Surely that is NICE's role: National Institute of Cost Effectiveness.
The cost to the Exchequer of one person getting irreversible neuropathy is far less than the cost of hundreds of thouusands of B12 / folate tests
Equally, it is not cost effective to spend £30,000 to give a cancer patient 5 weeks more life [when 30 of those days will be in hospital being treated for the side effects of the drug].
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-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Nick Miller
Sent: 10 February 2011 09:45
To: [log in to unmask]
Subject: Re: NICE do not do guidance
Thanks for that. I was expecting something a bit more hard-hitting!
However, there is plenty of rubbish to be chewed over e.g. NICE's recomendations not to measure B12 and folate unless the FBC and MCV show a macrocytosis.
i.e. wait until the subject may have irreversible neurological damage before taking steps to do something about it. And what about levels of B12 and folate de-saturation that are insufficient to produce a macrocytosis but sufficient to have other adverse effects?
I will leave the field clear for others to point out specifics where NICE is guided by cost-saving rather than science in their choice of "facts".
Nick Miller
London
On 10 February 2011 08:59, Nic Law <[log in to unmask]> wrote:
> Dear Colleagues
>
>
>
> One of the unadvertised resources on the NICE website is a database of
> activities that are discouraged as there is no evidence to support
> them. A considerable number of these are diagnostic tests. I append a
> spreadsheet of these that have been distilled by Geoff Lester and hope
> that you find them useful.
>
>
>
> Best wishes
>
> Julian Barth
>
>
>
>
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