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Health Technology Assessment: HTA

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https://www.readbyqxmd.com/read/29345224/therapy-interventions-for-children-with-neurodisabilities-a-qualitative-scoping-study
#1
Bryony Beresford, Susan Clarke, Jane Maddison
BACKGROUND: Therapy interventions emerged four times in the top 10 research priorities in a James Lind Alliance research prioritisation exercise for children with neurodisabilities (Morris C, Simkiss D, Busk M, Morris M, Allard A, Denness J, et al. Setting research priorities to improve the health of children and young people with neurodisability: a British Academy of Childhood Disability-James Lind Alliance Research Priority Setting Partnership. BMJ Open 2015;5:e006233). The National Institute for Health Research (NIHR) commissioned this study as part of an information-gathering exercise in response to this...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29318985/a-randomised-controlled-trial-and-economic-evaluation-of-intraoperative-cell-salvage-during-caesarean-section-in-women-at-risk-of-haemorrhage-the-salvo-cell-salvage-in-obstetrics-trial
#2
Khalid S Khan, Philip Moore, Matthew Wilson, Richard Hooper, Shubha Allard, Ian Wrench, Tracy Roberts, Carol McLoughlin, Lee Beresford, James Geoghegan, Jane Daniels, Sue Catling, Vicki A Clark, Paul Ayuk, Stephen Robson, Fang Gao-Smith, Matthew Hogg, Louise Jackson, Doris Lanz, Julie Dodds
BACKGROUND: Caesarean section is associated with blood loss and maternal morbidity. Excessive blood loss requires transfusion of donor (allogeneic) blood, which is a finite resource. Cell salvage returns blood lost during surgery to the mother. It may avoid the need for donor blood transfusion, but reliable evidence of its effects is lacking. OBJECTIVES: To determine if routine use of cell salvage during caesarean section in mothers at risk of haemorrhage reduces the rates of blood transfusion and postpartum maternal morbidity, and is cost-effective, in comparison with standard practice without routine salvage use...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29298736/multiple-frequency-bioimpedance-devices-for-fluid-management-in-people-with-chronic-kidney-disease-receiving-dialysis-a-systematic-review-and-economic-evaluation
#3
Graham Scotland, Moira Cruickshank, Elisabet Jacobsen, David Cooper, Cynthia Fraser, Michal Shimonovich, Angharad Marks, Miriam Brazzelli
BACKGROUND: Chronic kidney disease (CKD) is a long-term condition requiring treatment such as conservative management, kidney transplantation or dialysis. To optimise the volume of fluid removed during dialysis (to avoid underhydration or overhydration), people are assigned a 'target weight', which is commonly assessed using clinical methods, such as weight gain between dialysis sessions, pre- and post-dialysis blood pressure and patient-reported symptoms. However, these methods are not precise, and measurement devices based on bioimpedance technology are increasingly used in dialysis centres...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29280434/surveillance-versus-ablation-for-incidentally-diagnosed-small-renal-tumours-the-surab-feasibility-rct
#4
Naeem Soomro, Jan Lecouturier, Deborah D Stocken, Jing Shen, Ann Marie Hynes, Holly F Ainsworth, David Breen, Grenville Oades, David Rix, Michael Aitchison
BACKGROUND: There is uncertainty around the appropriate management of small renal tumours. Treatments include partial nephrectomy, ablation and active surveillance. OBJECTIVES: To explore the feasibility of a randomised trial of ablation versus active surveillance. DESIGN: Two-stage feasibility study: stage 1 - clinician survey and co-design work; and stage 2 - randomised feasibility study with qualitative and economic components. METHODS: Stage 1 - survey of radiologists and urologists, and development of patient information materials...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29271741/interventions-for-hyperhidrosis-in-secondary-care-a-systematic-review-and-value-of-information-analysis
#5
Ros Wade, Stephen Rice, Alexis Llewellyn, Eoin Moloney, Julie Jones-Diette, Julija Stoniute, Kath Wright, Alison M Layton, Nick J Levell, Gerard Stansby, Dawn Craig, Nerys Woolacott
BACKGROUND: Hyperhidrosis is uncontrollable excessive sweating that occurs at rest, regardless of temperature. The symptoms of hyperhidrosis can significantly affect quality of life. The management of hyperhidrosis is uncertain and variable. OBJECTIVE: To establish the expected value of undertaking additional research to determine the most effective interventions for the management of refractory primary hyperhidrosis in secondary care. METHODS: A systematic review and economic model, including a value-of-information (VOI) analysis...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29271339/virtual-chromoendoscopy-for-the-real-time-assessment-of-colorectal-polyps-in-vivo-a-systematic-review-and-economic-evaluation
#6
Joanna Picot, Micah Rose, Keith Cooper, Karen Pickett, Joanne Lord, Petra Harris, Sophie Whyte, Dankmar Böhning, Jonathan Shepherd
BACKGROUND: Current clinical practice is to remove a colorectal polyp detected during colonoscopy and determine whether it is an adenoma or hyperplastic by histopathology. Identifying adenomas is important because they may eventually become cancerous if untreated, whereas hyperplastic polyps do not usually develop into cancer, and a surveillance interval is set based on the number and size of adenomas found. Virtual chromoendoscopy (VCE) (an electronic endoscopic imaging technique) could be used by the endoscopist under strictly controlled conditions for real-time optical diagnosis of diminutive (≤ 5 mm) colorectal polyps to replace histopathological diagnosis...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29268843/clinical-effectiveness-and-cost-effectiveness-of-issuing-longer-versus-shorter-duration-3-month-vs-28-day-prescriptions-in-patients-with-chronic-conditions-systematic-review-and-economic-modelling
#7
Céline Miani, Adam Martin, Josephine Exley, Brett Doble, Ed Wilson, Rupert Payne, Anthony Avery, Catherine Meads, Anne Kirtley, Molly Morgan Jones, Sarah King
BACKGROUND: To reduce expenditure on, and wastage of, drugs, some commissioners have encouraged general practitioners to issue shorter prescriptions, typically 28 days in length; however, the evidence base for this recommendation is uncertain. OBJECTIVE: To evaluate the evidence of the clinical effectiveness and cost-effectiveness of shorter versus longer prescriptions for people with stable chronic conditions treated in primary care. DESIGN/DATA SOURCES: The design of the study comprised three elements...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29265999/a-novel-peer-support-intervention-using-motivational-interviewing-for-breastfeeding-maintenance-a-uk-feasibility-study
#8
Shantini Paranjothy, Lauren Copeland, Laura Merrett, Aimee Grant, Rhiannon Phillips, Nina Gobat, Julia Sanders, Deborah Fitzsimmons, Billie Hunter, Sian Regan, Rebecca Playle, Amy Brown, Sally Tedstone, Heather Trickey, Mike Robling
BACKGROUND: In total, 81% of women in the UK start breastfeeding, but fewer than half continue beyond 6 weeks. Peer support in the early postnatal period may encourage women to breastfeed for longer. OBJECTIVE: To develop a breastfeeding peer-support intervention based on motivational interviewing (MI) for breastfeeding maintenance and to test the feasibility of delivering it to mothers in areas with high levels of social deprivation. DESIGN: Intervention development and a non-randomised multisite feasibility study...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29265004/self-management-toolkit-and-delivery-strategy-for-end-of-life-pain-the-mixed-methods-feasibility-study
#9
Michael I Bennett, Matthew R Mulvey, Natasha Campling, Sue Latter, Alison Richardson, Hilary Bekker, Alison Blenkinsopp, Paul Carder, Jose Closs, Amanda Farrin, Kate Flemming, Jean Gallagher, David Meads, Stephen Morley, John O'Dwyer, Alexandra Wright-Hughes, Suzanne Hartley
BACKGROUND: Pain affects most people approaching the end of life and can be severe for some. Opioid analgesia is effective, but evidence is needed about how best to support patients in managing these medicines. OBJECTIVES: To develop a self-management support toolkit (SMST) and delivery strategy and to test the feasibility of evaluating this intervention in a future definitive trial. DESIGN: Phase I - evidence synthesis and qualitative interviews with patients and carers...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29235986/managing-diabetes-in-people-with-dementia-a-realist-review
#10
Frances Bunn, Claire Goodman, Peter Reece Jones, Bridget Russell, Daksha Trivedi, Alan Sinclair, Antony Bayer, Greta Rait, Jo Rycroft-Malone, Chris Burton
BACKGROUND: Dementia and diabetes mellitus are common long-term conditions that coexist in a large number of older people. People living with dementia and diabetes may be at increased risk of complications such as hypoglycaemic episodes because they are less able to manage their diabetes. OBJECTIVES: To identify the key features or mechanisms of programmes that aim to improve the management of diabetes in people with dementia and to identify areas needing further research...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29231159/facet-joint-injections-for-non-specific-low-back-pain-a-feasibility-rct
#11
Saowarat Snidvongs, Rod S Taylor, Alia Ahmad, Simon Thomson, Manohar Sharma, Angela Farr, Deborah Fitzsimmons, Stephanie Poulton, Vivek Mehta, Richard Langford
BACKGROUND: Pain of lumbar facet-joint origin is a common cause of low back pain in adults and may lead to chronic pain and disability, with associated health and socioeconomic implications. The socioeconomic burden includes an inability to return to work resulting in loss of productivity in addition to direct and indirect health-care utilisation costs. Lumbar facet-joints are paired synovial joints between the superior and inferior articular processes of consecutive lumbar vertebrae and between the fifth lumbar vertebra and the sacrum...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29214975/home-based-health-promotion-for-older-people-with-mild-frailty-the-homehealth-intervention-development-and-feasibility-rct
#12
Kate Walters, Rachael Frost, Kalpa Kharicha, Christina Avgerinou, Benjamin Gardner, Federico Ricciardi, Rachael Hunter, Ann Liljas, Jill Manthorpe, Vari Drennan, John Wood, Claire Goodman, Ana Jovicic, Steve Iliffe
BACKGROUND: Mild frailty or pre-frailty is common and yet is potentially reversible. Preventing progression to worsening frailty may benefit individuals and lower health/social care costs. However, we know little about effective approaches to preventing frailty progression. OBJECTIVES: (1) To develop an evidence- and theory-based home-based health promotion intervention for older people with mild frailty. (2) To assess feasibility, costs and acceptability of (i) the intervention and (ii) a full-scale clinical effectiveness and cost-effectiveness randomised controlled trial (RCT)...
December 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29208190/preventing-blood-borne-virus-infection-in-people-who-inject-drugs-in-the-uk-systematic-review-stakeholder-interviews-psychosocial-intervention-development-and-feasibility-randomised-controlled-trial
#13
Gail Gilchrist, Davina Swan, April Shaw, Ada Keding, Sarah Towers, Noel Craine, Alison Munro, Elizabeth Hughes, Steve Parrott, Noreen Mdege, John Strang, Avril Taylor, Judith Watson
BACKGROUND: Opioid substitution therapy and needle exchanges have reduced blood-borne viruses (BBVs) among people who inject drugs (PWID). Some PWID continue to share injecting equipment. OBJECTIVES: To develop an evidence-based psychosocial intervention to reduce BBV risk behaviours and increase transmission knowledge among PWID, and conduct a feasibility trial among PWID comparing the intervention with a control. DESIGN: A pragmatic, two-armed randomised controlled, open feasibility trial...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29206093/the-clinical-effectiveness-and-cost-effectiveness-of-treat-to-target-strategies-in-rheumatoid-arthritis-a-systematic-review-and-cost-effectiveness-analysis
#14
Allan Wailoo, Emma S Hock, Matt Stevenson, Marrissa Martyn-St James, Andrew Rawdin, Emma Simpson, Ruth Wong, Naila Dracup, David L Scott, Adam Young
BACKGROUND: Treat to target (TTT) is a broad concept for treating patients with rheumatoid arthritis (RA). It involves setting a treatment target, usually remission or low disease activity (LDA). This is often combined with frequent patient assessment and intensive and rapidly adjusted drug treatment, sometimes based on a formal protocol. OBJECTIVE: To investigate the clinical effectiveness and cost-effectiveness of TTT compared with routine care. DATA SOURCES: Databases including EMBASE and MEDLINE were searched from 2008 to August 2016...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29205150/a-pragmatic-multicentre-randomised-controlled-trial-comparing-stapled-haemorrhoidopexy-with-traditional-excisional-surgery-for-haemorrhoidal-disease-the-ethos-study
#15
Angus Jm Watson, Jonathan Cook, Jemma Hudson, Mary Kilonzo, Jessica Wood, Hanne Bruhn, Steven Brown, Brian Buckley, Finlay Curran, David Jayne, Malcolm Loudon, Ramesh Rajagopal, Alison McDonald, John Norrie
BACKGROUND: Haemorrhoids are a benign anorectal condition and are highly prevalent in the UK population. Treatments involve clinic-based procedures and surgery. The surgical procedures available include stapled haemorrhoidopexy (SH) and traditional haemorrhoidectomy (TH), and over 25,000 operations are performed for haemorrhoids annually in the UK. The disease is therefore important both to patients and to health service commissioners. Debate remains as to which of these surgical procedures is the most clinically effective and cost-effective...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29188764/assessing-the-performance-of-methodological-search-filters-to-improve-the-efficiency-of-evidence-information-retrieval-five-literature-reviews-and-a-qualitative-study
#16
Carol Lefebvre, Julie Glanville, Sophie Beale, Charles Boachie, Steven Duffy, Cynthia Fraser, Jenny Harbour, Rachael McCool, Lynne Smith
BACKGROUND: Effective study identification is essential for conducting health research, developing clinical guidance and health policy and supporting health-care decision-making. Methodological search filters (combinations of search terms to capture a specific study design) can assist in searching to achieve this. OBJECTIVES: This project investigated the methods used to assess the performance of methodological search filters, the information that searchers require when choosing search filters and how that information could be better provided...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29183563/a-systematic-review-and-economic-evaluation-of-adalimumab-and-dexamethasone-for-treating-non-infectious-intermediate-uveitis-posterior-uveitis-or-panuveitis-in-adults
#17
Hazel Squires, Edith Poku, Inigo Bermejo, Katy Cooper, John Stevens, Jean Hamilton, Ruth Wong, Alastair Denniston, Ian Pearce, Fahd Quhill
BACKGROUND: Non-infectious intermediate uveitis, posterior uveitis and panuveitis are a heterogeneous group of inflammatory eye disorders. Management includes local and systemic corticosteroids, immunosuppressants and biological drugs. OBJECTIVES: To evaluate the clinical effectiveness and cost-effectiveness of subcutaneous adalimumab (Humira®; AbbVie Ltd, Maidenhead, UK) and a dexamethasone intravitreal implant (Ozurdex®; Allergan Ltd, Marlow, UK) in adults with non-infectious intermediate uveitis, posterior uveitis or panuveitis...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29171379/collaborative-care-for-screen-positive-elders-with-major-depression-casper-plus-a-multicentred-randomised-controlled-trial-of-clinical-effectiveness-and-cost-effectiveness
#18
Katharine Bosanquet, Joy Adamson, Katie Atherton, Della Bailey, Catherine Baxter, Jules Beresford-Dent, Jacqueline Birtwistle, Carolyn Chew-Graham, Emily Clare, Jaime Delgadillo, David Ekers, Deborah Foster, Rhian Gabe, Samantha Gascoyne, Lesley Haley, Jahnese Hamilton, Rebecca Hargate, Catherine Hewitt, John Holmes, Ada Keding, Helen Lewis, Dean McMillan, Shaista Meer, Natasha Mitchell, Sarah Nutbrown, Karen Overend, Steve Parrott, Jodi Pervin, David A Richards, Karen Spilsbury, David Torgerson, Gemma Traviss-Turner, Dominic Trépel, Rebecca Woodhouse, Simon Gilbody
BACKGROUND: Depression in older adults is common and is associated with poor quality of life, increased morbidity and early mortality, and increased health and social care use. Collaborative care, a low-intensity intervention for depression that is shown to be effective in working-age adults, has not yet been evaluated in older people with depression who are managed in UK primary care. The CollAborative care for Screen-Positive EldeRs (CASPER) plus trial fills the evidence gap identified by the most recent guidelines on depression management...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29153075/is-whole-colon-investigation-by-colonoscopy-computerised-tomography-colonography-or-barium-enema-necessary-for-all-patients-with-colorectal-cancer-symptoms-and-for-which-patients-would-flexible-sigmoidoscopy-suffice-a-retrospective-cohort-study
#19
Wendy Atkin, Kate Wooldrage, Urvi Shah, Kate Skinner, Jeremy P Brown, Willie Hamilton, Ines Kralj-Hans, Michael R Thompson, Karen G Flashman, Steve Halligan, Siwan Thomas-Gibson, Margaret Vance, Amanda J Cross
BACKGROUND: For patients referred to hospital with suspected colorectal cancer (CRC), it is current standard clinical practice to conduct an examination of the whole colon and rectum. However, studies have shown that an examination of the distal colorectum using flexible sigmoidoscopy (FS) can be a safe and clinically effective investigation for some patients. These findings require validation in a multicentre study. OBJECTIVES: To investigate the links between patient symptoms at presentation and CRC risk by subsite, and to provide evidence of whether or not FS is an effective alternative to whole-colon investigation (WCI) in patients whose symptoms do not suggest proximal or obstructive disease...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29110753/a-multicentre-randomised-controlled-trial-of-position-during-the-late-stages-of-labour-in-nulliparous-women-with-an-epidural-clinical-effectiveness-and-an-economic-evaluation-bumpes
#20
Debra Bick, Annette Briley, Peter Brocklehurst, Pollyanna Hardy, Edmund Juszczak, Lynn Lynch, Christine MacArthur, Phillip Moore, Mary Nolan, Oliver Rivero-Arias, Julia Sanders, Andrew Shennan, Matt Wilson
BACKGROUND: Epidural analgesia leads to increased risk of instrumental vaginal delivery (IVD). There is debate about whether or not posture in second-stage labour influences the incidence of spontaneous vaginal birth (SVB). OBJECTIVES: In nulliparous women with epidural analgesia, does a policy of adopting an 'upright position' throughout second-stage labour increase the incidence of SVB compared with a policy of adopting a 'lying-down' position? DESIGN: Two-arm randomised controlled trial...
November 2017: Health Technology Assessment: HTA
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