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The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.

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The quick reference guide presents recommendations for health professionals

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The published NICE clinical guideline, contains the recommendations for health professionals and NHS bodies.

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The published full clinical guideline for specialists with background, evidence, recommendations and methods used.

  • Guidance issuedObesity (CG43)

    The summary of the published clinical guideline on Obesity. It links to the published guidance and key documents.

    View the summary and implementation tools 13 December 2006

    About this guideline

    About this guideline NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales. The guideline was developed by the National Collaborating Centre for Primary Care and the Centre for Public Health Excellence at NICE. They worked with a group of healthcare professionals (including consultants, GPs and nurses), patients and carers, and technical staff, who reviewed the evidence and drafted the recommendations. The recommendations were finalised after public consultation. The methods and processes for developing NICE clinical guidelines are described in The guidelines manual . This guideline updates and replaces NICE technology appraisals 22, 31 and 46. The recommendations from this guideline have been incorporated into diet and physical activity NICE Pathways. We have produced a summary for patients and carers . Tools to help you put the guideline into practice and information about the evidence it is based on are also available . Your responsibility This guidance represents the view of NICE, which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, and informed by the summary of product characteristics of any drugs they are considering. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Copyright © National Institute for Health and Clinical Excellence 2006. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE. Contact NICE National Institute for Health and Clinical Excellence Level 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT www.nice.org.uk nice@nice.org.uk 0845 033 7780

    Appendix A: The Guidance Development Groups

    Appendix A: The Guidance Development Groups Professor James McEwen (Chair) Emeritus Professor in Public Health and Honorary Senior Research Fellow, University of Glasgow Public health Mrs Mary Amos (from October 2005) Health and Social Policy Manager at Eastleigh Borough Council and South West Hampshire Primary Care Trusts Alliance Miss Elizabeth Biggs Hertfordshire Healthy Schools Coordinator and East of England Regional Coordinator Dr Mary Corcoran Director of Public Health, Gedling Primary Care Trust Dr Sara Kirk Principal Research Fellow, University of Leeds Mrs Esther Kurland Planning Advisor, Commission for Architecture and the Built Environment Dr Louis Levy Branch Head, Nutrition Policy and Advice, Food Standards Agency Ms Sue Mabley (to February 2005) Public Health Specialist, Welsh Local Government Association Dr Harshad Mistri Lay representative Mr Andy Ramwell Director of the Manchester Institute of Sport and Physical Activity, Manchester Metropolitan University Mrs Tracy Sortwell Lay representative Ms Helen Storer Dietetic Services Manager, Nottingham City Primary Care Trust Mr Malcolm Ward Principal Public Health Practitioner, National Public Health Service for Wales Clinical management Mrs Mandakini Amin Health Visitor, Hinckley and Bosworth Primary Care Trust Ms Jude Cohen Lay representative Ms Helen Croker Clinical Research Dietitian, University College London Dr Penelope Gibson Consultant Community Paediatrician, Blackwater Valley and Hart Primary Care Trust Professor Paul Little General Practitioner and Professor of Primary Care Research, University of Southampton Mrs Suzanne Lucas Consumer representative Ms Mary O'Kane Clinical Specialist Dietitian, The General Infirmary at Leeds Mrs Sara Richards Practice Nurse, Slough Primary Care Trust Dr Ken Snider Public Health Physician, Director, County Durham and Tees Valley Public Health Network Professor John Wilding Professor of Medicine and Honorary Consultant, University Hospital Aintree, University of Liverpool Guidance Development Group co-optees Public health Professor Gerard Hasting Director, Institute for Social Marketing and Centre for Tobacco Control Research, University of Stirling and the Open University Dr Gill Hawksworth Community Pharmacist and Lecturer/Practitioner, University of Bradford Ms Wendy Hicks Specialist Nurse, Weight Management Service, Newcastle Primary Care Trust Mrs Anne Hollis Clinical Manager for School Nursing, Fareham and Gosport Primary Care Trust Dr Ira Madan, nominated by the Faculty of Occupational Medicine Consultant Occupational Physician, Guy's and St Thomas' NHS Trust Mr Lindley Owen Manager, Sustrans Cornwall Dr David Wilson Senior Lecturer in Paediatric Gastroenterology and Nutrition, Child Life and Health, University of Edinburgh Clinical management Dr John Buckley Exercise Physiologist, Keele University Laurel Edmunds Research Psychologist and Independent Consultant, Bristol Royal Children's Hospital Dr Nicholas Finer Senior Research Associate, University of Cambridge, and Honorary Consultant in Obesity Medicine, University of Cambridge Hospitals Trust Mr Tam Fry Honorary Chair, Child Growth Foundation Professor Philip James Chairman of the International Obesity Taskforce and Senior Vice President of the International Association for the Study of Obesity Mr David Kerrigan Consultant Surgeon, University Hospital Aintree Dr Krystyn Matyka Senior Lecturer in Paediatrics, University of Warwick Professor Mary Rudolf Consultant Paediatrician and Professor of Child Health, Leeds Primary Care Trust and the University of Leeds Russell Viner Consultant/ Honorary Senior Lecturer in Adolescent Medicine and Endocrinology, University College London Hospitals and Great Ormond St Hospital Professor Jane Wardle Professor of Clinical Psychology, University College London National Institute for Health and Clinical Excellence Project Team, Centre for Public Health Excellence Dr Hugo Crombie Analyst Dr Adrienne Cullum Analyst (Technical Lead) Mr Simon Ellis Associate Director (Methodology) Professor Mike Kelly Director Dr Caroline Mulvihill Analyst Ms Susan Murray Analyst Dr Bhash Naidoo Analyst Ms Karen Peploe Analyst Dr Nichole Taske Analyst Obesity Collaborating Centre ? Cardiff Ms Sally Fry (from October 2004 to September 2005) Information Specialist Ms Hilary Kitcher (from April 2005 to September 2005) Information Specialist Dr Helen Morgan (from January 2006) Information Specialist Ms Lesley Sander (from April 2005) Information Specialist Dr Alison Weightman Associate Director and Head of Library Service Development; Director, Support Unit for Research Evidence Obesity Collaborating Centre ? University of Teesside Ms Tamara Brown Research Fellow Mr Phil Ray Research Assistant (from September 2004 to September 2005) Professor Carolyn Summerbell Professor of Human Nutrition and Assistant Dean for Research External Collaborators ? University of York Dr Catriona McDaid, Research Fellow, Centre for Reviews and Dissemination Dr Amanda Sowden, Associate Director, Centre for Reviews and Dissemination Ms Sarah Redmond, Research Fellow, York Health Economics Consortium Mr Paul Trueman, Director, York Health Economics Consortium National Collaborating Centre for Primary Care (NCC-PC) Ms Janette Camosso-Stefinovic, Information Librarian, NCC-PC, Department of Health Sciences, University of Leicester Ms Charmaine , Project Manager, NCC-PC Mr Richard Norman, Health Economist, NCC-PC, and Queen Mary College, University of London Ms Vanessa Nunes, Research Associate (Children's Lead); NCC-PC, Department of Health Sciences, University of Leicester Ms Elizabeth Shaw, Research Fellow (Adult's Lead); NCC-PC, Department of Health Sciences, University of Leicester Dr Tim Stokes, Project Lead; Clinical Director, NCC-PC, Senior Lecturer in General Practice, Department of Health Sciences, University of Leicester Dr Kathy DeMott, Senior Health Research Fellow, NCC-PC Ms Katie Pike, Statistician, Department of Health Sciences, University of Leicester Mrs Nancy Turnbull, Chief Executive, NCC-PC

    Appendix B: The Guideline Review Panel

    Appendix B: The Guideline Review Panel The Guideline Review Panel is an independent panel that oversees the development of the guideline and takes responsibility for monitoring adherence to NICE guideline development processes. In particular, the panel ensures that stakeholder comments have been adequately considered and responded to. The Panel includes members from the following perspectives: primary care, secondary care, lay, public health and industry. Professor Mike Drummond (Chair) Professor of Health Economics, Centre for Health Economics, University of York Dr Ann Hoskins Deputy Regional Director of Public Health, NHS North West Dr Matt Kearney GP Public Health Practitioner, Knowsley PCT, and General Practitioner, Castlefields, Runcorn Professor Ruth Hall Regional Director, Health Protection Agency South West Dr John Harley Clinical Governance and Prescribing Lead, North Tees PCT Mr Barry Stables Patient/Lay Representative Dr Robert Walker General Practitioner, West Cumbria

  • Guidance issuedHeavy menstrual bleeding (CG44)

    The summary of the published clinical guideline on Heavy menstrual bleeding. It links to the published guidance and key documents.

    View the summary and implementation tools 24 January 2007

    About this guideline

    About this guideline NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales. The guideline was developed by the National Collaborating Centre for Women's and Children's Health. The Collaborating Centre worked with a group of healthcare professionals (including consultants, GPs and nurses), patients and carers, and technical staff, who reviewed the evidence and drafted the recommendations. The recommendations were finalised after public consultation. The methods and processes for developing NICE clinical guidelines are described in The guidelines manual . We have produced information for the public explaining this guideline. Tools to help you put the guideline into practice and information about the evidence it is based on are also available . Changes after publication October 2013: minor maintenance May 2012: minor maintenance Your responsibility This guidance represents the view of NICE, which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, and informed by the summary of product characteristics of any drugs they are considering. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Copyright © National Institute for Health and Clinical Excellence 2007. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE.

    Appendix A: The Guideline Development Group

    Appendix A: The Guideline Development Group Anna-Maria Belli Consultant Radiologist, St George's Hospital, London Dianne Crowe Gynaecology Specialist Nurse Practitioner, Hexham NHS Trust, Northumberland Sean Duffy Clinical Director, Leeds Healthcare Trust Sarah Gray General Practitioner, Cornwall Yasmin Gunaratnam Patient/Carer Representative Mary Ann Lumsden GDG Leader, Professor of Gynaecology and Honorary Consultant Obstetrician and Gynaecologist, University of Glasgow Klim McPherson Visiting Professor of Public Health Epidemiology, University of Oxford David Parkin Consultant Gynaecological Oncologist, Aberdeen Jane Preston Consultant Obstetrician and Gynaecologist, James Paget Hospital, Norfolk Mark Shapley General Practitioner, Staffordshire Bridgette York Patient/Carer Representative, Fibroid Network

    Appendix B: The Guideline Review Panel

    Appendix B: The Guideline Review Panel The Guideline Review Panel is an independent panel that oversees the development of the guideline and takes responsibility for monitoring adherence to NICE guideline development processes. In particular, the panel ensures that stakeholder comments have been adequately considered and responded to. The panel includes members from the following perspectives: primary care, secondary care, lay, public health and industry. Jill Freer Acting Director of Provider Services, Rugby PCT John Seddon Chairman V.O.I.C.E.S Mike Baldwin Head of Health Technology Appraisals, Sanofi-Aventis Peter J Robb Consultant ENT Surgeon Epsom & St Helier, University Hospitals and The Royal Surrey County NHS Trusts

  • Guidance issuedAntenatal and postnatal mental health (CG45)

    The summary of the published clinical guideline on Antenatal and postnatal mental health. It links to the published guidance and key documents.

    View the summary and implementation tools 28 February 2007

    About this guideline

    About this guideline NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales. The guideline was developed by the National Collaborating Centre for Mental Health. The Collaborating Centre worked with a group of healthcare professionals (including consultants, GPs and nurses), patients and carers, and technical staff, who reviewed the evidence and drafted the recommendations. The recommendations were finalised after public consultation. The methods and processes for developing NICE clinical guidelines are described in The guidelines manual . The recommendations from this guideline have been incorporated into a NICE Pathway . We have produced information for the public explaining this guideline. Tools to help you put the guideline into practice and information about the evidence it is based on are also available . Your responsibility This guidance represents the view of NICE, which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, and informed by the summary of product characteristics of any drugs they are considering. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Copyright © National Institute for Health and Clinical Excellence 2007. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE. Contact NICE National Institute for Health and Clinical Excellence Level 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT www.nice.org.uk nice@nice.org.uk 0845 033 7780

    Appendix A: The Guideline Development Group

    Appendix A: The Guideline Development Group Dr Dave Tomson (Chair) GP and Consultant in patient-centred primary care, North Shields Mr Stephen Pilling (Facilitator) Joint Director, National Collaborating Centre for Mental Health; Director, Centre for Outcomes Research and Effectiveness; Consultant Clinical Psychologist, Camden and Islington Mental Health and Social Care Trust Dr Fiona Blake Consultant Psychiatrist , Cambridge University Hospitals NHS Foundation Trust Ms Rachel Burbeck (from July 2005) Systematic Reviewer, National Collaborating Centre for Mental Health Dr Sandra Elliott Consultant Clinical Psychologist, South London and Maudsley NHS Trust Dr Pauline Evans Service user representative Ms Josephine Foggo (until August 2005) Project Manager, National Collaborating Centre for Mental Health Dr Alain Gregoire Consultant Perinatal Psychiatrist, Hampshire Partnership NHS Trust and University Dr Jane Hamilton Consultant Psychiatrist in Maternal Health, Sheffield Care Trust Mrs Claire Hesketh Primary Care Mental Health Manager, Northumberland, Tyne and Wear NHS Trust Ms Rebecca King (from August 2005) Project Manager, National Collaborating Centre for Mental Health Dr Elizabeth McDonald Consultant Perinatal Psychiatrist, East London and the City NHS Mental Health Trust Ms Rosa Matthews (until July 2005) Systematic Reviewer, National Collaborating Centre for Mental Health Dr Ifigeneia Mavranezouli Health Economist, National Collaborating Centre for Mental Health Mr Patrick O'Brien Obstetrician, University College London Hospitals NHS Foundation Trust Dr Donald Peebles Obstetrician, University College London Hospitals NHS Foundation Trust Mrs Sue Power Team Manager for Community Mental Health Team, Vale of Glamorgan County Council Mrs Yana Richens Consultant Midwife, University College London Hospitals NHS Foundation Trust Mrs Ruth Rothman Specialist Health Visitor for Postnatal Depression and Clinical Lead for Mental Health, Southend Primary Care Trust Ms Fiona Shaw Service user representative Ms Sarah Stockton Information Scientist, National Collaborating Centre for Mental Health Dr Clare Taylor Editor, National Collaborating Centre for Mental Health Ms Lois Thomas (until September 2005) Research Assistant, National Collaborating Centre for Mental Health Dr Clare Thormod General Practitioner, London Ms Jenny Turner (from November 2005) Research Assistant, National Collaborating Centre for Mental Health

    Appendix B: The Guideline Review Panel

    Appendix B: The Guideline Review Panel The Guideline Review Panel is an independent panel that oversees the development of the guideline and takes responsibility for monitoring adherence to NICE guideline development processes. In particular, the panel ensures that stakeholder comments have been adequately considered and responded to. The Panel includes members from the following perspectives: primary care, secondary care, lay, public health and industry. Professor Mike Drummond (Chair) Professor of Health Economics, Centre for Health Economics, University of York Dr Graham Archard General Practitioner, Dorset Dr Jo Cox Clinical Research Physician, Eli Lily Ms Karen Cowley Practice Development Nurse, York Health Services NHS Trust Mr Barry Stables Lay Representative

  • Guidance issuedFaecal incontinence (CG49)

    The summary of the published clinical guideline on Faecal incontinence. It links to the published guidance and key documents.

    View the summary and implementation tools 27 June 2007

    About this guideline

    About this guideline NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales. The guideline was developed by the National Collaborating Centre for Acute Care. The Collaborating Centre worked with a group of healthcare professionals (including consultants, GPs and nurses), patients and carers, and technical staff, who reviewed the evidence and drafted the recommendations. The recommendations were finalised after public consultation. The methods and processes for developing NICE clinical guidelines are described in The guidelines manual . We have produced information for the public explaining this guideline. Tools to help you put the guideline into practice and information about the evidence it is based on are also available . Changes after publication June 2012: minor maintenance October 2013: minor maintenance Your responsibility This guidance represents the view of NICE, which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, and informed by the summary of product characteristics of any drugs they are considering. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Copyright © National Institute for Health and Clinical Excellence 2007. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE.

    Appendix A: The Guideline Development Group

    Appendix A: The Guideline Development Group Professor Christine Norton (GDG Chair) Professor of Gastrointestinal Nursing, King's College, London; and Nurse Consultant, St Mark's Hospital, Harrow Professor James Barrett Consultant Physician, Wirral Hospital; and Professor of Healthcare of Older People, Liverpool John Moores University, British Geriatrics Society Mr David Bartolo Consultant Colorectal Surgeon, Western General Hospital, Edinburgh, Association of Coloproctology of Great Britain and Ireland, The Royal College of Surgeons of Edinburgh Ms Susan Bennett Trusette/Director, In contact Dr Anton Emmanuel Consultant Gastroenterologist and Senior Lecturer in Neurogastroenterology University College Hospital, London, Royal College of Physicians, British Society of Gastroenterology Mrs June Gallagher Clinical Development Nurse, Barchester Healthcare, Royal College of Nursing Miss Julie Lang Clinical Specialist Physiotherapist, Victoria Infirmary, Glasgow, Clinical Effectiveness Forum for Allied Health Professionals Ms Marlene Powell Community-based Continence Adviser, St Martin's Hospital, Bath, Association for Continence Advice Dr Judith Wardle Director, Continence Foundation NCC-AC staff in the Guideline Development Group Ms Louise Thomas Project Manager Dr John Browne Methodological Advisor Dr Saoussen Ftouh Project Manager (from January 2007) Miss Clare Jones Research Associate Mr Peter B Katz Information Scientist Ms Kathryn Oliver Research Associate Ms Veena Mazarello Paes Research Associate Mr Carlos Sharpin Information Scientist/Research Associate Mr David Wonderling Senior Health Economist

    Appendix B: The Guideline Review Panel

    Appendix B: The Guideline Review Panel The Guideline Review Panel is an independent panel that oversees the development of the guideline and takes responsibility for monitoring adherence to NICE guideline development processes. In particular, the panel ensures that stakeholder comments have been adequately considered and responded to. The Panel includes members from the following perspectives: primary care, secondary care, lay, public health and industry. Mr Peter Robb ? Chair Consultant ENT Surgeon, Epsom & St Helier University Hospitals and The Royal Trusts Mrs Jill Freer Director of Patient Services, Rugby PCT Mr John Seddon Patient representative Mr Mike Baldwin Head of Health Technology Appraisals, Sanofi-Aventis Dr Christine Hine Consultant in Public Health (Acute), South Gloucestershire PCT

  • Guidance issuedEndovascular stent-graft placement in thoracic aortic aneurysms and dissections (IPG127)

    The summary of the published interventional procedure on Endovascular stent-graft placement in thoracic aortic aneurysms and dissections. It links to the published guidance and key documents.

    View the summary and implementation tools 22 June 2005

    4 About this guidance

    4 About this guidance NICE interventional procedure guidance makes recommendations on the safety and efficacy of the procedure. It does not cover whether or not the NHS should fund a procedure. Funding decisions are taken by local NHS bodies after considering the clinical effectiveness of the procedure and whether it represents value for money for the NHS. It is for healthcare professionals and people using the NHS in England, Wales, Scotland and Northern Ireland, and is endorsed by Healthcare Improvement Scotland for implementation by NHSScotland. This guidance was developed using the NICE interventional procedure guidance process. We have produced a summary of this guidance for patients and carers . Information about the evidence it is based on is also available . Changes since publication 24 January 2012: minor maintenance. Your responsibility This guidance represents the views of NICE and was arrived at after careful consideration of the available evidence. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of healthcare professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties. Copyright © National Institute for Health and Clinical Excellence 2005. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE. Contact NICE National Institute for Health and Clinical Excellence Level 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT www.nice.org.uk nice@nice.org.uk 0845 033 7780

    2.3 Efficacy

    2.3 Efficacy 2.3.1 A systematic review of the published evidence on this procedure was commissioned by the Institute. A total of 29 studies were identified for inclusion (27 case series and two comparative observational studies). 2.3.2 In one comparative study, the technical success rate was 100% (67/67 patients). The overall technical success rate was 93% across 18 studies (16 case series and two comparative studies). 2.3.3 The rate of conversion to open repair varied from 0% (0/26 patients) to 7% (1/14 patients). The proportion of patients who experienced an increase in aneurysm size varied from 0% (0/18) to 7% (2/29) of patients. In the study with the largest number of patients, the aneurysm increased in size (by ( 5 mm) in 5% (4/84) of patients. The proportion of patients who experienced a decrease in aneurysm size varied from 100% (18/18) to 17% (5/29) of patients. For more details, refer to the Sources of evidence.

    3 Further information

    3 Further information

  • Guidance issuedArtificial metacarpophalangeal and interphalangeal joint replacement for end-stage arthritis (IPG110)

    The summary of the published interventional procedure on Artificial metacarpophalangeal and interphalangeal joint replacement for end-stage arthritis. It links to the published guidance and key documents.

    View the summary and implementation tools 23 February 2005

    4 About this guidance

    4 About this guidance NICE interventional procedure guidance makes recommendations on the safety and efficacy of the procedure. It does not cover whether or not the NHS should fund a procedure. Funding decisions are taken by local NHS bodies after considering the clinical effectiveness of the procedure and whether it represents value for money for the NHS. It is for healthcare professionals and people using the NHS in England, Wales, Scotland and Northern Ireland, and is endorsed by Healthcare Improvement Scotland for implementation by NHSScotland. This guidance was developed using the NICE interventional procedure guidance process. We have produced a summary of this guidance for patients and carers . Information about the evidence it is based on is also available . Changes since publication 26 January 2012: minor maintenance. Your responsibility This guidance represents the views of NICE and was arrived at after careful consideration of the available evidence. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of healthcare professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties. Copyright © National Institute for Health and Clinical Excellence 2005. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE. Contact NICE National Institute for Health and Clinical Excellence Level 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT www.nice.org.uk nice@nice.org.uk 0845 033 7780

    2.3 Efficacy

    2.3 Efficacy 2.3.1 Four studies reported efficacy data on a total of 125 patients and 202 joints. Pain relief was the main outcome reported. In three studies, the proportion of joints with less pain after the procedure ranged from 97% (67/69) to 100% (31/31). Two studies, including 74 joints with osteoarthritis, reported that there was no significant improvement in the range of movement, but another study reported that 71% (22/31) of joints had improved power and 81% (25/31) had improved dexterity. Two studies reported that 95% (18/19) and 87% (27/31) of patients were satisfied with the result of the surgery, after mean follow-up of 3 years and 6 years, respectively. For more details, refer to the Sources of evidence. 2.3.2 The Specialist Advisors noted concerns regarding the long-term benefits compared with the use of arthrodesis.

    3 Further information

    3 Further information 3.1 The Institute has issued guidance on artificial trapeziometacarpal joints of the hand for end-stage osteoarthritis . Andrew Dillon Chief Executive February 2005

  • Guidance issuedCustomised titanium implants for orofacial reconstruction (IPG28)

    The summary of the published interventional procedure on Customised titanium implants for orofacial reconstruction. It links to the published guidance and key documents.

    View the summary and implementation tools 17 December 2003

    About this guidance

    About this guidance NICE interventional procedure guidance makes recommendations on the safety and efficacy of the procedure. It does not cover whether or not the NHS should fund a procedure. Funding decisions are taken by local NHS bodies after considering the clinical effectiveness of the procedure and whether it represents value for money for the NHS. It is for healthcare professionals and people using the NHS in England, Wales, Scotland and Northern Ireland, and is endorsed by Healthcare Improvement Scotland for implementation by NHSScotland. This guidance was developed using the NICE interventional procedure guidance process. We have produced a summary of this guidance for patients and carers . Information about the evidence it is based on is also available . Your responsibility This guidance represents the views of NICE and was arrived at after careful consideration of the available evidence. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of healthcare professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties. Copyright © National Institute for Health and Clinical Excellence 2003. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE. Contact NICE National Institute for Health and Clinical Excellence Level 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT www.nice.org.uk nice@nice.org.uk 0845 033 7780

    Changes since publication

    Changes since publication 31 January 2012: minor maintenance. March 2013: information added about a partial update of this guidance by Insertion of customised titanium implants with soft tissue cover for orofacial reconstruction (NICE interventional procedure guidance 449).

    2.3 Efficacy

    2.3 Efficacy 2.3.1 The evidence base for this procedure was very small, making efficacy difficult to establish. The study populations ranged from 1 to 22 patients, and the studies reported variable results. For more details refer to the sources of evidence section. 2.3.2 The Specialist Advisors considered that this procedure was still a novel and evolving procedure, and efficacy was not yet proven.

  • Guidance issuedSupraorbital minicraniotomy for intracranial aneurysm (IPG84)

    The summary of the published interventional procedure on Supraorbital minicraniotomy for intracranial aneurysm. It links to the published guidance and key documents.

    View the summary and implementation tools 25 August 2004

    4 About this guidance

    4 About this guidance NICE interventional procedure guidance makes recommendations on the safety and efficacy of the procedure. It does not cover whether or not the NHS should fund a procedure. Funding decisions are taken by local NHS bodies after considering the clinical effectiveness of the procedure and whether it represents value for money for the NHS. It is for healthcare professionals and people using the NHS in England, Wales, Scotland and Northern Ireland, and is endorsed by Healthcare Improvement Scotland for implementation by NHSScotland. This guidance was developed using the NICE interventional procedure guidance process. We have produced a summary of this guidance for patients and carers . Information about the evidence it is based on is also available . Changes since publication 26 January 2012: minor maintenance. Your responsibility This guidance represents the views of NICE and was arrived at after careful consideration of the available evidence. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of healthcare professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties. Copyright © National Institute for Health and Clinical Excellence 2004. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE. Contact NICE National Institute for Health and Clinical Excellence Level 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT www.nice.org.uk nice@nice.org.uk 0845 033 7780

    2.3 Efficacy

    2.3 Efficacy 2.3.1 No controlled studies were identified. In two studies, all the aneurysms were either successfully clipped or wrapped, but length of follow-up was not reported. In another study, 89% (33/37 patients) showed good recovery on the Glasgow Outcome Scale, but it was not clear how many of the patients were followed up for the entire duration of the study (17 months). This study also reported good cosmetic outcomes following surgery. For more details, refer to the Sources of evidence section. 2.3.2 One Specialist Advisor considered it unlikely that the efficacy of treating an aneurysm would be affected by the small exposure used in this procedure when compared with the standard surgical approach.

    3 Further information

    3 Further information

  • Guidance issuedBone-anchored cystourethropexy (using data from In-Tac and Vesica as specified by SERNIP) (IPG18)

    The summary of the published interventional procedure on Bone-anchored cystourethropexy (using data from In-Tac and Vesica as specified by SERNIP). It links to the published guidance and key documents.

    View the summary and implementation tools 26 November 2003

    5 About this guidance

    5 About this guidance NICE interventional procedure guidance makes recommendations on the safety and efficacy of the procedure. It does not cover whether or not the NHS should fund a procedure. Funding decisions are taken by local NHS bodies after considering the clinical effectiveness of the procedure and whether it represents value for money for the NHS. It is for healthcare professionals and people using the NHS in England, Wales, Scotland and Northern Ireland, and is endorsed by Healthcare Improvement Scotland for implementation by NHSScotland. This guidance was developed using the NICE interventional procedure guidance process. We have produced a summary of this guidance for patients and carers . Information about the evidence it is based on is also available . Your responsibility This guidance represents the views of NICE and was arrived at after careful consideration of the available evidence. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of healthcare professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties. Copyright © National Institute for Health and Clinical Excellence 2003. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE. Contact NICE National Institute for Health and Clinical Excellence Level 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT www.nice.org.uk nice@nice.org.uk 0845 033 7780

    4 Changes since publication

    4 Changes since publication As part of NICE's work programme, the current guidance was considered for review but did not meet the review criteria as set out in the IP process guide. The guidance below therefore remains current. 31 January 2012: minor maintenance.

    2.3 Efficacy

    2.3 Efficacy 2.3.1 In three studies of the In-tac® cystourethropexy bone-anchoring system, 1-year continence rates were between 80% (24/30) and 82% (50/61). In a more recent case series of 28 women with a mean follow-up of 67.7 months, only six (21.4%) women remained continent at final follow-up. Four studies of the Vesica® cystourethropexy bone-anchoring system have followed up women for at least 1 year, with one study reporting on 5-year outcomes. This study reported that 95% (39/41) of women were continent at 6 months but only 15% (6/41) remained continent at 5 years. For more details refer to 'Sources of evidence'. 2.3.2 The Specialist Advisors considered that the long-term data for this procedure were poor.

  • Guidance issuedNon-surgical reduction of myocardial septum (IPG40)

    The summary of the published interventional procedure on Non-surgical reduction of myocardial septum. It links to the published guidance and key documents.

    View the summary and implementation tools 25 February 2004

    4 About this guidance

    4 About this guidance NICE interventional procedure guidance makes recommendations on the safety and efficacy of the procedure. It does not cover whether or not the NHS should fund a procedure. Funding decisions are taken by local NHS bodies after considering the clinical effectiveness of the procedure and whether it represents value for money for the NHS. It is for healthcare professionals and people using the NHS in England, Wales, Scotland and Northern Ireland, and is endorsed by Healthcare Improvement Scotland for implementation by NHSScotland. This guidance was developed using the NICE interventional procedure guidance process. We have produced a summary of this guidance for patients and carers . Information about the evidence it is based on is also available . Changes since publication 30 January 2012: minor maintenance. Your responsibility This guidance represents the views of NICE and was arrived at after careful consideration of the available evidence. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of healthcare professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties. Copyright © National Institute for Health and Clinical Excellence 2004. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for-profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE. Contact NICE National Institute for Health and Clinical Excellence Level 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT www.nice.org.uk nice@nice.org.uk 0845 033 7780

    2.3 Efficacy

    2.3 Efficacy 2.3.1 The studies showed that non-surgical reduction of the myocardial septum is efficacious in the short term. In three non-randomised studies, the mean reduction in gradient across the left ventricular outflow tract (LVOT) ranged from 22 mmHg to 42 mmHg, and compared favourably to the mean reduction in LVOT gradient for open surgery. The studies also reported reduced numbers of patients suffering from severe breathlessness and fainting spells after treatment. There is, however, a lack of long-term follow-up. For more details, refer to the 'Sources of evidence' section. 2.3.2 The Specialist Advisors considered the procedure to be an established alternative to surgical relief of outflow tract obstruction in patients with HOCM.

    3 Further information

    3 Further information

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Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.