NICE Guideline – scope consultation

The draft scope for this guideline has now been issued for consultation. Some changes have been made following the scoping workshop, and the official workshop notes can now be viewed on the NICE website, so you can see the variety of the discussions.

LDA will be submitting a written response because there are a fair number of points that we think need making. These include comments on some of the “Context” section where we feel the wording may mislead. For example:

  • “Lyme disease can be asymptomatic” – evidence is required for this as it appears to minimise the disease.
  • Reference to “post infectious Lyme disease” – this phrasing implies that infection has been eliminated, and this cannot be proved.
  • The increase in cases has not mentioned the fact that B burgdorferi may be spreading through wildlife following its relatively recent introduction to the UK.

NICE would like to receive comments from stakeholders on the following questions:

  1. Is the time period of ‘< than 6 months since tick bite or first symptoms or signs’ an acceptable interpretation for ‘early Lyme borreliosis’?
  2. Is the time period of ‘> 6 months since tick bite or first symptoms or signs’ or an acceptable interpretation for ‘late Lyme borreliosis’?
  3. The use of the British Infection Association position paper classification to determine the range of clinical presentations that will be considered. This just refers to the 14 different clinical presentations in Table 2 of that paper – don’t worry about the rest of the paper. (In fact don’t read it: if you’re a patient it’s bad for your blood pressure and if you’re a doctor it’s bad for your practice.)
  4. The inclusion of the following strains of Lyme borreliosis for consideration as part of our review of the evidence: B. burgdorferi sensu stricto, B. garinii, B. afzelii.
  5. The appropriate diagnostic tests for consideration (when searching for evidence and information)

How can you comment?

  • Any individual may comment on this scope. If you want to make a comment on the draft scope, simply fill in the comments form on the NICE website and return it to the address on the form. The form contains instructions.
  • Through one of the stakeholder organisations. For health professionals, this will be through your organisation; for patients, carers and members of the public, you can send comments to one of the patient organisations on the stakeholder list. Currently those listed are Caudwell Lyme, Lyme Disease Action, Lyme Disease UK, LymeAid UK, LymeResearch UK.

If you would like to send comments to LDA then contact us via our NICE email address.
We shall keep our NICE webpage updated with progress and you can find links to all documents and our NICE news items from there.