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  1. Management of anaemia of chronic kidney disease with concurrent illness:- What is the optimal management (in terms of clinical and cost effectiveness) of anaemia of chronic kidney disease (CKD) in patients who are receiving erythropoietic stimulating agents (ESAs) and have a significant concurrent acute infectious illness?

    Recommendation ID NG8/1 Question Management of anaemia of chronic kidney disease with concurrent illness:- What is the optimal management

  2. Management of smouldering myeloma:- Which combinations of FISH, molecular technologies, bone marrow plasma cell percentage, whole-body imaging, immunophenotype, serum-free light-chain levels or ratio, Hevylite, paraprotein levels, immunoparesis, and International Staging System (ISS) are most effective at risk stratification for people with smouldering myeloma? What is the comparative effectiveness of fixed duration treatment (with or without bone-directed therapy), continuous treatment (with or without bone-directed therapy) and no treatment (with or without bone-directed therapy) for people with smouldering myeloma?

    Recommendation ID NG35/3 Question Management of smouldering myeloma:- Which combinations of FISH, molecular technologies, bone marrow plasma

  3. Management of stable angina in people with evidence of ischaemia on non-invasive functional testing:- Do people with stable angina and evidence of reversible ischaemia on noninvasive functional testing who are on optimal drug treatment benefit from routine coronary angiography with a view to revascularisation?

    Recommendation ID CG126/2 Question Management of stable angina in people with evidence of ischaemia on non-invasive functional testing:-

  4. Management strategies to reduce the risk of symptomatic urinary tract infections:- In people with neurogenic lower urinary tract dysfunction, which management strategies (including the use of prophylactic antibiotics and various invasive and non-invasive techniques to aid bladder drainage) reduce the risk of symptomatic urinary tract infections?

    Recommendation ID CG148/3 Question Management strategies to reduce the risk of symptomatic urinary tract infections:- In people with neurogenic

  5. Managing behaviour that challenges in children and young people with autism:- Is a group-based parent training intervention for parents or carers of children and young people with autism clinically and cost effective in reducing early and emerging behaviour that challenges in the short- and medium-term compared with treatment as usual?

    Recommendation ID CG170/2 Question Managing behaviour that challenges in children and young people with autism:- Is a group-based parent

  6. NICE agreed that further research was needed because there is currently no clinical- or cost-effectiveness evidence evaluating the use of Holoclar in both eyes in bilateral patients. The committee was aware of the ongoing HOLOCORE trial which is recruiting both unilateral and bilateral patients, but only evaluates the success of a second transplant in 1 eye rather than transplant success in both eyes.

    Recommendation ID TA467/1 Question NICE agreed that further research was needed because there is currently no clinical- or cost-effectiveness

  7. NICE agreed that further research would be of value to investigate factors which can predict the likelihood of rapid progression of disease and response to treatment with biological DMARDs. Factors to investigate include:- persistent elevation of inflammatory markers (such as C-reactive protein [CRP]) and- presence of erosions on X-ray and- positive for anti-citrullinated protein antibodies (ACPA).

    Recommendation ID TA375/1 Question NICE agreed that further research would be of value to investigate factors which can predict the likelihood

  8. NICE also considered the role of FeNO in guiding inhaled corticosteroid dosing through stepping-up and stepping-down protocols. It accepted there is a need for more evidence on which protocols offer the safest and most optimal asthma management when used in UK clinical practice. Therefore, further studies are recommended, with consideration for the different protocols and cut-off points that may be necessary in different populations.

    Recommendation ID DG12/3 Question NICE also considered the role of FeNO in guiding inhaled corticosteroid dosing through stepping-up and

  9. NICE also considered the role of FeNO measurement in asthma management. It accepted that currently available evidence on the use of FeNO measurement in asthma management is unclear on whether benefits of treatment are maintained long-term. NICE concluded that long-term studies following patients for several years could address this gap.

    Recommendation ID DG12/2 Question NICE also considered the role of FeNO measurement in asthma management. It accepted that currently available

  10. NICE also encourages data collection and publication of outcomes on all patients having percutaneous transluminal radiofrequency sympathetic denervation of the renal artery for resistant hypertension. Clinicians should submit data on all patients having this procedure to the national register when it becomes available.

    Recommendation ID IPG418/2 Question NICE also encourages data collection and publication of outcomes on all patients having percutaneous

  11. NICE considered that further research is needed to determine whether faecal haemoglobin levels are influenced by age, sex and medicines that increase the risk of gastrointestinal bleeding. It noted that these data could be used to further develop risk scores that include variables such as age, sex and symptoms to help determine pre-test probability. The data could also be combined with faecal haemoglobin concentration to refine management after the use of faecal immunochemical tests in primary care.

    Recommendation ID DG30/1 Question NICE considered that further research is needed to determine whether faecal haemoglobin levels are influenced

  12. NICE encourages further research into balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Details of patient selection, all complications, and subsequent treatments and interventions for pulmonary hypertension should be collected. Reports should include quality-of-life outcomes, long-term efficacy outcomes and survival. NICE may update the guidance on publication of further evidence.

    Recommendation ID IPG554/1 Question NICE encourages further research into balloon pulmonary angioplasty for chronic thromboembolic pulmonary

  13. NICE encourages further research into bioresorbable stent implantation for treating coronary artery disease and may review the procedure on publication of further evidence. Details of subsequent antiplatelet therapy should be reported and outcomes should include major adverse cardiac events (MACE) and target vessel revascularisation (defined as any repeat percutaneous intervention or surgical bypass of any segment of the treated vessel), particularly in the long term (at least 2–3 years). Studies on the safety and efficacy of the procedure compared with other types of coronary stent implantation would be useful.

    Recommendation ID IPG492/1 Question NICE encourages further research into bioresorbable stent implantation for treating coronary artery

  14. NICE encourages clinicians to enter patients into research studies with the particular aims of guiding selection of patients and of defining the place of percutaneous balloon cryoablation in relation to other procedures for treating atrial fibrillation. Further research should define patient selection criteria clearly and should document adverse events and long-term control of atrial fibrillation.

    Recommendation ID IPG427/1 Question NICE encourages clinicians to enter patients into research studies with the particular aims of guiding

  15. NICE encourages further data collection, including randomised controlled trials on microstructural scaffold insertion without autologous cell implantation for repairing symptomatic chondral knee defects. Studies should clearly describe patient selection, clinical indications and adjunctive treatments. Outcome measures should include symptom relief, functional ability, long-term outcomes measured by appropriate imaging techniques and patient-reported outcomes.

    Recommendation ID IPG560/1 Question NICE encourages further data collection, including randomised controlled trials on microstructural

  16. NICE encourages further research into CXL using riboflavin and UVA for keratoconus and keratectasia, especially epithelium-on (transepithelial) CXL and the combination (CXL-plus) procedures. Details of the techniques used should be clearly described. Reported outcomes should include visual acuity, corneal topography and quality of life. Data on long-term outcomes for all types of CXL using riboflavin and UVA for keratoconus and keratectasia would be useful – specifically data about prevention of progression to corneal transplantation and about repeat procedures and their efficacy.

    Recommendation ID IPG466/1 Question NICE encourages further research into CXL using riboflavin and UVA for keratoconus and keratectasia

  17. NICE encourages further research and data collection on endoscopic full thickness removal of non-lifting colonic polyps and may update the guidance on publication of further evidence. This should include safety and efficacy outcomes such as perforation, bleeding, the need for immediate re-intervention, inadequate resection and longer-term follow-up of patients found to have malignant disease.

    Recommendation ID IPG580/1 Question NICE encourages further research and data collection on endoscopic full thickness removal of non-lifting

  18. NICE encourages further research and data collection on partial replacement of the meniscus of the knee using a biodegradable scaffold. This should include clear descriptions of patient selection and adjunctive treatments. Outcome measures should include symptom relief and functional ability in the short term and the need for further treatment in the longer term.

    Recommendation ID IPG430/1 Question NICE encourages further research and data collection on partial replacement of the meniscus of the

  19. NICE encourages further research into endoscopic radiofrequency ablation for Barrett's oesophagus with no dysplasia. Studies should define clearly the policies used for histological diagnosis. Outcomes should include complete resolution of Barrett's oesophagus, change and progression to low-grade dysplasia, high-grade dysplasia or cancer. All complications should be reported, particularly development of strictures. Comparative studies against surveillance would be useful.

    Recommendation ID IPG496/1 Question NICE encourages further research into endoscopic radiofrequency ablation for Barrett's oesophagus with

  20. NICE encourages further research into endoscopic radiofrequency ablation for squamous dysplasia of the oesophagus, including observational data collection. Studies should clearly define patient selection. Outcomes should include completeness of ablation, resolution of squamous dysplasia, progression to cancer and quality of life. All complications should be reported, particularly development of oesophageal strictures.

    Recommendation ID IPG497/1 Question NICE encourages further research into endoscopic radiofrequency ablation for squamous dysplasia of

  21. NICE encourages further research and publication of results from consecutive case series of patients having this procedure. Details of patient selection should be clearly documented. Reported outcomes should include the effects of the procedure on symptoms and quality of life, the duration of benefits, and the need for further procedures. All complications should be reported. NICE may review this procedure in the light of longer-term outcomes.

    Recommendation ID IPG475/1 Question NICE encourages further research and publication of results from consecutive case series of patients

  22. NICE encourages further research and publication on efficacy of miniature lens system implantation for advanced age-related macular degeneration (AMD) which patients may benefit and on safety and efficacy outcomes, particularly longer-term results. NICE may update the guidance on publication of further evidence.

    Recommendation ID IPG565/1 Question NICE encourages further research and publication on efficacy of miniature lens system implantation

  23. NICE encourages further research into extracorporeal shockwave therapy (ESWT) for refractory greater trochanteric pain syndrome. Research studies should clearly describe patient selection, imaging, and treatment protocols. Outcomes should include functional and quality-of-life scores with at least 1 year of follow-up.

    Recommendation ID IPG376/1 Question NICE encourages further research into extracorporeal shockwave therapy (ESWT) for refractory greater

  24. NICE encourages further research comparing ultrasound-enhanced, catheter-directed thrombolysis for deep vein thrombosis against catheter-directed thrombolysis alone. Patient selection should be documented, including the duration and extent of thrombosis. The dose of thrombolytic agent used and the duration of thrombolysis should be reported, together with all complications. Outcome measures should include the success of thrombolysis (complete, partial or failed) and long-term sequelae. NICE may update the guidance on publication of further evidence.

    Recommendation ID IPG523/1 Question NICE encourages further research comparing ultrasound-enhanced, catheter-directed thrombolysis for

  25. NICE encourages further research into focal cryoablation for localised prostate cancer. This should take the form of controlled studies comparing the procedure against other forms of management. Studies should clearly define patient selection criteria and should report outcomes including local recurrence in the long term.

    Recommendation ID IPG423/1 Question NICE encourages further research into focal cryoablation for localised prostate cancer. This should

  26. NICE encourages further research into focal therapy using high-intensity focused ultrasound (HIFU) for localised prostate cancer. This should take the form of controlled studies comparing the procedure against other forms of management. Studies should clearly define patient selection criteria and should report outcomes including local recurrence in the long term.

    Recommendation ID IPG424/1 Question NICE encourages further research into focal therapy using high-intensity focused ultrasound (HIFU)

  27. NICE encourages further research into hysteroscopic morcellation of uterine leiomyomas (fibroids) which could include data collection with publication of the findings, particularly of safety outcomes. Patient selection should be clearly described. Outcomes should include symptom relief, quality of life, recurrence rates and information about fertility and subsequent pregnancies. All complications should be documented. NICE may update the guidance on publication of further evidence.

    Recommendation ID IPG522/1 Question NICE encourages further research into hysteroscopic morcellation of uterine leiomyomas (fibroids) which

  28. NICE encourages further research into intravesical microwave hyperthermia and chemotherapy for non-muscle-invasive bladder cancer. Research should include randomised controlled trials, which stratify patients by risk and give adequate follow-up. They should report frequency of adverse events, patientreported outcome measures, overall and disease-free survival and quality of life.

    Recommendation ID IPG628/1 Question NICE encourages further research into intravesical microwave hyperthermia and chemotherapy for non-muscle-invasive

  29. NICE encourages further research into laparoscopic insertion of a magnetic titanium ring for gastro-oesophageal reflux disease (GORD), and may update the guidance on publication of further evidence. Long-term outcome data and comparative trials with other anti-reflux surgery would be helpful.

    Recommendation ID IPG585/1 Question NICE encourages further research into laparoscopic insertion of a magnetic titanium ring for gastro-oesophageal

  30. NICE encourages further research into low-energy contact X-ray brachytherapy (CXB) for early-stage rectal cancer. Research should clearly describe details of patient selection and treatment intent. It should document adjunctive treatments and subsequent procedures. Outcomes should include local recurrence, survival, disease-free survival and quality of life. NICE may update the guidance on publication of further evidence.

    Recommendation ID IPG532/1 Question NICE encourages further research into low-energy contact X-ray brachytherapy (CXB) for early-stage