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Faulkner et al Lyme governance STand S accepted version July 2019.pdf (329.21 kB)

Definitely maybe: new governance of uncertainty and risk in patient group involvement with UK guidance on testing for Lyme disease

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journal contribution
posted on 2023-06-09, 18:38 authored by Alex Faulkner, Kate Bloor, Vahsti Hale
States that claim responsibility for citizens’ healthcare try to deal with knowledge uncertainties while preserving a duty of care. Production of clinical guidelines in disputed medical conditions or where uncertainty is high, is difficult. Patient groups may advocate non-credentialed evidence, contribute to debates and form alliances with established policy actors. In this context, Lyme disease, especially highly contested ‘chronic’ Lyme disease is a good case with which to examine how official governance institutions are managing diagnostic uncertainty and evidence for tests. The healthcare state has been provoked to develop extensive policy for Lyme disease. In the UK, national Health Technology Assessment agency, NICE, began a consultation process in 2016. NICE and other policy actors are moving towards more participatory modes of decision-making. The article analyses NICE’s recently published guidelines and consultation documents; patient groups’ contributions; observations of consultations and of evidence review processes; and recent Department of Health systematic reviews, including patient group participation. We draw on concepts of participatory governance, patient group activism and guideline involvement. We find an increased level of participation by patient groups in recent policy and evidence review processes, and hence legitimation of them as ‘stakeholders’, alongside a strengthened state position on pre-existing diagnostic and testing standards.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

Science, Technology and Society

ISSN

0971-7218

Publisher

SAGE Publications

Issue

1

Volume

26

Page range

116-134

Department affiliated with

  • International Relations Publications

Research groups affiliated with

  • Centre for Global Health Policy Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2019-08-14

First Open Access (FOA) Date

2021-01-20

First Compliant Deposit (FCD) Date

2019-08-13

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