A week in the life of a NICE information specialist... Caroline - - PowerPoint PPT Presentation

A week in the life of a NICE information specialist...

Caroline Miller Senior Information Specialist, NICE Supporting evidence-based healthcare: practice guideline production London health libraries study day,14 July 2011

Aim and coverage

• To illustrate how the NICE information services team

support the production of NICE guidance as well as wider information needs at the Institute

• Demonstrated by a typical working week which could

apply to all posts in the team including Assistant Information Specialists, Information Specialists and Senior Information Specialists

• For a ‘fictional’ member of staff!

The National Institute for Health and Clinical Excellence (NICE) is an independent organisation responsible for providing national guidance

• n the promotion of good health and the prevention and treatment of ill
• health. NICE also sets quality standards and manages NHS Evidence.

NICE produces; –Clinical guidelines –Technology appraisals –Interventional procedures –Public health guidance –Medical technologies guidance –Diagnostics guidance –Quality standards –Quality Outcomes Framework

NICE

Information services (IS) team – who are we?

• 25 members of staff, mostly qualified information

professionals;

– Associate Director (1) – Senior Information Specialists (5) – Information Specialists (13) – Assistant Information Specialists (5) – Administrator (1)

• 1/3 of the team are in London and 2/3 in Manchester
• Centralised team that provides tailored support for NICE
• All work on different projects – matrix management
• Liaison leads, embedded in team processes &

collaborate with analysts

• Information specialists in wider ‘NICE family’

Monday morning…

• A literature search request form has come in for an

Interventional Procedures topic and I’ll need to make a start on the systematic searches

• An interventional procedure is an invasive procedure

used for diagnosis or for treatment. This can involve:

– making a cut or a hole to gain access to the inside of a patient's body – using electromagnetic radiation (which includes X-rays, lasers, gamma-rays and ultraviolet light)

• NICE interventional procedures guidance

covers: the safety and efficacy of the procedure

Interventional Procedures

• Once I have a good idea of the topic area I’ll make a

start on drafting and refining the MEDLINE search…

• …and once I’m happy with the MEDLINE search it can

be translated for searching other databases and websites (e.g. EMBASE, Cochrane Library, CINAHL, DARE)

• Recent examples of topics include

– Endoscopic saphenous vein harvest for coronary artery bypass grafting – Endovascular closure of perimembranous ventricular septal defect

Monday afternoon…

• This afternoon I’m going to check our Internal electronic

Helpdesk to find requests for articles/books from NICE staff

• A training request has also come in for Reference

Manager training

• We also receive reference enquiries and ad

hoc searches requests via the helpdesk

Library service

• The Information Services team provides a library

service for all NICE staff. In addition to a document supply service, this includes: – Physical collections

• Books, Journals, reference material

– Electronic collections

• Databases (e.g. MEDLINE, EMBASE)
• eJournals

– Electronic Library catalogue (Librarything) – Intranet resources – Swap-a-book collection

Information skills training

• Introductory literature searching
• Advanced literature searching
• Pharmaceutical information
• Health information on the internet
• Searching clinical trials registries
• Reference managing
• Accessing journal articles
• Searching the Cochrane library

Tuesday morning…

• I’m working on a topic selection briefing note for a new

drug in the pipeline - rivaroxaban for the prevention of venous thromboembolism

• Required to identify all the related NICE guidance and

topics in the topic selection process and formulate a draft remit according to the proposed indication

Topic Selection

• Topic selection is the process whereby topics are

assessed and prioritised for the NICE work programme

• The briefing notes that the IS team contribute to are

reviewed at a topic selection prioritisation meeting

• Prioritised topics are then considered by DH Ministers
• Ministers then make final referrals to NICE,

for guidance topics

Tuesday afternoon…

• We’ve just received a referral from the Health Minister

for a new batch of topics for the NICE work programme. I’ll need to assign each topic indexing terms from the NICE taxonomy so that people searching the website by subject will retrieve the topics

• I’ll also need to liaise with the comms team and the

indexers around timelines and to ensure that any new terms are uploaded to the website content management system (CMS)

NICE Taxonomy

• A classification scheme providing a consistent language

across NICE to support website navigation and the efficient search and retrieval of information

• The Taxonomy was created using terms from other

controlled vocabularies (MeSH, ICD-10, BNF, PHL and

• thers)
• The Taxonomy is Multi-hierarchical in structure and ‘fit

for purpose’

• It is updated once a month by the

IS team using Multites software

Later on Tuesday afternoon…

• I will be doing searches for briefing papers for the

following quality and outcomes framework (QOF indicator) topic - Urinary incontinence in women

• The QOF is a voluntary incentive scheme which

rewards GP practices in the UK for how well they care for patients.

• I’ll gather UK guidance, policies, epidemiological

information etc to set the context for QOF indicators for the QOF team

Last thing on Tuesday…

• Lastly this afternoon I will be doing scoping searches

for the following quality standards (QS) topic - Depression.

• NICE quality standards are a set of specific, concise

statements that act as markers of high-quality, cost- effective patient care, covering the treatment and prevention of different diseases and conditions.

• Similar to the QOF work, I’ll be gathering related NICE

guidance, other UK guidance and policy information

Wednesday morning…

A public health topic has been received for scoping input on the physical and emotional wellbeing of looked after children and young people

• working with a public health analyst to establish the

groups of children that could be included

• look at the topic selection briefing note
• search for further background
• locate some statistics

Public health guidance

• Public health guidance makes recommendations for

populations and individuals on activities, policies and strategies that can help prevent disease or improve health.

• The guidance may focus on a particular topic (such as

smoking), a particular population (such as schoolchildren) or a particular setting (such as the workplace).

• Systematic review process is carried out externally by

collaborating centers or external groups

Wednesday afternoon…

• This afternoon I’m going to work on a bulletin for the

monthly current awareness service.

• I coordinate the development of a current awareness

bulletin on ‘Research Methodology’

• We produce 10 bulletins listing bibliographic references

and reports

• Subjects include NICE work, public health,

information science, commissioning, patient & public involvement, patient access schemes, implementation and market research.

Thursday morning…

Later on this morning I’ve been asked to attend a meeting with the short clinical guideline team to discuss the clinical questions for a guideline on ‘The recognition and diagnosis of coeliac disease’ I’ll need to do some preparation for the meeting:

• review the questions to check they are ‘searchable’
• think through the timelines for each search

Short clinical guidelines

• The short clinical guidelines are developed by an in-

house technical team following the same robust methodology as for the ‘standard’ guideline programme, using the ‘Guidelines manual’

• There are 8 clinical questions and it looks like some of

the questions can be ‘lumped’ together for searching purposes, making 4 searchable (PICO-type) questions – Incidence and prevalence – Signs and symptoms of coeliac disease – Co-existing conditions and risk of coeliac disease – Diagnosis of coeliac disease (serological testing)

Thursday afternoon…

I’ve been asked to work on the scope for a technology appraisal on Exenatide for type 2 diabetes – search for further details on exenatide, background and epidemiological information – search for key trials – Related guidance – NICE & external – collate information on our intranet – Analysts use the information to write a draft scope that will go out for consultation

Later on Thursday afternoon

• I receive a request to work on a search for NICE

pathways

• I need to identify all NICE guidance relevant to diabetes

for the NICE pathway on diabetes

• I hope to reuse some of the searches I did for related

NICE guidance for the technology appraisal topic I was working on this morning

NICE pathways

• NICE Pathways is an online tool for health and social

care professionals that brings together all related NICE guidance and associated products in a set of interactive topic-based diagrams.

• Each pathway includes all relevant NICE guidance,

including clinical guidelines, public health guidance, technology appraisals, interventional procedures, medical technology and diagnostics guidance, and quality standards, and accompanying tools produced by NICE to support implementation

Friday morning…

• I’ve just had the input from the technical analyst

regarding a review of a technology appraisal.

• All technology appraisals have a review date where a

decision is made as to whether the guidance will be reviewed

• The IS team writes review proposals to be

considered for guidance executive on whether appraisals should be reviewed after publication.

Late Friday morning

• A search for a Medical Technologies Evaluation

Programme (MTEP) topic on a new device - Ambulight photodynamic therapy for the treatment of non- melanoma skin cancer has just come in.

• A search for background on the technology, the

population and prevalence/incidence, trials, comparators, policy information and related NICE and external guidance is required.

Medical technologies guidance

• The Medical Technologies Evaluation Programme

(MTEP) focuses specifically on the selection and evaluation of new or innovative medical technologies

• Medical technologies guidance is designed to help the

NHS adopt efficient and cost effective medical devices and diagnostics more rapidly and consistently.

• 2 types of guidance;

– Medical technology appraisal guidance – Diagnostics guidance

Friday afternoon…

• This afternoon I’m working on the focused searching for

chronic fatigue syndrome for the guidelines review programme

• Very much a balance between sensitivity and

specificity: when to stop searching when you’re not sure how much evidence is enough to change an existing recommendation?

• Analysts give a steer on the questions to be addressed

and the searching required

Clinical guideline reviews

• Assessing whether guidance needs updating
• Carry out scoping and focused searching to find

evidence that would trigger review

• Review decision put out for consultation and then a

national collaborating centre will update the guideline if the decision is taken to review

In summary…the IS team supports…

• Interventional

procedures

• Short clinical guidelines
• Technology appraisals

scoping

• Medical technologies

guidance

• Public health
• QOF & quality

standards

• Decisions on whether

to review technology appraisals and clinical guidelines

• NICE pathways
• Topic selection
• NICE library service,

current awareness, training & taxonomy

In summary… the role of the IS team in supporting guidance production

• Systematic & general literature searching
• Reviewing and updating literature searches
• Quality assurance of search strategies and protocols

from external public health collaborating centres

• Identifying related NICE and other UK/international

guidance

• Retrieving policy information
• Finding background information on diseases,

behaviours, populations, technologies etc

• Finding statistics – incidence & prevalence data
• Current awareness
• Provide a library service – information resources

The end of the week… Any questions…?