Surveillance reviews
During a surveillance review, NICE actively seeks new evidence and other information, such as topic expert feedback, changes to legislation or policy, and information about implementation. When appropriate, routinely collected health data, such as real-world evidence, may be sought. This information is brought together and assessed against the guidance to inform a proposal as to whether the recommendations should be updated, amended, retired, or incorporated into other guidance.
A surveillance review can be done in response to information identified through monitoring (reactive surveillance review), or it can be planned.
Reactive surveillance reviews
Subject to constraints on capacity, NICE carries out reactive surveillance reviews if new information is received through monitoring that is likely to have an impact on guidance recommendations and needs further investigation. This informs a decision on whether to make any changes to guidance.
Planned surveillance reviews
A surveillance review may be planned if there is uncertainty around the evidence used to develop guidance recommendations (for example, if there is a close balance between benefits, harms and costs, or there is a lack of high-quality evidence), and research is planned, or underway, that could address this uncertainty.
NICE plans when the surveillance review will be done, based on when the new information is likely to become available.
Activities included in surveillance reviews
How NICE carries out surveillance reviews depends on the nature of the guidance, the evidence that informed the guidance recommendations, and any new information identified through monitoring. The aim of the review is to provide enough information to allow a decision on whether to make any changes to guidance. A review could involve:
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searching for new evidence
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seeking the views of topic experts (for example, current and previous NICE committee members)
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requesting information from the company that produces a medicine, technology or device
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examining and analysing routinely collected data (for example, on the uptake of a procedure, technology or medicine)
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seeking information on the current price of a technology, medicine, test or other intervention
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searching for guidance produced on the same or related topic by other health technology assessment agencies or guidance developers
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seeking the views of other teams within NICE or external organisations.
Surveillance review outcomes
NICE produces a surveillance report that summarises the evidence and intelligence identified through the surveillance process and explains the reasons for the proposed outcome or outcomes. For topics considered by NICE's prioritisation board, we publish a short summary of this surveillance decision.
Possible outcomes include:
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updating or amending the guidance (which could involve collaborating with another organisation)
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retiring guidance or guidance recommendations
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incorporating recommendations into other NICE guidance
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proactively tracking developments that are likely to have an impact on guidance recommendations in the future
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doing a planned future surveillance review
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publishing a supplementary document that includes technical and pricing information to allow the 2 technologies to be compared, if the guidance remains valid but a newer version of a technology is available
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no further action.
NICE's prioritisation board uses information gathered in surveillance reviews to make decisions about our future work, as set out in the NICE-wide topic prioritisation manual.
ISBN: 978-1-4731-7234-0