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Child health Gastrointestinal Infections and infestations

Threadworm

Last revised in February 2025

Threadworm or pinworm (Enterobius vermicularis) is a parasitic worm which infests the intestines of humans.

Threadworm: Summary

  • Threadworm or pinworm (Enterobius vermicularis) is a parasitic worm that infests the human gut.
  • Transmission occurs by the faecal-oral route when threadworm eggs are ingested.
    • Eggs can be ingested by hand-to-mouth transfer (after scratching) from the faeces/perianal area of an infected person or by handling contaminated surfaces such as toys, bedding, or clothing.
  • Threadworm is the commonest parasitic worm infestation in the UK — it most often affects children under the age of 18 years, household contacts of infected children, and people living in institutions.
  • Infestation often presents with intense perianal itching, which is typically worse during the night.
    • Some people may be asymptomatic and only become aware of infection when small white thread-like worms (which may be slowly moving) are seen on the perianal skin or in the stools.
    • In females, the genital area can also be involved and presentation may include pruritus vulvae.
    • Nocturnal itching may lead to disturbed sleep and irritability.
  • If the diagnosis is uncertain, the adhesive tape test for eggs may be useful. Transparent tape is applied to the perianal area first thing in the morning and then examined under a microscope to detect threadworm eggs. Stool examination is not generally recommended.
  • Other causes of perineal and vulval itch include dermatitis, candidal infection, pubic lice, and haemorrhoids. Threadworms are rarely confused with other types of worm infestation because of their specific appearance.
  • Treatment is recommended if threadworms have been seen or eggs detected. Treatment of all household members at the same time (unless contraindicated) should be considered.
    • For adults and children aged over 6 months, an anthelmintic (mebendazole) combined with hygiene measures is recommended — mebendazole is not licensed for children under the age of 2 years.
    • For children aged 6 months and under, hygiene measures alone for 6 weeks, are recommended.
    • For pregnant or breastfeeding women, the recommended treatment is hygiene measures for 6 weeks. Treatment with mebendazole is contraindicated in the first trimester of pregnancy and the manufacturer recommends avoidance throughout pregnancy and caution when breastfeeding. 
  • If infestation recurs this is usually due to re-infection and not failure of anthelmintic therapy:
    • Other causes of symptoms should be considered.
    • If the diagnosis is certain, re-treatment of the person and household contacts with mebendazole is recommended (unless contraindicated).
    • The importance of strict hygiene measures should be reinforced.
  • If the person has frequent recurrences advice should be sought from a paediatrician or consultant in infectious diseases.

Have I got the right topic?

From birth onwards.

This CKS topic covers the treatment of threadworm (pinworm) infestation (Enterobius vermicularis).

This CKS topic does not cover the treatment of tapeworm, hookworm, or other rare worm infestations.

There are separate CKS topics on Pruritus ani, Pruritus vulvae, Pubic Lice and Roundworm.

The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary healthcare.

How up-to-date is this topic?

Changes

February 2025 — minor update. The section on mebendazole has been updated in line with the Roundworm topic.

Previous changes

February 2023 — reviewed. A literature search was conducted in December 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key RCTs published since the last revision of the topic. No major changes were made to the clinical recommendations.

February 2018 — reviewed. A literature search was conducted in November 2017 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No major changes to clinical recommendations have been made.

September 2013 — minor update. Pripsen® products have been discontinued and removed from the recommendations.

December 2011 — revised. A literature search was conducted in October 2011 to identify evidence-based guidelines, UK policy, systematic reviews, and key RCTs published since the last revision of the topic. No changes to clinical recommendations have been made. 

March 2011 — topic structure revised to ensure consistency across CKS topics — no changes to clinical recommendations have been made.

August 2007 — minor typographical update to the Clinical Summary. 

March to June 2007 — converted from CKS guidance to CKS topic structure. The evidence-base has been reviewed in detail, and recommendations are more clearly justified and transparently linked to the supporting evidence. There are no major changes to the recommendations.

November 2005 — minor technical update. 

March 2004 — updated with additional information for nurse prescribers. 

August 2003 — reviewed. Validated in December 2003 year and issued in February 2004.

March 2001 — rewritten. Validated in March 2001 and issued in June 2001.

June 1998 — reviewed.

September 1997 — written.

Update

New evidence

Evidence-based guidelines

No new evidence-based guidelines since 1 December 2022.

HTAs (Health Technology Assessments)

No new HTAs since 1 December 2022.

Economic appraisals

No new economic appraisals relevant to England since 1 December 2022.

Systematic reviews and meta-analyses

No new systematic reviews or meta-analysis which reach the CKS threshold for inclusion since 1 December 2022.

Primary evidence

No new primary evidence which reaches the CKS threshold for inclusion published since 1 December 2022.

New policies

No new national policies or guidelines since 1 December 2022.

New safety alerts

No new safety alerts since 1 December 2022.

Changes in product availability

No changes in product availability since 1 December 2022.

Goals and outcome measures

Goals

To support primary healthcare professionals to:

  • Identify and manage threadworm infection.
  • Give advice on prevention of re-infection and transmission of threadworm to others.

Outcome measures

No outcome measures were found during the review of this topic.

Audit criteria

No audit criteria were found during the review of this topic.

QOF indicators

No QOF indicators were found during the review of this topic.

QIPP - Options for local implementation

No QIPP indicators were found during the review of this topic.

NICE quality standards

No NICE quality standards were found during the review of this topic.

Background information

What is it?

  • Threadworm or pinworm (Enterobius vermicularis) is a common parasitic worm that infests the human gut.
    • Threadworms have a white, thread-like appearance — adult males are 2–5 mm in length, and adult females 8–13 mm.
    • Threadworm eggs are not visible to the naked eye and can survive for up to 2 weeks.
    • Humans are thought to be the only host.
  • Transmission occurs by the faecal-oral route when threadworm eggs are ingested:
    • Eggs can be ingested by hand-to-mouth transfer (after scratching) from the faeces/perianal area of an infected person or by handling contaminated surfaces such as toys, bedding, or clothing.
      • Occasionally, transmission may occur by inhaling and then swallowing eggs in environmental dust (for example after shaking contaminated bedding).
    • Once ingested, larvae emerge from the eggs and mature within 1–2 months into adults in the small intestine.
    • The mature adult female worm migrates through the anus and lays thousands of eggs on the peri-anal skin (typically at night) causing itching.
    • Adult threadworms survive for about 6 weeks and infection is maintained by swallowing fresh eggs.
    • There is no extraintestinal phase of the transmission cycle, and therefore, signs of systemic infection are uncommon.

[Wendt, 2019; CDC, 2020; BMJ Best Practice, 2021; UKHSA, 2023]

How common is it?

  • Threadworm is the commonest parasitic worm infestation in the UK — it can affect anyone but is mainly found in children under the age of 18 years, household contacts of infected children, and people living in institutions.
  • The exact prevalence is not known, but European estimates have suggested that 20 to 30% of pre-school and primary-school-aged children will have threadworm infestation.
    • Asymptomatic infection is common.
    • Many people seek over-the-counter treatment.
    • Children aged 4 to 11 are most frequently affected with male children slightly more likely to have an infestation. 

[Watkins, 2014; Wendt, 2019; CDC, 2020; BMJ Best Practice, 2021; UKHSA, 2023]

What are the complications?

  • Complications caused by threadworm include:
    • Lack of sleep (due to itching) with subsequent daytime irritability and difficulty concentrating.
    • Enuresis (bedwetting).
    • Weight loss, loss of appetite.
    • Excoriation and secondary infection of the perianal skin.
    • Disease due to migration of adult worms to ectopic sites such as:
      • The female genito-urinary tract causing pruritus vulvae, vaginitis, or salpingitis.
      • The urethra causing urethritis.
    • Enterobius vermicularis-associated appendicitis is an uncommon post-operative pathological finding, occurring in 1 to 2% of appendicitis cases.
    • Colitis, abscess, and granuloma formation may occur within the intestines, along the perineal skin, and within the peritoneum, but this is extremely rare.

[Weatherhead, 2015; Wendt, 2019; CDC, 2020; RCH, 2020; BMJ Best Practice, 2021; Sousa, 2022; NHS Inform, 2022]

What is the prognosis?

  • The lifecycle of the threadworm lasts approximately 2 months, but, as re-infection is common, infection is unlikely to resolve without treatment.
    • Regular hand washing, laundry, and regular cleaning can help reduce the risk of re-infection.
    • Breaking the cycle of re-infection in children who suck their thumbs can be difficult.

[Wendt, 2019; CDC, 2020; BMJ Best Practice, 2021; UKHSA, 2023]

Diagnosis of threadworm

When should I suspect threadworm infestation?

Suspect threadworm infection in anyone presenting with:

  • Intense perianal itching, typically worse during the night.
    • Some people may be asymptomatic and only become aware of infection when small white thread-like worms (which may be slowly moving) are seen on the perianal skin or in the stools.
    • In females, the genital area can also be involved and presentation may include pruritus vulvae.
    • Nocturnal itching may lead to disturbed sleep and irritability.
  • Secondary bacterial infection can occur due to irritation and excoriation of the perianal area.

Basis for recommendation

The information on the clinical features of threadworm infection is based on the clinical guideline Parasites - Enterobiasis (also known as pinworm infection) [CDC, 2020] and expert opinion in review articles [Weatherhead, 2015; Wendt, 2019; BMJ Best Practice, 2021].

How should I assess a person with suspected threadworm infection?

  • Take a history asking about:
    • Symptoms of threadworm infection such as perianal and/or vulval itching and restlessness or insomnia.
    • Appearance of threadworms in the stools or on the peri-anal skin.
    • Contacts with similar symptoms or confirmed infection.
  • Examine the person looking for:
    • Signs of scratching (excoriation) and localized secondary bacterial infection in the perianal area.
    • Worms in the perianal area (it is unusual to see these when the person is examined during the day).
  • Arrange investigations if the diagnosis is uncertain — the adhesive tape test for eggs may be useful. Stool examination is much less reliable and is generally not recommended.
    • Advise the person (or parent/carer, if the person being assessed is a child) to:
      • Apply transparent adhesive tape to the perianal skin first thing in the morning, before wiping or bathing.
      • Remove the tape and place it in a specimen container.
      • Hand this to the surgery, so that it can be examined under a microscope either by a GP or local laboratory.
      • Note: Tape may need to be examined on 3 consecutive mornings to confirm diagnosis.

Basis for recommendation

The recommendations on how to assess a person with suspected threadworm infection are based on the clinical guideline Parasites - Enterobiasis (also known as pinworm infection) [CDC, 2020] and expert opinion in review articles [Wendt, 2019; BMJ Best Practice, 2021].

Ask about contacts with similar symptoms or confirmed infection

  • Threadworms are highly transmissible — known infection in household or classroom contacts is suggestive of transmission [BMJ Best Practice, 2021].

Stool examination is unreliable

What else might it be?

  • Consider other causes of perianal and vulval itch — for a detailed discussion, see the CKS topics on Pruritus ani and Pruritus vulvae:
    • Skin conditions such as atopic or contact dermatitis, psoriasis, and lichen planus.
    • Infections and infestations such as pubic lice and candida.
    • Gastrointestinal and systemic disease such as inflammatory bowel disease.
  • Other worm infestations are less common in the UK:
    • Roundworm — unlikely to be confused as adult roundworms, which may occasionally be passed in the stools, are much larger (up to 30cm) than threadworms.
      • For more information, see the CKS topic on Roundworm.
    • Tapeworm — segments (proglottids) may be seen in the stools as single proglottids (like grains of rice) or as chains.

[Watkins, 2014; BMJ Best Practice, 2021]

Management

Scenario: Management of threadworm

From birth onwards.

How should I manage threadworm infestation in primary care?

  • Explain the diagnosis and management to the person.
  • Treat with a single dose of an anthelmintic such as mebendazole (unless contraindicated) — the dose may need to be repeated in 2 weeks if infection persists.
    • Children under the age of 6 months and pregnant or breastfeeding women should be treated with hygiene measures alone for 6 weeks.
      • Mebendazole is not licensed for the treatment of threadworm in children under the age of 2 years.
      • Seek advice from an infectious disease specialist if unsure about treatment.
    • Consider treating all household contacts (unless contraindicated) as threadworms are highly transmissible.
  • Advise rigorous hygiene measures for 2 weeks if treated with mebendazole, or 6 weeks if using hygiene measures alone:
    • Wash hands thoroughly with soap and warm water after using the toilet, changing nappies, and before handling food.
    • Cut fingernails regularly, avoid biting nails and scratching around the anus.
    • Shower each morning, including the perianal area, to remove eggs from the skin.
    • Change bed linen and nightwear daily for several days after treatment.
      • Do not shake out items as this may distribute eggs around the room.
      • Washing/drying in a hot cycle will kill threadworm eggs.
    • Thoroughly dust and vacuum (including vacuuming mattresses) and clean the bathroom by 'damp-dusting' surfaces, washing the cloth frequently in hot water.
  • If infection recurs this is usually due to re-infection not failure of anthelmintic therapy:
    • Consider other causes of symptoms and re-treat with mebendazole if the diagnosis is certain – ensure all household contacts are treated (unless contraindicated).
    • Reinforce the importance of strict hygiene measures.
  • If the person has frequent recurrences consider seeking advice from a paediatrician or consultant in infectious diseases.

Basis for recommendation

The recommendations on the management of pinworm infection in primary care are based on the clinical guidelines Treatment of threadworm/pinworm in pregnancy [UKTIS, 2023], Parasites - Enterobiasis (also known as pinworm infection) [CDC, 2020], Guidance. Health protection in children and young people settings, including education [UKHSA, 2023], and expert opinion in review articles [Weatherhead, 2015; Wendt, 2019; BMJ Best Practice, 2021].

Exclusion
  • UK Health Security Agency guidance states that it is not necessary to exclude children with threadworm from school [UKHSA, 2023].
Use of anthelmintics
  • CKS found no good trial evidence regarding the efficacy of anthelmintics in the treatment of threadworm. The limited data available are from relatively old, small studies comparing mebendazole with either placebo or with drugs that are not available in the UK.
  • The British National Formulary [BNF, 2023] states that mebendazole is the drug of choice for treating threadworm infection in patients of all ages over 6 months.
  • There are few contraindications to the use of mebendazole, and the manufacturer reports that safety has been evaluated in 6276 subjects participating in 39 clinical trials for the treatment of single or mixed parasitic infestations of the gastrointestinal tract. In these 39 clinical trials, no adverse drug reactions (ADRs) occurred in ≥1% of treated subjects [EMC, 2024a; ABPI, 2021].
Repeat dose after 2 weeks
  • There is some debate in the medical literature regarding whether a second dose of mebendazole should routinely be given 14 days after the initial dose.  One dose is sufficient to kill the adult worms. However, it may not destroy the eggs or larvae. A second treatment 2 weeks later may therefor eradicate worms from newly hatched eggs. CKS recommends that the dose is repeated if infection persists [EMC, 2024a; ABPI, 2021].
Treat all family members
  • The BNF [BNF, 2023] recommends that all members of the family require treatment.
  • The summary of product characteristics strongly recommends that all members of the family are treated at the same time [EMC, 2024a; ABPI, 2021].
Treatment of threadworm in pregnancy and breastfeeding
  • Hygiene measures alone are preferred for treatment of threadworm in breastfeeding and pregnancy.
  • Limited amounts of mebendazole are present in human milk following oral administration [Lactmed, 2020; EMC, 2024a; ABPI, 2021]. The manufacturers therefore advise that caution should be exercised when mebendazole is administered to breastfeeding women [EMC, 2024a; ABPI, 2021]. Advice from the NHS A-Z website states that mebendazole use may be considered in breastfeeding mothers of healthy infants.
  • The UK Teratology Information Service [UKTIS, 2023] states that mebendazole may be considered after first attempting rigorous hygiene measures but treatment should ideally be delayed until after the first trimester (treatment in any trimester is off-label). Each case requires a specific risk assessment including consideration of other risk factors which may independently increase the risk of adverse pregnancy outcome.
Treatment of threadworm in young children
  • The British National Formulary recommends mebendazole for treating threadworm infection in children over 6 months; however, it is not licensed for use in children less than 2 years of age [EMC, 2024a; ABPI, 2021; BNF, 2023].
  • Expert opinion in the British Medical Journal Best Practice series recommends consultation with an infectious-disease specialist before treating young children with anthelmintic as these drugs have not been studied extensively in children under the age of 2 years [BMJ Best Practice, 2021].
Hygiene measures
  • Expert opinion varies regarding how long personal hygiene measures should continue. As a pragmatic approach, CKS suggests that personal hygiene measures should be continued for:
    • Two weeks in people who have taken an anthelmintic (as eggs can remain viable in the environment for up to 2 weeks).
    • Six weeks in people who are using hygiene measures alone (the approximate lifespan of an adult threadworm).

Prescribing information

Important aspects of prescribing information relevant to primary healthcare are covered in this section specifically for the drugs recommended in this CKS topic. For further information on contraindications, cautions, drug interactions, and adverse effects, see the electronic Medicines Compendium (eMC), or the British National Formulary (BNF).

Mebendazole

Dose

  • In adults, 100 mg for 1 dose, if reinfection occurs, a second dose may be needed after 2 weeks.
  • In children, aged 6 months to 17 years, 100 mg for 1 dose, if reinfection occurs, a second dose may be needed after 2 weeks.

[CDC, 2020; ABPI, 2021; BNF, 2023; EMC, 2024a]

Contraindications and cautions

    • Do not prescribe mebendazole to women who are pregnant.

[BNF, 2024; EMC, 2024b]

Adverse effects

    • Gastrointestinal
      • Common: abdominal pain (common); 
      • Uncommon: abdominal discomfort, diarrhoea, flatulence, nausea, vomiting. 
    • Rare adverse effects include:
      • Convulsions, dizziness.
      • Rash, toxic epidermal necrolysis, Stevens-Johnson syndrome, exanthema, angioedema, urticaria.

[BNF, 2024; EMC, 2024b]

Drug interactions

    • The levels of mebendazole are reduced when taken concurrently with:
      • Carbamazepine.
      • Phenobarbital.
      • Phenytoin.
      • Primidone.
      • Ritonavir.
    • For systemic infections, the dose of mebendazole may need to be increased. There is no need to adjust the dose when mebendazole is used for intestinal worm infections. 
    • Cimetidine — levels of mebendazole are increased if taken concurrently with cimetidine. Consider monitoring for increased mebendazole adverse effects (dizziness, nausea, vomiting).

[Preston, 2024]

Pregnancy and breastfeeding

  • Pregnancy

    • Mebendazole is contraindicated in women who are pregnant.

    Breastfeeding

    • Mebendazole is excreted in small amounts in breastmilk and is not expected to be harmful.
    • The manufacturer advises caution when used in women who are breastfeeding.

    [BNF, 2024; EMC, 2024b]

Supporting evidence

This CKS topic is largely based on recommendations provided in clinical guidelines Parasites - Enterobiasis (also known as pinworm infection) [CDC, 2020], Guidance: Health protection in children and young people settings, including education [UKHSA, 2023], Treatment of threadworm/pinworm in pregnancy [UKTIS, 2023], and expert opinion in review articles [Weatherhead, 2015; Wendt, 2019; BMJ Best Practice, 2021].

How this topic was developed

This section briefly describes the processes used in developing and updating this topic. Further details on the full process can be found in the About Us section and on the Clarity Informatics website.

Search strategy

A literature search was conducted for guidelines, systematic reviews and randomized controlled trials on primary care management of threadworm.

Search dates

November 2017 - December 2022

Key search terms

Various combinations of searches were carried out. The terms listed below are the core search terms that were used for Medline.

  • exp Enterobius/, exp Enterobiasis/
  • threadworm*.tw., thread worm*.tw., thread-worm*.tw., pinworm*.tw., pin worm*.tw., pin-worm*.tw., enterobius.tw., enterobiasis.tw., oxyuriasis.tw.

Sources of guidelines

Sources of systematic reviews and meta-analyses

  • The Cochrane Library:
    • Systematic reviews
    • Protocols
    • Database of Abstracts of Reviews of Effects
  • Medline (with systematic review filter)
  • EMBASE (with systematic review filter)

Sources of health technology assessments and economic appraisals

Sources of randomized controlled trials

  • The Cochrane Library:
    • Central Register of Controlled Trials
  • Medline (with randomized controlled trial filter)
  • EMBASE (with randomized controlled trial filter)

Sources of evidence based reviews and evidence summaries

Sources of national policy

Patient experiences

Sources of medicines information

The following sources are used by CKS pharmacists and are not necessarily searched by CKS information specialists for all topics. Some of these resources are not freely available and require subscriptions to access content.

Stakeholder engagement

Our policy

The external review process is an essential part of CKS topic development. Consultation with a wide range of stakeholders provides quality assurance of the topic in terms of:

  • Clinical accuracy.
  • Consistency with other providers of clinical knowledge for primary care.
  • Accuracy of implementation of national guidance (in particular NICE guidelines).
  • Usability.

Principles of the consultation process

  • The process is inclusive and any individual may participate.
  • To participate, an individual must declare whether they have any competing interests or not. If they do not declare whether or not they have competing interests, their comments will not be considered.
  • Comments received after the deadline will be considered, but they may not be acted upon before the clinical topic is issued onto the website.
  • Comments are accepted in any format that is convenient to the reviewer, although an electronic format is encouraged.
  • External reviewers are not paid for commenting on the draft topics.
  • Discussion with an individual or an organization about the CKS response to their comments is only undertaken in exceptional circumstances (at the discretion of the Clinical Editor or Editorial Steering Group).
  • All reviewers are thanked and offered a letter acknowledging their contribution for the purposes of appraisal/revalidation.
  • All reviewers are invited to be acknowledged on the website. All reviewers are given the opportunity to feedback about the external review process, enabling improvements to be made where appropriate.

Stakeholders

  • Key stakeholders identified by the CKS team are invited to comment on draft CKS topics. Individuals and organizations can also register an interest to feedback on a specific topic, or topics in a particular clinical area, through the Getting involved section of the Clarity Informatics website.
  • Stakeholders identified from the following groups are invited to review draft topics:
    • Experts in the topic area.
    • Professional organizations and societies (for example, Royal Colleges).
    • Patient organizations, Clarity has established close links with groups such as Age UK and the Alzheimer’s Society specifically for their input into new topic development, review of current topic content and advice on relevant areas of expert knowledge.
    • Guideline development groups where the topic is an implementation of a guideline.
    • The British National Formulary team.
    • The editorial team that develop MeReC Publications.
  • Reviewers are provided with clear instructions about what to review, what comments are particularly helpful, how to submit comments, and declaring interests.

Patient engagement

Clarity Informatics has enlisted the support and involvement of patients and lay persons at all stages in the process of creating the content which include:

  • Topic selection
  • Scoping of topic
  • Selection of clinical scenarios
  • First draft internal review
  • Second draft internal review
  • External review
  • Final draft and pre-publication

Our lay and patient involvement includes membership on the editorial steering group, contacting expert patient groups, organizations and individuals.

Evidence exclusion criteria

Our policy

Scoping a literature search, and reviewing the evidence for CKS is a methodical and systematic process that is carried out by the lead clinical author for each topic. Relevant evidence is gathered in order that the clinical author can make fully informed decisions and recommendations. It is important to note that some evidence may be excluded for a variety of reasons. These reasons may be applied across all CKS topics or may be specific to a given topic.

Studies identified during literature searches are reviewed to identify the most appropriate information to author a CKS topic, ensuring any recommendations are based on the best evidence. We use the principles of the GRADE and PICOT approaches to assess the quality of published research. We use the principles of AGREE II to assess the quality of published guidelines.

Standard exclusions for scoping literature:

  • Animal studies
  • Original research is not written in English

Possible exclusions for reviewed literature:

  • Sample size too small or study underpowered
  • Bias evident or promotional literature
  • Population not relevant
  • Intervention/treatment not relevant
  • Outcomes not relevant
  • Outcomes have no clear evidence of clinical effectiveness
  • Setting not relevant
  • Not relevant to UK
  • Incorrect study type
  • Review article
  • Duplicate reference

Organizational, behavioural and financial barriers

Our policy

The CKS literature searches take into consideration the following concepts, which are discussed at the initial scoping of the topic.

  • Feasibility
    • Studies are selected depending on whether the intervention under investigation is available in the NHS and can be practically and safely undertaken in primary care.
  • Organizational and Financial Impact Analysis
  • Studies are selected and evaluated on whether the intervention under investigations may have an impact on local clinical service provision or national impact on cost for the NHS. The principles of clinical budget impact analysis are adhered to, evaluated and recorded by the author. The following factors are considered when making this assessment and analysis.
    • Eligible population
    • Current interventions
    • Likely uptake of new intervention or recommendation
    • Cost of the current or new intervention mix
    • Impact on other costs
    • Condition-related costs
    • In-direct costs and service impacts
    • Time dependencies
  • Cost-effectiveness or cost-benefit analysis studies are identified where available. 

We also evaluate and include evidence from NICE accredited sources which provide economic evaluations of recommendations, such as NICE guidelines. When a recommended action may not be possible because of resource constraints, this is explicitly indicated to healthcare professionals by the wording of the CKS recommendation.

Declarations of interest

Our policy

Clarity Informatics requests that all those involved in the writing and reviewing of topics, and those involved in the external review process to declare any competing interests. Signed copies are securely held by Clarity Informatics and are available on request with the permission of the individual. A copy of the declaration of interest form which participants are asked to complete annually is also available on request. A brief outline of the declarations of interest policy is described here and full details of the policy is available on the Clarity Informatics website. Declarations of interests of the authors are not routinely published, however competing interests of all those involved in the topic update or development are listed below. Competing interests include:

  • Personal financial interests
  • Personal family interest
  • Personal non-financial interest
  • Non-personal financial gain or benefit

Although particular attention is given to interests that could result in financial gains or losses for the individual, competing interests may also arise from academic competition or for political, personal, religious, and reputational reasons. An individual is not obliged to seek out knowledge of work done for, or on behalf of, the healthcare industry within the departments for which they are responsible if they would not normally expect to be informed.

Who should declare competing interests?

Any individual (or organization) involved in developing, reviewing, or commenting on clinical content, particularly the recommendations should declare competing interests. This includes the authoring team members, expert advisers, external reviewers of draft topics, individuals providing feedback on published topics, and Editorial Steering Group members. Declarations of interest are completed annually for authoring team and editorial steering group members, and are completed at the start of the topic update and development process for external stakeholders.

Competing interests declared for this topic:

None.

References

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