BMJ  2007;334:814 (21 April), doi:10.1136/bmj.39185.472743.3A

Letters

Transparency in NICE

Construction and assumptions of models should be explicit

The first 150 words of the full text of this article appear below.

The National Institute for health and Clinical Excellence (NICE) uses Markov modelling, a form of decision analysis that models the effectiveness and cost effectiveness of drugs or other medical interventions in a cohort of patients over time.1 2 Construction of a Markov model relies on judgments of the likely outcomes of drug treatment, including benefits and harms.

I was asked to comment on the updated hypertension guidelines produced by NICE and the British Hypertension Society (BHS) on behalf of the Royal College of General Practitioners as part of the consultation process in spring 2006. Drug treatment for hypertension is a controversial area as guideline recommendations between the United States and the United Kingdom differ in the interpretation of recent randomised trials comparing newer and older antihypertensive agents.3

My comments related to the transparency of the Markov assumptions, including preferential modelling of diabetes as an adverse health state, failure to model differential . . . [Full text of this article]

Tom Fahey, professor of general practice and family medicine

Royal College of Surgeons in Ireland Medical School, Mercers Medical Centre, Dublin 2

tomfahey@rcsi.ie


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This article has been cited by other articles:

  • Alderson, P. R, Page, M., Littlejohns, P. (2007). NICE was explicit in constructing guideline. BMJ 334: 918-918 [Full text]  

Rapid Responses:

Read all Rapid Responses

Transparency of NICE hypertension guideline
Philip R Alderson, et al.
bmj.com, 25 Apr 2007 [Full text]
Re: Transparency of NICE hypertension guideline
Tom Fahey
bmj.com, 26 Apr 2007 [Full text]
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