The Centre in Ireland for Clinical guideline support and Evidence Reviews (CICER) is funded by the Health Research Board (HRB) and hosted by HIQA.
HIQA was awarded funding spanning the period from 2017 to 2024, and again from 2024 to 2028, to conduct evidence synthesis to support the development of National Clinical Guidelines. CICER comprises a dedicated multidisciplinary research team supported by the Health Technology Assessment Directorate in HIQA and the Discipline of Public Health and Primary Care in the School of Medicine at Trinity College Dublin, as well as national and international clinical and methodological experts.
What are clinical guidelines?
Clinical guidelines are sets of evidence-based recommendations that aim to provide guidance for improving the quality, safety and cost-effectiveness of healthcare. They promote healthcare that is effective and consistent, ensuring best outcomes for patients and people using services.
In Ireland, National Clinical Guidelines are developed under the oversight of the National Clinical Effectiveness Committee (NCEC) and approved by the Minister for Health in Ireland. NCEC National Clinical Guidelines are based on the best available scientific evidence of clinical benefits and cost-effectiveness, and are required to consider the budget impact of their implementation.
What does CICER do?
The role of CICER is to independently review evidence and provide scientific support for the development, by guideline development groups, of National Clinical Guidelines. CICER undertakes systematic reviews of the clinical effectiveness and cost-effectiveness of interventions included in the guidelines, as well as estimating the budget impact of implementing the recommendations. CICER further supports guideline development groups by:
- providing tailored training sessions;
- assisting in the development of clinical questions and search strategies;
- performing systematic reviews of international clinical guidelines and supporting the assessment of their suitability for adaption to Ireland; and
- supporting the use of evidence-to-decision frameworks to develop evidence-based recommendations within the National Clinical Guidelines.
In addition, CICER aims to build capacity and drive innovation in the evidence synthesis and methodological research communities through national and international collaborations. CICER is an organisational member of the Guidelines International Network.
This research is funded by the Health Research Board under grant number ESCG-2024-002.
Completed clinical guidelines
The role of CICER is to independently review evidence and provide scientific support for the development, by guideline development groups, of National Clinical Guidelines. The team undertakes systematic reviews of clinical effectiveness and cost-effectiveness to inform interventions included in the guidelines, as well as estimating the budget impact of implementing the recommendations.
As of 2025, CICER has supported a total of 15 guideline development groups, 10 of which have published their guideline to date.
Work in progress
The CICER team works to support a number of National Clinical Guidelines at any one time, as well as additional related projects.
Methodological outputs
CICER regularly provides methodological support to the National Clinical Effectiveness Committee.
Research Collaborations
CICER aims to support innovation in the evidence synthesis and methodological research communities through national and international collaborations. Here are some completed and ongoing funded research collaborations involving the CICER team:
- Optimising the dissemination of health research in Ireland (PI: M. Sharp, awarded 2023)
- Rapid Health Technology Assessments (rHTA) in Ireland: When do we need them? (PI: B. Clyne, awarded 2023)
- Evidence synthesis and translation of findings for national clinical guideline development: addressing the needs and preferences of guideline development groups (PI: B. Clyne, awarded 2019)
Academic Publications
In addition to published reports, CICER frequently publishes its work in peer-reviewed academic journals.
Training materials
CICER aims to build national capacity in the topics of evidence synthesis and guideline development. As CICER training resources and opportunities become available, they will be shared here.
Events
On September 17th 2024, the CICER team hosted a stand at the National Patient Safety Office Conference at the Printworks, Dublin Castle.
External resources
Here are links to key national and international organisations that focus on guideline development and evidence synthesis:
- The National Clinical Effectiveness Committee’s mission is to provide a framework for national endorsement of clinical guidelines and audit to optimise patient and service user care in Ireland. It publishes guidance for the development of National Clinical Guidelines, and prioritises and quality-assures those guidelines.
- The Health Service Executive (HSE) National Central Repository is the central source for accessing, storage and document control of HSE National clinical guidelines, as well as national policies, procedures, protocols, and other guidance.
- Evidence Synthesis Ireland (ESI) is an all-Ireland initiative that builds evidence synthesis knowledge, awareness and capacity among the public, health care institutions and policymakers, clinicians, and researchers.
- Guidelines International Network (GIN) is a network of organisations and individuals interested in evidence-based guidelines and has one of the world’s largest international guideline libraries. CICER is an organisational member of GIN.
- INGUIDE is a comprehensive, evidence-based, and up-to-date training program for guideline recommendation and development. It is the product of a joint partnership between Guidelines International Network and McMaster University’s Department of Health Research Methods, Evidence, and Impact.
- World Health Organisation Eastern Mediterranean Region has compiled a training package of online resources that includes content on both developing and adapting clinical practice guidelines.