Evidence
How we made the decision
How we made the decision
We check our guidelines regularly to ensure they remain up to date. We based the decision on surveillance 6 years after the publication of autism spectrum disorder in under 19s: recognition, referral and diagnosis (2011) NICE guideline CG128, and 4 years after the publication of autism spectrum disorder in under 19s: support and management (2013) NICE guideline CG170.
For details of the process and update decisions that are available, see ensuring that published guidelines are current and accurate in 'Developing NICE guidelines: the manual'.
Previous surveillance update decisions for NICE guideline CG128 are on our website.
New evidence
Autism spectrum disorder in under 19s: recognition, referral and diagnosis (NICE guideline CG128)
We found 83 new studies in a search for diagnostic studies published between 1 January 2014 and 26 January 2016. We also considered 4 additional studies identified by members of the guideline committee who originally worked on this guideline. A further 3 studies were identified through post-publication communications.
Evidence identified in previous surveillance 4 years after publication of the guideline was also considered. This included 144 studies identified by search and 25 studies identified during the 2‑year evidence update.
From all sources, 259 studies were considered to be relevant to the guideline.
We also checked for relevant ongoing research, which will be evaluated again at the next surveillance review of the guideline.
See appendix A1: summary of new evidence from surveillance and references for all new evidence considered.
Autism spectrum disorder in under 19s: support and management (NICE guideline CG170)
We found 38 new studies in a search for randomised controlled trials and systematic reviews published between 1 January 2013 and 19 January 2016. We also considered 7 additional studies identified by members of the guideline committee who originally worked on this guideline. A further 6 studies were identified through post-publication communications.
From all sources, 51 studies were considered to be relevant to the guideline.
We also checked for relevant ongoing research, which will be evaluated again at the next surveillance review of the guideline.
See appendix A2: summary of new evidence from surveillance and references for all new evidence considered.
Views of topic experts
We considered the views of topic experts, including those who helped to develop the guideline and other correspondence we have received since the publication of the guideline. This included a meeting with experts to discuss potential areas for update in NICE guideline CG128.
Views of stakeholders
Stakeholders commented on the decision not to update NICE guideline CG170. Overall, 11 stakeholders commented. See appendix B for stakeholders' comments and our responses.
Eleven stakeholders commented on the proposal not to update the guideline: 3 agreed with the decision and 9 disagreed with the decision. Consultees suggested new evidence which was related to specific review questions and recommendations. The relevant evidence was added to appendices A1 and A2 but was not felt to impact on guideline recommendations. Consultees felt that applied behavioural analysis (ABA) should be recommended by NICE as an intervention to manage autism in children and young people. However, it was noted that high quality evidence was not found for ABA during guideline development or surveillance review. Most of the evidence for ABA comes from single-case experimental designs which have limitations like the restriction of generalisation to wider population and the high risk of publication bias. This area will be considered again at the next surveillance review of the guideline.
This surveillance review also proposed to remove 4 research recommendations from the NICE version of NICE guideline CG170 and the NICE research recommendations database. Six consultees answered the proposal. Four consultees disagreed and 2 agreed with this proposal. It was decided to retain these research recommendations based on the overwhelming feedback on their importance.
See ensuring that published guidelines are current and accurate in 'Developing NICE guidelines: the manual' for more details on our consultation processes.
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