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