a stroke; surgery for people who have had a stroke.
NICE Guideline
Full Guideline
Algorithm 1 (TIA Pathway)
Algorithm 2 (Stroke Pathway)
Quick Reference Guide
Understanding NICE Guidance
Costing Template
Costing Report
Prescribing of antibiotics for self-limiting respiratory tract infections in adults and children in primary care Clinical Guideline CG69 (23rd July 2008)
This guidance is about the care and treatment of people with respiratory tract infections (RTIs) in the NHS in England and Wales. It explains guidance (advice) from NICE (the National Institute for Health and Clinical Excellence). It is written for adults and parents of children aged 3 months and older, but it may also be useful for families or carers or for anyone with an interest in the condition.
Full Guideline
Quick Reference Guide
Appendices
Understanding NICE Guidance
Costing Template
Costing Report
Induction of labour Clinical Guideline CG70 (23rd July 2008)
This guidance is an update of NICE inherited clinical guideline D (published in June 2001) and will replace it.
NICE Guidance
Full Guideline
Quick Reference Guide
Search Strategies
Evidence Tables
Understanding NICE Guidance
Costing Statement
Diabetes in pregnancy: management of diabetes and its complications from pre-conception to the postnatal period Clinical Guideline CG63 (23rd July 2008)
Since publication in March 2008, the information on the therapeutic indications, contraindications and use in pregnancy and lactation of drugs used in diabetes management and retinal assessment (specifically insulins, the oral hypoglycaemic agents metformin and glibenclamide, and tropicamide) has been corrected to follow the relevant summaries of product characteristics (SPCs) (July 2008). Changes have been made to the NICE guideline, the full guideline and the quick reference guide. The recommendation on the use of the rapid-acting insulin analogues aspart and lispro in pregnant women with diabetes (recommendation 1.1.6.2) is now as follows: Healthcare professionals should be aware that data from clinical trials and other sources do not suggest that the rapid-acting insulin analogues (aspart and lispro) adversely affect the pregnancy or the health of the fetus or newborn baby.
NICE Guideline (reissued)
Full Guideline (reissued)
Quick Reference Guide (reissued)
Continuous subcutaneous insulin infusion for the treatment of diabetes (review) Technology Appraisal TA151 (23rd July 2008)
This guidance replaces NICE technology appraisal guidance 57 issued in February 2003. The review and re-appraisal of the use of continuous subcutaneous insulin infusion for the treatment of diabetes mellitus has resulted in a change in the guidance. Specifically there has been a change to the recommendation on the use of continuous subcutaneous insulin infusion in children younger than 12 years with type 1 diabetes mellitus.
Guidance
Quick Reference Guide
Understanding NICE Guidance
Audit Support
Drug-eluting stents for the treatment of coronary artery disease Technology Appraisal TA152 (23rd July 2008)
Drug-eluting stents are recommended as a possible treatment for people with coronary artery disease only if: the artery to be treated is less than 3 mm in diameter or the affected section of the artery is longer than 15 mm, and the additional cost of the drug-eluting stents over bare-metal stents is £300 or less. This guidance replaces sections 1.2-1.4 of NICE technology appraisal guidance 71 (2003).
Guidance
Quick Reference Guide
Understanding NICE Guidance
Cost Template
Guidance on preventing the uptake of smoking by children and young people Public Health Intervention Guidance PH14 (23rd July 2008)
This guidance is for all those with a remit to improve the health and wellbeing of children and young people under 18. This includes those working in the NHS, local authorities, the criminal justice system and the wider public, voluntary and community sectors. It is also aimed at the private sector, in particular the retail industry and mass-media services. In addition, it may be of interest to children, young people and their carers, as well as other members of the public.
Full Guidance
Quick Reference Guide (professionals)
Quick Reference Guide (public)
Brachytherapy as the sole method of adjuvant radiotherapy for breast cancer after local excision Interventional Procedure Guidance IPG268 (23rd July 2008)
Treatment for breast cancer usually involves surgery to remove part or all of the breast. This is sometimes followed by radiotherapy, particularly if only part of the breast has been removed. Brachytherapy is a type of radiotherapy in which a radiation source is placed inside the body area to be treated. It typically involves the insertion of radioactive implants into the space in the breast where tissue has been removed. The implants are usually in place for one to five days. The aim of the procedure is to minimise the chance of the cancer recurring.
Guidance
Understanding NICE Guidance
Consultation Comments
Direct Skeletal fixation of limb or digit prostheses using intraosseous transcutanious implants Interventional Procedure Guidance IPG270 (23rd July 2008)
If a leg, arm, finger or thumb has had to be amputated, or is missing at birth, an artificial substitute (known as a prosthetic limb or prosthesis) may be fitted. Prosthetic limbs usually have a socket and are held in place either by suction or by being strapped to the stump of the missing limb. In this procedure, a metal implant is inserted through the skin and into the centre of the bone of the stump. A prosthetic limb is then attached to the metal implant. The aim is to produce a more comfortable and securely attached prosthetic limb.
Guidance
Understanding NICE Guidance
This document describes the principles that NICE should follow in designing the processes it uses to develop its guidance (recommendations), and in developing individual pieces of guidance. It is mainly about the judgements that NICE and its advisory bodies should apply when making decisions about the effectiveness and cost effectiveness of interventions, especially where such decisions affect the allocation of NHS resources.
Click here for the Document
Report on NICE Citizens Council meeting - Quality Adjusted Life years (QALYs) and the severity of illness 31st January - 2nd February 2008 (18th July 2008)
This is the Council's report of its January 2008 meeting, at which it was asked by NICE's Board to discuss the following question: Should NICE and its advisory bodies take into account the severity of a disease when making decisions? If yes, should the advisory committees: take severity "into consideration" alongside the cost and clinical effectiveness evidence; or should severity be included in the calculation of the QALY? The Council's report on this question will be presented to the Board in September 2008. In the meantime, comments on the report are invited from stakeholders in NICE's work, members of NICE advisory bodies and members of the wider public. If you should have any comments, please send them to Clifford Middleton at clifford.middleton@nice.org.uk or NICE, MidCity Place, 71 High Holborn, London WC1V 6NA by 5pm on Friday, 15 August 2008.
Click here for the Report
The diagnosis and acute management of stroke and transient ischaemic attacks Clinical Guideline CG68 (23rd July 2008)
The advice in the NICE guideline covers: how healthcare professionals should recognise the symptoms of a stroke or transient ischaemic attack (TIA) and make a diagnosis quickly; when people should have a brain scan and other types of scan; specialist care for people in the first 2 weeks after a stroke; drug treatments for people who have had a stroke; surgery for people who have had a stroke.
NICE Guideline
Full Guideline
Algorithm 1 (TIA Pathway)
Algorithm 2 (Stroke Pathway)
Quick Reference Guide
Understanding NICE Guidance
Costing Template
Costing Report
Prescribing of antibiotics for self-limiting respiratory tract infections in adults and children in primary care Clinical Guideline CG69 (23rd July 2008)
This guidance is about the care and treatment of people with respiratory tract infections (RTIs) in the NHS in England and Wales. It explains guidance (advice) from NICE (the National Institute for Health and Clinical Excellence). It is written for adults and parents of children aged 3 months and older, but it may also be useful for families or carers or for anyone with an interest in the condition.
Full Guideline
Quick Reference Guide
Appendices
Understanding NICE Guidance
Costing Template
Costing Report
Induction of labour Clinical Guideline CG70 (23rd July 2008)
This guidance is an update of NICE inherited clinical guideline D (published in June 2001) and will replace it.
NICE Guidance
Full Guideline
Quick Reference Guide
Search Strategies
Evidence Tables
Understanding NICE Guidance
Costing Statement
Diabetes in pregnancy: management of diabetes and its complications from pre-conception to the postnatal period Clinical Guideline CG63 (23rd July 2008)
Since publication in March 2008, the information on the therapeutic indications, contraindications and use in pregnancy and lactation of drugs used in diabetes management and retinal assessment (specifically insulins, the oral hypoglycaemic agents metformin and glibenclamide, and tropicamide) has been corrected to follow the relevant summaries of product characteristics (SPCs) (July 2008). Changes have been made to the NICE guideline, the full guideline and the quick reference guide. The recommendation on the use of the rapid-acting insulin analogues aspart and lispro in pregnant women with diabetes (recommendation 1.1.6.2) is now as follows: Healthcare professionals should be aware that data from clinical trials and other sources do not suggest that the rapid-acting insulin analogues (aspart and lispro) adversely affect the pregnancy or the health of the fetus or newborn baby.
NICE Guideline (reissued)
Full Guideline (reissued)
Quick Reference Guide (reissued)
Continuous subcutaneous insulin infusion for the treatment of diabetes (review) Technology Appraisal TA151 (23rd July 2008)
This guidance replaces NICE technology appraisal guidance 57 issued in February 2003. The review and re-appraisal of the use of continuous subcutaneous insulin infusion for the treatment of diabetes mellitus has resulted in a change in the guidance. Specifically there has been a change to the recommendation on the use of continuous subcutaneous insulin infusion in children younger than 12 years with type 1 diabetes mellitus.
Guidance
Quick Reference Guide
Understanding NICE Guidance
Audit Support
Drug-eluting stents for the treatment of coronary artery disease Technology Appraisal TA152 (23rd July 2008)
Drug-eluting stents are recommended as a possible treatment for people with coronary artery disease only if: the artery to be treated is less than 3 mm in diameter or the affected section of the artery is longer than 15 mm, and the additional cost of the drug-eluting stents over bare-metal stents is £300 or less. This guidance replaces sections 1.2-1.4 of NICE technology appraisal guidance 71 (2003).
Guidance
Quick Reference Guide
Understanding NICE Guidance
Cost Template
Guidance on preventing the uptake of smoking by children and young people Public Health Intervention Guidance PH14 (23rd July 2008)
This guidance is for all those with a remit to improve the health and wellbeing of children and young people under 18. This includes those working in the NHS, local authorities, the criminal justice system and the wider public, voluntary and community sectors. It is also aimed at the private sector, in particular the retail industry and mass-media services. In addition, it may be of interest to children, young people and their carers, as well as other members of the public.
Full Guidance
Quick Reference Guide (professionals)
Quick Reference Guide (public)
Brachytherapy as the sole method of adjuvant radiotherapy for breast cancer after local excision Interventional Procedure Guidance IPG268 (23rd July 2008)
Treatment for breast cancer usually involves surgery to remove part or all of the breast. This is sometimes followed by radiotherapy, particularly if only part of the breast has been removed. Brachytherapy is a type of radiotherapy in which a radiation source is placed inside the body area to be treated. It typically involves the insertion of radioactive implants into the space in the breast where tissue has been removed. The implants are usually in place for one to five days. The aim of the procedure is to minimise the chance of the cancer recurring.
Guidance
Understanding NICE Guidance
Consultation Comments
Direct Skeletal fixation of limb or digit prostheses using intraosseous transcutanious implants Interventional Procedure Guidance IPG270 (23rd July 2008)
If a leg, arm, finger or thumb has had to be amputated, or is missing at birth, an artificial substitute (known as a prosthetic limb or prosthesis) may be fitted. Prosthetic limbs usually have a socket and are held in place either by suction or by being strapped to the stump of the missing limb. In this procedure, a metal implant is inserted through the skin and into the centre of the bone of the stump. A prosthetic limb is then attached to the metal implant. The aim is to produce a more comfortable and securely attached prosthetic limb.
Guidance
Understanding NICE Guidance
Audit Support
Laparoscopic gastrectomy for cancer Interventional Procedure Guidance IPG269 (23rd July 2008)
Cancer of the stomach can be treated by partial or total removal of the stomach (gastrectomy) to take out the tumour and any affected lymph nodes. Gastrectomy was traditionally carried out by open surgery. In this procedure, the gastrectomy is performed using keyhole surgery, the cancer is then removed in exactly the same way as open surgery.
Guidance
Understanding NICE Guidance
Consultation Comments
Rheumatoid Arthritis - adalimumab, etanercept and infliximab (sequential use): final appraisal determination (21st July 2008)
After considering the feedback from consultation, the Appraisal Committee has prepared a Final Appraisal Determination (FAD) on the sequential use of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis and submitted it to the Institute. The FAD has been sent to the formal consultees for this appraisal who have 15 working days to consider whether they wish to appeal against it. Subject to any appeal by consultees, the FAD may be used as the basis for the Institute's guidance on the use of the appraised technology in the NHS in England and Wales. Please note that the appeal period for this appraisal will close at 5pm on 1 August 2008.
Final Appraisal Determination
Response to consultee, commentator and public comments
Consultee and commentator comments
Autologous blood injection for refractory tendonitis (interventional procedures consultation) (28th July 2008)
The National Institute for Health and Clinical Excellence is examining autologous blood injection for tendonitis and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. The Institute's Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about autologous blood injection for tendonitis. Closing date for comments is 26th August 2008.
Consultation
Laparoscopic prostatectomy for benign prostatic obstruction (interventional procedures consultation) (28th July 2008)
The National Institute for Health and Clinical Excellence is examining laparoscopic prostatectomy for benign prostatic obstruction and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. The Institute's Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about laparoscopic prostatectomy for benign prostatic obstruction. Closing date for comments is 26th August 2008.
Consultation
Occipital nerve stimulation for intractable headache (interventional procedures consultation) (28th July 2008)
The National Institute for Health and Clinical Excellence is examining occipital nerve stimulation for intractable headache and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. The Institute's Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about occipital nerve stimulation for intractable headache. Closing date for comments is 26th August 2008.
Consultation
Ultrasound-guided regional nerve block (interventional procedures consultation) (28th July 2008)
The National Institute for Health and Clinical Excellence is examining ultrasound-guided regional nerve block and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. The Institute's Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about ultrasound-guided regional nerve block. Closing date for comments is 26th August 2008.
Consultation
Laparoscopic gastrectomy for cancer Interventional Procedure Guidance IPG269 (23rd July 2008)
Cancer of the stomach can be treated by partial or total removal of the stomach (gastrectomy) to take out the tumour and any affected lymph nodes. Gastrectomy was traditionally carried out by open surgery. In this procedure, the gastrectomy is performed using keyhole surgery, the cancer is then removed in exactly the same way as open surgery.
Guidance
Understanding NICE Guidance
Consultation Comments
Rheumatoid Arthritis - adalimumab, etanercept and infliximab (sequential use): final appraisal determination (21st July 2008)
After considering the feedback from consultation, the Appraisal Committee has prepared a Final Appraisal Determination (FAD) on the sequential use of adalimumab, etanercept and infliximab for the treatment of rheumatoid arthritis and submitted it to the Institute. The FAD has been sent to the formal consultees for this appraisal who have 15 working days to consider whether they wish to appeal against it. Subject to any appeal by consultees, the FAD may be used as the basis for the Institute's guidance on the use of the appraised technology in the NHS in England and Wales. Please note that the appeal period for this appraisal will close at 5pm on 1 August 2008.
Final Appraisal Determination
Response to consultee, commentator and public comments
Consultee and commentator comments
Autologous blood injection for refractory tendonitis (interventional procedures consultation) (28th July 2008)
The National Institute for Health and Clinical Excellence is examining autologous blood injection for tendonitis and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. The Institute's Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about autologous blood injection for tendonitis. Closing date for comments is 26th August 2008.
Consultation
Laparoscopic prostatectomy for benign prostatic obstruction (interventional procedures consultation) (28th July 2008)
The National Institute for Health and Clinical Excellence is examining laparoscopic prostatectomy for benign prostatic obstruction and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. The Institute's Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about laparoscopic prostatectomy for benign prostatic obstruction. Closing date for comments is 26th August 2008.
Consultation
Occipital nerve stimulation for intractable headache (interventional procedures consultation) (28th July 2008)
The National Institute for Health and Clinical Excellence is examining occipital nerve stimulation for intractable headache and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. The Institute's Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about occipital nerve stimulation for intractable headache. Closing date for comments is 26th August 2008.
Consultation
Ultrasound-guided regional nerve block (interventional procedures consultation) (28th July 2008)
The National Institute for Health and Clinical Excellence is examining ultrasound-guided regional nerve block and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. The Institute's Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about ultrasound-guided regional nerve block. Closing date for comments is 26th August 2008.
Consultation
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