Med Tech-related technology assessments and clinical guidelines from NICE in June 2022

In June 2022, NICE published three Interventional Procedures Guidance (IPG):

• Vertebral body tethering for idiopathic scoliosis in children and young people;
• Nerve graft for corneal denervation;
• Synthetic cartilage implant insertion for first metatarsophalangeal joint osteoarthritis (hallux rigidus).

IPG is developed for most of the novel interventional procedures entering the English market. The program focuses solely on clinical evidence. Recommendations may vary from "for research only" to "for use with standard arrangements for clinical governance, consent, and audit." Recommendations are not binding, although they are followed by providers and commissioners.

NICE made the following conclusions:

• Evidence on the safety of vertebral body tethering for idiopathic scoliosis in children and young people is limited but raises concerns of serious complications. Evidence on its efficacy is inadequate in quality and quantity. Therefore, this procedure should only be used in the context of research;
• Evidence on the safety of nerve graft for corneal denervation is limited but raises no major safety concerns. Evidence on efficacy is limited in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research;
• For synthetic cartilage implant insertion for first metatarsophalangeal joint osteoarthritis (hallux rigidus), conclusions differ depending on the clinical indications: for people with advanced disease for whom arthrodesis is indicated, evidence on the safety shows no major concerns in the short term, but evidence on efficacy is limited in quantity and quality. Therefore, for these people, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research; for all other people with hallux rigidus, evidence on safety shows no major concerns in the short term, but evidence on efficacy is inadequate in quantity and quality. Therefore, for these people, this procedure should only be used in the context of research.

Four new clinical guidelines were published in June 2022:

• Gout: diagnosis and management;
• Reducing sexually transmitted infections;
• Multiple sclerosis in adults: management;
• Depression in adults: treatment and management.

See the full details for guidance here, and for MIBs here

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