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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    1 Recommendations

    1.1 There is not enough evidence to recommend the routine use of the PredictSURE IBD and IBDX tests to help identify people at high risk of severe Crohn's disease and guide treatment.

    1.2 Further research is recommended (see section 5) to:

    • assess how accurate the tests are for identifying a low or high risk of severe Crohn's disease

    • understand how the tests affect decisions about treatment

    • assess how the tests affect clinical outcomes.

    Why the committee made these recommendations

    PredictSURE IBD and IBDX are tests that may be able to identify people at high risk of severe Crohn's disease. If people can be identified in this way, clinicians could offer the most appropriate treatment to control symptoms while minimising side effects. 'Top-down' treatment has been suggested to be more effective for people with severe Crohn's disease. This reverses the standard order of treatment, starting with biological therapies such as tumour necrosis factor (TNF)-alpha inhibitors.

    The clinical evidence for the tests comes from only a small number of people, which does not give confidence in the results reported. There's also not much evidence on how effective top-down treatment is in people who would be classified as high risk using the test, particularly in the NHS where it is not standard practice.

    Because of this, the cost-effectiveness estimates are very uncertain and more research is needed. Therefore, these tests are not recommended for routine use in the NHS.