Economic modelling of diagnostic/treatment pathways in NICE clinical guidelines

Lead Research Organisation: Brunel University
Department Name: Health Economics Research Group

Abstract

NICE clinical guidelines state which tests and treatments should be offered to patients by the NHS. These services should provide value for money, as well as effective care for patients. But health economists who work on guidelines do not have the time to assess the costs and health benefits of every type of service that could be provided. Instead they select services that are likely to be important ? because the costs or health effects are large - and where guideline groups are unsure of the right choice. But it is possible that this may miss important links between the services. For example, a test will only be useful if followed by the right treatment. And treatment will only work if it is given to the right patients. So the value of tests and treatments may depend on the order or combination in which they are offered to patients. In this study we want to test whether it is possible to assess a system of services recommended in a guideline ?pathway?, rather than looking at single services in isolation. To make things easier, we will start by testing our methods on two existing guidelines which are due to be updated soon. For these guidelines, the pathway of recommended services has already been decided and the evidence about these services already collected together. We will build computer models that will predict the health outcomes for patients and costs to the NHS that are likely to arise if the guidelines are followed. When NICE is deciding whether to update a guideline, it looks to see if any new evidence is available and considers whether there are parts of the guideline that it should look at again. We will collect information that arises during this process, and ask experts and patient representatives to rate the importance of updating suggested topics. We will then use the computer models to estimate the likely value of reconsidering these topics. The results of this analysis will be given to the experts and patient representatives, and they will be asked to consider whether this changes their views. In summary, we want to see if we can model the pathways of care that are recommended in NICE clinical guidelines, use the models to see if NICE should reconsider parts of the guidelines, and see if this adds anything to the current way that NICE reviews its guidelines.

Technical Summary

NICE clinical guidelines make recommendations about the diagnosis and care of people with specific diseases and conditions in the NHS in England and Wales. In keeping with the principles of decision-making for NICE advisory bodies, these recommendations should take account of the cost-effectiveness of alternative services, as well as their clinical effectiveness. However, health economists working on clinical guidelines cannot formally evaluate cost-effectiveness for all services under consideration, but instead prioritise selected issues for modelling work. It has been argued that evaluating specific healthcare interventions in isolation may miss important interconnections between services within a broader pathway of care. This project will test whether a more systematic approach to economic modelling can be applied in NICE clinical guidelines. For simplicity, we propose to test this approach initially by modelling two existing guidelines, for which the pathways of care are well-articulated and systematic reviews of evidence are available, but which are shortly due for update. We will build simulation models to estimate the health outcomes (QALYs) and costs associated with the current recommended pathways. We will then collect information about new evidence and suggestions for changes to the pathways that arise during the standard updating process, and people involved in this process will be invited to rate the suggested topics in terms of priority for inclusion in a guideline update. The models will be used to estimate the incremental cost-effectiveness of possible variations to the pathway. A value of information approach will also be used to estimate the potential net benefit from reducing uncertainty over selected model parameters. The topics that are identified as priorities for updating through pathway modelling ? those with a high estimated net benefit and/or high value of information across the relevant population ? will be compared with the priorities obtained from participants in the standard update process. These people will be presented with information about our modelling work and invited reconsider their previously-stated priorities in the light of this information. This will allow us to test: a) whether modelling of NICE guideline pathways is feasible; b) how such models can be used to evaluate the incremental cost-effectiveness of possible variations to the pathway; b) whether this approach can be used to prioritise topics for update; and c) whether the resulting priorities differ from those elicited during the standard update process.
 
Guideline Title Atrial fibrillation: the management of atrial fibrillation. NICE Clinical Guideline CG180
Description NICE Atrial Fibrillation Clinical Guideline
Geographic Reach National 
Policy Influence Type Citation in clinical guidelines
Impact We provided the guideline developers with a draft copy of our HTA report, and gave them a copy of our Atrial Fibrillation model and training on it's use. The health economist working on the guideline adapted the model to assess the cost-effectiveness risk stratification tools for stroke risk and bleeding risk and choice of antithrombotic therapy (see Appendix L in the Full Guideline, p476-532). The results of this analysis contributed to new recommendations on the use of the CHA2DS2-VASc stroke risk score (8.2.4 p113-116 in the Full Guideline document), the HAS-BLED score (10.2.4 p164-7), and antithrombotic therapy (9.2.4 p143-150).
URL http://www.nice.org.uk/guidance/cg180/evidence
 
Guideline Title Prostate cancer: diagnosis and treatment. NICE (CG175). Update January 2014.
Description NICE Prostate Cancer Clinical Guideline
Geographic Reach National 
Policy Influence Type Citation in clinical guidelines
Impact The Guideline Development Group considered evidence from the prostate cancer economic model developed for our MAPGuide project. On the basis of this cost-effectiveness evidence and associated clinical evidence they made a new recommendation to consider use of brachytherapy in combination with external beam radiotherapy for men with intermediate and high-risk localised prostate cancer. Given the high level of uncertainty over clinical and cost-effectiveness, they also made a recommendation for more research on this topic.
URL http://www.nice.org.uk/guidance/cg175
 
Title Atrial Fibrillation simulation model 
Description Simulation model that reflects the treatment pathway for patients with prostate cancer following the NICE clinical guidline. The model simulates which tests and treatments members of an incident cohort would receive, and then estimates associated costs and health outcomes (QALYs). 
Type Of Material Model of mechanisms or symptoms - human 
Year Produced 2012 
Provided To Others? Yes  
Impact The model was supplied to the National Clinical Guidelines Centre (based at the Royal College of Physicians) were commissioned by NICE to update the clinical guideline on Atrial Fibrillation. We engaged with researchers in the NCGC to assist them in making use of our model to address cost-effectiveness quesitons within the guideline. This influenced a number of guideline recommendations (see impact on practice). 
 
Title Prostate cancer simulation model 
Description Simulation model that reflects the treatment pathway for patients with prostate cancer following the NICE clinical guidline. The model simulates which tests and treatments members of an incident cohort would receive, and then estimates associated costs and health outcomes (QALYs). 
Type Of Material Model of mechanisms or symptoms - human 
Year Produced 2012 
Provided To Others? Yes  
Impact The MAPGuide prostate cancer model was given to the National Coordinating Centre for Cancer (NCC-C) developed the update of the NICE clinical guideline on prostate cancer. The model was used to conduct an economic anaysis of LDR or HDR brachytherapy in combination with external beam radiotherapy. This analysis is reported in the Full Guideline document, and influenced a practice and research recommendation (see impact on practice section). 
 
Description Brompton AF modelling 
Organisation Royal Brompton & Harefield NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution We have met with electrophysiologists at the Royal Brompton and Harefield Trust to discuss use of our MAPGuide Atrial Fibrillation model to evaluate clinical questions of interest. We have advised on a cost analysis being conducted by RBHT and to compare oral anticoagulation with the WATCHMAN Left Atrial Appendage Closure Device for the prevention of strokes. We have agreed to use our MAPGuide model to conduct a full cost-utility analysis on this question, and the Health Economics Research Group at Brunel University has agreed to fund time for a Research Fellow to conduct this analysis during 2014. HERG has also contributed as a co-applicant on a proposal to the NIHR EME to evaluate catheter ablation versus thoracoscopically assisted surgical ablation in long standing persistent atrial fibrillation.
Collaborator Contribution Electrophysiology experts at the RBHT have been collaborating with Boston Scientific to conduct a cost analysis of the WATCHMAN device. During 2013, they engaged with health economists at Brunel University to seek advice on the conduct of this study, and to discuss use of the MAPGuide AF model to conduct a full cost-utility analysis. RBHT also led on an outline proposal to NIHR EME on catheter ablation versus thoracoscopically assisted surgical ablation for AF. They identified HERG as a source of health economic expertise, and engaged with us to seek input to their proposal.
Impact A proposal to evaluate the efficacy, effectiveness and cost-effectiveness of ablation procedures for long standing persistent atrial fibrillation was submitted to the NIHR EME in January 2014. This bid was successful, and the project has started.
Start Year 2012
 
Description HERG/LSHTM/ScHARR 
Organisation Brunel University London
Department Health Economics Research Group
Country United Kingdom 
Sector Academic/University 
PI Contribution The MAPGuide project has been completed following successful research partnership between health economists and information systems/ operational research modellers from the Department of Information Systems and Computing (DISC) and Health Economics Research Group (HERG) Brunel University, School of Health and Related Research (ScHARR) at the University of Sheffield, and the London School of Hygiene and Tropical Medicine (LSHTM). Since completion of the research, the team have continued to work together on publications.
Collaborator Contribution A team of researchers at Brunel developed a discrete event simulation model to estimate the cost-effectiveness of the NICE clinical guideline on atrial fibrillation . Another team at LSHTM/ScHARR developed another simulation model for the NICE prostate cancer guideline in parellel. The two teams met regularly throughout the two-year project period, including two-day workship meetings, to discuss and agree methods.
Impact The two models provide a resource that can be used for future cost-effectiveness analyses. Both teams have engaged with guideline developers working on updates of the NICE clinical guidelines on prostate cancer and atrial fibrilation, and have made the MAPGuide models and results available to them. The MAPGuide prostate cancer model was used by the LSHTM and National Coordinating Centre for Cancer (NCC-C) economists to conduct an economic anaysis of LDR or HDR brachytherapy in combination with external beam radiotherapy. This is analysis is reported in the draft NICE clinical guideline on prostate cancer, which went out for public consultation in July 2013 (p189 and Appendix E), and led to a research recommendation. The final guideline is due for publication in January 2014. The Brunel team met with developers of the NICE clinical guideline update on atrial fibrillation - the National Clinical Guidelines Centre (NCGC). A copy of the MAPGuide AF model was given to the NCGC economist working on the guideline, and members of the Brunel MAPGuide team gave advice on how to adapt and use the model to address cost-effectiveness questions in the guideline update. The draft guideline is due to be published for consultation shortly, and the final version of the guideline should be published in June 2014. The academic and NICE/NCC partners in the MAPGuide project have all contributed as authors to an HTA monograph, which is currently in press (due for publication in December 2013).
Start Year 2010
 
Description HERG/LSHTM/ScHARR 
Organisation Brunel University London
Department School of Information Systems, Computing and Mathematics
Country United Kingdom 
Sector Academic/University 
PI Contribution The MAPGuide project has been completed following successful research partnership between health economists and information systems/ operational research modellers from the Department of Information Systems and Computing (DISC) and Health Economics Research Group (HERG) Brunel University, School of Health and Related Research (ScHARR) at the University of Sheffield, and the London School of Hygiene and Tropical Medicine (LSHTM). Since completion of the research, the team have continued to work together on publications.
Collaborator Contribution A team of researchers at Brunel developed a discrete event simulation model to estimate the cost-effectiveness of the NICE clinical guideline on atrial fibrillation . Another team at LSHTM/ScHARR developed another simulation model for the NICE prostate cancer guideline in parellel. The two teams met regularly throughout the two-year project period, including two-day workship meetings, to discuss and agree methods.
Impact The two models provide a resource that can be used for future cost-effectiveness analyses. Both teams have engaged with guideline developers working on updates of the NICE clinical guidelines on prostate cancer and atrial fibrilation, and have made the MAPGuide models and results available to them. The MAPGuide prostate cancer model was used by the LSHTM and National Coordinating Centre for Cancer (NCC-C) economists to conduct an economic anaysis of LDR or HDR brachytherapy in combination with external beam radiotherapy. This is analysis is reported in the draft NICE clinical guideline on prostate cancer, which went out for public consultation in July 2013 (p189 and Appendix E), and led to a research recommendation. The final guideline is due for publication in January 2014. The Brunel team met with developers of the NICE clinical guideline update on atrial fibrillation - the National Clinical Guidelines Centre (NCGC). A copy of the MAPGuide AF model was given to the NCGC economist working on the guideline, and members of the Brunel MAPGuide team gave advice on how to adapt and use the model to address cost-effectiveness questions in the guideline update. The draft guideline is due to be published for consultation shortly, and the final version of the guideline should be published in June 2014. The academic and NICE/NCC partners in the MAPGuide project have all contributed as authors to an HTA monograph, which is currently in press (due for publication in December 2013).
Start Year 2010
 
Description HERG/LSHTM/ScHARR 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Department Faculty of Public Health and Policy
Country United Kingdom 
Sector Academic/University 
PI Contribution The MAPGuide project has been completed following successful research partnership between health economists and information systems/ operational research modellers from the Department of Information Systems and Computing (DISC) and Health Economics Research Group (HERG) Brunel University, School of Health and Related Research (ScHARR) at the University of Sheffield, and the London School of Hygiene and Tropical Medicine (LSHTM). Since completion of the research, the team have continued to work together on publications.
Collaborator Contribution A team of researchers at Brunel developed a discrete event simulation model to estimate the cost-effectiveness of the NICE clinical guideline on atrial fibrillation . Another team at LSHTM/ScHARR developed another simulation model for the NICE prostate cancer guideline in parellel. The two teams met regularly throughout the two-year project period, including two-day workship meetings, to discuss and agree methods.
Impact The two models provide a resource that can be used for future cost-effectiveness analyses. Both teams have engaged with guideline developers working on updates of the NICE clinical guidelines on prostate cancer and atrial fibrilation, and have made the MAPGuide models and results available to them. The MAPGuide prostate cancer model was used by the LSHTM and National Coordinating Centre for Cancer (NCC-C) economists to conduct an economic anaysis of LDR or HDR brachytherapy in combination with external beam radiotherapy. This is analysis is reported in the draft NICE clinical guideline on prostate cancer, which went out for public consultation in July 2013 (p189 and Appendix E), and led to a research recommendation. The final guideline is due for publication in January 2014. The Brunel team met with developers of the NICE clinical guideline update on atrial fibrillation - the National Clinical Guidelines Centre (NCGC). A copy of the MAPGuide AF model was given to the NCGC economist working on the guideline, and members of the Brunel MAPGuide team gave advice on how to adapt and use the model to address cost-effectiveness questions in the guideline update. The draft guideline is due to be published for consultation shortly, and the final version of the guideline should be published in June 2014. The academic and NICE/NCC partners in the MAPGuide project have all contributed as authors to an HTA monograph, which is currently in press (due for publication in December 2013).
Start Year 2010
 
Description HERG/LSHTM/ScHARR 
Organisation University of Sheffield
Department School of Health and Related Research (ScHARR)
Country United Kingdom 
Sector Academic/University 
PI Contribution The MAPGuide project has been completed following successful research partnership between health economists and information systems/ operational research modellers from the Department of Information Systems and Computing (DISC) and Health Economics Research Group (HERG) Brunel University, School of Health and Related Research (ScHARR) at the University of Sheffield, and the London School of Hygiene and Tropical Medicine (LSHTM). Since completion of the research, the team have continued to work together on publications.
Collaborator Contribution A team of researchers at Brunel developed a discrete event simulation model to estimate the cost-effectiveness of the NICE clinical guideline on atrial fibrillation . Another team at LSHTM/ScHARR developed another simulation model for the NICE prostate cancer guideline in parellel. The two teams met regularly throughout the two-year project period, including two-day workship meetings, to discuss and agree methods.
Impact The two models provide a resource that can be used for future cost-effectiveness analyses. Both teams have engaged with guideline developers working on updates of the NICE clinical guidelines on prostate cancer and atrial fibrilation, and have made the MAPGuide models and results available to them. The MAPGuide prostate cancer model was used by the LSHTM and National Coordinating Centre for Cancer (NCC-C) economists to conduct an economic anaysis of LDR or HDR brachytherapy in combination with external beam radiotherapy. This is analysis is reported in the draft NICE clinical guideline on prostate cancer, which went out for public consultation in July 2013 (p189 and Appendix E), and led to a research recommendation. The final guideline is due for publication in January 2014. The Brunel team met with developers of the NICE clinical guideline update on atrial fibrillation - the National Clinical Guidelines Centre (NCGC). A copy of the MAPGuide AF model was given to the NCGC economist working on the guideline, and members of the Brunel MAPGuide team gave advice on how to adapt and use the model to address cost-effectiveness questions in the guideline update. The draft guideline is due to be published for consultation shortly, and the final version of the guideline should be published in June 2014. The academic and NICE/NCC partners in the MAPGuide project have all contributed as authors to an HTA monograph, which is currently in press (due for publication in December 2013).
Start Year 2010
 
Description NICE/NCCs 
Organisation National Collaborating Centre for Mental Health (NCC MH)
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution The MAPGuide project was a collaboration between academic researchers and technical experts working within the NICE Clinical Guidelines Programme - including staff from NICE and from three National Collaborating Centers, who develop guidelines for NICE. During the project, the group met regularly as a Project Management Committee. Acadmics from Brunel University led the project, and contributed expertise in health economic evaluation and simulation modeling. Two academic groups led on developing simulation models of NICE guidelines: a team at the LSHTM and Sheffield, who developed a prostate cancer model; and a team at Brunel who developed an atrial fibrillation model. The teams have met with NCC staff who have been updating the NICE clinical guidelines on prostate cancer and atrial fibrillation, and have provided access to the MAPGuide models and results to assist the NCC economists in addressing cost-effectiveness questions in the guideline updates.
Collaborator Contribution The NCC and NICE members of the PMC contributed expert knowledge and experience of the development processes and methods for NICE clinical guidelines to the MAPGuide project. They also contributed methdological expertise in health economics, medical statistics and systematic reviewing.
Impact This project has fostered multidisciplinary links between health economists, medical statisticians, systematic reviewers and simulation modellers. The two models provide a resource that can be used for future cost-effectiveness analyses. Both teams have engaged with guideline developers working on updates of the NICE clinical guidelines on prostate cancer and atrial fibrilation, and have made the MAPGuide models and results available to them. The MAPGuide prostate cancer model was used by the LSHTM and National Coordinating Centre for Cancer (NCC-C) economists to conduct an economic anaysis of LDR or HDR brachytherapy in combination with external beam radiotherapy. This is analysis is reported in the draft NICE clinical guideline on prostate cancer, which went out for public consultation in July 2013 (p189 and Appendix E), and led to a research recommendation. The final guideline is due for publication in January 2014. The Brunel team met with developers of the NICE clinical guideline update on atrial fibrillation - the National Clinical Guidelines Centre (NCGC). A copy of the MAPGuide AF model was given to the NCGC economist working on the guideline, and members of the Brunel MAPGuide team gave advice on how to adapt and use the model to address cost-effectiveness questions in the guideline update. The draft guideline is due to be published for consultation shortly, and the final version of the guideline should be published in June 2014. The academic and NICE/NCC partners in the MAPGuide project have all contributed as authors to an HTA monograph, which is currently in press (due for publication in December 2013).
Start Year 2010
 
Description NICE/NCCs 
Organisation National Institute for Health and Care Excellence (NICE)
Department Centre for Clinical Practice
Country United Kingdom 
Sector Public 
PI Contribution The MAPGuide project was a collaboration between academic researchers and technical experts working within the NICE Clinical Guidelines Programme - including staff from NICE and from three National Collaborating Centers, who develop guidelines for NICE. During the project, the group met regularly as a Project Management Committee. Acadmics from Brunel University led the project, and contributed expertise in health economic evaluation and simulation modeling. Two academic groups led on developing simulation models of NICE guidelines: a team at the LSHTM and Sheffield, who developed a prostate cancer model; and a team at Brunel who developed an atrial fibrillation model. The teams have met with NCC staff who have been updating the NICE clinical guidelines on prostate cancer and atrial fibrillation, and have provided access to the MAPGuide models and results to assist the NCC economists in addressing cost-effectiveness questions in the guideline updates.
Collaborator Contribution The NCC and NICE members of the PMC contributed expert knowledge and experience of the development processes and methods for NICE clinical guidelines to the MAPGuide project. They also contributed methdological expertise in health economics, medical statistics and systematic reviewing.
Impact This project has fostered multidisciplinary links between health economists, medical statisticians, systematic reviewers and simulation modellers. The two models provide a resource that can be used for future cost-effectiveness analyses. Both teams have engaged with guideline developers working on updates of the NICE clinical guidelines on prostate cancer and atrial fibrilation, and have made the MAPGuide models and results available to them. The MAPGuide prostate cancer model was used by the LSHTM and National Coordinating Centre for Cancer (NCC-C) economists to conduct an economic anaysis of LDR or HDR brachytherapy in combination with external beam radiotherapy. This is analysis is reported in the draft NICE clinical guideline on prostate cancer, which went out for public consultation in July 2013 (p189 and Appendix E), and led to a research recommendation. The final guideline is due for publication in January 2014. The Brunel team met with developers of the NICE clinical guideline update on atrial fibrillation - the National Clinical Guidelines Centre (NCGC). A copy of the MAPGuide AF model was given to the NCGC economist working on the guideline, and members of the Brunel MAPGuide team gave advice on how to adapt and use the model to address cost-effectiveness questions in the guideline update. The draft guideline is due to be published for consultation shortly, and the final version of the guideline should be published in June 2014. The academic and NICE/NCC partners in the MAPGuide project have all contributed as authors to an HTA monograph, which is currently in press (due for publication in December 2013).
Start Year 2010
 
Description NICE/NCCs 
Organisation Royal College of Obstetricians and Gynaecologists (RCOG)
Department National Collaborating Centre for Women's and Children's Health (NCC WCH)
Country United Kingdom 
Sector Academic/University 
PI Contribution The MAPGuide project was a collaboration between academic researchers and technical experts working within the NICE Clinical Guidelines Programme - including staff from NICE and from three National Collaborating Centers, who develop guidelines for NICE. During the project, the group met regularly as a Project Management Committee. Acadmics from Brunel University led the project, and contributed expertise in health economic evaluation and simulation modeling. Two academic groups led on developing simulation models of NICE guidelines: a team at the LSHTM and Sheffield, who developed a prostate cancer model; and a team at Brunel who developed an atrial fibrillation model. The teams have met with NCC staff who have been updating the NICE clinical guidelines on prostate cancer and atrial fibrillation, and have provided access to the MAPGuide models and results to assist the NCC economists in addressing cost-effectiveness questions in the guideline updates.
Collaborator Contribution The NCC and NICE members of the PMC contributed expert knowledge and experience of the development processes and methods for NICE clinical guidelines to the MAPGuide project. They also contributed methdological expertise in health economics, medical statistics and systematic reviewing.
Impact This project has fostered multidisciplinary links between health economists, medical statisticians, systematic reviewers and simulation modellers. The two models provide a resource that can be used for future cost-effectiveness analyses. Both teams have engaged with guideline developers working on updates of the NICE clinical guidelines on prostate cancer and atrial fibrilation, and have made the MAPGuide models and results available to them. The MAPGuide prostate cancer model was used by the LSHTM and National Coordinating Centre for Cancer (NCC-C) economists to conduct an economic anaysis of LDR or HDR brachytherapy in combination with external beam radiotherapy. This is analysis is reported in the draft NICE clinical guideline on prostate cancer, which went out for public consultation in July 2013 (p189 and Appendix E), and led to a research recommendation. The final guideline is due for publication in January 2014. The Brunel team met with developers of the NICE clinical guideline update on atrial fibrillation - the National Clinical Guidelines Centre (NCGC). A copy of the MAPGuide AF model was given to the NCGC economist working on the guideline, and members of the Brunel MAPGuide team gave advice on how to adapt and use the model to address cost-effectiveness questions in the guideline update. The draft guideline is due to be published for consultation shortly, and the final version of the guideline should be published in June 2014. The academic and NICE/NCC partners in the MAPGuide project have all contributed as authors to an HTA monograph, which is currently in press (due for publication in December 2013).
Start Year 2010
 
Description NICE/NCCs 
Organisation Royal College of Physicians of London
Department National Clinical Guideline Centre (NCGC)
Country United Kingdom 
Sector Public 
PI Contribution The MAPGuide project was a collaboration between academic researchers and technical experts working within the NICE Clinical Guidelines Programme - including staff from NICE and from three National Collaborating Centers, who develop guidelines for NICE. During the project, the group met regularly as a Project Management Committee. Acadmics from Brunel University led the project, and contributed expertise in health economic evaluation and simulation modeling. Two academic groups led on developing simulation models of NICE guidelines: a team at the LSHTM and Sheffield, who developed a prostate cancer model; and a team at Brunel who developed an atrial fibrillation model. The teams have met with NCC staff who have been updating the NICE clinical guidelines on prostate cancer and atrial fibrillation, and have provided access to the MAPGuide models and results to assist the NCC economists in addressing cost-effectiveness questions in the guideline updates.
Collaborator Contribution The NCC and NICE members of the PMC contributed expert knowledge and experience of the development processes and methods for NICE clinical guidelines to the MAPGuide project. They also contributed methdological expertise in health economics, medical statistics and systematic reviewing.
Impact This project has fostered multidisciplinary links between health economists, medical statisticians, systematic reviewers and simulation modellers. The two models provide a resource that can be used for future cost-effectiveness analyses. Both teams have engaged with guideline developers working on updates of the NICE clinical guidelines on prostate cancer and atrial fibrilation, and have made the MAPGuide models and results available to them. The MAPGuide prostate cancer model was used by the LSHTM and National Coordinating Centre for Cancer (NCC-C) economists to conduct an economic anaysis of LDR or HDR brachytherapy in combination with external beam radiotherapy. This is analysis is reported in the draft NICE clinical guideline on prostate cancer, which went out for public consultation in July 2013 (p189 and Appendix E), and led to a research recommendation. The final guideline is due for publication in January 2014. The Brunel team met with developers of the NICE clinical guideline update on atrial fibrillation - the National Clinical Guidelines Centre (NCGC). A copy of the MAPGuide AF model was given to the NCGC economist working on the guideline, and members of the Brunel MAPGuide team gave advice on how to adapt and use the model to address cost-effectiveness questions in the guideline update. The draft guideline is due to be published for consultation shortly, and the final version of the guideline should be published in June 2014. The academic and NICE/NCC partners in the MAPGuide project have all contributed as authors to an HTA monograph, which is currently in press (due for publication in December 2013).
Start Year 2010