Threshold Index (2025)

About Clinical Thresholds

Clinical thresholds are evidence-based values or criteria used in healthcare decision-making to guide appropriate patient management. These thresholds help standardise care by providing clear benchmarks for actions such as referrals, investigations, treatments, and escalations. They are developed by authoritative bodies including NICE, Royal Colleges, and specialist societies based on current research and clinical consensus.

Using thresholds appropriately supports clinical judgement rather than replacing it, helping to ensure patients receive timely, consistent care while optimising resource allocation. Thresholds may vary by setting (primary/secondary care), population (adult/paediatric), and urgency (routine/urgent/time-critical).

Using the Threshold Index

This index allows healthcare professionals to quickly find and compare clinical thresholds across different specialties and guidance bodies. The database is searchable by keyword and filterable by multiple parameters to help identify relevant criteria for specific clinical scenarios.

Search tips:

• Use specific clinical terms (e.g., "CKD stage 3b", "PSA monitoring") for precise results
• Filter by specialty to narrow to relevant clinical areas
• Use decision type filters to find specific action types (referral, monitoring, etc.)
• Check urgency levels to identify time-critical thresholds
• Review multiple guidance bodies where available to understand different perspectives

Each threshold entry includes the clinical topic, decision area, and source guidance with direct links to authoritative sources for detailed context.

Clinical Decision-Making Context

Thresholds should be applied within the context of individual patient circumstances, comorbidities, and clinical presentation. While thresholds provide valuable guidance, they are not absolute rules and clinical judgement remains essential. Factors such as patient preferences, symptom progression, and resource availability may appropriately influence threshold application.

Regular review of thresholds is important as evidence evolves. This index aims to reflect current guidance but users should verify against the latest source documents, particularly for time-sensitive or high-risk decisions.

Implementation Considerations

When implementing clinical thresholds in practice, consider:

• Local service configurations and pathways
• Interdisciplinary agreement on threshold application
• Documentation of threshold-based decisions
• Audit mechanisms to review threshold appropriateness
• Patient education regarding threshold-based management plans
• Integration with clinical information systems where possible

Effective use of clinical thresholds can enhance patient safety, reduce variation in care, and support efficient healthcare delivery when applied as part of comprehensive clinical assessment.