Littlejohns, Peter, Chalkidou, Kalipso, Wyatt, Jeremy C. and Pearson, Steven D (2009) Assessing evidence and prioritizing clinical and public health guidance recommendations: the NICE way. In: Killoran, Amanda and Kelly, M. P., (eds.) Evidence-based Public Health: Effectiveness and Efficiency. Oxford, U.K.: Oxford University Press, pp. 336-343. ISBN 9780199563623

Abstract

The National Institute for Health and Clinical Excellence (NICE) is the independent organization responsible for providing national guidance on promoting good health, and preventing and treating ill health in England and Wales. It was established as a special health authority in 1999 to offer National Health Service (NHS) healthcare professionals guidance on how to provide their patients with the highest attainable standards of care and to reduce variation in the quality of care. In 2005, its remit was expanded to include health promotion and disease prevention. This chapter describes the deliberations that have led to the adoption, by NICE, of a set of generic principles, consistent across all its programmes, to govern the processes of assessing evidence and classifying recommendations. These principles reinforce the importance of basing decision making on good quality meta-analyses and reviews of studies designed to minimize systematic error. They also hold that, whatever the hierarchy or typology used to assess evidence, it should not be the sole factor driving the decision making process; and the evidence ‘rank’ should be considered separately from the strength of the recommendation(s) it supports.

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