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How effective and cost effective are education-based alcohol interventions targeted at children and young people aged 11 to 25 with SEND who are thought to be vulnerable to alcohol misuse?

Recommendation ID NG135/4 Question How effective and cost effective are education-based alcohol interventions targeted at children and young

Research recommendation Published October 2019

How effective and cost effective are individual, compared with group, education-based interventions for children and young people aged 11 to 18 in full-time education who are thought to be vulnerable to alcohol misuse?

Recommendation ID NG135/2 Question How effective and cost effective are individual, compared with group, education-based interventions for

Research recommendation Published October 2019

In a mild-to-moderate first presentation or inflammatory exacerbation of proctitis that is resistant to standard treatment, what is the effectiveness of topical immunomodulators, such as tacrolimus, in achieving clinical remission and what is the most effective formulation (suppository/ointment)?

Recommendation ID NG130/1 Question In a mild-to-moderate first presentation or inflammatory exacerbation of proctitis that is resistant

Research recommendation Published October 2019

What is the effectiveness of oral tacrolimus and systemic (intramuscular/subcutaneous/oral) methotrexate in the induction of remission in mild-to-moderate ulcerative colitis unresponsive to aminosalicylates?

Recommendation ID NG130/2 Question What is the effectiveness of oral tacrolimus and systemic (intramuscular/subcutaneous/oral) methotrexate

Research recommendation Published October 2019

What is the clinical and cost effectiveness of prednisolone, budesonide, and beclometasone in addition to aminosalicylates compared with each other and with aminosalicylate monotherapy for the induction of remission for people with mild-to-moderate ulcerative colitis?

Recommendation ID NG130/3 Question What is the clinical and cost effectiveness of prednisolone, budesonide, and beclometasone in addition

Research recommendation Published October 2019

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) and

Research recommendation Published October 2019

How effective and cost effective are universal, education-based alcohol interventions for children and young people aged 11 to 25 with SEND?

Recommendation ID NG135/3 Question How effective and cost effective are universal, education-based alcohol interventions for children and

Research recommendation Published October 2019

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

Research recommendation Published October 2019

What components of alcohol education delivery contribute to its effectiveness for children and young people aged 11 to 18 in full-time education, and those with special educational needs and disabilities (SEND) up to the age of 25?

Recommendation ID NG135/1 Question What components of alcohol education delivery contribute to its effectiveness for children and young

Research recommendation Published October 2019

What is the most suitable surveillance protocol (including the role of digital rectal examination [DRE] and prostate-specific antigen [PSA] measures) for people for whom active surveillance is appropriate, as assessed by multiparametric MRI and biopsy, when there are no clinical concerns during follow‑up?

Recommendation ID NG131/1 Question What is the most suitable surveillance protocol (including the role of digital rectal examination [DRE]

Research recommendation Published October 2019

The committee recommended further research to determine if using the lead‑I electrocardiogram (ECG) devices in primary care for people with signs or symptoms of atrial fibrillation, and an irregular pulse, increases the number of people with atrial fibrillation (including paroxysmal) detected, ompared with current practice (that is, a 12‑lead ECG done later). The committee considered the feasibility of collecting data to see if using the lead‑I ECG devices increased the detection of atrial fibrillation that would be missed if only 12‑lead ECGs done later were available. It noted that even if a lead‑I ECG is used and atrial fibrillation is detected, a subsequent 12‑lead ECG would still be done to check for structural cardiac abnormalities and inform further management decisions. The committee concluded that practices using lead‑I ECG devices could determine the number of additional cases of atrial fibrillation detected by the devices. This can be done by identifying people with a confirmed positive lead‑I ECG for atrial fibrillation who subsequently had a 12‑lead ECG that was negative because the atrial fibrillation had stopped. The committee also considered that data collected on the time between the initial lead‑I ECG and the subsequent 12‑lead ECG would be useful.

Recommendation ID DG35/1 Question The committee recommended further research to determine if using the lead‑I electrocardiogram (ECG) devices

Research recommendation Published October 2019

What are the benefits, risk and cost effectiveness of enteral nutrition in maintaining remission in the post-surgical period of Crohn's disease?

Recommendation ID NG129/1 Question What are the benefits, risk and cost effectiveness of enteral nutrition in maintaining remission in the

Research recommendation Published October 2019

The committee recommended that data should be collected to evaluate the system impact of adopting the lead‑I ECGs on both primary and secondary care. In particular, data should be collected on how ECGs generated by the devices would be interpreted in practice, including staff time needed to interpret the ECG traces and associated costs.

Recommendation ID DG35/2 Question The committee recommended that data should be collected to evaluate the system impact of adopting the

Research recommendation Published October 2019

In patients with negative MRI (Likert score 1 or 2), what is the next best diagnostic investigation to rule out clinically significant prostate cancer? What is the diagnostic accuracy of transperineal mapping biopsy compared with transperineal non-mapping biopsy in the diagnosis of clinically significant prostate cancer?

Recommendation ID NG131/7 Question In patients with negative MRI (Likert score 1 or 2), what is the next best diagnostic investigation to

Research recommendation Published October 2019

What is the clinical and cost effectiveness of prednisolone compared with aminosalicylates for the induction of remission for people with moderate ulcerative colitis?

Recommendation ID NG130/4 Question What is the clinical and cost effectiveness of prednisolone compared with aminosalicylates for the induction

Research recommendation Published October 2019

What is the clinical and cost effectiveness of prednisolone plus an aminosalicylate compared with beclometasone plus an aminosalicylate for induction of remission for people with moderate ulcerative colitis?

Recommendation ID NG130/5 Question What is the clinical and cost effectiveness of prednisolone plus an aminosalicylate compared with beclometasone

Research recommendation Published October 2019

What are the benefits, risks and cost effectiveness of methotrexate, ciclosporin, tacrolimus, adalimumab and infliximab compared with each other and with placebo for induction of remission for people with subacute ulcerative colitis that is refractory to systemic corticosteroids?

Recommendation ID NG130/6 Question What are the benefits, risks and cost effectiveness of methotrexate, ciclosporin, tacrolimus, adalimumab

Research recommendation Published October 2019

secondary research is recommended to understand the clinical validity of enzyme-linked immunosorbent assay (ELISA) tests, that is the correlation between ELISA test results and health outcomes or states, such as remission, response, low or high disease activity or flares in rheumatoid arthritis

Recommendation ID DG36/2 Question secondary research is recommended to understand the clinical validity of enzyme-linked immunosorbent assay

Research recommendation Published October 2019

Secondary research is recommended to understand the comparative performance of different ELISA tests for therapeutic monitoring of tumour necrosis factor (TNF)‑alpha inhibitors in rheumatoid arthritis

Recommendation ID DG36/3 Question Secondary research is recommended to understand the comparative performance of different ELISA tests for

Research recommendation Published October 2019

Most women will need to use contraception for more than 30 years. Patterns of contraceptive use vary with age, ethnicity, marital status, fertility intention, education and lifestyle. Large prospective cohort studies are needed to identify: patterns of use (initiation, continuation and switching between methods) of LARC methods compared with non‑LARC methods factors that influence the patterns of use of LARC.

Recommendation ID CG30/2 Question Most women will need to use contraception for more than 30 years. Patterns of contraceptive use vary with

Research recommendation Published October 2019

What is the effectiveness and cost effectiveness of different scheduling of zoledronic acid in the prevention and reduction of skeletal events in people with hormone-refractory prostate cancer?

Recommendation ID NG131/8 Question What is the effectiveness and cost effectiveness of different scheduling of zoledronic acid in the prevention

Research recommendation Published October 2019

Further primary research is recommended on the clinical effectiveness of using ELISA tests for therapeutic monitoring of TNF‑alpha inhibitors in people with rheumatoid arthritis.

Recommendation ID DG36/1 Question Further primary research is recommended on the clinical effectiveness of using ELISA tests for therapeutic

Research recommendation Published October 2019

Which people with extreme hypertension (220/120 mmHg or higher) or emergency symptoms should be referred for same-day hospital specialist assessment?

Recommendation ID NG136/6 Question Which people with extreme hypertension (220/120 mmHg or higher) or emergency symptoms should be referred

Research recommendation Published November 2019

What is the most accurate prenatal screening marker for TAPS, including middle cerebral artery peak systolic velocity (MCA‑PSV)?

Recommendation ID NG137/1 Question What is the most accurate prenatal screening marker for TAPS, including middle cerebral artery peak systolic

Research recommendation Published November 2019

For isoniazid-resistant TB, what is the most effective regimen for reducing mortality andmorbidity?

Recommendation ID NG33/3 Question For isoniazid-resistant TB, what is the most effective regimen for reducing mortality andmorbidity?

Research recommendation Published November 2019

For people with active, drug susceptible TB who experience treatment interruptions because of adverse events, particularly hepatotoxicity, what approach to re-establishing treatment is mosteffective in reducing mortality and morbidity?

Recommendation ID NG33/5 Question For people with active, drug susceptible TB who experience treatment interruptions because of adverse

Research recommendation Published November 2019

In people with suspected TB, what is the relative clinical and cost effectiveness of universal andrisk-based use of rapid nucleic acid amplification tests?

Recommendation ID NG33/1 Question In people with suspected TB, what is the relative clinical and cost effectiveness of universal andrisk-based

Research recommendation Published November 2019

ion (with or without type 2 diabetes), what are the appropriate risk and blood pressure thresholds for starting treatment?

Recommendation ID NG136/2 Question ion (with or without type 2 diabetes), what are the appropriate risk and blood pressure thresholds for

Research recommendation Published November 2019

What is the clinical and cost effectiveness of relaxation therapies for managing primary hypertension in adults in terms of reducing cardiovascular events and improving quality of life?

Recommendation ID NG136/5 Question What is the clinical and cost effectiveness of relaxation therapies for managing primary hypertension

Research recommendation Published November 2019

What effects does isolation have on the quality of life of people being treated for TB?

Recommendation ID NG33/4 Question What effects does isolation have on the quality of life of people being treated for TB? Any explanatory

Research recommendation Published November 2019

What is the effectiveness and safety of regimens using mifepristone and misoprostol for women who are having medical abortion after 23+6 weeks' gestation, particularly for those who have had a previous caesarean section or uterine surgery?

Recommendation ID NG140/6 Question What is the effectiveness and safety of regimens using mifepristone and misoprostol for women who are

Research recommendation Published November 2019

For women who are having medical abortion between 10+1 and 12+0 weeks, what is the efficacy and acceptability of expulsion at home compared with expulsion in a clinical setting?

Recommendation ID NG140/4 Question For women who are having medical abortion between 10+1 and 12+0 weeks, what is the efficacy and acceptability

Research recommendation Published November 2019

Are there subgroups of people with hypertension who should start on dual therapy?

Recommendation ID NG136/4 Question Are there subgroups of people with hypertension who should start on dual therapy? Any explanatory

Research recommendation Published November 2019

The committee noted that there was no clinical evidence showing that having sodium zirconium cyclosilicate 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 sodium zirconium cyclosilicate 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.

Recommendation ID TA599/1 Question The committee noted that there was no clinical evidence showing that having sodium zirconium cyclosilicate

Research recommendation Published November 2019

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

Research recommendation Published November 2019

Current evidence on the safety and efficacy of valve-in-valve transcatheter aortic valve implantation (ViV‑TAVI) for aortic bioprosthetic dysfunction is adequate to support the use of this procedure provided that standard arrangements are in place for clinical governance, consent and audit.

Recommendation ID IPG653/1 Question Current evidence on the safety and efficacy of valve-in-valve transcatheter aortic valve implantation

Research recommendation Published November 2019

The evidence on the safety of transurethral laser ablation for recurrent non-muscle-invasive bladder cancer shows that there are no major safety concerns. However, current evidence on its 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 IPG656/1 Question The evidence on the safety of transurethral laser ablation for recurrent non-muscle-invasive bladder

Research recommendation Published November 2019

What is the utility of routine cardiovascular evaluation for asymptomatic people with FH?

Recommendation ID CG71/6 Question What is the utility of routine cardiovascular evaluation for asymptomatic people with FH? Any explanatory

Research recommendation Published November 2019

When is it safe to stop contact casting in the treatment of acute Charcot arthropathy?

Recommendation ID NG19/12 Question When is it safe to stop contact casting in the treatment of acute Charcot arthropathy? Any explanatory

Research recommendation Published November 2019

Which risk stratification tools can be used to predict the likelihood of Charcot arthropathy?

Recommendation ID NG19/11 Question Which risk stratification tools can be used to predict the likelihood of Charcot arthropathy? Any

Research recommendation Published November 2019

What is the effectiveness and cost effectiveness of a trial of hydrolysed formula in formula‑fed infants with frequent regurgitation associated with marked distress?

Recommendation ID NG1/2 Question What is the effectiveness and cost effectiveness of a trial of hydrolysed formula in formula‑fed infants

Research recommendation Published November 2019

What is the malformation rate and longer term neurodevelopmental outcome of children born to mothers who have taken AEDs during pregnancy?

Recommendation ID CG137/5 Question What is the malformation rate and longer term neurodevelopmental outcome of children born to mothers

Research recommendation Published November 2019

What is the clinical effectiveness of maggot debridement therapy in the debridement of diabetic foot ulcers?

Recommendation ID NG19/10 Question What is the clinical effectiveness of maggot debridement therapy in the debridement of diabetic foot

Research recommendation Published November 2019

What is the clinical effectiveness of negative pressure wound therapy in the treatment of diabetic foot ulcers?

Recommendation ID NG19/9 Question What is the clinical effectiveness of negative pressure wound therapy in the treatment of diabetic foot

Research recommendation Published November 2019

What is the clinical effectiveness of different dressing types in treating diabetic foot problems?

Recommendation ID NG19/5 Question What is the clinical effectiveness of different dressing types in treating diabetic foot problems?

Research recommendation Published November 2019

What is the clinical effectiveness of double-dose PPIs in people with severe erosive reflux disease (Los Angeles classification grade C/D or Savary–Miller grade 3/4): to reduce severe oesophagitis to control symptoms as maintenance therapy?

Recommendation ID CG184/3 Question What is the clinical effectiveness of double-dose PPIs in people with severe erosive reflux disease (Los

Research recommendation Published November 2019

Which of the electronic information-sharing systems perform best for the care of people approaching the end of their life?

Recommendation ID NG142/2 Question Which of the electronic information-sharing systems perform best for the care of people approaching the

Research recommendation Published November 2019

What are the initial and add-on AEDs of choice in the treatment of the epilepsy syndromes with onset in childhood, for example, myoclonic-astatic epilepsy and Dravet syndrome?

Recommendation ID CG137/2 Question What are the initial and add-on AEDs of choice in the treatment of the epilepsy syndromes with onset

Research recommendation Published November 2019

What is the effectiveness of laparoscopic fundoplication compared with medical management in people with GORD that does not respond to optimal proton pump inhibitor (PPI) treatment?

Recommendation ID CG184/2 Question What is the effectiveness of laparoscopic fundoplication compared with medical management in people with

Research recommendation Published November 2019

What are the appropriate indications, effectiveness and safety of LDL apheresis in people with heterozygous FH?

Recommendation ID CG71/4 Question What are the appropriate indications, effectiveness and safety of LDL apheresis in people with heterozygous

Research recommendation Published November 2019