Med Tech-related technology assessments from NICE in November 2024

The National Institute for Health and Care Excellence (NICE) develops Interventional Procedures Guidance (IPG) for most 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.

In November 2024, NICE published one new IPG on endoscopic bipolar radiofrequency ablation for malignant biliary obstruction. NICE recommended that the procedure be done only in the context of research. The reasons for this recommendation include the following:

• The evidence for this procedure shows no major safety concerns but suggests that the procedure does not improve stent patency, which is the main aim of the procedure. Also, there is a lack of evidence on how the procedure affects quality of life, which is a key outcome;
• There is conflicting evidence on whether the procedure affects how long people live. In the evidence that shows a small benefit in overall survival, it is unclear why this is happening and whether it is affected by other factors;
• There is a lot of variability in the studies on the procedure. For example, they include different tumor types at different locations. They also use different types of stents and varying protocols for radiofrequency ablation;
• So, there are uncertainties, and more research is needed to understand the procedure's benefits better.

Furthermore, in November 2024, NICE published one new clinical guideline, Asthma: diagnosis, monitoring, and chronic asthma management, in collaboration with the British Thoracic Society (BTS) and Scottish Intercollegiate Guidelines Network (SIGN).

Two clinical guidelines were updated:

• Endometriosis: diagnosis and management – a new recommendation is made on transvaginal ultrasound, which is now should be offered to all patients with suspected endometriosis;
• Menopause: identification and management.

See the full details here.

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