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  1. Current evidence on the safety of percutaneous mechanical thrombectomy for acute deep vein thrombosis (DVT) of the leg shows there are well-recognised but infrequent complications. For acute iliofemoral DVT the evidence on efficacy is limited in quality and quantity, therefore this procedure should only be used with  special arrangements   for clinical governance, consent, and audit or research.

    Recommendation ID IPG651/1 Question Current evidence on the safety of percutaneous mechanical thrombectomy for acute deep vein thrombosis

  2. Episcissors-60 show promise for mediolateral episiotomy. But there is currently not enough evidence to support the case for routine adoption in the NHS. Research is recommended to address uncertainties about the efficacy and safety of using Episcissors-60. This research should: - determine if using Episcissors-60 in addition to other care bundle measures is more effective in achieving an optimal episiotomy angle and in preventing episiotomy-related obstetric anal sphincter injuries (OASI) than standard episiotomy scissors - include patient-reported outcome measures - address potential equality considerations by ensuring patients at greatest risk of OASI are recruited - determine the relative cost of using Episcissors-60 compared with standard episiotomy scissors.

    Recommendation ID MTG47/1 Question Episcissors-60 show promise for mediolateral episiotomy. But there is currently not enough evidence

  3. The committee noted that there was no clinical evidence showing that having patiromer improved length or quality of life or allowed patients to stay on optimal doses of renin-angiotensin-aldosterone system (RAAS) inhibitors. It therefore considered that it would be valuable to have studies comparing patiromer plus standard care with standard care alone in people with confirmed hyperkalaemia of 6.0 mmol/litre and above, and that these should investigate: - mortality- disease progression- patterns of RAAS inhibitor use- healthcare utilisation and- health-related quality of life. The committee recalled that the DIAMOND trial is ongoing and may help to provide evidence on mortality (see section 3.11). However, the trial is not going to complete until 2022. The committee concluded that the guidance should be reviewed when evidence from DIAMOND is available.

    Recommendation ID TA623/1 Question The committee noted that there was no clinical evidence showing that having patiromer improved length

  4. 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