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

Adrian said:
It sounds very much like current corporate speak.
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https://www.mycoted.com/Assumption_Surfacing
Assumption Surfacing
The aim of this technique is to make underlying assumptions more visible.



    • Identify a particular choice you have made, and ask yourself why you feel it is the best choice – i.e. what assumptions guide this choice.
    • List the assumptions, and beside each write a counter-assumption - not necessarily its negation, but the opposite to the issue it represents.
    • Work down the list and delete ineffective assumption/counter-assumption pairs i.e. where it would make little difference to your choice whether the assumption or the counter-assumption were actually the case.
    • Assess each of the remaining assumptions in terms of high or low potential impact (how critical is its truth to justifying your pattern of behaviour?) and high or low plausibility (how confident are you that it is, in fact, true?).
    • Plot the assumptions on a 2x2 matrix (high/low impact on one axis, high/low plausibility on the other).
High impact/high plausibility assumptions are clearly the most crucial, but high impact/low plausibility assumptions need to be taken seriously, in case they turn out to be true, so check them out if you can.

The assumptions in the ‘high impact’ cells are those that the user sees as largely justifying their actions. Are they over-estimating them? What could change these assumptions? What benefits would there be and for whom?

The assumptions in the ‘low impact’ cells are seen as less critical, but it might be worth checking this out – are they being under-estimated?
 
Snow Leopard said:
"surfacing and understanding points of divergence"

Is this English? What does it mean?
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I have a vague hope it's a reference to NICE's surfacing aspirations to school Cochrane in the basics of calculus.

NICE: "So, here we have two time series from a repeated maximal grip strength test. The upper one is of patients fulfilling the Oxford criterion only, the lower one is of patients also fulfilling the ICC. Can you see how the lower series start to diverge from the upper one at timepoint 2?"

Cochrane: "Oh, yes! So that's divergent then? But what does it even mean?"
 
The sections of this dealing with the infiltration of the NHS by McKinsey should be compulsory reading, and then we can set about verification of the information.
McKinsey & Company - Wikispooks

EDIT this section from the linked article is instructive.
Lobbying for tech
McKinsey has long advocated the use of more technology in healthcare, the digitisation of whole health systems, and the opening up of provider and patient data.

For example, a 2012 McKinsey report – The ‘big data’ revolution in healthcare: Accelerating value and innovation - looks at the impact of data and analytics on the healthcare sector. Big data, it claims, will both cut costs and improve the quality of services by: empowering people so they look after themselves better; promoting more evidence-based care (tailored more to individuals); providing accurate assessment of healthcare providers and the quality of their services, and by 'improving innovation'. The consequences, it says, will be improved health and a reduction of potentially hundreds of billions of dollars in healthcare costs. It does, however, include a few (important) caveats:

'Patients will not benefit from [big data] research on exercise, for example, if they persist in their sedentary lifestyles. And physicians may not improve patient outcomes if they refuse to follow treatment protocols based on big data and instead rely solely on their own judgment.'[26]
Another 2010 McKinsey report on technology in healthcare published with GSMA, which represents the interests of commercial mobile operators worldwide, is called mHealth: A new vision for healthcare and similarly discusses the benefits from healthcare systems adopting mHealth (the use of mobile technologies to deliver healthcare services). This includes texting people to remind them to take medicines; remote diagnosis and even treatment for patients; and remote health monitoring devices that track and report patients’ conditions. Remote monitoring, for example, 'could help overweight adults... by tracking activity levels and nutrition intake,' i.e. whether they exercise and what they eat

Is this behind all the silly Apps which are being trialled for ME? Normally this would not be a problem for someone who left an organisation 13 years ago. However when that organisation claims a lifetime hold over alumni the potential for COI is enormous

EDIT
And this is from the CV
Chief Executive of the Accelerated Access Collaborative
NHS England and NHS Improvement
May 2019 - Aug 20201 year 4 months

London, United Kingdom

The Accelerated Access Collaborative (AAC) is the umbrella organisation for UK health innovation. Bringing together the Government, NHS and industry leaders, the AAC will act as the front door for innovators looking to get their products tested in or funded by the NHS and will provide a tailored package of support to overcome barriers in the health system which can prevent the best medical innovations from reaching patients.
The new and boosted Accelerated Access Collaborative (AAC) was launched in M
 
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chrisb said:
Let us, for the moment, suppose that this project might be safe in the hands of GL. Why should it be thought that it would be safe in the hands of an, as yet, unidentified successor?
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Not quite sure which organisation you are referring to.

Re NICE - it occurred to me that the Cochranites, within NICE, are analogues to free masons --- if you want to make it up the NICE career tree, then a belief in the principles of GRADE/Cochrane are fast track routes.

As for Cochrane, yes if Gillian is prepared to dig in and hold out for evidence based reviews then good luck to her --- seems to be a lonely post with plenty of demons ---- I'd suggest a pleasant beach to sit on instead. But, lets see, she may be made of sterner stuff.
 
I was thinking in terms of NICE and its proposed collaboration with Cochrane. I suspect that the Masons are old-hat. It now looks as though the entire system is handed on a plate to McKinsey. Who was it said that "business ethics" is an oxymoron.
 
chrisb said:
This one looks interesting McKinsey pockets £600k for seven-week review into NHS tech leadership (digitalhealth.net)

EDIT Baroness Dido Harding, who began her career at McKinsey, has been appointed the interim executive chair of the new organisation.

Small world isn't it?
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Pretty shocking --- filling your pockets from the public purse and wrecking the health service under the guise of "improvement" - no wonder @Jonathan Edwards packed it in (retired).

--- the title of the new organisation ---National Institute for Health Protection ---- seems Orwellian
 
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