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National Institute for Health and Care Excellence clinical guidelines development principles and processes
  1. Madalina Garbi
  1. Department of Cardiology, Royal Papworth Hospital, Cambridge Biomedical Campus, Cambridge, UK
  1. Correspondence to Dr Madalina Garbi, Department of Cardiology, Royal Papworth Hospital, Cambridge CB2 0AY, UK; madalina.garbi{at}


Clinical guidelines are developed by professional societies and also, in England, by an independent non-departmental public body, the National Institute for Health and Care Excellence (NICE). Similarities and differences between these guidelines should be viewed in the context of different objectives, responsibilities and roles of guideline developers. This review describes the NICE clinical guidelines development principles and processes with the aim to provide the reader an informed perspective on the recommendations made. NICE clinical guidelines are developed by an appointed independent advisory committee comprising healthcare professionals as well as lay members, supported by a professional team comprising project managers, information specialists, systematic reviewers and health economists. Furthermore, registered stakeholders comprising organisations that have an interest in the guideline topic, or represent people whose practice or care may be directly affected by the guideline, are consulted on the draft scope and draft guidelines. NICE selects a limited number of high impact questions to be answered by the review of evidence, rather than cover a certain topic exhaustively as the clinical guidelines developed by professional societies may do. NICE clinical guidelines recommendations reflect both the clinical effectiveness and the cost-effectiveness of interventions.

  • heart valve diseases
  • health services
  • quality of health care
  • health care economics and organisations

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  • Contributors MG is the sole author of this review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The views expressed in this publication are those of the author and not necessarily those of NICE.

  • Competing interests MG is the NICE topic advisor on heart valve disease.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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