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Assessment of the Need to Update Comparative Effectiveness Reviews: Report of an Initial Rapid Program Assessment (2005–2009) [Internet]

AHRQ recognizes that periodic assessments of the evidence base supporting each of the comparative effectiveness reviews is an important and necessary part of the Effective Health Care (EHC) Program. The rapidity with which new research findings accumulate makes it imperative that the evidence be assessed periodically to determine the need for a full-scale update. The EHC Program, then, initiated concurrent and parallel work to address this need both methodologically and programmatically. The development of methods guidance for updating was initiated to inform the research of systematic reviewers. This methodologic guidance will supplement the EHC Methods Guide for Comparative Effectiveness Reviews (www.effectiveheathcare.gov). In parallel with the methods effort, an initial, rapid program assessment was commissioned to assess the need for the findings of the CERs completed to that point to be updated. The Southern California Evidence-based Practice Center (SCEPC) was tasked with conducting this assessment. Findings from the assessment were presented to AHRQ for consideration within the usual program criteria to prioritize the topics for updating within the EHC Program. This document presents the findings from the assessment for public information and transparency.

Agency for Healthcare Research and Quality (US).

Version: September 10, 2009
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Nonpharmacological Versus Pharmacological Treatments for Adult Patients With Major Depressive Disorder [Internet]

To compare the benefits and harms of second-generation antidepressants (SGAs), psychological, complementary and alternative medicine, and exercise treatment options as first-step interventions for adult outpatients with acute-phase major depressive disorder (MDD), and as second-step interventions for patients with MDD who did not achieve remission after a first treatment attempt with SGAs.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: December 2015
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Findings of Bayesian Mixed Treatment Comparison Meta-Analyses: Comparison and Exploration Using Real-World Trial Data and Simulation [Internet]

Specific objectives were to examine the following: (1a) how results of Bayesian mixed treatment comparison (MTC) methods compare with several commonly considered frequentist indirect methods; (1b) how Bayesian MTC methods perform for different evidence network patterns; (2) how meta-regression can be used with Bayesian MTC meta-analysis to explore heterogeneity; and (3) how findings of Bayesian MTC meta-analyses compare for different numbers of studies and different network pattern assumptions. For objectives 1 and 2, we aimed to conduct case studies using data from two recent comparative effectiveness reviews (CERs). For objective 3, we aimed to use simulated data.

Methods Research Reports - Agency for Healthcare Research and Quality (US).

Version: February 2013
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Assessment of a Method to Detect Signals for Updating Systematic Reviews [Internet]

Systematic reviews are a cornerstone of evidence-based medicine. The Agency for Healthcare Research and Quality (AHRQ) has a program to produce systematic reviews. Systematic reviews will become out of date as new evidence gets published. Determining when a systematic review has gone sufficiently out of date to warrant an update is challenging. AHRQ has a surveillance system that uses limited literature searches and expert opinion to detect signals for when a systematic review is out of date. While the surveillance system has face validity, an assessment of predictive validity has not been performed

Research White Papers - Agency for Healthcare Research and Quality (US).

Version: March 2014
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Depression (PDQ®): Health Professional Version

Expert-reviewed information summary about the diagnosis, assessment, and treatment of depression in adults and children who have cancer.

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

Version: March 28, 2016

Sleep Disorders (PDQ®): Health Professional Version

Expert-reviewed information summary about causes and management of sleep disorders in people with cancer.

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

Version: March 10, 2016

Antidepressants in Elderly Patients with Major and Minor Depression: A Review of Clinical Effectiveness and Guidelines [Internet]

While clinical trials of antidepressants may include some individuals over the age of 65, it is not clear that evidence of safety and efficacy in such subgroup analyses are reflective of this age group more broadly. The generalizability of outcome data across populations can potentially be uncertain and the comparative efficacy of different antidepressants in older adults could potentially differ than what is seen in younger populations. As well, age-related changes that affect the pharmacokinetics and pharmacodynamics of drugs can affect the safety and potential harms with antidepressants in older adults. Older adults are at increased risk of anticholinergic side effects (common to a number of antidepressant classes), and orthostatic and sedative effects. These effects can exacerbate underlying conditions such as cardiovascular disease, cognitive impairment, delirium and can increase the risk of falls and fractures.

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

Version: August 17, 2015
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Evaluation and Treatment of Tinnitus: Comparative Effectiveness [Internet]

A review was undertaken to evaluate the peer-reviewed literature on three areas of tinnitus management for the following Key Questions (KQs): (1) measures used to assess patients for management needs (KQ1); (2) effectiveness of treatments (KQ2); and (3) identification of prognostic factors (KQ3).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: August 2013
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Selective serotonin and norepinephrine reuptake inhibitors (SNRI) for patients with depression: Executive summary of final report A05-20A, Version 1.0

The aim of this research is to assess the benefit of the selective serotonin and norepinephrine reuptake inhibitors (SNRI) venlafaxine and duloxetine in treating the acute phase of depression, in maintenance therapy (relapse prevention), and in recurrence prevention compared to treatment with placebo, treatment with other antidepressants, each other, in each case in adult patients with depression with reference to patient-relevant outcomes.

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

Version: June 17, 2009

Drug Misuse: Opioid Detoxification

The guideline on Drug misuse: opioid detoxification, commissioned by NICE and developed by the National Collaborating Centre for Mental Health, sets out clear, evidence-based recommendations for healthcare staff on how to work with people who misuse opioids to significantly improve their treatment and care, and to deliver detoxification safely and effectively. Of the estimated 4 million people in the UK who use illicit drugs each year, approximately 50,000 misuse opioids (such as heroin, opium, morphine, codeine and methadone). Opioid misuse presents a considerable health risk and can lead to significant social problems. This NICE guideline is an important tool in helping people to overcome their drug problem.

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

Version: 2008
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Bupropion, mirtazapine, and reboxetine in the treatment of depression: Executive summary of final report A05-20C, Version 1.1

The aim of this research is to assess the benefit of treatment with bupropion, mirtazapine or reboxetine in treating the acute phase of depression, in maintenance therapy (relapse prevention), and in recurrence prevention compared to treatment with placebo each other treatment with other antidepressants in each case in adult patients with depression. The focus of the investigation was on patient-relevant outcomes.

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

Version: May 30, 2011

Cancer-Related Post-traumatic Stress (PDQ®): Health Professional Version

Expert-reviewed information summary about post-traumatic stress and related symptoms in cancer patients, cancer survivors, and their family members. Assessment and treatment of these symptoms are discussed.

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

Version: January 7, 2015

Treatment for Post-Traumatic Stress Disorder, Operational Stress Injury, or Critical Incident Stress: A Review of Guidelines [Internet]

Critical incidents are events where individuals witness or experience tragedy, death, serious injuries, or threatening situations, which may have strong emotional impact. Emergency service workers and law enforcement workers are often affected by critical incident stress (CIS), which may or may not develop a post-traumatic stress disorders (PTSD) after a critical incident or traumatic event. The signs and symptoms of CIS can be physical (e.g., fatigue, headache, dizziness), cognitive (e.g., confusion, nightmares, poor attention and concentration), emotional (e.g., fear, guilt, anger, depression, chronic anxiety) and behavioral (e.g., restlessness, withdrawal, increased alcohol consumption). Tools for the management of CIS include demobilization, crisis management briefings, defusing, and debriefing.

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

Version: April 27, 2015
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Obsessive-Compulsive Disorder: Core Interventions in the Treatment of Obsessive-Compulsive Disorder and Body Dysmorphic Disorder

This guideline has been developed to advise on the identification, treatment and management of obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD). Although distinct disorders, OCD and BDD share a number of common features and there is a high degree of similarity between the treatments for the two conditions. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, people with OCD, a carer and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to clinicians and service commissioners in providing and planning high quality care for those with OCD and BDD while also emphasising the importance of the experience of care for people with OCD, BDD, and carers.

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

Version: 2006
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Interventions to treat premature ejaculation: a systematic review short report

The study aimed to systematically review evidence for clinical effectiveness of behavioural, topical and systemic treatments for premature ejaculation. Several interventions significantly improved intravaginal ejaculatory latency time, and many also improved sexual satisfaction and other outcomes. However, assessment of longer-term safety and effectiveness is required to evaluate whether or not initial treatment effects are maintained long-term, whether or not dose escalation is required, how soon treatment effects end following treatment cessation and whether or not treatments can be stopped and resumed at a later time. In addition, assessment of the adverse effects associated with long-term treatment and whether or not different doses have differing adverse effect profiles is required.

Health Technology Assessment - NIHR Journals Library.

Version: March 2015
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Short- and Long-Term Use of Benzodiazepines in Patients with Generalized Anxiety Disorder: A Review of Guidelines [Internet]

The mainstay of generalized anxiety disorder (GAD) treatment involves pharmacologic treatment but can also consist of psychological treatment (i.e. cognitive behavioural therapy). First-line pharmacological treatment involves either the selective serotonin reuptake inhibitors (SSRIs) or the selective norepinephrine/noradrenaline reuptake inhibitors (SNRIs). While these are the most effective treatments, they can produce adverse events and they also have a slower onset of action, during which there may be an increase in anxiety. Benzodiazepines (BZDs) are a class of drug that is presumed to indirectly promote gamma-amino butyric acid (GABA) activity and rapidly control the core symptoms associated with GAD. They have been historically effective when used in the short-term treatment of GAD but have to be used with caution due to their adverse effect profile such as drowsiness, falls, confusion, impairment of memory, and incoordination (which can be particularly problematic in the elderly), their tendency for dependence, and potential for substance abuse. For these reasons and to determine their appropriate use, this report will review the evidence for the short- and long-term use of BZDs for the treatment of GAD.

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

Version: July 28, 2014
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Strategies To De-escalate Aggressive Behavior in Psychiatric Patients [Internet]

To compare the effectiveness of strategies to prevent and de-escalate aggressive behaviors in psychiatric patients in acute care settings, including interventions aimed specifically at reducing use of seclusion and restraint.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: July 2016
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Antidepressant Treatment of Depression During Pregnancy and the Postpartum Period

To evaluate the benefits and harms of pharmacological therapy for depression in women during pregnancy or the postpartum period.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: July 2014
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Screening for Depression in Adults: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]

Depression is relatively common in primary care patients but is not always identified by primary care providers.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: January 2016
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Multiple Sclerosis: Management of Multiple Sclerosis in Primary and Secondary Care

Multiple sclerosis (MS) is an acquired chronic immune-mediated inflammatory condition of the central nervous system (CNS), affecting both the brain and spinal cord. It affects approximately 100,000 people in the UK. It is the commonest cause of serious physical disability in adults of working age.

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

Version: October 2014
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