Validity of NICE guidance for GPs questioned

Most studies used to develop NICE guidelines for general practice are not applicable to primary care, a UK study has found.

NICE: advice for GPs questioned by UK researchers
NICE: advice for GPs questioned by UK researchers

Only 39% of the studies NICE has used to draw up recommendations for primary are actually relevant to that setting, University of East Anglia research shows.

The findings will be presented at the Society for Academic Primary Care conference next week. Ahead of the conference, Dr Asmaa Abdelhamid told GP that guidelines should explicitly state when evidence is relevant to a target population.

NICE guidelines form the basis of QOF indicators, but much of the research used in guidelines is conducted in secondary care settings.

The researchers examined 22 clinical guidelines, which included 777 recommendations relevant to primary care. But only 39% of 1,573 studies behind these recommendations were deemed relevant to primary care.

The researchers warned that when guidelines are developed, evidence ‘is often simply not assessed for relevance to its intended audience, in this case primary care’.

A NICE spokesman said: 'As the "consequences" section of the abstract points out, there may not actually be any evidence that has been collected from primary care. It is our belief that in the guidelines examined, if the evidence had existed, we would have found it.'

He added that since the study was concluded, NICE has introduced a system called GRADE, which assesses the relevance of evidence, including the setting in which it was conducted.

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