7 Decisions about whether an update is needed

NICE process and methods

The decision-making process will be the same at all surveillance time points.

It will be based on a balanced assessment of new evidence that has become available since guideline publication and the views of the Guideline Development Group (GDG) and other sources of information about the continued relevance of the guideline. The findings of the surveillance review and the proposed decision will be discussed with the chair or clinical adviser of the original GDG. A surveillance review proposal will be made initially by the Centre for Clinical Practice (CCP) analysts who conducted the review, and will reflect their knowledge of the existing guideline and experience of undertaking reviews of this nature. All surveillance review proposals will go through an internal validation process (including sign-off by the Technical Adviser, Associate Director and CCP Director) before submission to NICE Guidance Executive.

The surveillance review proposal will be one of the options shown in table 2.

Table 2 Possible surveillance review proposal options

Decision	Outcome and actions
Substantial update	Commissioned using standard guideline development process (see the NICE guidelines manual 2012).
Rapid update	Commissioned using the Updates Standing Committee process (in development).
No update	Review again at next surveillance time point or Bring forward next surveillance evidence review time point. This decision would be made exceptionally – for example, if it is clear that new evidence critical to the decision is in the process of being published. Consultation with stakeholders only at 4-year and 8-year surveillance evidence reviews.
Transfer to the static list	Topics that have undergone a full surveillance evidence review with 'no update' proposed will be considered for the 'static list', with public consultation on the decision. Guidelines on the static list will remain extant and will be assessed again after 5 years.
Withdraw the guideline	The guideline no longer applies. This decision would be made exceptionally – for example, it may be decided that the recommendations in a guideline no longer apply but that the guideline is not of sufficiently high priority for updating. In this case the guideline will be withdrawn. Consult with stakeholders on the decision.

The final decision on whether to update a clinical guideline in whole or in part (the surveillance review decision) will be taken by NICE Guidance Executive following advice from the CCP Director.