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Updated: May 25, 2026

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
06:05

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

Published on: February 19, 2021

Updating clinical practice recommendations: is it worthwhile and when?

Georgios Lyratzopoulos1, Steven Barnes, Heather Stegenga

  • 1National Institute for Health and Clinical Excellence (NICE). gl290@medschl.cam.ac.uk

International Journal of Technology Assessment in Health Care
|January 13, 2012
PubMed
Summary
This summary is machine-generated.

Updating clinical practice guidelines is challenging. The UK National Institute for Health and Clinical Excellence (NICE) system improved recommendations for interventional procedures by focusing on evidence growth.

Related Experiment Videos

Last Updated: May 25, 2026

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
06:05

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

Published on: February 19, 2021

Area of Science:

  • Health Services Research
  • Clinical Practice Guidelines
  • Evidence-Based Medicine

Background:

  • Updating clinical practice recommendations requires significant resources, often competing with the evaluation of new treatments.
  • Maintaining current guidelines amidst evolving evidence is a persistent challenge in healthcare.

Purpose of the Study:

  • To describe and evaluate the UK National Institute for Health and Clinical Excellence (NICE) approach for updating clinical practice recommendations for new interventional procedures.
  • To assess the association between changes in the evidence base and updated recommendations.

Main Methods:

  • The NICE system categorizes procedures based on evidence adequacy for safety and efficacy, recommending "normal" or "special" arrangements for patient consent, data collection, and oversight.
  • The study examined changes in recommendations for procedures updated after initial appraisal, focusing on those with initially inadequate evidence.
  • Changes in recommendations were analyzed in relation to increases in patient data from observational studies.

Main Results:

  • Since 2008, NICE has updated recommendations for procedures initially lacking sufficient evidence.
  • Eleven procedures with "special arrangements" recommendations were updated, with six transitioning to "normal arrangements" after a median of 5.3 years.
  • Procedures with recommendation changes showed a notable increase in patient numbers within published observational studies.

Conclusions:

  • Changes in clinical practice recommendations, particularly from "special" to "normal" arrangements, correlated with a strengthened evidence base.
  • This NICE experience offers insights for policymakers on resource allocation for updating clinical practice recommendations.
  • Further research is needed to understand the perceived value of updated recommendations among clinicians, policymakers, and patients.