NICE process and methods

4 Structure of the surveillance process

A number of elements are common to all surveillance reviews, but for some time periods specific tasks need to be undertaken.

4.1 The 2-year review

The aim of the 2-year surveillance review is to assess quickly whether a recently published guideline needs updating. Therefore the process at 2 years after publication is to identify the occasional guideline that needs a rapid update.

The related NICE Evidence Update will be used as the basis for judgements about changes in evidence since guideline publication. Surveillance is limited to the scope of the existing guideline. As described in the current Evidence Updates process, the number of studies summarised is limited, following thorough sifting of search results and final prioritisation by the Evidence Update Assessment Group (EUAG) chair.

The views of the original Guideline Development Group (GDG) members will not formally be sought, because these will be captured through comments on the new evidence from the EUAG, which will regularly include former GDG members. However, the decision about whether to update the guideline or not will be discussed with the GDG chair and/or clinical adviser.

See appendix A for an algorithm outlining the process for the 2-year review (and also those for other time points).

4.2 The 4-year and 8-year reviews

The surveillance reviews at 4 and 8 years after guideline publication will involve a more rigorous exploration of any changes in the evidence base than those undertaken at other time points. A broad search will be used to identify any new studies available. This process is similar to that used previously for 3-year reviews.

The focus of the surveillance review will be on the original scope of the guideline, but any additional clinical areas or changes in clinical practice that are identified during intelligence gathering will also be considered.

Information about the existing guideline will be sought from a number of standard sources by the NICE Information Services team, including a check of the status of related NICE guidance. The original GDG members will be surveyed to get their opinions on the relevance of the existing guideline, recent developments in the topic area and their knowledge of any new important evidence since publication of the guideline.

A thorough literature search will be conducted by Information Services across a range of databases (for example, Medline, Medline In-Process, Embase and Cochrane as standard sources).

4.3 The 6-year and 10-year reviews

The 6-year and 10-year surveillance reviews offer additional rapid assessments of whether a published guideline needs updating. At 6 and 10 years, the task will be to identify the topics for which a substantial update is still not needed. These reviews will be limited to the scope of the existing guideline.

Intelligence about the existing guideline will be sought from a number of standard sources and the original GDG members will be surveyed as described in section 4.2.

A limited literature search will be conducted by NICE Information Services identifying systematic reviews only. The same range of databases will be searched as for the 4-year and 8-year surveillance evidence reviews.

4.4 All review time points

All new evidence will be summarised in a surveillance decision document by a Centre for Clinical Practice (CCP) analyst, and any studies that may have an important impact on one or more recommendations will be highlighted. An overall summary of the main themes of the new evidence across the guideline will also be provided. This information will form the basis of either a public consultation document or a NICE Guidance Executive decision paper.