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The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders: a systematic review

Shoulder pain is a significant cause of morbidity; the prevalence of self-reported pain is estimated to be between 16 and 26%, and it is the third most common cause of musculoskeletal consultation in primary care. The cause can be difficult to diagnose owing to the complex anatomy of the shoulder and the spectrum of underlying disorders. Most shoulder problems fall into three major categories: soft tissue disorders, articular injury or instability, and arthritis. The incidence of lesions increases with age as tendon tissue progressively weakens or degenerates, but repeated microtrauma or overuse from professional or athletic activity can also cause soft tissue problems in all age groups.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2003

Positron emission tomography (PET) and PET/CT in bone and soft tissue tumours: Executive summary of final report D06-01K, Version 1.0

The primary goal of the report was to describe the patient-relevant benefit that doctors and patients can expect from the imaging techniques PET and PET/CT in the primary diagnostics, primary staging, restaging and recurrence diagnostics of bone and soft tissue tumours. “Benefit” was understood here to mean the changes that are causally attributed to the use of PET or PET/CT and that have perceptible consequences for the patient.

Institute for Quality and Efficiency in Health Care: Executive Summaries [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 20, 2012

High‐dose chemotherapy followed by autologous hematopoietic stem cell transplantation for non‐rhabdomyosarcoma soft tissue sarcomas

We reviewed the evidence about the effect of high‐dose chemotherapy followed by autologous hematopoietic stem cell transplantation compared to standard‐dose chemotherapy on overall survival in people with non‐rhabdomyosarcoma soft tissue sarcomas. We found one randomized controlled trial (RCT) comparing both treatments and 48 studies with results from transplantation only.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Autologous stem cell transplantation for soft tissue sarcoma: Executive summary of final report N05-03D, Version 1.0

The aim of this investigation was to assess the benefit of autologous hematopoietic stem cell transplantation (HSCT) on patient-relevant outcomes in patients with soft tissue sarcomas compared to a procedure without HSCT.

Institute for Quality and Efficiency in Health Care: Executive Summaries [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 17, 2009

Adult Soft Tissue Sarcoma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of adult soft tissue sarcoma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: September 21, 2015

Childhood Soft Tissue Sarcoma Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of childhood soft tissue sarcomas.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: October 30, 2015

Adult Soft Tissue Sarcoma Treatment (PDQ®): Health Professional Version

Expert-reviewed information summary about the treatment of adult soft tissue sarcoma.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 2, 2015

Childhood Soft Tissue Sarcoma Treatment (PDQ®): Health Professional Version

Expert-reviewed information summary about the treatment of childhood soft tissue sarcomas.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: January 28, 2016

Faecal Incontinence: The Management of Faecal Incontinence in Adults

For many people faecal incontinence is the result of a complex interplay of contributing factors, many of which can co-exist. Some may be relatively simple to reverse.

NICE Clinical Guidelines - National Collaborating Centre for Acute Care (UK).

Version: 2007
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The effectiveness of diagnostic tests for the assessment of shoulder pain due to soft tissue disorders: a systematic review

OBJECTIVES: To evaluate the evidence for the effectiveness and cost-effectiveness of the newer diagnostic imaging tests as an addition to clinical examination and patient history for the diagnosis of soft tissue shoulder disorders.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Surgery for rotator cuff disease

may not lead to any difference in pain compared with different exercise programs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Regular clotting factor replacement therapy to prevent joint disease in people with severe hemophilia A or B

Hemophilia A and B are X‐linked inherited bleeding disorders, in which the major clinical problem is repeated bleeding into joints. As this disorder progresses, joints become deformed and movement limited. Current therapy for treating and preventing bleeding includes plasma‐derived or recombinant clotting factor concentrates. This review includes six randomised controlled trials. Two compare the regular use of clotting factor concentrates to prevent joint bleeds with their use 'on demand'. Four compare different regimens of regular use in children and adults with hemophilia. It was clearly evident that preventative therapy, as intravenous infusion of factor concentrate repeated more times a week and started early in childhood was able to reduce joint deterioration as compared to treatment administered after bleeding occurred. This favourable effect is due to a consistent reduction in total bleeds and hemarthrosis (bleeding into joints) and leads to a significant improvement in quality of life. Preventative therapy is linked to an increased factor usage and cost of treatment. We found weaker evidence (due to lack of data) to show preventative therapy reduced joint deterioration when treatment is started after joint damage has been established. Further studies are needed to establish the best preventative regimen, i.e. for example starting time, dosage frequency, minimally effective dose.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Glyceryl trinitrate patches for rotator cuff disease

This summary of a Cochrane review presents what we know from research about the effect of glyceryl trinitrate patches on rotator cuff disease (RCD).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Treating all teeth (full mouth) within 24 hours for chronic gum disease (periodontitis) in adults

Long lasting (chronic) gum disease causes damage to the gums and soft tissue structures around teeth. This review seeks to evaluate the effectiveness of full‐mouth treatments carried out within 24 hours compared to the more conventional treatment of partial mouth scaling and root planing (SRP) usually done over a number of weeks. The treatments being reviewed are full‐mouth scaling (FMS) and full‐mouth disinfection (FMD). A secondary aim was to establish if there was a difference in effectiveness between FMS and FMD. This review updates our previous review published in 2008.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Which therapies are the most effective to prevent the progression of autosomal dominant polycystic kidney disease?

Current clinical care for people who have autosomal dominant polycystic kidney disease (ADPKD) focuses on controlling future risks for need for dialysis and symptom management, mainly pain and bleeding. Newly discovered molecules that may slow kidney cyst growth has recently switched attention from care and treatment toward preventing disease progression and symptom control.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Antibacterial Sutures for Wound Closure After Surgery: A Review of Clinical and Cost-Effectiveness and Guidelines for Use [Internet]

Surgical site infections (SSIs) account for approximately 20% of all compromised wounds in the Canadian healthcare setting. It is estimated that 6.3% of surgical wounds in Canada result in infection. An overall SSI rate of 2.5% was reported in a sample of hospitalized adults across Canada. In addition to increasing the risk of morbidity, delayed recovery, and prolonged hospital stay, SSIs may increase Canadian healthcare costs associated with surgical procedures. It is estimated that the incidence of SSIs could be reduced by over 50% with the implementation of various evidence-based prevention strategies. Risk factors for SSIs include patient related factors (e.g., diabetes, obesity), category of wound (e.g., clean, clean-contaminated), bacterial species, and hospital-related infection prevention measures. Sutures may act as a medium for bacterial growth and it has been demonstrated by in-vitro and in-vivo animal studies that antimicrobial coating may reduce the risk of SSIs. Antimicrobial sutures, which are currently commercially limited to triclosan coated sutures (TCS) (e.g., Vicryl [polyglactin 910] Plus, Monocryl [poliglecaprone 25] Plus, PDS [polydioxanone] Plus), are targeted for the prevention of SSIs. Although antimicrobial sutures are more costly than conventional sutures, if effective for SSI prevention they may reduce surgery related costs. The reported clinical efficacy of antimicrobial sutures is inconsistent, with some systematic reviews reporting an overall benefit, while others do not. A previous CADTH report summarized evidence suggesting that TCS reduced SSIs compared to non-coated sutures. This report will provide an update and augment a recent CADTH Rapid Response reference list.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 21, 2014
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A systematic review and economic evaluation of new-generation computed tomography scanners for imaging in coronary artery disease and congenital heart disease: Somatom Definition Flash, Aquilion ONE, Brilliance iCT and Discovery CT750 HD

Report finds that new-generation computed tomography (NGCCT) may be sufficiently accurate to diagnose clinically significant coronary artery disease (CAD) in some, or all, difficult-to-image patient groups and may be particularly useful in ruling out patients from further invasive investigations. Economic analyses suggest that NGCCT is likely to be considered cost-effective for difficult-to-image patients with CAD, at current levels of willingness to pay in the NHS. For patients with suspected CAD, the NGCCT-only strategy may be most favourable; for patients with known CAD, NGCCT along with invasive coronary angiography may be most favourable.

Health Technology Assessment - NIHR Journals Library.

Version: March 2013
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Chronic Kidney Disease (Partial Update): Early Identification and Management of Chronic Kidney Disease in Adults in Primary and Secondary Care

The Renal National Service Framework (NSF), and the subsequent NICE Clinical Practice Guideline for early identification and management of adults with chronic kidney disease (CKD) in primary and secondary care (CG73), served to emphasise the change in focus in renal medicine from treatment of established kidney disease to earlier identification and prevention of kidney disease.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: July 2014
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Parkinson's Disease: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care

It is almost 200 years since James Parkinson described the major symptoms of the disease that came to bear his name. Slowly but surely our understanding of the disease has improved and effective treatment has been developed, but Parkinson’s disease remains a huge challenge to those who suffer from it and to those involved in its management. In addition to the difficulties common to other disabling neurological conditions, the management of Parkinson’s disease must take into account the fact that the mainstay of pharmacological treatment, levodopa, can eventually produce dyskinesia and motor fluctuation. Furthermore, there are a number of agents besides levodopa that can help parkinsonian symptoms, and there is the enticing but unconfirmed prospect that other treatments might protect against worsening neurological disability. Thus, a considerable degree of judgement is required in tailoring individual therapy and in timing treatment initiation. It is hoped that this guideline on Parkinson’s disease will be of considerable help to those involved at all levels in these difficult management decisions. The guideline has been produced using standard NICE methodology and is therefore based on a thorough search for best evidence.

NICE Clinical Guidelines - National Collaborating Centre for Chronic Conditions (UK).

Version: 2006

Advanced Breast Cancer: Diagnosis and Treatment

Breast cancer is the most common cancer for women in England and Wales, with about 37,000 new cases diagnosed and 11,000 deaths recorded in England and Wales each year. In men breast cancer is rare, with about 270 cases diagnosed, and 70 deaths in England and Wales each year. Of these new cases in women and men, around 10% are diagnosed in the advanced stages, when the tumour has spread significantly within the breast or to other organs of the body. In addition, there is a significant number of women who have been previously treated with curative intent who subsequently develop either a local recurrence or metastases. Over recent years there have been important developments in the investigation and management of these patients including new chemotherapy, and biological and hormonal agents. There is some evidence of practice variation across the country and of patchy availability of certain treatments and procedures. A clinical guideline will help to address these issues and offer guidance on best practice.

NICE Clinical Guidelines - National Collaborating Centre for Cancer (UK).

Version: February 2009
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