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**NICE Guidance Dissemination:** UK's Health Standards Online - The Role & Impact of NICE; Accessibility, Discrepancies,

Explore the UK's experience with health and the web through the perspective of Professor Sir Michael Rawlins, Chairman at NICE. Learn about NICE's purpose, development of guidance, and dissemination methods, including societal preferences and limitations. Discover the challenges and advancements in evidence development and dissemination techniques.

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**NICE Guidance Dissemination:** UK's Health Standards Online - The Role & Impact of NICE; Accessibility, Discrepancies,

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  1. Health and the Web:UK Experience Professor Sir Michael Rawlins Chairman, National Institute for Health and Clinical Excellence And Professor of Clinical Pharmacology, Newcastle upon Tyne

  2. Scope 1. Healthcare and the Web: UK Overview 2. NICE and the Web • Developing guidance • Disseminating guidance

  3. UK overview: general 1. Information • Public • Professional 2. Communications • Between professionals • Between professionals and patients 3. Research • Clinical trials • Patient monitoring

  4. UK overview: the NHS Primary care • Health records • Prescribing • Hospital appointments Secondary care • Patchy

  5. NICE’s Purpose To provide professional staff with advice on: • securing the highest attainable standards of clinical care for National Health Service patients • promoting and sustaining the public health

  6. NICE: setting standards For clinicians: • Use of individual health technologies • Management of conditions For public health professionals: • Single interventions • Programmes Effectiveness in practice Cost effectiveness

  7. The “virtual” Institute NICE Appraisal Committees Interventional Procedures Technology Assessment Groups Specialist advisors Public health interventions Collaborating Centres (clinical guidelines) PDGs (Public health) GDGs Collaborating Centres (public health)

  8. Developing NICE guidance Critical features: • Clinically/scientifically robust • Inclusive • Transparent • Independent

  9. Disseminating NICE guidance Predominantly web-based: • Full guidance • Short forms of guidance • Supporting evidence base

  10. Monthly page requests

  11. Monthly unique visitors

  12. Monthly visitor sessions

  13. Current in May 2006 Page requests: 6.2 million 200 Gigabytes E-mail newsletter: >35,000 registered E-mail updates: up to 6,000 per day

  14. Visitors 56.3% 43.4%

  15. Disseminating NICE guidance Limitations: 1. Short formats • How short? • For what purpose? 2. Patient formats • Access?

  16. The future? 1. Developing the evidence? 2. Disseminating the guidance? 3. Discovering societal preferences?

  17. Evidence development 1.Web-based approaches to clinical trial registries 2. Web-based approaches to conducting clinical trials 3. Web-based approaches to developing and maintaining registries 4. Web-based access to results of clinical trials

  18. Disseminating guidance Professionals: • PCs, hand-helds • E-mail alerts • Format(s) • Revisions/updates • Self-learning modules (CPD) Patients, families, carers • ??????

  19. Societal preferences (1) NICE’s Citizens Council: • Stratified random sample • age and gender • socio-economic status • ethnicity and disability • geography • Thirty members • Cross-section – not representative Deliberative democracy

  20. Citizens council (2005)

  21. Societal preferences (2) What is needed: • Broader representation (n=300 or 3000) • Retaining the deliberative element Could the web help?

  22. For more about NICE…. www.nice.org.uk

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