gms | German Medical Science

G-I-N Conference 2012

Guidelines International Network

22.08 - 25.08.2012, Berlin

Survival Analysis of the Life-Span of NICE Clinical Practice Guidelines

Meeting Abstract

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  • P. Alderson - National Institute for Health and Clinial Excellence (NICE), Manchester, United Kingdom
  • L. Alderson - National Institute for Health and Clinial Excellence (NICE), Manchester, United Kingdom
  • T. Tan - National Institute for Health and Clinial Excellence (NICE), Manchester, United Kingdom

Guidelines International Network. G-I-N Conference 2012. Berlin, 22.-25.08.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocO06

DOI: 10.3205/12gin038, URN: urn:nbn:de:0183-12gin0389

Published: July 10, 2012

© 2012 Alderson et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: Over 135 clinical practice guidelines have been published by the UK National Institute for Health and Clinical Excellence (NICE) since 2002. While there is international consensus on the features of clinical practice guideline development that ensure rigour, there is more uncertainty about the process that should be used to identify how and when guidelines need updating. Current policy of NICE is to review its guidelines three years after publication.

Objectives: To describe the length of time NICE clinical guidelines have remained valid.

Methods: Survival analysis of published NICE clinical guidelines with Kaplan-Meier curves and log rank test.

Results: Survival analysis suggested that about 86% of guidelines are still up-to-date 3 years after their publication. The median life-span was 60 months (95% confidence interval: 51 to 69).

Discussion: As the estimates of life-span show, many guidelines seem to remain up-to-date for several years, and it does not seem necessary to schedule time consuming and expensive reviews too frequently. With NICE's current policy, we might expect about 14% of guidelines to be judged in need of updating at a review scheduled at three years. It may be more efficient to schedule routine reviews at longer intervals but ensure that there are effective mechanisms for stakeholders to trigger earlier reviews if there are concerns about validity.

Implications for guideline developers/users: It may be more efficient to review guidelines at longer intervals than three years, but with efficient systems to trigger updates if developments merit this.