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BMJ 2003;327:1061-1062 (8 November), doi:10.1136/bmj.327.7423.1061
The report card is good, but incomplete
| The first 150 words of the full text of this article appear below. |
The National Institute of Clinical Excellence (NICE) has emerged in the brief period of its existence as an important influence on decision making and allocation of resources by the NHS. The recent release of a report by the World Health Organization on NICE's technology appraisal programme provides an international perspective on NICE's processes and impact.1
By design, the report has important limitations. NICE commissioned it in response to concerns raised by the 2002 Select Committee Inquiry2 regarding the scientific validity of its processes. NICE restricted WHO to consideration of the "methods and scientific robustness" of technology appraisal and resulting guidance. Other important roles NICE has, such as providing clinical guidelines and recommendations on audit methods, are not assessed. Wider questions about NICE's role as a de facto priority setting body for the NHS are acknowledged but not addressed. These include non-trivial issueswhat impact does guidance from NICE have in practice
Nancy Devlin, professor
(n.j.devlin@city.ac.uk)
David Parkin, professor
(d.parkin@city.ac.uk) City Health Economics Centre, City University, London EC1V OHB
Marthe Gold, Logan Professor of Community Health and Social Medicine
City University of New York Medical School, 138th Street and Convent Avenue, New York, NY 10031, USA (goldmr@sci.ccny.cuny.edu)
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