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Agilio: Diagnosis and Treatment Guidance June 2025 Update

This update contains 8 significant changes and 26 minor changes.

Significant Changes:

  • Appendicitis — reviewed. A literature search was conducted in February 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. There have been minor structural changes to the topic, with changes to the basis for recommendations updated in line with current clinical guidelines and expert opinion review articles.
  • Corticosteroids – inhaled— reviewed. A literature search was conducted in March 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last version of this topic. No major changes to recommendations have been made.
  • Cough — reviewed. A literature search was conducted in April 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. The topic has undergone restructuring. No major changes to the recommendations have been made.
  • Dupuytren’s disease — reviewed. A literature search was conducted in March 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. There have been minor structural changes to the topic, including minor additions and clarifications for the recommendations, to align with current evidence on Dupuytren’s disease.
  • Menopause — reviewed. A literature search was conducted in January 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. The topic has undergone minor restructuring to improve clarity and navigation. The recommendations have been updated in line with the National Institute for Health and Care Excellence (NICE) clinical guideline Menopause NICE, 2024 and other relevant literature. A section detailing the investigation and management of unscheduled bleeding on hormone replacement therapy (HRT) has been added in line with guidance prepared on behalf of the British Menopause Society, in partnership with the British Society of Gynaecological Endoscopy, British Gynaecological Cancer Society, Faculty of Sexual & Reproductive Healthcare, Getting It Right First Time (GIRFT), Royal College of General Practitioners and the Royal College of Obstetricians & Gynaecologists BMS, 2024.
  • Neck lump — reviewed. A literature search was conducted in March 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. No major changes to the recommendations have been made.
  • Pityriasis versicolor— reviewed. A literature search was conducted in February 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic.
  • Vitiligo — reviewed. A literature search was conducted in March 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic.

Minor Changes:

  • Alcohol – problem drinking — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Angina — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Antiplatelet treatment — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Asthma — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26. Prescribing information for ipratropium inhalers has been removed.
  • Atrial fibrillation — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Bipolar disorder — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Chronic kidney disease — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Chronic obstructive pulmonary disease — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • CVD risk assessment and management — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Dementia — minor update. A small typographical mistake was corrected. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Diarrhoea – antibiotic associated — minor update. Revised wording on recurrent C. Difficile infection to improve clarity of the definition.
  • Heart failure – chronic — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Hypercholesterolaemia – familial— minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Hypertension — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Insomnia — minor update. Added information about snris causing insomnia and additional information regarding ADHD, autism spectrum disorder, menopausal symptoms and tinnitus when assessing a person with insomnia. Further links to other CKS topics also added.
  • Lipid modification – CVD prevention — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Mental health in students — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26
  • MI-secondary prevention — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Obesity — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Peripheral arterial disease — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Pityriasis rosea — minor update. Revised wording on the potential risks and the management in first trimester of pregnancy.
  • Psychosis and Schizophrenia — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Scabies — minor update. Updated the management section to advise that first-line treatment is now recommended as either topical permethrin or oral ivermectin. This is in line with the British Association for Sexual Health and HIV National Guideline on the Management of Scabies in adults 2025 Morris, 2025.
  • Shingles — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Smoking cessation— minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.
  • Stroke and TIA — minor update. QOF indicators updated in line with the NHS England Quality and Outcomes Framework guidance for 2025/26.