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  1. 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

  2. Evidence on the efficacy of open prenatal repair of open neural tube defects in the fetus is adequate in quantity and quality. However, evidence on its safety shows serious but well recognised safety concerns for the mother and fetus. Therefore, this procedure should only be used with  special arrangements   for clinical governance, consent, and audit or research.

    Recommendation ID IPG668 Question Evidence on the efficacy of open prenatal repair of open neural tube defects in the fetus is adequate