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Bibliographic details: Zhang L, Ouyang XB, He JD.  Biphasic insulin aspart 30 given three times daily for type 2 diabetes: a systematic review. Chinese Journal of Evidence-Based Medicine 2012; 12(7): 822-829 Available from: http://www.cjebm.org.cn/oa/DArticle.aspx?type=view&id=2012070015

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

Version: 2012

INTRODUCTION: Biphasic waveforms are routinely used for implantable defibrillators. These waveforms have been less readily adopted for external defibrillation. This study was performed in order to evaluate the efficacy and harms of biphasic waveforms over monophasic waveforms for the transthoracic defibrillation of patients in ventricular fibrillation (VF) or haemodynamically unstable ventricular tachycardia.

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

Version: 2003

OBJECTIVE: Biphasic defibrillation is more effective than monophasic one in controlled in-hospital conditions. The present review evaluated the performance of both waveforms in the defibrillation of patients of out-of-hospital cardiac arrest (OHCA) with initial ventricular fibrillation (Vf) rhythm under the context of current recommendations for cardiopulmonary resuscitation.

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

Version: 2013

The efficacy benefits of biphasic insulin aspart formulation (BIAsp 30) in patients with diabetes mellitus have been reported in several studies. BIAsp 30 has been shown to be more effective in terms of glycaemic control than standard biphasic human insulin 30 (BHI 30). In addition to gauging the treatment in terms of clinical evidence of benefits provided, it is also important to evaluate the strength of the evidence supporting the therapeutic improvements offered by BIAsp 30. In this paper, we evaluated the strength of the available data that relate to the use of BIAsp 30 in the treatment of patients with type 2 diabetes based on a comprehensive literature review. Selected publications that provided relevant data were obtained via a literature search and from the manufacturer, Novo Nordisk. These were graded in terms of the strength of the evidence they provided using the Oxford Centre for Evidence-Based Medicine (CEBM) system in the following categories: (i) twice-daily use versus basal insulin; (ii) twice-daily use versus other treatments; (iii) once-daily use; (iv) thrice-daily use; (v) use in combination with thiazolidinediones; and (vi) use in comparison with BHI 30. A total of 30 publications for BIAsp 30 were identified and graded. For the majority of categories (four out of six), the evidence supporting the use of BIAsp 30 was given an overall CEBM grade of A (highest quality); evidence supporting clinical efficacy in the other two categories (twice-daily use versus basal insulin and thrice-daily BIAsp 30 administration) was graded B. In most of the studies examined, the efficacy of BIAsp 30 was evaluated in terms of glycaemic control (glycosylated haemoglobin [HbA(1c)] reduction, proportion of patients achieving HbA(1c) target of <6.5% or <7%, fasting blood glucose, blood glucose profile and/or prandial and postprandial glucose increments). In some studies, efficacy was further evaluated using plasma insulin and glucose infusion rates, plasma C-peptide levels, mean serum fructosamine levels, postprandial hyperlipidaemia, overall well-being, treatment satisfaction and quality of life. Safety was evaluated using physical and laboratory investigations and assessment of incidence of adverse events, including, in many of the studies reviewed, specific evaluation of those events known to be associated with antidiabetic treatment, hypoglycaemia and weight gain. Strong evidence was provided for better glycaemic control with BIAsp 30 without increases in the incidence of major hypoglycaemia or nocturnal hypoglycaemic episodes. Overall, weight gain with BIAsp 30 was minimal and not significantly greater than with basal insulin or BHI 30. Thus, we can confirm that the reported efficacy and tolerability of BIAsp 30 in the treatment of diabetes based on a variety of clinical endpoints is supported by a good body of evidence relating to its use in different dosage regimens and in comparison with other insulin treatment regimens.

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

Version: 2007

OBJECTIVES: To use systematic review to evaluate the diagnostic accuracy of segmental enhancement inversion (SEI) at contrast-enhanced biphasic multi-detector computed tomography (MDCT) for the diagnosis of renal oncocytoma.

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

Version: 2014

OBJECTIVE: It is uncertain whether the addition of biphasic insulin analogues to oral antidiabetic drugs (OADs) is as effective and safe as basal insulin in patients with type 2 diabetes mellitus (T2DM). We performed a systematic review to compare glycaemic control and selected clinical outcomes in T2DM patients inadequately controlled with OADs whose treatment was intensified by adding biphasic insulin aspart (BIAsp 30) or insulin glargine (IGlar).

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

Version: 2014

This review assessed the safety of biphasic insulin aspart 30 (BIAsp 30) for patients with diabetes. The authors concluded that the safety profile is comparable to that of biphasic human insulin 30 (BHI 30) and neutral protamine Hagedorn (NPH) insulin, and that the risk of major and nocturnal hypoglycaemia is lower. Poor reporting and problems with review methodology mean that the reliability of these conclusions should be regarded with great caution.

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

Version: 2005

The objective of this review was to update the systematic review and network meta-analysis of third-line therapies for type 2 diabetes.

CADTH Optimal Use Report - Canadian Agency for Drugs and Technologies in Health.

Version: July 2013

Evidence-informed recommendations were developed by the Canadian Drug Expert Committee (CDEC) to address the following policy questions:

CADTH Optimal Use Report - Canadian Agency for Drugs and Technologies in Health.

Version: July 2013

The purpose of this report is to review the available evidence on clinical effectiveness and safety of treating patients with depression with electroconvulsive therapy (ECT) conducted outside of a surgical suite and the associated evidence based guidelines. In addition the clinical effectiveness of ECT compared with other non-pharmacological modalities will be reviewed.

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

Version: January 14, 2015

As a follow-up to the overview of reviews conducted for Research Questions 1a and 1b in the main health technology assessment (HTA) protocol, and to address gaps within the published systematic review (SR) literature, an SR of relevant published primary studies on the clinical effectiveness, comparative clinical effectiveness, and safety of interventions for the treatment of obstructive sleep apnea (OSA) in adults will be conducted. Specifically, this SR will focus on addressing Research Questions 1a and 1b, in relation to certain combinations of interventions, comparators, and outcomes that are missing in the overview of reviews, as listed in Table 1.

CADTH Optimal Use Report - Canadian Agency for Drugs and Technologies in Health.

Version: June 2016

This study found that the effectiveness of fibrin sealants do not appear to vary according to surgical procedures with regard to reducing the risk of seroma or haematoma.

Health Technology Assessment - NIHR Journals Library.

Version: December 2016

The objective of this study was to perform an update of CADTH’s original systematic review, network meta-analysis, and cost-effectiveness analysis of second-line diabetes pharmacotherapy. The research questions that were addressed in the update were the same as in the original review:

CADTH Optimal Use Report - Canadian Agency for Drugs and Technologies in Health.

Version: July 2013

The objective of this review was to summarize and critically appraise the evidence regarding the clinical effectiveness and harms of combination use of dipeptidyl peptidase-4 (DPP-4) inhibitors or glucagon-like peptide-1 (GLP-1) analogues with insulin. The following research questions were assessed:

CADTH Optimal Use Report - Canadian Agency for Drugs and Technologies in Health.

Version: July 2013

Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the prevention and management of long term complications and disability.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: August 2015

To compare the effectiveness and adverse event profiles of amylin agonists, DPP-4 inhibitors, incretin mimetics, TZDs, and certain combination products for people with type 2 diabetes and for people with type 1 diabetes for pramlintide only.

Drug Class Reviews - Oregon Health & Science University.

Version: February 2011

Side effects of birth control pills may keep women from using them as planned. Attempts to decrease side effects led to the two‐phase pill. Pills with phases provide different amounts of hormones over three weeks. Whether two‐phase pills lead to fewer pregnancies than one‐phase pills is unknown. Nor is it known if the pills give better cycle control or have fewer side effects. This review looked at whether two‐phase pills worked as well as one‐phase pills. It also studied whether women had fewer side effects with these pills.

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

Version: July 19, 2006

When a person's heart stops beating it may be necessary to deliver an electrical shock (called 'defibrillation') to the person's chest to restart their heart. Two electrodes are placed on the person's chest to allow the defibrillator to deliver the electrical shock. Historically, the electrical current applied to the chest has travelled in one direction between the electrodes. More recently, defibrillators have been designed to send the electrical pulse in one direction and then in the reverse direction. This is known as a 'biphasic' waveform.

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

Version: February 10, 2016

Side effects of birth control pills may keep women from using them as planned. Attempts to decrease side effects led to the three‐phase pill in the 1980s. Pills with phases provide different amounts of hormones over three weeks. Whether three‐phase pills lead to fewer pregnancies than two‐phase pills is unknown. Nor is it known if the pills give better cycle control or have fewer side effects. This review looked at whether two‐phase pills worked as well as three‐phase pills. We also studied whether women had fewer side effects with these pills.

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

Version: July 19, 2006

CPAP therapy can improve breathing at night and significantly relieve symptoms of obstructive sleep apnea. However, wearing a sleeping mask at night takes some getting used to and may require support. CPAP stands for “continuous positive airway pressure.” In this form of treatment, people with obstructive sleep apnea wear a mask while they sleep that covers only their nose or their mouth and nose. The mask is connected to a respirator through a tube. This respirator blows compressed air into the airways. The incoming air keeps the airways open, preventing breathing pauses. Therapy with the breathing mask takes some getting used to, but most people can already handle their CPAP machine quite well after one or two nights. Others have problems and stop using the machine. This information offers some practical tips for dealing with common problems.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 15, 2015

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