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Health Technology Assessment: HTA

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https://www.readbyqxmd.com/read/28914229/clinical-effectiveness-and-cost-effectiveness-of-beta-interferon-and-glatiramer-acetate-for-treating-multiple-sclerosis-systematic-review-and-economic-evaluation
#1
G J Melendez-Torres, Peter Auguste, Xavier Armoiry, Hendramoorthy Maheswaran, Rachel Court, Jason Madan, Alan Kan, Stephanie Lin, Carl Counsell, Jacoby Patterson, Jeremy Rodrigues, Olga Ciccarelli, Hannah Fraser, Aileen Clarke
BACKGROUND: At the time of publication of the most recent National Institute for Health and Care Excellence (NICE) guidance [technology appraisal (TA) 32] in 2002 on beta-interferon (IFN-β) and glatiramer acetate (GA) for multiple sclerosis, there was insufficient evidence of their clinical effectiveness and cost-effectiveness. OBJECTIVES: To undertake (1) systematic reviews of the clinical effectiveness and cost-effectiveness of IFN-β and GA in relapsing-remitting multiple sclerosis (RRMS), secondary progressive multiple sclerosis (SPMS) and clinically isolated syndrome (CIS) compared with best supportive care (BSC) and each other, investigating annualised relapse rate (ARR) and time to disability progression confirmed at 3 months and 6 months and (2) cost-effectiveness assessments of disease-modifying therapies (DMTs) for CIS and RRMS compared with BSC and each other...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28895526/molecular-testing-for-lynch-syndrome-in-people-with-colorectal-cancer-systematic-reviews-and-economic-evaluation
#2
Tristan Snowsill, Helen Coelho, Nicola Huxley, Tracey Jones-Hughes, Simon Briscoe, Ian M Frayling, Chris Hyde
BACKGROUND: Inherited mutations in deoxyribonucleic acid (DNA) mismatch repair (MMR) genes lead to an increased risk of colorectal cancer (CRC), gynaecological cancers and other cancers, known as Lynch syndrome (LS). Risk-reducing interventions can be offered to individuals with known LS-causing mutations. The mutations can be identified by comprehensive testing of the MMR genes, but this would be prohibitively expensive in the general population. Tumour-based tests - microsatellite instability (MSI) and MMR immunohistochemistry (IHC) - are used in CRC patients to identify individuals at high risk of LS for genetic testing...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28877841/cognitive-behaviour-therapy-for-health-anxiety-in-medical-patients-champ-a-randomised-controlled-trial-with-outcomes-to-5-years
#3
Peter Tyrer, Paul Salkovskis, Helen Tyrer, Duolao Wang, Michael J Crawford, Simon Dupont, Sylvia Cooper, John Green, David Murphy, Georgina Smith, Sharandeep Bhogal, Shaeda Nourmand, Valentina Lazarevic, Gemma Loebenberg, Rachel Evered, Stephanie Kings, Antoinette McNulty, Yvonne Lisseman-Stones, Sharon McAllister, Kofi Kramo, Jessica Nagar, Steven Reid, Rahil Sanatinia, Katherine Whittamore, Gemma Walker, Aaron Philip, Hilary Warwick, Sarah Byford, Barbara Barrett
BACKGROUND: Health anxiety is an under-recognised but frequent cause of distress that is potentially treatable, but there are few studies in secondary care. OBJECTIVE: To determine the clinical effectiveness and cost-effectiveness of a modified form of cognitive-behaviour therapy (CBT) for health anxiety (CBT-HA) compared with standard care in medical outpatients. DESIGN: Randomised controlled trial. SETTING: Five general hospitals in London, Middlesex and Nottinghamshire...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28869006/amisulpride-augmentation-in-clozapine-unresponsive-schizophrenia-amicus-a-double-blind-placebo-controlled-randomised-trial-of-clinical-effectiveness-and-cost-effectiveness
#4
Thomas Re Barnes, Verity C Leeson, Carol Paton, Louise Marston, Linda Davies, William Whittaker, David Osborn, Raj Kumar, Patrick Keown, Rameez Zafar, Khalid Iqbal, Vineet Singh, Pavel Fridrich, Zachary Fitzgerald, Hemant Bagalkote, Peter M Haddad, Mariwan Husni, Tim Amos
BACKGROUND: When treatment-refractory schizophrenia shows an insufficient response to a trial of clozapine, clinicians commonly add a second antipsychotic, despite the lack of robust evidence to justify this practice. OBJECTIVES: The main objectives of the study were to establish the clinical effectiveness and cost-effectiveness of augmentation of clozapine medication with a second antipsychotic, amisulpride, for the management of treatment-resistant schizophrenia...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28862129/duration-of-intravenous-antibiotic-therapy-for-children-with-acute-osteomyelitis-or-septic-arthritis-a-feasibility-study
#5
Hans de Graaf, Priya Sukhtankar, Barbara Arch, Nusreen Ahmad, Amanda Lees, Abigail Bennett, Catherine Spowart, Helen Hickey, Annmarie Jeanes, Kate Armon, Andrew Riordan, Jethro Herberg, Scott Hackett, Carrol Gamble, Delane Shingadia, Ann Pallett, Stuart C Clarke, Philip Henman, Marieke Emonts, Mike Sharland, Adam Finn, Andrew J Pollard, Colin Powell, Peter Marsh, Claire Ballinger, Paula R Williamson, Nicholas Mp Clarke, Saul N Faust
BACKGROUND: There is little current consensus regarding the route or duration of antibiotic treatment for acute osteomyelitis (OM) and septic arthritis (SA) in children. OBJECTIVE: To assess the overall feasibility and inform the design of a future randomised controlled trial (RCT) to reduce the duration of intravenous (i.v.) antibiotic use in paediatric OM and SA. DESIGN: (1) A prospective service evaluation (cohort study) to determine the current disease spectrum and UK clinical practice in paediatric OM/SA; (2) a prospective cohort substudy to assess the use of targeted polymerase chain reaction (PCR) in diagnosing paediatric OM/SA; (3) a qualitative study to explore families' views and experiences of OM/SA; and (4) the development of a core outcome set via a systematic review of literature, Delphi clinician survey and stakeholder consensus meeting...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28857740/a-pilot-randomised-controlled-trial-of-community-led-antipsychotic-drug-reduction-for-adults-with-learning-disabilities
#6
Rachel McNamara, Elizabeth Randell, David Gillespie, Fiona Wood, David Felce, Renee Romeo, Lianna Angel, Aude Espinasse, Kerry Hood, Amy Davies, Andrea Meek, Katy Addison, Glyn Jones, Paul Deslandes, David Allen, Martin Knapp, Ajay Thapar, Michael Kerr
BACKGROUND: Data suggest that approximately 50,000 adults with learning disabilities (LDs) in England and Wales are currently prescribed antipsychotic medication. Illness in this population is common, including significant rates of challenging behaviour and mental illness, but there is particular concern over the use of antipsychotics prescribed for reasons other than the treatment of psychosis. Control of challenging behaviour is the primary reason why such medications are prescribed despite the absence of good evidence for any therapeutic effect for this purpose...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28857042/cost-and-outcome-of-behavioural-activation-cobra-a-randomised-controlled-trial-of-behavioural-activation-versus-cognitive-behavioural-therapy-for-depression
#7
David A Richards, Shelley Rhodes, David Ekers, Dean McMillan, Rod S Taylor, Sarah Byford, Barbara Barrett, Katie Finning, Poushali Ganguli, Fiona Warren, Paul Farrand, Simon Gilbody, Willem Kuyken, Heather O'Mahen, Ed Watkins, Kim Wright, Nigel Reed, Emily Fletcher, Steven D Hollon, Lucy Moore, Amy Backhouse, Claire Farrow, Julie Garry, Deborah Kemp, Faye Plummer, Faith Warner, Rebecca Woodhouse
BACKGROUND: Depression is a common, debilitating and costly disorder. The best-evidenced psychological therapy - cognitive-behavioural therapy (CBT) - is complex and costly. A simpler therapy, behavioural activation (BA), may be an effective alternative. OBJECTIVES: To determine the clinical effectiveness and cost-effectiveness of BA compared with CBT for depressed adults at 12 and 18 months' follow-up, and to investigate the processes of treatments. DESIGN: Randomised controlled, non-inferiority trial stratified by depression severity, antidepressant use and recruitment site, with embedded process evaluation; and randomisation by remote computer-generated allocation...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28853392/pilot-of-a-randomised-controlled-trial-of-the-selective-serotonin-reuptake-inhibitor-sertraline-versus-cognitive-behavioural-therapy-for-anxiety-symptoms-in-people-with-generalised-anxiety-disorder-who-have-failed-to-respond-to-low-intensity-psychological-treatments
#8
Marta Buszewicz, John Cape, Marc Serfaty, Roz Shafran, Thomas Kabir, Peter Tyrer, Caroline S Clarke, Irwin Nazareth
BACKGROUND: Generalised anxiety disorder (GAD) is common, causing unpleasant symptoms and impaired functioning. The National Institute for Health and Care Excellence (NICE) guidelines have established good evidence for low-intensity psychological interventions, but a significant number of patients will not respond and require more intensive step 3 interventions, recommended as either high-intensity cognitive behavioural therapy (CBT) or a pharmacological treatment such as sertraline. However, there are no head-to-head comparisons evaluating which is more clinically effective and cost-effective, and current guidelines suggest that treatment choice at step 3 is based mainly on patient preference...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28836493/developing-a-multidisciplinary-rehabilitation-package-following-hip-fracture-and-testing-in-a-randomised-feasibility-study-fracture-in-the-elderly-multidisciplinary-rehabilitation-femur
#9
Nefyn H Williams, Jessica L Roberts, Nafees Ud Din, Joanna M Charles, Nicola Totton, Michelle Williams, Kevin Mawdesley, Claire A Hawkes, Val Morrison, Andrew Lemmey, Rhiannon T Edwards, Zoe Hoare, Aaron W Pritchard, Robert T Woods, Swapna Alexander, Catherine Sackley, Pip Logan, Clare Wilkinson, Jo Rycroft-Malone
BACKGROUND: Proximal femoral fracture is a major health problem in old age, with annual UK health and social care costs of £2.3B. Rehabilitation has the potential to maximise functional recovery and maintain independent living, but evidence of clinical effectiveness and cost-effectiveness is lacking. OBJECTIVES: To develop an enhanced community-based rehabilitation package following surgical treatment for proximal femoral fracture and to assess acceptability and feasibility for a future definitive randomised controlled trial (RCT) and economic evaluation...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28812541/systematic-review-of-interventions-for-treating-or-preventing-antipsychotic-induced-tardive-dyskinesia
#10
Hanna Bergman, Dawn-Marie Walker, Adriani Nikolakopoulou, Karla Soares-Weiser, Clive E Adams
BACKGROUND: Antipsychotic medication can cause tardive dyskinesia (TD) - late-onset, involuntary, repetitive movements, often involving the face and tongue. TD occurs in > 20% of adults taking antipsychotic medication (first-generation antipsychotics for > 3 months), with this proportion increasing by 5% per year among those who continue to use these drugs. The incidence of TD among those taking newer antipsychotics is not different from the rate in people who have used older-generation drugs in moderate doses...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28805188/managing-faecal-incontinence-in-people-with-advanced-dementia-resident-in-care-homes-finch-study-a-realist-synthesis-of-the-evidence
#11
Claire Goodman, Christine Norton, Marina Buswell, Bridget Russell, Danielle Harari, Rowan Harwood, Brenda Roe, Jo Rycroft-Malone, Vari M Drennan, Mandy Fader, Michelle Maden, Karen Cummings, Frances Bunn
BACKGROUND: Eighty per cent of care home residents in the UK are living with dementia. The prevalence of faecal incontinence (FI) in care homes is estimated to range from 30% to 50%. There is limited evidence of what is effective in the reduction and management of FI in care homes. OBJECTIVE: To provide a theory-driven explanation of the effectiveness of programmes that aim to improve FI in people with advanced dementia in care homes. DESIGN: A realist synthesis...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28795682/effects-of-antenatal-diet-and-physical-activity-on-maternal-and-fetal-outcomes-individual-patient-data-meta-analysis-and-health-economic-evaluation
#12
Ewelina Rogozińska, Nadine Marlin, Louise Jackson, Girish Rayanagoudar, Anneloes E Ruifrok, Julie Dodds, Emma Molyneaux, Mireille Nm van Poppel, Lucilla Poston, Christina A Vinter, Fionnuala McAuliffe, Jodie M Dodd, Julie Owens, Ruben Barakat, Maria Perales, Jose G Cecatti, Fernanda Surita, SeonAe Yeo, Annick Bogaerts, Roland Devlieger, Helena Teede, Cheryce Harrison, Lene Haakstad, Garry X Shen, Alexis Shub, Nermeen El Beltagy, Narges Motahari, Janette Khoury, Serena Tonstad, Riitta Luoto, Tarja I Kinnunen, Kym Guelfi, Fabio Facchinetti, Elisabetta Petrella, Suzanne Phelan, Tânia T Scudeller, Kathrin Rauh, Hans Hauner, Kristina Renault, Christianne Jm de Groot, Linda R Sagedal, Ingvild Vistad, Signe Nilssen Stafne, Siv Mørkved, Kjell Å Salvesen, Dorte M Jensen, Márcia Vitolo, Arne Astrup, Nina Rw Geiker, Sally Kerry, Pelham Barton, Tracy Roberts, Richard D Riley, Arri Coomarasamy, Ben Willem Mol, Khalid S Khan, Shakila Thangaratinam
BACKGROUND: Diet- and physical activity-based interventions in pregnancy have the potential to alter maternal and child outcomes. OBJECTIVES: To assess whether or not the effects of diet and lifestyle interventions vary in subgroups of women, based on maternal body mass index (BMI), age, parity, Caucasian ethnicity and underlying medical condition(s), by undertaking an individual patient data (IPD) meta-analysis. We also evaluated the association of gestational weight gain (GWG) with adverse pregnancy outcomes and assessed the cost-effectiveness of the interventions...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28774374/effectiveness-and-cost-effectiveness-of-serum-b-type-natriuretic-peptide-testing-and-monitoring-in-patients-with-heart-failure-in-primary-and-secondary-care-an-evidence-synthesis-cohort-study-and-cost-effectiveness-model
#13
Maria Pufulete, Rachel Maishman, Lucy Dabner, Syed Mohiuddin, William Hollingworth, Chris A Rogers, Julian Higgins, Mark Dayer, John Macleod, Sarah Purdy, Theresa McDonagh, Angus Nightingale, Rachael Williams, Barnaby C Reeves
BACKGROUND: Heart failure (HF) affects around 500,000 people in the UK. HF medications are frequently underprescribed and B-type natriuretic peptide (BNP)-guided therapy may help to optimise treatment. OBJECTIVE: To evaluate the clinical effectiveness and cost-effectiveness of BNP-guided therapy compared with symptom-guided therapy in HF patients. DESIGN: Systematic review, cohort study and cost-effectiveness model. SETTING: A literature review and usual care in the NHS...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28738015/observational-study-to-estimate-the-changes-in-the-effectiveness-of-bacillus-calmette-gu%C3%A3-rin-bcg-vaccination-with-time-since-vaccination-for-preventing-tuberculosis-in-the-uk
#14
Punam Mangtani, Patrick Nguipdop-Djomo, Ruth H Keogh, Lucy Trinder, Peter G Smith, Paul Em Fine, Jonathan Sterne, Ibrahim Abubakar, Emilia Vynnycky, John Watson, David Elliman, Marc Lipman, Laura C Rodrigues
BACKGROUND: Until recently, evidence that protection from the bacillus Calmette-Guérin (BCG) vaccination lasted beyond 10 years was limited. In the past few years, studies in Brazil and the USA (in Native Americans) have suggested that protection from BCG vaccination against tuberculosis (TB) in childhood can last for several decades. The UK's universal school-age BCG vaccination programme was stopped in 2005 and the programme of selective vaccination of high-risk (usually ethnic minority) infants was enhanced...
July 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28682222/the-clinical-effectiveness-and-cost-effectiveness-of-cetuximab-review-of-technology-appraisal-no-176-and-panitumumab-partial-review-of-technology-appraisal-no-240-for-previously-untreated-metastatic-colorectal-cancer-a-systematic-review-and-economic-evaluation
#15
Nicola Huxley, Louise Crathorne, Jo Varley-Campbell, Irina Tikhonova, Tristan Snowsill, Simon Briscoe, Jaime Peters, Mary Bond, Mark Napier, Martin Hoyle
BACKGROUND: Colorectal cancer is the fourth most commonly diagnosed cancer in the UK after breast, lung and prostate cancer. People with metastatic disease who are sufficiently fit are usually treated with active chemotherapy as first- or second-line therapy. Targeted agents are available, including the antiepidermal growth factor receptor (EGFR) agents cetuximab (Erbitux(®), Merck Serono UK Ltd, Feltham, UK) and panitumumab (Vecitibix(®), Amgen UK Ltd, Cambridge, UK). OBJECTIVE: To investigate the clinical effectiveness and cost-effectiveness of panitumumab in combination with chemotherapy and cetuximab in combination with chemotherapy for rat sarcoma (RAS) wild-type (WT) patients for the first-line treatment of metastatic colorectal cancer...
June 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28681717/clinical-effectiveness-cost-effectiveness-and-acceptability-of-low-intensity-interventions-in-the-management-of-obsessive-compulsive-disorder-the-obsessive-compulsive-treatment-efficacy-randomised-controlled-trial-octet
#16
Karina Lovell, Peter Bower, Judith Gellatly, Sarah Byford, Penny Bee, Dean McMillan, Catherine Arundel, Simon Gilbody, Lina Gega, Gillian Hardy, Shirley Reynolds, Michael Barkham, Patricia Mottram, Nicola Lidbetter, Rebecca Pedley, Jo Molle, Emily Peckham, Jasmin Knopp-Hoffer, Owen Price, Janice Connell, Margaret Heslin, Christopher Foley, Faye Plummer, Christopher Roberts
BACKGROUND: The Obsessive-Compulsive Treatment Efficacy randomised controlled Trial emerged from a research recommendation in National Institute for Health and Care Excellence obsessive-compulsive disorder (OCD) guidelines, which specified the need to evaluate cognitive-behavioural therapy (CBT) treatment intensity formats. OBJECTIVES: To determine the clinical effectiveness and cost-effectiveness of two low-intensity CBT interventions [supported computerised cognitive-behavioural therapy (cCBT) and guided self-help]: (1) compared with waiting list for high-intensity CBT in adults with OCD at 3 months; and (2) plus high-intensity CBT compared with waiting list plus high-intensity CBT in adults with OCD at 12 months...
June 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28661375/barriers-to-and-facilitators-of-smoking-cessation-in-pregnancy-and-following-childbirth-literature-review-and-qualitative-study
#17
Linda Bauld, Hilary Graham, Lesley Sinclair, Kate Flemming, Felix Naughton, Allison Ford, Jennifer McKell, Dorothy McCaughan, Sarah Hopewell, Kathryn Angus, Douglas Eadie, David Tappin
BACKGROUND: Although many women stop smoking in pregnancy, others continue, causing harm to maternal and child health. Smoking behaviour is influenced by many factors, including the role of women's significant others (SOs) and support from health-care professionals (HPs). OBJECTIVES: To enhance understanding of the barriers to, and facilitators of, smoking cessation and the feasibility and acceptability of interventions to reach and support pregnant women to stop smoking...
June 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28648148/debt-counselling-for-depression-in-primary-care-an-adaptive-randomised-controlled-pilot-trial-decoder-study
#18
Mark B Gabbay, Adele Ring, Richard Byng, Pippa Anderson, Rod S Taylor, Caryn Matthews, Tirril Harris, Vashti Berry, Paula Byrne, Elliot Carter, Pam Clarke, Laura Cocking, Suzanne Edwards, Richard Emsley, Mauro Fornasiero, Lucy Frith, Shaun Harris, Peter Huxley, Siw Jones, Peter Kinderman, Michael King, Liv Kosnes, Daniel Marshall, Dave Mercer, Carl May, Debbie Nolan, Ceri Phillips, Tim Rawcliffe, Alexandra V Sardani, Elizabeth Shaw, Sam Thompson, Jane Vickery, Brian Wainman, Mark Warner
BACKGROUND: Depression and debt are common in the UK. Debt Counselling for Depression in Primary Care: an adaptive randomised controlled pilot trial (DeCoDer) aimed to assess the clinical effectiveness and cost-effectiveness of the addition of a primary care debt counselling advice service to usual care for patients with depression and debt. However, the study was terminated early during the internal pilot trial phase because of recruitment delays. This report describes the rationale, methods and findings of the pilot study, and implications for future research...
June 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28644115/evaluation-of-the-effectiveness-and-cost-effectiveness-of-lightweight-fibreglass-heel-casts-in-the-management-of-ulcers-of-the-heel-in-diabetes-a-randomised-controlled-trial
#19
William Jeffcoate, Frances Game, Vivienne Turtle-Savage, Alison Musgrove, Patricia Price, Wei Tan, Lucy Bradshaw, Alan Montgomery, Deborah Fitzsimmons, Angela Farr, Thomas Winfield, Ceri Phillips
BACKGROUND: Ulcers of the foot in people with diabetes mellitus are slow to heal and result in considerable cost and patient suffering. The prognosis is worst for ulcers of the heel. OBJECTIVE: To assess both the clinical effectiveness and the cost-effectiveness of lightweight fibreglass casts in the management of heel ulcers. DESIGN: A pragmatic, multicentre, parallel, observer-blinded randomised controlled trial. A central randomisation centre used a computer-generated random number sequence to allocate participants to groups...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28643629/faecal-immunochemical-tests-to-triage-patients-with-lower-abdominal-symptoms-for-suspected-colorectal-cancer-referrals-in-primary-care-a-systematic-review-and-cost-effectiveness-analysis
#20
Marie Westwood, Isaac Corro Ramos, Shona Lang, Marianne Luyendijk, Remziye Zaim, Lisa Stirk, Maiwenn Al, Nigel Armstrong, Jos Kleijnen
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in the UK. Presenting symptoms that can be associated with CRC usually have another explanation. Faecal immunochemical tests (FITs) detect blood that is not visible to the naked eye and may help to select patients who are likely to benefit from further investigation. OBJECTIVES: To assess the effectiveness of FITs [OC-Sensor (Eiken Chemical Co./MAST Diagnostics, Tokyo, Japan), HM-JACKarc (Kyowa Medex/Alpha Laboratories Ltd, Tokyo, Japan), FOB Gold (Sentinel/Sysmex, Sentinel Diagnostics, Milan, Italy), RIDASCREEN Hb or RIDASCREEN Hb/Hp complex (R-Biopharm, Darmstadt, Germany)] for primary care triage of people with low-risk symptoms...
May 2017: Health Technology Assessment: HTA
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