Med Tech and IVD-related technology assessments and guidance from NICE in the first half May 2017

The following technology assessments and clinical guidelines have been already released by NICE in May 2017:

• Medtech Innovation Briefings for NaviCam (magnetically controlled capsule endoscopy system, which is used for diagnosing conditions of the upper gastrointestinal tract and small bowel) and Hemosep (used for cell salvage and haemoconcentration during surgery)
• Clinical Guidelines for hip fracture management, intravenous fluid therapy in adults in hospital and management of type 2 diabetes in adults were updated
• Interventional Procedure Guidance: Irreversible electroporation for treating pancreatic cancer. This procedure should only be used with special arrangements for clinical governance, consent and audit or research due to inadequate quantity and quality of current evidence on the safety and efficacy.
• Diagnostic Guidance for Virtual chromoendoscopy to assess colorectal polyps during colonoscopy

NICE published new Diagnostic Guidance for Virtual chromoendoscopy to assess colorectal polyps during colonoscopy. Virtual chromoendoscopy using NBI, FICE or i‑scan is recommended to assess polyps of 5 mm or less during colonoscopy, instead of histopathology, to determine whether they are adenomatous or hyperplastic, only if:

• high-definition enabled virtual chromoendoscopy equipment is used;
• the endoscopist has been trained to use virtual chromoendoscopy, and accredited to use the technique under a national accreditation scheme;
• the endoscopy service includes systems to audit endoscopists and provide ongoing feedback on their performance;
• the assessment is made with high confidence.

Clinical Guidelines for hip fracture management, intravenous fluid therapy in adults in hospital and management of type 2 diabetes in adults were updated.

NICE has updated recommendations on the surgical management of hip fracture in the Clinical Guideline:

• offer replacement arthroplasty (total hip replacement or hemiarthroplasty) to patients with a displaced intracapsular hip fracture
• Offer total hip replacement rather than hemiarthroplasty to patients with a displaced intracapsular hip fracture who:
  • were able to walk independently out of doors with no more than the use of a stick and
  • are not cognitively impaired and
  • are medically fit for anaesthesia and the procedure

In the Clinical guideline for management of type 2 diabetes in adults text on sodium–glucose cotransporter 2 (SGLT-2) inhibitors was added to the section on initial drug treatment, including new information on SGLT-2 inhibitors to take if metformin is contraindicated or not tolerated. The algorithm for blood glucose lowering therapy in adults with type 2 diabetes was also updated.

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