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Guidance on liver testing with glitazones is often ignored

Dr Chaand Nagpaul ­ 'NICE in talks over drug firm link-ups' (News, September 6) ­ is right to point out the importance of NICE maintaining its independence from the pharmaceutical industry. We maintain our independence from all those who take an interest in and contribute to our work.

In developing our guidance we take account of the reasoned arguments put to us during consultation, from wherever they come.

Our recommendations are formed by independent advisory committees and guideline development groups whose members are not exposed to and will not respond to pressure from any quarter.

When it comes to implementing our published recommendations we have always been prepared to work with any group that can support their use in clinical practice. As we begin more actively to support the NHS in its use of our work, it would be foolish not to look at examples of successful strategies for disseminating clinical practice advice.

Regardless of the value you place on what is being marketed by the health care industries, their experience in engaging with clinicians is extensive. Not all of what they do in this respect is relevant to the promotion on our guidance, but where it is, we are quite prepared to consider adapting it for our purposes.

Our work in supporting implementation of our guidance is unconnected to the initiative by SIGN mentioned in your article, but no doubt their intensions are similar to ours.

Dr Andrew Dillon

Chief Executive

Nice, London

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