Rawlins Michael D
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
J R Soc Med. 2015 Jun;108(6):211-9. doi: 10.1177/0141076815587658.
The National Institute for Clinical Excellence was established in 1999. Its original remit was to undertake technology appraisals of (mainly) new interventions and to develop clinical guidelines. In providing both forms of guidance, it was required to take into account both clinical and cost effectiveness. After a difficult first few months, it gained the confidence and trust of the professions. It subsequently gained additional responsibilities with a commensurate increase in its staffing and budget. It is, moreover, the only one of the National Health Service organisations established in the late 1990s and early 2000s to have not only survived but grown. This paper describes not only the National Institute for Clinical Excellence's early years but also, in the author's view, the features of its guidance programmes that led to its success and (in retrospect) some things it could have done differently.
国家临床优化研究所成立于1999年。其最初的职责是对（主要是）新干预措施进行技术评估并制定临床指南。在提供这两种指导形式时，它需要同时考虑临床效果和成本效益。在经历了艰难的最初几个月后，它赢得了专业人士的信心和信任。随后，它承担了更多责任，人员配备和预算也相应增加。此外，它是20世纪90年代末和21世纪初成立的国民保健服务机构中唯一不仅存活下来而且发展壮大的机构。本文不仅描述了国家临床优化研究所的早期岁月，而且在作者看来，还阐述了其指导计划取得成功的特点以及（事后看来）一些它本可以采取不同做法的事情。
