2 Evidence gaps

This section describes the evidence gaps, why they need to be addressed and their relative importance for future committee decision making.

The committee will not be able to make a positive recommendation without the essential evidence gaps (see section 2.1) being addressed. The company can strengthen their evidence base by also addressing as many other evidence gaps (see section 2.2) as possible. Addressing these will help the committee to make a recommendation by better understanding the patient or healthcare system benefits of the technology.

2.1 Evidence that is essential to allow the committee to make a recommendation in future

Effectiveness of the technologies compared with routine care

This is essential to understand the technologies clinical and cost effectiveness. The committee has highlighted that this evidence should use validated clinical outcomes for symptoms of severity and impairment such as the Revised Children's Anxiety and Depression Scale (RCADS) and the Strengths and Difficulties Questionnaire (SDQ).

2.2 Evidence that further supports committee decision making

Evidence for important subgroups of children and young people

Neurodivergent children and young people, and children and young people with low mood only, may interact with the technologies differently or have different outcomes compared with other children and young people. So, the clinical and cost effectiveness of the technologies should be established for these 2 subgroups if the technology developers expect their technology to be used in those groups.

Levels of user engagement and rates for stopping treatment

This will support the NICE committee in assessing the real-world uptake of the technology, its acceptance by children and young people, and other implementation challenges. Ideally, reasons for stopping treatment should also be collected.

Health-related quality of life

This outcome measures children and young people's perspectives on how changes in their health state relate to their quality of life. This information can be incorporated into health economic evaluations, for which quality of life is an important driver. The committee have recommended Child Health Utility (CHU-9D) as a valid tool for measuring this outcome.