title: Evidence based public health: A review of the experience of the National Institute of Health and Clinical Excellence (NICE) of developing public health guidance in England.
abstract: This paper describes the application of the principles of evidence based medicine to public health. It recounts the experience of the National Institute for Health and Clinical Excellence in England (NICE) which acquired a remit to develop public health guidance in 2005. Some of the history of the origins of the evidence based approach is described in the writings of Cochrane and others, and the way that this came to be a critical part of the NICE approach to developing clinical cost effectiveness is outlined. The challenge of applying these methods to an evidence base which is social and psychological as well as biomedical is considered. Key problems are identified: the breadth of the evidence base, different analytic levels of explanation, and the length of the causal chain between interventions and outcomes in public health.
authors.affiliation: The Centre for Public Health Excellence, The National Institute of Health and Clinical Excellence (NICE), Mid City Place, 71, High Holborn, London WC1V 6NA, UK. mike.kelly@nice.org.uk
authors.forename: Michael
authors.initials: M
authors.lastname: Kelly
authors.forename: Antony
authors.initials: A
authors.lastname: Morgan
authors.forename: Simon
authors.initials: S
authors.lastname: Ellis
authors.forename: Tricia
authors.initials: T
authors.lastname: Younger
authors.forename: Jane
authors.initials: J
authors.lastname: Huntley
authors.forename: Catherine
authors.initials: C
authors.lastname: Swann
mesh_terms: D026683:Advisory Committees / Q000458:organization & administration*; D003362:Cost-Benefit Analysis; D004739:England; D019317:Evidence-Based Medicine; D006126:Group Processes; D006801:Humans; D011635:Public Health Administration; D013222:State Medicine / Q000191:economics