NICE and Cochrane sign collaborative agreement to deliver ‘living’ guideline recommendations

Sly Saint

Sly Saint

Senior Member (Voting Rights)
NICE and Cochrane have today (01st September 2021) signed a collaborative agreement which will help to deliver ‘living’ recommendations across the NICE guideline portfolio.

NICE and Cochrane have today (01st September 2021) signed a collaborative agreement which will help to deliver ‘living’ recommendations across the NICE guideline portfolio.

The agreement will mean that the NHS and patients will benefit from a collaborative process which will enable NICE to better use Cochrane reviews in responding to changes in the evidence. The partnership will allow NICE to make efficient and effective updates to the recommendations in its guidelines.

The announcement today follows the recent publication of NICE’s new 5-year strategy which commits it to finding more flexible and faster ways of working.

One of the keys aims to the strategy is to provide dynamic, living guideline recommendations that are useful, useable and rapidly updated.

Cochrane has a long-established relationship with the NHS and receives a large proportion of its funding from the National Institute for Health Research (NIHR), and their systematic reviews of health evidence are already used to inform NICE guidelines.
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rest of article here
https://www.wired-gov.net/wg/news.n...guideline+recommendations+01092021120500?open
 
My heart sinks with just reading the title of the thread.

I do hope I am not being over pessimistic, and the NICE ME/CFS evidence review, though the resultant guidelines are not without fault, was to be fair of much higher standard than the related Cochrane reviews.
 
Might be more reasonable if only both NICE and Cochrane had a proper understanding of what constitutes a conflict of interest and subsequently disregarded any reviews that were conducted by those researchers or clinicians who have them, but we know how this goes.

With regards to ME/CFS this piece of news highlights how essential it is that PEM/PESE is considered the cardinal symptom of the condition by NICE.
 
Two organizations utterly incapable of following through on necessary corrections taking several years inspires exactly zero confidence in their ability to do any of this. Neither can even correct basic mistakes made more than a decade ago with overwhelming evidence of failure and massively worsened outcomes.

Zero chance that this is good for patients, it's the kind of news that should send shivers down millions of spines.
 
Ariel said:
Why would NICE want to do this??
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I suspect to cut costs.

A NICE review will be very expensive. And I think if I were the Department of Health I would wonder quite why four years have to be spent creating vast spreadsheets of a body of evidence that turns out to say nothing useful.

Maybe a systematic review is needed but if Cochrane is mostly funded by NIHR the DoH is paying to do the same thing twice.
 
Ariel said:
Why would NICE want to do this??
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I guess they've agreed some set of protocols about how each uses data, very likely based on what has already been happening without a formal agreement, and this will mean that whenever Cochrane produces a review this can translate into a NICE update without NICE having to go through the full round of its processes. As a management approach it looks to be very sensible, how it works in practice time will tell. I don't think it is particularly sinister although the rule of unintended consequences will no doubt produce some interesting outcomes over time.
 
Ariel said:
Why is Cochrane funded by NIHR?
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Only the review groups (usually based round a disease area) based in the UK are funded by NIHR. That about half of them. Eg. the MS group is based in Italy so is not funded by NIHR. The Work Group is based in The Netherlands. The "consumers and communication" group is based in australia. There is a bloated central executive in London which is funded by NIHR but NIHR are threatening to withdraw the funding for infrastructure. The whole structure is pretty stupid. The way NICE does reviews (ie. reviewing all treatments for one condition at once to inform guidelines) is much more useful to patients. This collaboration with NICE is a way Cochrane can try and survive I guess because they can drip feed reviews on one treatment at a time. But the volunteer model leading to significant problems of researcher allegiance (as we saw with ME CFS reviews) needs to be addressed. I am not confident it will be. But NICE will save money because they won't have to pay professional non-conflicted reviewers any more.
 
Wonko said:
So, unprofessional conflicted reviewers are cheaper?

Therefore the way to go.

Gotta love 'em
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I'm sure they're not *all* unprofessional and conflicted. But there will be no way of telling whether they are or not, and presumably NICE won't be concerned about researcher allegiance any more than Cochrane were with the CFS reviews. Neither Cochrane or NICE look at conflicts in individual studies so I am sure they are not going to start now. I will write and ask how NICE are going to make sure Cochrane reviewers always use GRADE sensibly as they have made different judgements on the evidence quality for GET. There seems little point now in Cochrane continuing with the exercise review as there is no new evidence to feed into NICE's review. So perhaps they will finally withdraw it...
 
article said:
which will enable NICE to better use Cochrane reviews in responding to changes in the evidence. The partnership will allow NICE to make efficient and effective updates to the recommendations in its guidelines.
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Caroline Struthers said:
There seems little point now in Cochrane continuing with the exercise review as there is no new evidence to feed into NICE's review. So perhaps they will finally withdraw it...
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or, it ups the stakes for the Cochrane Exercise Review?

Hasn't another PACE paper been promised? What could possibly go wrong?
 
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