NICE and Cochrane sign collaborative agreement to deliver ‘living’ guideline recommendations

@CRG
I was a little surprised to learn that Gillian Leng, recently retired Chief Executive of NICE, "[had been]Editor for the Cochrane Collaboration for many years, and is now chair of the Guidelines International Network"*.
NICE of course recently signed a collaborative agreement with Cochrane.

I'm guessing that these two facts don't necessarily add up to anything inappropriate but I thought I'd seek your views. Thanks.


*"In Conversation Live with Professor Gillian Leng CBE
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About this event
  • Date and timeWed 26 Jan 2022 from 7:00pm to 8:05pm
  • LocationOnline
Register here to join our In Conversation Live with Professor Gillian Leng CBE

Professor Gillian Leng, Chief Executive of NICE, will be joining Professor Roger Kirby, RSM President, for a conversation about --- her strategic approach to improving NICE guidelines and evaluating medicines---

Gillian trained in medicine at Leeds and as a Junior Doctor she was struck by variations in clinical practice, this developed into a passion for using evidence to improve care. She then moved to work on clinical trials and epidemiological research in Edinburgh, and later, was a Public Health Consultant in London. She was an Editor for the Cochrane Collaboration for many years, and is now chair of the Guidelines International Network."
 
I listened to some of the interview with Leng. Kirby tried to get her to comment on controversial things but she specifically started by saying she was not going to mention ME!

So presumably ME has been uppermost in her mind as controversial. Interesting that she referred to it just as ME, not even ME/CFS.
 
Jonathan Edwards said:
I listened to some of the interview with Leng. Kirby tried to get her to comment on controversial things but she specifically started by saying she was not going to mention ME!

So presumably ME has been uppermost in her mind as controversial. Interesting that she referred to it just as ME, not even ME/CFS.
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Ahh. I completely forgot about this.
 
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Jonathan Edwards said:
I listened to some of the interview with Leng. Kirby tried to get her to comment on controversial things but she specifically started by saying she was not going to mention ME!

So presumably ME has been uppermost in her mind as controversial. Interesting that she referred to it just as ME, not even ME/CFS.
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With great power comes no comment.

It's so nice to be beneath comment. Really emphasizes that our lives are in such good hands.
 
I listened too. Was interested she specifically said she was not going to talk about the ME guideline! I missed the answer she gave to Charles Shepherd as I was composing my own question (about the lack of transparency in Cochrane compared to NICE) which was not answered. She was forced to talk (briefly) about the pause in the end.

She replied to my email this morning. (link to my email https://healthycontrol.org/2021/12/31/letter-to-gill-leng-nice/)

I wonder if she will be the new CEO of Cochrane...it crossed my mind a few months ago?! Could happen...

Dear Caroline

Thank you for your email regarding the Cochrane/NICE collaboration. I understand that you raise 2 key issues for NICE which I will address in turn.

Firstly, your concern about the ongoing Cochrane review into exercise therapy. It would be inappropriate for me to comment on decisions taken by Cochrane about the continuation of their review. From a broader perspective on NICE’s collaboration with Cochrane, we are developing a Guideline Support Document (GSD). This will be an operational guide that broadly aims to support the use of Cochrane reviews and topic expertise within Cochrane Review Groups in the development of NICE guidelines. We are currently compiling a working draft of the GSD for inclusion within the 2022 update to the guideline manual, where it will be subject to public consultation later this year.

We recognise the inherent value of reducing duplication of reviewing activity. However, we also accept that there will be occasions where undertaking separate reviews will be beneficial/appropriate. This is supported by the following extract from the working draft of the GSD:

“Discuss and seek agreement from the NICE quality assurance team for the rationale for the exclusion of a Cochrane review, at the earliest opportunity, if the guideline committee is of the view that it is not appropriate for consideration in the guideline and a new review is required. On occasion, it might be appropriate or beneficial for Cochrane and NICE to produce separate systematic reviews on a topic. For example, where differing perspectives (NICE’s UK focus versus Cochrane’s global perspective) may impact on how the question is framed, or where there are particular controversies or uncertainties in a research area and replication of a review could be helpful.“

Secondly, in terms of the quality assurance of Cochrane reviews. As above, we recognise that there will be occasions where replication of a review to ensure NICE’s needs are met will be appropriate (for example, where differences in PICOs, methodological approach etc between NICE and Cochrane might be entirely reasonable). As you say, our guideline development and quality assurance processes are designed to mitigate risk. Importantly, the GSD also provides mechanisms for linking guideline developers, the NICE QA team, Cochrane authors and the Cochrane editorial (QA) team for surfacing and understanding points of divergence which will be key in informing ongoing development of systematic reviewing and guideline development methods and processes.

Yours sincerely,

Professor Gillian Leng CBE
Chief executive


National Institute for Health and Care Excellence
2nd Floor, 2 Redman Place
London
E20 1JQ
 
FMMM1 said:
@CRG
I was a little surprised to learn that Gillian Leng, recently retired Chief Executive of NICE, "[had been]Editor for the Cochrane Collaboration for many years, and is now chair of the Guidelines International Network"*.
NICE of course recently signed a collaborative agreement with Cochrane.

I'm guessing that these two facts don't necessarily add up to anything inappropriate but I thought I'd seek your views. Thanks.
Click to expand...
Yes previous connection to Cochrane probably should have been highlighted somewhere in the publicity around the NICE/CC closer ties arrangement. I guess it would have been common knowledge to all the sector insiders, nevertheless it would have been good form simply to have added a line noting Leng's involvement with both organisations when the final announcement was made. It's one of those things where not acknowledging a connection, even where no conflict of interest was involved is itself problematic, even where the connection itself was not.

The Guideline Network looks to be a wholly logical development in terms of global health, and is probably going to be at some level a force for good. Bagging the retiring head of NICE as your Chair would be something of coup and I would guess Leng's appointment would be broadly welcomed across academia and health providers. I suppose it might raise concerns around creating a small talent pool where narrow perspectives prevail, but it's hard to see it as an appointment on anything other than merit.

~ new developments here: https://www.s4me.info/threads/indep...ed-by-hilda-bastian.13645/page-89#post-403356
 
CRG said:
Yes previous connection to Cochrane probably should have been highlighted somewhere in the publicity around the NICE/CC closer ties arrangement. I guess it would have been common knowledge to all the sector insiders, nevertheless it would have been good form simply to have added a line noting Leng's involvement with both organisations when the final announcement was made. It's one of those things where not acknowledging a connection, even where no conflict of interest was involved is itself problematic, even where the connection itself was not.
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I agree i.e. Leng's involvement with both organisations (NICE & Cochrane) should have been noted in the final announcement of the NICE/Cochrane collaboration and indeed the business case re that collaboration.

CRG said:
The Guideline Network looks to be a wholly logical development in terms of global health, and is probably going to be at some level a force for good. Bagging the retiring head of NICE as your Chair would be something of coup and I would guess Leng's appointment would be broadly welcomed across academia and health providers. I suppose it might raise concerns around creating a small talent pool where narrow perspectives prevail, but it's hard to see it as an appointment on anything other than merit.
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Yes, @Caroline Struthers acknowledged Leng's suitabilty e.g. to head up Cochrane. I don't question Leng's ability but I'm far from persuaded re Cochrane producing sound reviews and presumably that also applies to Guidelines International Network (international Cochrane?). However, lets hope that I'm entirely wrong and we see Cochrane (& Guidelines International Network) producing evidence based review

https://www.s4me.info/threads/indep...ed-by-hilda-bastian.13645/page-89#post-403366
 
chrisb said:
"Surfacing" in what sense? Bringing to the surface and revealing, or concealing the cracks. And does a "point" have a surface? Or is that a different sort of point?
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I was thinking thinking submarines, rather than plastering. There is a whole fleet of pointy submarines down there, desperate to be "surfaced" during future high-level Cochrane - NICE discussions.
 
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