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  1. The evidence on the safety of reinforcement of a permanent stoma with a synthetic or biological mesh to prevent a parastomal hernia shows there are serious but well-recognised complications. The evidence on efficacy is limited in quantity and quality. Therefore, this procedure should not be used unless  special arrangements   are in place for clinical governance, consent, and audit or research.

    Recommendation ID IPG654/1 Question The evidence on the safety of reinforcement of a permanent stoma with a synthetic or biological mesh

  2. NICE may update this guidance after 3 years or sooner if important new information becomes available, including evidence on: the epidemiology of CJD, including data on the prevalence of CJD and its infectivity in the UK population the transmission of CJD by surgical instruments, including cases of CJD in which surgery is a possible route of transmission the cost effectiveness of single-use instruments for use in interventional procedures on high-risk tissues commercially available decontmination methods that are safe and cost effective against prions the systems for, and cost effectiveness of, maintaining set integrity and traceability of instruments.

    Recommendation ID IPG666/1 Question NICE may update this guidance after 3 years or sooner if important new information becomes available

  3. Few women use contraception perfectly (that is, exactly in accordance with the product instructions) and consistently. Pregnancy rates during typical use reflect effectiveness of a method among women who use the method incorrectly or inconsistently. Few data are available on typical use of any contraceptive method among women in the UK. Much of the data on contraceptive effectiveness used in the guideline come from clinical trials or surveys undertaken in other countries such as the USA. Large prospective cohort studies are needed to compare the contraceptive effectiveness of LARC methods with non‑LARC methods during typical use in the UK.

    Recommendation ID CG30/1 Question Few women use contraception perfectly (that is, exactly in accordance with the product instructions)

  4. Current evidence on the safety of ultrasound-guided high‑intensity transcutaneous focused ultrasound for symptomatic uterine fibroids shows there are well-recognised complications including skin burns. The evidence on efficacy is limited in quality. Therefore, this procedure should only be used with  special arrangements   for clinical governance, consent, and audit or research.

    Recommendation ID IPG657/1 Question Current evidence on the safety of ultrasound-guided high‑intensity transcutaneous focused ultrasound

  5. In addition to individual circumstances and needs, a woman's choice and acceptance of LARC may be influenced by potential health disbenefits (side effects and risks) as well as non‑contraceptive benefits of LARC (such as alleviation of menorrhagia). Large population studies of appropriate design are needed to determine the effect of these factors on the uptake of LARC methods and the implications for NHS resources.

    Recommendation ID CG30/3 Question In addition to individual circumstances and needs, a woman's choice and acceptance of LARC may be influenced