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Health Technology Assessment: HTA

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https://www.readbyqxmd.com/read/28629510/screening-strategies-for-atrial-fibrillation-a-systematic-review-and-cost-effectiveness-analysis
#1
Nicky J Welton, Alexandra McAleenan, Howard Hz Thom, Philippa Davies, Will Hollingworth, Julian Pt Higgins, George Okoli, Jonathan Ac Sterne, Gene Feder, Diane Eaton, Aroon Hingorani, Christopher Fawsitt, Trudie Lobban, Peter Bryden, Alison Richards, Reecha Sofat
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. OBJECTIVES: To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28628003/clinical-effectiveness-and-cost-effectiveness-results-from-the-randomised-phase-iib-trial-in-previously-untreated-patients-with-chronic-lymphocytic-leukaemia-to-compare-fludarabine-cyclophosphamide-and-rituximab-with-fludarabine-cyclophosphamide-mitoxantrone
#2
Dena R Howard, Talha Munir, Lucy McParland, Andy C Rawstron, Anna Chalmers, Walter M Gregory, John L O'Dwyer, Alison Smith, Roberta Longo, Abraham Varghese, Alexandra Smith, Peter Hillmen
BACKGROUND: The conventional frontline therapy for fit patients with chronic lymphocytic leukaemia (CLL) is fludarabine, cyclophosphamide and rituximab (FCR). Rituximab (Mabthera(®), Roche Products Ltd) targets the CD20 antigen, which is expressed at low levels in CLL. The standard dose of rituximab in CLL (375 mg/m(2) in cycle 1 and 500 mg/m(2) in cycles 2-6) was selected based on toxicity data only. Small doses of rituximab (as low as 20 mg) have biological activity in CLL, with an immediate reduction in circulating CLL cells and down-regulation of CD20...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28627356/aquatic-therapy-for-children-with-duchenne-muscular-dystrophy-a-pilot-feasibility-randomised-controlled-trial-and-mixed-methods-process-evaluation
#3
Daniel Hind, James Parkin, Victoria Whitworth, Saleema Rex, Tracey Young, Lisa Hampson, Jennie Sheehan, Chin Maguire, Hannah Cantrill, Elaine Scott, Heather Epps, Marion Main, Michelle Geary, Heather McMurchie, Lindsey Pallant, Daniel Woods, Jennifer Freeman, Ellen Lee, Michelle Eagle, Tracey Willis, Francesco Muntoni, Peter Baxter
BACKGROUND: Duchenne muscular dystrophy (DMD) is a rare disease that causes the progressive loss of motor abilities such as walking. Standard treatment includes physiotherapy. No trial has evaluated whether or not adding aquatic therapy (AT) to land-based therapy (LBT) exercises helps to keep muscles strong and children independent. OBJECTIVES: To assess the feasibility of recruiting boys with DMD to a randomised trial evaluating AT (primary objective) and to collect data from them; to assess how, and how well, the intervention and trial procedures work...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28625273/development-of-a-core-outcome-set-for-disease-modification-trials-in-mild-to-moderate-dementia-a-systematic-review-patient-and-public-consultation-and-consensus-recommendations
#4
Lucy Webster, Derek Groskreutz, Anna Grinbergs-Saull, Rob Howard, John T O'Brien, Gail Mountain, Sube Banerjee, Bob Woods, Robert Perneczky, Louise Lafortune, Charlotte Roberts, Jenny McCleery, James Pickett, Frances Bunn, David Challis, Georgina Charlesworth, Katie Featherstone, Chris Fox, Claire Goodman, Roy Jones, Sallie Lamb, Esme Moniz-Cook, Justine Schneider, Sasha Shepperd, Claire Surr, Jo Thompson-Coon, Clive Ballard, Carol Brayne, Orlaith Burke, Alistair Burns, Linda Clare, Peter Garrard, Patrick Kehoe, Peter Passmore, Clive Holmes, Ian Maidment, Fliss Murtagh, Louise Robinson, Gill Livingston
BACKGROUND: There is currently no disease-modifying treatment available to halt or delay the progression of the disease pathology in dementia. An agreed core set of the best-available and most appropriate outcomes for disease modification would facilitate the design of trials and ensure consistency across disease modification trials, as well as making results comparable and meta-analysable in future trials. OBJECTIVES: To agree a set of core outcomes for disease modification trials for mild to moderate dementia with the UK dementia research community and patient and public involvement (PPI)...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28621643/the-clinical-effectiveness-of-different-surveillance-strategies-to-prevent-colorectal-cancer-in-people-with-intermediate-grade-colorectal-adenomas-a-retrospective-cohort-analysis-and-psychological-and-economic-evaluations
#5
Wendy Atkin, Amy Brenner, Jessica Martin, Katherine Wooldrage, Urvi Shah, Fiona Lucas, Paul Greliak, Kevin Pack, Ines Kralj-Hans, Ann Thomson, Sajith Perera, Jill Wood, Anne Miles, Jane Wardle, Benjamin Kearns, Paul Tappenden, Jonathan Myles, Andrew Veitch, Stephen W Duffy
BACKGROUND: The UK guideline recommends 3-yearly surveillance for patients with intermediate-risk (IR) adenomas. No study has examined whether or not this group has heterogeneity in surveillance needs. OBJECTIVES: To examine the effect of surveillance on colorectal cancer (CRC) incidence; assess heterogeneity in risk; and identify the optimum frequency of surveillance, the psychological impact of surveillance, and the cost-effectiveness of alternative follow-up strategies...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28621259/clinical-effectiveness-and-cost-effectiveness-of-a-multifaceted-podiatry-intervention-for-falls-prevention-in-older-people-a-multicentre-cohort-randomised-controlled-trial-the-reducing-falls-with-orthoses-and-a-multifaceted-podiatry-intervention-trial
#6
Sarah Cockayne, Sara Rodgers, Lorraine Green, Caroline Fairhurst, Joy Adamson, Arabella Scantlebury, Belen Corbacho, Catherine E Hewitt, Kate Hicks, Robin Hull, Anne-Maree Keenan, Sarah E Lamb, Caroline McIntosh, Hylton B Menz, Anthony Redmond, Zoe Richardson, Wesley Vernon, Judith Watson, David J Torgerson
BACKGROUND: Falls are a serious cause of morbidity and cost to individuals and society. Evidence suggests that foot problems and inappropriate footwear may increase the risk of falling. Podiatric interventions could help reduce falls; however, there is limited evidence regarding their clinical effectiveness and cost-effectiveness. OBJECTIVES: To determine the clinical effectiveness and cost-effectiveness of a multifaceted podiatry intervention for preventing falls in community-dwelling older people at risk of falling, relative to usual care...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28619124/multiplex-tests-to-identify-gastrointestinal-bacteria-viruses-and-parasites-in-people-with-suspected-infectious-gastroenteritis-a-systematic-review-and-economic-analysis
#7
Karoline Freeman, Hema Mistry, Alexander Tsertsvadze, Pam Royle, Noel McCarthy, Sian Taylor-Phillips, Rohini Manuel, James Mason
BACKGROUND: Gastroenteritis is a common, transient disorder usually caused by infection and characterised by the acute onset of diarrhoea. Multiplex gastrointestinal pathogen panel (GPP) tests simultaneously identify common bacterial, viral and parasitic pathogens using molecular testing. By providing test results more rapidly than conventional testing methods, GPP tests might positively influence the treatment and management of patients presenting in hospital or in the community. OBJECTIVE: To systematically review the evidence for GPP tests [xTAG(®) (Luminex, Toronto, ON, Canada), FilmArray (BioFire Diagnostics, Salt Lake City, UT, USA) and Faecal Pathogens B (AusDiagnostics, Beaconsfield, NSW, Australia)] and to develop a de novo economic model to compare the cost-effectiveness of GPP tests with conventional testing in England and Wales...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28617240/what-carcinoembryonic-antigen-level-should-trigger-further-investigation-during-colorectal-cancer-follow-up-a-systematic-review-and-secondary-analysis-of-a-randomised-controlled-trial
#8
Bethany Shinkins, Brian D Nicholson, Tim James, Indika Pathiraja, Sian Pugh, Rafael Perera, John Primrose, David Mant
BACKGROUND: Following primary surgical and adjuvant treatment for colorectal cancer, many patients are routinely followed up with blood carcinoembryonic antigen (CEA) testing. OBJECTIVE: To determine how the CEA test result should be interpreted to inform the decision to undertake further investigation to detect treatable recurrences. DESIGN: Two studies were conducted: (1) a Cochrane review of existing studies describing the diagnostic accuracy of blood CEA testing for detecting colorectal recurrence; and (2) a secondary analysis of data from the two arms of the FACS (Follow-up After Colorectal Surgery) trial in which CEA testing was carried out...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28613154/seal-or-varnish-a-randomised-controlled-trial-to-determine-the-relative-cost-and-effectiveness-of-pit-and-fissure-sealant-and-fluoride-varnish-in-preventing-dental-decay
#9
Ivor Gordon Chestnutt, Simon Hutchings, Rebecca Playle, Sarah Morgan-Trimmer, Deborah Fitzsimmons, Nadine Aawar, Lianna Angel, Sharron Derrick, Cheney Drew, Ceri Hoddell, Kerenza Hood, Ioan Humphreys, Nigel Kirby, Tin Man Mandy Lau, Catherine Lisles, Maria Zeta Morgan, Simon Murphy, Jacqueline Nuttall, Kateryna Onishchenko, Ceri Phillips, Timothy Pickles, Charlotte Scoble, Julia Townson, Beverley Withers, Barbara Lesley Chadwick
BACKGROUND: Fissure sealant (FS) and fluoride varnish (FV) have been shown to be effective in preventing dental caries when tested against a no-treatment control. However, the relative clinical effectiveness and cost-effectiveness of these interventions is unknown. OBJECTIVE: To compare the clinical effectiveness and cost-effectiveness of FS and FV in preventing dental caries in first permanent molars (FPMs) in 6- and 7-year-olds and to determine their acceptability...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28440211/a-cluster-randomised-trial-cost-effectiveness-analysis-and-psychosocial-evaluation-of-insulin-pump-therapy-compared-with-multiple-injections-during-flexible-intensive-insulin-therapy-for-type-1-diabetes-the-repose-trial
#10
Simon Heller, David White, Ellen Lee, Julia Lawton, Daniel Pollard, Norman Waugh, Stephanie Amiel, Katharine Barnard, Anita Beckwith, Alan Brennan, Michael Campbell, Cindy Cooper, Munyaradzi Dimairo, Simon Dixon, Jackie Elliott, Mark Evans, Fiona Green, Gemma Hackney, Peter Hammond, Nina Hallowell, Alan Jaap, Brian Kennon, Jackie Kirkham, Robert Lindsay, Peter Mansell, Diana Papaioannou, David Rankin, Pamela Royle, W Henry Smithson, Carolin Taylor
BACKGROUND: Insulin is generally administered to people with type 1 diabetes mellitus (T1DM) using multiple daily injections (MDIs), but can also be delivered using infusion pumps. In the UK, pumps are recommended for patients with the greatest need and adult use is less than in comparable countries. Previous trials have been small, of short duration and have failed to control for training in insulin adjustment. OBJECTIVE: To assess the clinical effectiveness and cost-effectiveness of pump therapy compared with MDI for adults with T1DM, with both groups receiving equivalent structured training in flexible insulin therapy...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28414020/modifying-alcohol-consumption-to-reduce-obesity-macro-development-and-feasibility-trial-of-a-complex-community-based-intervention-for-men
#11
Iain K Crombie, Kathryn B Cunningham, Linda Irvine, Brian Williams, Falko F Sniehotta, John Norrie, Ambrose Melson, Claire Jones, Andrew Briggs, Peter M Rice, Marcus Achison, Andrew McKenzie, Elena Dimova, Peter W Slane
BACKGROUND: Obese men who consume alcohol are at a greatly increased risk of liver disease; those who drink > 14 units of alcohol per week have a 19-fold increased risk of dying from liver disease. OBJECTIVES: To develop an intervention to reduce alcohol consumption in obese men and to assess the feasibility of a randomised controlled trial (RCT) to investigate its effectiveness. DESIGN OF THE INTERVENTION: The intervention was developed using formative research, public involvement and behaviour change theory...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28412995/development-and-validation-of-prediction-models-for-risks-of-complications-in-early-onset-pre-eclampsia-prep-a-prospective-cohort-study
#12
Shakila Thangaratinam, John Allotey, Nadine Marlin, Ben W Mol, Peter Von Dadelszen, Wessel Ganzevoort, Joost Akkermans, Asif Ahmed, Jane Daniels, Jon Deeks, Khaled Ismail, Ann Marie Barnard, Julie Dodds, Sally Kerry, Carl Moons, Richard D Riley, Khalid S Khan
BACKGROUND: The prognosis of early-onset pre-eclampsia (before 34 weeks' gestation) is variable. Accurate prediction of complications is required to plan appropriate management in high-risk women. OBJECTIVE: To develop and validate prediction models for outcomes in early-onset pre-eclampsia. DESIGN: Prospective cohort for model development, with validation in two external data sets. SETTING: Model development: 53 obstetric units in the UK...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28409743/pet-neck-a-multicentre-randomised-phase-iii-non-inferiority-trial-comparing-a-positron-emission-tomography-computerised-tomography-guided-watch-and-wait-policy-with-planned-neck-dissection-in-the-management-of-locally-advanced-n2-n3-nodal-metastases-in-patients
#13
Hisham Mehanna, Chris C McConkey, Joy K Rahman, Wai-Lup Wong, Alison F Smith, Chris Nutting, Andrew Gj Hartley, Peter Hall, Claire Hulme, Dharmesh K Patel, Sandra Ventorin von Zeidler, Max Robinson, Bal Sanghera, Lydia Fresco, Janet A Dunn
BACKGROUND: Planned neck dissection (ND) after radical chemoradiotherapy (CRT) for locally advanced nodal metastases in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Thirty per cent of ND specimens show histological evidence of tumour. Consequently, a significant proportion of clinicians still practise planned ND. Fludeoxyglucose positron emission tomography (PET)-computerised tomography (CT) scanning demonstrated high negative predictive values for persistent nodal disease, providing a possible alternative paradigm to ND...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28409557/randomised-controlled-trial-of-silk-therapeutic-garments-for-the-management-of-atopic-eczema-in-children-the-clothes-trial
#14
Kim S Thomas, Lucy E Bradshaw, Tracey H Sach, Fiona Cowdell, Jonathan M Batchelor, Sandra Lawton, Eleanor F Harrison, Rachel H Haines, Amina Ahmed, Taraneh Dean, Nigel P Burrows, Ian Pollock, Hannah K Buckley, Hywel C Williams, Joanne Llewellyn, Clare Crang, Jane D Grundy, Juliet Guiness, Andrew Gribbin, Eileen V Wake, Eleanor J Mitchell, Sara J Brown, Alan A Montgomery
BACKGROUND: Atopic eczema (AE) is a chronic, itchy, inflammatory skin condition that affects the quality of life of children and their families. The role of specialist clothing in the management of AE is poorly understood. OBJECTIVES: To assess the effectiveness and cost-effectiveness of silk garments for the management of AE in children with moderate to severe disease. DESIGN: Parallel-group, observer-blind, randomised controlled trial of 6 months' duration, followed by a 2-month observational period...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28406394/a-randomised-controlled-trial-to-compare-the-safety-effectiveness-and-cost-effectiveness-of-doxycycline-200%C3%A2-mg-day-with-that-of-oral-prednisolone-0-5%C3%A2-mg-kg-day-for-initial-treatment-of-bullous-pemphigoid-the-bullous-pemphigoid-steroids-and-tetracyclines-blister
#15
Joanne R Chalmers, Fenella Wojnarowska, Gudula Kirtschig, James Mason, Margaret Childs, Diane Whitham, Karen Harman, Anna Chapman, Shernaz Walton, Enno Schmidt, Thomas R Godec, Andrew J Nunn, Hywel C Williams
BACKGROUND: Bullous pemphigoid (BP) is an autoimmune blistering skin disorder with increased morbidity and mortality in the elderly. OBJECTIVES: To evaluate the effectiveness, safety and cost-effectiveness of a strategy of initiating BP treatment with oral doxycycline or oral prednisolone. We hypothesised that starting treatment with doxycycline gives acceptable short-term blister control while conferring long-term safety advantages over starting treatment with oral prednisolone...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28399988/youth-social-behaviour-and-network-therapy-y-sbnt-adaptation-of-a-family-and-social-network-intervention-for-young-people-who-misuse-alcohol-and-drugs-a-randomised-controlled-feasibility-trial
#16
Judith Watson, Paul Toner, Ed Day, Donna Back, Louca-Mai Brady, Caroline Fairhurst, Charlotte Renwick, Lorna Templeton, Shabana Akhtar, Charlie Lloyd, Jinshuo Li, Kim Cocks, Sangeeta Ambegaokar, Steve Parrott, Paul McArdle, Eilish Gilvarry, Alex Copello
BACKGROUND: Family interventions appear to be effective at treating young people's substance misuse. However, implementation of family approaches in UK services is low. This study aimed to demonstrate the feasibility of recruiting young people to an intervention based on an adaptation of adult social behaviour and network therapy. It also sought to involve young people with experience of using substance misuse services in the research process. OBJECTIVES: To demonstrate the feasibility of recruiting young people to family and social network therapy and to explore ways in which young people with experience of using substance misuse services could be involved in a study of this nature...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28398196/preconception-care-for-women-with-type-1-or-type-2-diabetes-mellitus-a-mixed-methods-study-exploring-uptake-of-preconception-care
#17
Sarah Earle, Anisah Tariq, Carol Komaromy, Cathy E Lloyd, M Ali Karamat, Jackie Webb, Paramjit S Gill
BACKGROUND: Diabetes mellitus is a global health problem and one of the most common medical conditions in pregnancy. A wide range of modifiable risk factors are associated with diabetes mellitus in pregnancy, and it is widely acknowledged that preconception care (PCC) is beneficial for women with pre-existing diabetes mellitus. However, uptake of PCC services is low. OBJECTIVES: To systematically review qualitative research on PCC for women with pre-existing diabetes mellitus of childbearing age, identify facilitators of and barriers to uptake of PCC and establish themes and gaps in knowledge...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28397649/support-and-assessment-for-fall-emergency-referrals-safer-2-a-cluster-randomised-trial-and-systematic-review-of-clinical-effectiveness-and-cost-effectiveness-of-new-protocols-for-emergency-ambulance-paramedics-to-assess-older-people-following-a-fall-with-referral
#18
Helen A Snooks, Rebecca Anthony, Robin Chatters, Jeremy Dale, Rachael Fothergill, Sarah Gaze, Mary Halter, Ioan Humphreys, Marina Koniotou, Phillipa Logan, Ronan Lyons, Suzanne Mason, Jon Nicholl, Julie Peconi, Ceri Phillips, Judith Phillips, Alison Porter, A Niroshan Siriwardena, Graham Smith, Alun Toghill, Mushtaq Wani, Alan Watkins, Richard Whitfield, Lynsey Wilson, Ian T Russell
BACKGROUND: Emergency calls are frequently made to ambulance services for older people who have fallen, but ambulance crews often leave patients at the scene without any ongoing care. We evaluated a new clinical protocol which allowed paramedics to assess older people who had fallen and, if appropriate, refer them to community-based falls services. OBJECTIVES: To compare outcomes, processes and costs of care between intervention and control groups; and to understand factors which facilitate or hinder use...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28394249/cognitive-behavioural-therapy-and-short-term-psychoanalytic-psychotherapy-versus-brief-psychosocial-intervention-in-adolescents-with-unipolar-major-depression-impact-a-multicentre-pragmatic-observer-blind-randomised-controlled-trial
#19
Ian M Goodyer, Shirley Reynolds, Barbara Barrett, Sarah Byford, Bernadka Dubicka, Jonathan Hill, Fiona Holland, Raphael Kelvin, Nick Midgley, Chris Roberts, Rob Senior, Mary Target, Barry Widmer, Paul Wilkinson, Peter Fonagy
BACKGROUND: Although there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years. OBJECTIVE: To determine whether or not either of two specialist psychological treatments, cognitive-behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28393757/prehospital-randomised-assessment-of-a-mechanical-compression-device-in-out-of-hospital-cardiac-arrest-paramedic-a-pragmatic-cluster-randomised-trial-and-economic-evaluation
#20
Simon Gates, Ranjit Lall, Tom Quinn, Charles D Deakin, Matthew W Cooke, Jessica Horton, Sarah E Lamb, Anne-Marie Slowther, Malcolm Woollard, Andy Carson, Mike Smyth, Kate Wilson, Garry Parcell, Andrew Rosser, Richard Whitfield, Amanda Williams, Rebecca Jones, Helen Pocock, Nicola Brock, John Jm Black, John Wright, Kyee Han, Gary Shaw, Laura Blair, Joachim Marti, Claire Hulme, Christopher McCabe, Silviya Nikolova, Zenia Ferreira, Gavin D Perkins
BACKGROUND: Mechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA). OBJECTIVE: Evaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA...
March 2017: Health Technology Assessment: HTA
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