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Letters NICE guidelines on the menopause

NICE guideline committee’s comments on editorial about menopause guideline

BMJ 2016; 353 doi: (Published 11 May 2016) Cite this as: BMJ 2016;353:i2257
  1. Grammati Sarri, senior research fellow and guideline lead1,
  2. Melanie Davies, clinical director, consultant gynaecologist2,
  3. Mary Ann Lumsden, professor of medical education and gynaecology, honorary consultant gynaecologist3
  1. 1National Collaborating Centre for Women’s and Children’s Health, Royal College of Obstetricians and Gynaecologists, London NW1 4RG, UK
  2. 2National Collaborating Centre for Women’s and Children’s Health, Royal College of Gynaecologists and Obstetricians; University College London Hospitals, London, UK
  3. 3Reproductive and Maternal Medicine, University of Glasgow; Glasgow Royal Infirmary, Glasgow, UK
  1. gsarri{at}

We read with interest editorial on the National Institute for Health and Care Excellence (NICE) menopause guideline,1 and their comments on the presentation of evidence underpinning the guideline’s recommendations.2

We dispute their allegation that “methodological deficiencies undermine its conclusions.” The development of this guideline was based on a rigorous methodological approach involving a complex meta-analysis, known as a network meta-analysis. This method was used to assess the relative effectiveness of different treatments (pharmacological and non-pharmacological) to reduce the occurrence of vasomotor symptoms. This complex meta-analysis is methodologically superior to conventional meta-analyses because it allows the simultaneous comparison of different treatments to achieve an outcome for the population of interest (in this case, women in menopause). All the relevant peer reviewed publications …

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