3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 10 sources, which was discussed by the committee. The evidence included 1 systematic review and meta-analysis, 7 randomised controlled trials (1 of which is also included in the systematic review), 1 case series and 1 review of seizures reported after deep rTMS. It is presented in table 2 of the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be reduction in obsessive-compulsive disorder symptoms and improvement in quality of life.
3.3 The professional experts and the committee considered the key safety outcomes to be headache, fatigue and concentration difficulties.
3.4 Patient commentary was sought but none was received.
3.5 The committee noted that there is more than 1 device available for this procedure, but that not all available devices are currently CE marked for treating obsessive-compulsive disorder.
3.6 The committee was pleased to receive commentary from a patient organisation.