CG123 Common mental health disorders - National Institute for ...

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Methods used to develop this guideline3 METHODS USED TO DEVELOP THISGUIDELINE3.1 OVERVIEWThe development of this guideline drew upon methods outlined by NICE (furtherinformation is available in The Guidelines Manual [NICE, 2009d]). A team of healthprofessionals, lay representatives and technical experts known as the GuidelineDevelopment Group (GDG), with support from the NCCMH staff, undertook thedevelopment of a patient-centred, evidence-based guideline. There are six basic stepsin the process of developing a guideline:1. Define the scope, which sets the parameters of the guideline and provides a focusand steer for the development work.2. Define review questions considered important for practitioners and people with acommon mental health disorder.3. Develop criteria for evidence searching and search for evidence.4. Design validated protocols for systematic review and apply to evidence recoveredby search.5. Synthesise and (meta-) analyse data retrieved, guided by the review questions, andproduce Grading of Recommendations: Assessment, Development and Evaluation(GRADE) evidence profiles and summaries.6. Answer review questions with evidence-based recommendations for clinical practice.The clinical practice recommendations made by the GDG are therefore derived fromthe most up-to-date and robust evidence base for the clinical and cost effectiveness of thetreatments and services used in the treatment and management of common mental healthdisorders. In addition, to ensure a patient and carer focus, the concerns of people withcommon mental health disorders and carers (regarding health and social care) have beenhighlighted and addressed by recommendations agreed by the whole GDG.3.2 THE SCOPEGuideline topics are selected by the Department of Health and the Welsh AssemblyGovernment, which identify the main areas to be covered by the guideline in aspecific remit (see The Guidelines Manual [NICE, 2009d] for further information).The NCCMH developed a scope for the guideline based on the remit. The purpose ofthe scope is to:● provide an overview of what the guideline will include and exclude●●identify the key aspects of care that must be includedset the boundaries of the development work and provide a clear framework toenable work to stay within the priorities agreed by NICE and the National41
Methods used to develop this guideline●●●Collaborating Centre and the remit from the Department of Health/WelshAssembly Governmentinform the development of the review questions and search strategyinform professionals and the public about expected content of the guidelinekeep the guideline to a reasonable size to ensure that its development can becarried out within the allocated period.An initial draft of the scope was sent to registered stakeholders who had agreed toattend a scoping workshop. The workshop was used to:● obtain feedback on the selected key clinical issues● identify which patient or population subgroups should be specified (if any)●●seek views on the composition of the GDGencourage applications for GDG membership.The draft scope was subject to consultation with registered stakeholders over a4-week period. During the consultation period, the scope was posted on the NICEwebsite (www.nice.org.uk). Comments were invited from stakeholder organisationsand the Guideline Review Panel. Further information about the Guideline ReviewPanel can also be found on the NICE website. The NCCMH and NICE reviewed thescope in light of comments received, and the revised scope was signed off by theGuideline Review Panel. The scope is reproduced in Appendix 1.3.3 THE GUIDELINE DEVELOPMENT GROUPThe GDG consisted of: professionals in psychiatry, clinical psychology, nursing andgeneral practice; academic experts in psychiatry and psychology; two people with acommon mental health disorder and a carer. The guideline development process wassupported by staff from the NCCMH, who undertook the clinical and health economicsliterature searches, reviewed and presented the evidence to the GDG, managed theprocess, and contributed to drafting the guideline.3.3.1 Guideline Development Group meetingsNine GDG meetings were held between December 2009 and January 2011. Duringeach day-long GDG meeting review questions and clinical and economic evidencewere reviewed and assessed, and recommendations formulated. At each meeting, allGDG members declared any potential conflicts of interest, and service user and carerconcerns were routinely discussed as part of a standing agenda.3.3.2 Topic groupsThe GDG divided its workload along clinically relevant lines to simplify the guidelinedevelopment process, and GDG members formed smaller topic groups to undertakeguideline work in that area of clinical practice: Topic Group 1 covered questions42
Page 1 and 2: Commonmental healthdisordersTHE NIC
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Summary of recommendations8.1.1.6 S
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Summary of recommendationsFigure 12
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Summary of recommendations●Genera
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Summary of recommendations8.4 STEPS
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Summary of recommendations●●a g
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Summary of recommendationsDiscuss w
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Summary of recommendationsinclude p
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Appendices9 APPENDICESAppendix 1: S
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Appendix 1of a depressive disorder
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Appendix 1b) Assessment of anxiety
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Appendix 2APPENDIX 2:DECLARATIONS O
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Appendix 2Mr Mike BessantEmployment
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Appendix 2Personal non-pecuniary in
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Appendix 2Actions takenMr Rupert Su
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Appendix 2Personal family interestN
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Appendix 3APPENDIX 3:STAKEHOLDERS A
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Appendix 4ClinicalpopulationPeople
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Appendix 4Case identificationNo. Pr
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Appendix 5APPENDIX 5:REVIEW PROTOCO
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Appendix 7APPENDIX 7:METHODOLOGY CH
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Appendix 9APPENDIX 9:METHODOLOGY CH
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Appendix 92.10 Are all important pa
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Appendix 9case also excludes costs
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Appendix 9For consistency, the EQ-5
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Appendix 9Answer ‘yes’ if the a
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Appendix 9Answer ‘yes’ if the e
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Appendix 9Answer ‘yes’ if appro
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Appendix 10APPENDIX 10: EVIDENCE TA
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Appendix 11APPENDIX 11:HIGH PRIORIT
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Appendix 11discussion of options bu
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Appendix 13APPENDIX 13:GENERALIZED
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ReferencesAndlin-Sobocki, P., Jöns
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ReferencesBower, P., Gilbody, S., R
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ReferencesCooper, S., Smiley, E., M
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ReferencesEhlers A., Gene-Cos N. &
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ReferencesGiles, D. E., Jarrett, R.
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ReferencesHorowitz, M. J., Wilner,
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ReferencesKnapp, M. & Ilson, S. (20
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ReferencesMarks, J., Goldberg, D. P
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ReferencesNCCMH (forthcoming) Self-
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ReferencesOzer, E. J., Best, S. R.,
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ReferencesSartorius, N. (2002) Eine
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ReferencesTiemens, B. G., Ormel, J.
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ReferencesWilkinson, M. J. B. & Bar
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Glossarybeliefs and interpretations
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Glossaryto learn to become more awa
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Abbreviations12 ABBREVIATIONSADDADS
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AbbreviationsOASISOCDONSORPHQ (-A,
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