Home > Search Results

Results: 1 to 20 of 149

Outreach programmes for health improvement of Traveller Communities: a synthesis of evidence

The study found no evidence to suggest the requirement to develop Traveller-specific health services. Outreach can be used to develop the cultural sensitivity, accessibility and acceptability of mainstream services. Texting appointment reminders is unlikely to be expensive and might constitute the minimum acceptable action to facilitate access to health care. Appropriate payment for the registration of Traveller Community members by general practitioners might also improve access. Mobile clinics are associated with the highest costs reported, with little indication of their acceptability or cost-effectiveness. Evidence suggests that outreach is likely to be more effective when delivered by workers who share the recipients’ ethnicity.

Public Health Research - NIHR Journals Library.

Version: July 2014

Elucigene FH20 and LIPOchip for the Diagnosis of Familial Hypercholesterolaemia: A Systematic Review and Economic Evaluation

Familial hypercholesterolemia (FH) is an autosomal dominant genetic condition causing a high risk of coronary heart disease. The prevalence of this disease is about 1 in 500 in the UK, affecting about 120,000 people across the whole of the UK. Current guidelines recommend DNA testing, however, these guidelines are poorly implemented, therefore 102,000 or 85% of this group remain undiagnosed.

Health Technology Assessment - NIHR Journals Library.

Version: March 2012

The Value of FDG Positron Emission Tomography/Computerised Tomography (PET/CT) in Pre-Operative Staging of Colorectal Cancer: A Systematic Review and Economic Evaluation

In the UK, colorectal cancer (CRC) is the third most common malignancy (behind lung and breast cancer) with 37,514 cases registered in 2006: around two-thirds (23,384) in the colon and one-third (14,130) in the rectum. Treatment of cancers of the colon can vary considerably, but surgical resection is the mainstay of treatment for curative intent. Following surgical resection, there is a comprehensive assessment of the tumour, it's invasion characteristics and spread (tumour staging). A number of imaging modalities are used in the pre-operative staging of CRCs including; computerised tomography (CT), magnetic resonance imaging, ultrasound imaging and positron emission tomography (PET). This report examines the role of CT in combination with PET scanning (PET/CT ‘hybrid’ scan). The research objectives are: to evaluate the diagnostic accuracy and therapeutic impact of fluorine-18-deoxyglucose (FDG) PET/CT for the pre-operative staging of primary, recurrent and metastatic cancer using systematic review methods; undertake probabilistic decision-analytic modelling (using Monte Carlo simulation); and conduct a value of information analysis to help inform whether or not there is potential worth in undertaking further research.

Health Technology Assessment - NIHR Journals Library.

Version: September 2011

What is the Value of Routinely Testing Full Blood Count, Electrolytes and Urea, and Pulmonary Function Tests Before Elective Surgery in Patients with No Apparent Clinical Indication and in Subgroups of Patients with Common Comorbidities: A Systematic Review of the Clinical and Cost-Effective Literature

The evidence base which supported the National Institute for Health and Clinical Excellence (NICE) published Clinical Guideline 3 was limited and 50% was graded as amber. However, the use of tests as part of pre-operative work-up remains a low-cost but high-volume activity within the NHS, with substantial resource implications. The objective of this study was to identify, evaluate and synthesise the published evidence on the clinical effectiveness and cost-effectiveness of the routine use of three tests, full blood counts (FBCs), urea and electrolytes tests (U&Es) and pulmonary function tests, in the pre-operative work-up of otherwise healthy patients undergoing minor or intermediate surgery in the NHS.

Health Technology Assessment - NIHR Journals Library.

Version: December 2012

The Clinical Effectiveness and Cost-Effectiveness of Management Strategies for Sciatica: Systematic Review and Economic Model

Sciatica is a symptom characterised by well-localised leg pain with a sharp, shooting or burning quality that radiates down the back of the leg and normally to the foot or ankle. It is often associated with numbness or altered sensation in the leg.

Health Technology Assessment - NIHR Journals Library.

Version: November 2011
Show search results within this document

The prognostic utility of tests of platelet function for the detection of ‘aspirin resistance’ in patients with established cardiovascular or cerebrovascular disease: a systematic review and economic evaluation

People with heart disease are often prescribed aspirin. Testing the function of platelets in the blood may be able to assess if aspirin is working properly. This review assessed all the evidence on the results of platelet function testing linked to the risk of having another cardiovascular event (such as a heart attack or stroke). The review found that people classified as ‘aspirin resistant’ by platelet function testing were, on average, slightly more at risk of having another cardiovascular event. However, the increase in risk was very small and it was not certain which was the most accurate of the platelet function tests available. Therefore, at the moment, the result of platelet function testing on its own is not very informative in determining a person’s future risk of cardiovascular events.

Health Technology Assessment - NIHR Journals Library.

Version: May 2015
Show search results within this document

Comparative Effectiveness of In-Hospital Use of Recombinant Factor VIIa for Off-Label Indications vs. Usual Care [Internet]

This report evaluates the level of evidence currently available to support the effectiveness and safety of using recombinant activated coagulation factor VII (rFVIIa) for clinical indications not approved by the U. S. Food and Drug Administration (FDA). rFVIIa is approved for a variety of uses in hemophilia patients who have developed antibody inhibitors that compromise the use of standard factor replacement. Use of this costly biologic product has expanded beyond these hemophilia-related indications to encompass a range of off-label uses, most of which are in-hospital uses. These uses differ substantially from the drug’s FDA approved label. The purpose of this report is two-fold: (1) To document the full range of clinical indications for which rFVIIa is being used and the types of studies available to evaluate these uses and (2) To provide a comparative effectiveness review of rFVIIa vs. usual care for several in-hospital clinical indications: intracranial hemorrhage, massive bleeding secondary to trauma, and the selected surgical procedures of cardiac surgery, liver transplantation, and prostatectomy.

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

Version: May 2010
Show search results within this document

The Clinical Effectiveness and Cost-Effectiveness of Different Surveillance Mammography Regimens After the Treatment for Primary Breast Cancer: Systematic Reviews, Registry Database Analyses and Economic Evaluation

Following primary breast cancer treatment, the early detection of ipsilateral breast tumour recurrence (IBTR) or ipsilateral secondary cancer in the treated breast and detection of new primary cancers in the contralateral breast is beneficial for survival. Surveillance mammography is used to detect these cancers, but the optimal frequency of surveillance and the length of follow-up are unclear.

Health Technology Assessment - NIHR Journals Library.

Version: September 2011

Non-Invasive Diagnostic Assessment Tools for the Detection of Liver Fibrosis in Patients with Suspected Alcohol-Related Liver Disease: A Systematic Review and Economic Evaluation

Excessive alcohol consumption may lead to the development of alcoholrelated liver disease (ALD). Liver biopsy may be used in patients with suspected ALD to confirm the diagnosis, exclude other or additional liver pathologies, and provide accurate staging of the degree of liver injury in order to enable the prediction of prognosis and inform treatment decisions. However, as it is an invasive procedure that carries the risk of morbidity and mortality, current UK guidance recommends that biopsy is not required to confirm the diagnosis in patients with a high clinical suspicion of ALD in whom blood tests have excluded other causes of liver disease, unless it is necessary to confirm a diagnosis of acute alcoholic hepatitis in order to inform specific treatment decisions.

Health Technology Assessment - NIHR Journals Library.

Version: February 2012

Positron Emission Tomography (PET) and Magnetic Resonance Imaging (MRI) for the Assessment of Axillary Lymph Node Metastases in Early Breast Cancer: Systematic Review and Economic Evaluation

Breast cancer is the most common type of cancer in women. Evaluation of axillary lymph node metastases is important for breast cancer staging and treatment planning.

Health Technology Assessment - NIHR Journals Library.

Version: January 2011

Urinary Incontinence in Women: The Management of Urinary Incontinence in Women

This guidance is a partial update of National Institute for Health and Care Excellence (NICE) clinical guideline 40 (published October 2006) and will replace it.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: September 2013
Show search results within this document

Psoriasis: Assessment and Management of Psoriasis

Psoriasis is a common, chronic disease, which for many people, is associated with profound functional, psychological and social morbidity and important comorbidities. Effective treatments are available. Some treatments are expensive; all require appropriate monitoring and some may only be accessed in specialist care settings. Evidence indicates that a substantial proportion of people with psoriasis are currently dissatisfied with their treatment.

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

Version: October 2012
Show search results within this document

Myocardial Infarction with ST-Segment Elevation: The Acute Management of Myocardial Infarction with ST-Segment Elevation [Internet]

When myocardial blood flow is acutely impaired (ischaemia), and often not provoked by exertion, a person will commonly suffer more prolonged pain; this is referred to as acute coronary syndrome (ACS). The underlying common pathophysiology of ACS involves the erosion or sudden rupture of an atherosclerotic plaque within the wall of a coronary artery. Exposure of the circulating blood to the cholesterol-rich material within the plaque stimulates blood clotting (thrombosis), which obstructs blood flow within the affected coronary artery. This coronary obstruction may be of short duration, and may not result in myocardial cell damage (necrosis), in which case the clinical syndrome is termed unstable angina. Unstable angina may result in reversible changes on the electrocardiogram (ECG) but does not cause a rise in troponin, a protein released by infarcting myocardial cells. Ischaemia which causes myocardial necrosis (infarction) will result in elevated troponin. When the ischaemia-causing infarction is either short-lived or affects only a small territory of myocardium the ECG will often show either no abnormality or subtle changes. This syndrome is termed non-ST-segment elevation myocardial infarction (NSTEMI). The diagnosis and immediate management of STEMI and the management of unstable angina and NSTEMI is addressed in other NICE Clinical Guidelines (CG95 and CG94).

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

Version: July 2013
Show search results within this document

Crohn's Disease: Management in Adults, Children and Young People

This guideline intends to show the place of both new and established treatments in the wider care pathway for Crohn's disease. This will be useful for clinicians and people with Crohn's disease because new drugs have been licensed for Crohn's disease in the last decade. The guideline also deals with those medications which are unlicensed for treatment of the condition, but which have been used in this way (off-label) for many years and their role is recognised in other NICE documents as well as the British National Formulary. They include azathioprine, mercaptopurine and methotrexate. The guideline aims to help improve the care offered to people with Crohn's disease and provide information about the clinical and cost effectiveness of potential care pathways. Management of Crohn's disease in specific populations (for example, in pregnancy) may require special consideration.

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

Version: October 10, 2012
Show search results within this document

Venous Thromboembolism: Reducing the Risk of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Hospital

Venous thromboembolism (VTE) is a term used to include the formation of a blood clot (a thrombus) in a vein which may dislodge from its site of origin to travel in the blood, a phenomenon called embolism. A thrombus most commonly occurs in the deep veins of the legs; this is called deep vein thrombosis. A dislodged thrombus that travels to the lungs is known as a pulmonary embolism.

NICE Clinical Guidelines - National Clinical Guideline Centre – Acute and Chronic Conditions (UK).

Version: 2010
Show search results within this document

Patient safety in ambulance services: a scoping review

This study aimed to identify and map available evidence relating to patient safety when using ambulance services. There was inconsistency of information on attitudes and approaches to patient safety, exacerbated by a lack of common terminology. Patient safety needs to become a more prominent consideration for ambulance services and development of new models of working must include adequate training and monitoring of clinical risks. Providers and commissioners need a full understanding of the safety implications of introducing new models of care. Areas requiring further work include the safety surrounding discharging patients, patient accidents, equipment and treatment, delays in transfer/admission to hospital, and treatment and diagnosis, with a clear need for increased reliability and training for improving handover to hospital.

Health Services and Delivery Research - NIHR Journals Library.

Version: May 2015
Show search results within this document

Drug Class Review: Newer Antihistamines: Final Report Update 2 [Internet]

Antihistamines inhibit the effects of histamine at H1 receptors. They have a number of clinical indications including allergic conditions (e.g., rhinitis, dermatoses, atopic dermatitis, contact dermatitis, allergic conjunctivitis, hypersensitivity reactions to drugs, mild transfusion reactions, and urticaria), chronic idiopathic urticaria (CIU), motion sickness, vertigo, and insomnia.

Drug Class Reviews - Oregon Health & Science University.

Version: May 2010
Show search results within this document

Radiotherapy Treatments for Head and Neck Cancer Update [Internet]

This report is an update of a Comparative Effectiveness Review (CER) published in final form in May 2010 on the benefits and harms of radiotherapy (RT) to treat patients with head and neck cancer (CER No. 20). RT modalities included two-dimensional RT (2DRT), three-dimensional conformal RT (3DCRT), intensity-modulated RT (IMRT), and proton-beam RT (PBT).

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

Version: December 2014
Show search results within this document

EOS 2D/3D X-ray Imaging System: A Systematic Review and Economic Evaluation

EOS is a biplane X-ray imaging system manufactured by EOS Imaging (formerly Biospace Med, Paris, France). It uses slot-scanning technology to produce a high-quality image with less irradiation than standard imaging techniques.

Health Technology Assessment - NIHR Journals Library.

Version: March 2012

Venous Thromboembolism Prophylaxis in Orthopedic Surgery [Internet]

This is an evidence report prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center (EPC) examining the comparative efficacy and safety of prophylaxis for venous thromboembolism in major orthopedic surgery (total hip replacement [THR], total knee replacement [TKR], and hip fracture surgery [HFS]) and other nonmajor orthopedic surgeries (knee arthroscopy, injuries distal to the hip requiring surgery, and elective spine surgery).

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

Version: March 2012
Show search results within this document

Systematic Reviews in PubMed

See all (90)...

Systematic Review Methods in PubMed

See all (7)...

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...