EDITORIAL

NICE guidelines

The NICE guidelines for the management of head injury: the view from a district hospital

A M Leaman

Correspondence to:
Correspondence to:
Mr A Leaman
Accident and Emergency Department, Princess Royal Hospital, Telford TF1 6TF, UK; caleaman@doctors.org.uk

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Compelling scientific evidence is required before implementation of new forms of health care

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Keywords: NICE guidelines; head injury

The first 150 words of the full text of this article appear below.

In June 2003 the National Institute for Clinical Excellence (NICE) issued guidance on the management of head injuries in the UK. The key features of this guidance were that the indications for computed tomography (CT) should be widened and that CT should replace skull radiography in the investigation of minor head injury. Reaction among my colleagues to these guidelines ranged from despair to disbelief.

Despair because this is yet another piece of central guidance that has been issued with little regard for its operational or financial consequences.

For example, an initial assessment of the impact of this guidance in this hospital indicates that an additional 725 CT scans will be required each year, of which about half will be performed outside office hours. Given that there is a national shortage of radiologists, is it a good idea to promote a policy that demands so much additional radiologist input?

. . . [Full text of this article]

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• Leaman, A M, Rysdale, E (2006). Can we abolish skull x rays for head injury?. Arch. Dis. Child. 91: 374-374 [Full Text]  
• Shravat, B P, Huseyin, T S, Hynes, K A (2006). NICE guideline for the management of head injury: an audit demonstrating its impact on a district general hospital, with a cost analysis for England and Wales. Emerg. Med. J. 23: 109-113 [Abstract] [Full Text]  
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NICE head injuries guidelines - expensive? Yes, but what are the alternatives?

Ian Sammy

EMJ Online, 4 Jan 2005 [Full text]