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Agilio: Diagnosis and Treatment Guidance September 2025 Update

This update contains 12 significant changes and 10 minor changes.Significant changes:

  • Bone and soft tissue sarcoma – recognition and referral — reviewed. This topic is a direct implementation of the National Institute for Health and Care Excellence (NICE) guideline Suspected cancer: recognition and referral. Minor structural changes have been made to this topic.
  • Brain and central nervous system cancers – recognition and referral — reviewed. This topic is a direct implementation of the National Institute for Health and Care Excellence guideline Suspected cancer: recognition and referral. Minor structural changes have been made to this topic.
  • Breast cancer – recognition and referral — reviewed. This topic is a direct implementation of the National Institute for Health and Care Excellence (NICE) guideline Suspected cancer: recognition and referral.
  • Corticosteroids – topical (skin), nose, and eyes — reviewed. A literature search was conducted in June 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last version of this topic. There have been no major changes to the recommendations.
  • Childhood cancer — reviewed. This topic is a direct implementation of the National Institute for Health and Care Excellence (NICE) guideline Suspected cancer: recognition and referral. Minor structural changes have been made to this topic
  • Gastrointestinal tract (lower) cancers – recognition and referral — reviewed. This topic is a direct implementation of the National Institute for Health and Care Excellence (NICE) guideline Suspected cancer: recognition and referral.
  • Gastrointestinal tract (upper) cancers – recognition and referral — reviewed. This topic is a direct implementation of the National Institute for Health and Care Excellence (NICE) guideline Suspected cancer: recognition and referral. Minor structural changes have been made to this topic.
  • Gynaecological cancers – recognition and referral — reviewed. This topic is a direct implementation of the National Institute for Health and Care Excellence (NICE) guideline Suspected cancer: recognition and referral. Minor structural changes have been made to this topic.
  • Insulin therapy in type 1 diabetes — 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. The recommendations have been updated in line with current evidence in the literature, specifically the indications for insulin pump therapy, continuous glucose monitoring (CGM), and the definition of what blood glucose level constitutes an alert value for hypoglycaemia.
  • Meningitis – bacterial meningitis and meningococcal disease — reviewed. A literature search was conducted in June 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. Dosage for ceftriaxone for pre-hospital management has been updated to be in line with recommendation from the BNFC.
  • Rosacea — reviewed. A literature search was conducted in June 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic..
  • Urological cancers — reviewed. This topic is a direct implementation of the National Institute for Health and Care Excellence (NICE) guideline Suspected cancer: recognition and referral. Minor structural changes have been made to this topic.

Minor changes:

  • Corticosteroids – inhaled — minor update. The sections on Actions of corticosteroids and Steroid alert cards have been revised. Broken links have been fixed.
  • Corticosteroids – oral — minor update. The sections on Contraindications and cautions, Initiation, and Steroid alert cards have been revised. A typographical error has also been corrected.
  • Deep vein thrombosis — minor update. Wording changed in the summary section describing the diagnosis of deep vein thrombosis to align more closely with NICE guidance NG158.
  • Immunizations – seasonal influenza — minor update. Influenza vaccines have been updated in line with those available in the UK for the 2025 to 2026 season.
  • Irritable bowel syndrome — minor update. Links to IBS Network have been removed.
  • Migraine — minor update. Added prescribing section for candesartan.
  • Obesity — minor update. Quality standards have been updated in line with the NICE QS 212 Overweight and Obesity Management.
  • Otitis externa — minor update. Reference to Otomize spray has been removed as the product has been discontinued.
  • Prostate cancer — minor update. Added prevalence data on mortality by ethnicity. Added information relating to Black men being more likely to have metastatic cancer at time of diagnosis. Revised wording on PSA testing in men over the age of 79 and added further information to the basis for information regarding the difference between advice from NICE and the AoMRC in this age group.
  • Tuberculosis — minor update. Definition of extensively drug-resistant tuberculosis has been updated in line with the 2021 updated WHO definition.