National Institute for Clinical Excellence

Over time, of course, such awareness has continued to grow, although so too has the realization that it should not be cost that drives macro or micro decision-making, but cost-effectiveness. That is, the health-care system needs to achieve a good balance between the resources it uses (the costs) and the outcomes it achieves (the effectiveness). More recent developments, such as the establishment of the National Institute for Clinical Excellence, make abundantly clear both the enduring relevance of economic considerations when deciding how to use health service resources and the pervasive need to balance economic with clinical (and related) objectives. 

Seizure Type American Academy of Neurology Scottish Intercollegiate Guidelines Network United Kingdom National Institute for Clinical Excellence... 

National Institute for Clinical Excellence. The Epilepsies The Diagnosis and Management of the Epilepsies in Children and Adults in Primary and Secondary Care http //www.nice.org.uk/ pdf/CG020NICEguideline.pdf. Accessed December 20, 2005. 

NICE, Depression Management of Depression in Primary and Secondary Care. Clinical Practice Guideline No. 23 , National Institute for Clinical Excellence www.nice.org.uk/page.aspxio = 235213 Nitzan, Uriel and Pesach Lichtenberg, Questionnaire Survey on Use of Placebo , British Medical Journal 329 (2004) 944-46 Park, Lee C. and Lino Covi, Nonblind Placebo Trial , Archives of General Psychiatry 12, no. 4 (1965) 336-45... 

Data from French Je, farmer AM, BautistaJ, etal. Neurology2004 62 1252-1260 French JA, farmer AM, Bautista J, eta Neurology 2004 62 1261-1273 National Institute for Clinical Excellence. 2006, htpZ/www.nice.org.uk National Institute for Clinical Excellence. 2006, http //rmw.nice org. uk Clauser T, Ben-Menachem E Bourgeois B, et al. Epilepsia 2006 47 1094-1120 and farceski S, Morrell MJ, Carpenter D. Expert opinion. Epilepsy Behav2005 7 SI-S64. 

In 1997, the British Government proposed in the White Paper The New NHSiModern and Dependable that the National Institute for Clinical Excellence (NICE) should be established,- a proposal endorsed by Griffin. ... 

The National Institute for Clinical Excellence (NICE). Available HTTP (accessed 2 April 2003). 

Rawlins, M. D, and A. J. Culyer. 2004. National Institute for Clinical Excellence and Its Value Judgments. British Medical Journal 329 224—227. 

WUby, J., A. Kainth, N. Hawkins, D. Epstein, C. McDaid, et al. 2003. A Rapid and Systematic Review of the Clinical Effectiveness, Tolerability and Cost-Effectiveness of Newer Drugs for Epilepsy in Adults. Report to the National Institute for Clinical Excellence, forthcoming. 

National Institute for Clinical Excellence. Dyspepsia-management of dyspepsia in adults in primary care. Clinical guidehne 2004 17 August [amended 2005 June]. Available from URL www.nice.org.uk... 

Since Kuhn s paper on imipramine, it has been believed that antidepressants are most effective in severe depression. Many people, who are sceptical of their widespread use for milder cases, maintain that antidepressants are nevertheless effective and necessary in severe depression. It has also been suggested that the reason some studies find little difference between antidepressants and placebo is because they are conducted with people with mild depression, who dilute the antidepressant effect (National Institute for Clinical Excellence 2004). The National Institute for Clinical Excellence guidelines on the treatment of depression have gone as far as to suggest recently that antidepressants should not be prescribed to people with mild depression, and should only be used in cases of moderate and severe depression. However there is actually little evidence for the presumption that antidepressants are effective in severe depression. 

Lithium is rarely used as the only treatment for acute mania, a practical acknowledgment of its limitations. If it is used at all it is combined with a neuroleptic and other sedatives are frequently prescribed as well. Trials comparing effects of lithium and carbamazepine in acute mania reveal that substantial doses of benzodiazepines or barbiturates were used in addition to the study drugs (Freeman et al. 1992 Small et al. 1991). However the belief in lithium s specificity for manic depression means it is still deemed an effective treatment and it is still recommended for mild to moderate cases of mania (National Institute for Clinical Excellence 2006). 

National Institute for Clinical Excellence. 2002, Schizophrenia Core interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care. National Institute for Clinical Excellence, London. 

The National Institute for Clinical Excellence published a guideline on diabetic footcare in 2004 which recommends regular (at least annual) visual inspection of patients feet with assessment of foot sensation and palpation of foot pulses by trained personnel (NICE, 2004). Pharmacists can play an important role in patient education around self-care and self-monitoring of the feet. 

Johnston, S. (2004), Ovarian cancer Review of the national institute for clinical excellence (NICE) guidance recommendations, Cancer Inv., 22,730-742. 

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