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Ontario Health Technology Assessment Series

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https://www.readbyqxmd.com/read/29213344/psychotherapy-for-major-depressive-disorder-and-generalized-anxiety-disorder-a-health-technology-assessment
#1
(no author information available yet)
Background: Major depressive disorder and generalized anxiety disorder are among the most commonly diagnosed mental illnesses in Canada; both are associated with a high societal and economic burden. Treatment for major depressive disorder and generalized anxiety disorder consists of pharmacological and psychological interventions. Three commonly used psychological interventions are cognitive behavioural therapy (CBT), interpersonal therapy, and supportive therapy. The objectives of this report were to assess the effectiveness and safety of these types of therapy for the treatment of adults with major depressive disorder and/or generalized anxiety disorder, to assess the cost-effectiveness of structured psychotherapy (CBT or interpersonal therapy), to calculate the budget impact of publicly funding structured psychotherapy, and to gain a greater understanding of the experiences of people with major depressive disorder and/or generalized anxiety disorder...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/29201261/electrical-stimulation-for-pressure-injuries-a-health-technology-assessment
#2
(no author information available yet)
Background: Pressure injuries (bedsores) are common and reduce quality of life. They are also costly and difficult to treat. This health technology assessment evaluates the effectiveness, cost-effectiveness, budget impact, and lived experience of adding electrical stimulation to standard wound care for pressure injuries. Methods: We conducted a systematic search for studies published to December 7, 2016, limited to randomized and non-randomized controlled trials examining the effectiveness of electrical stimulation plus standard wound care versus standard wound care alone for patients with pressure injuries...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/29201260/retinal-prosthesis-system-for-advanced-retinitis-pigmentosa-a-health-technology-assessment-update
#3
(no author information available yet)
Background: Retinitis pigmentosa is a group of inherited disorders characterized by the degeneration of the photoreceptors in the retina, resulting in progressive vision loss. The Argus II system is designed to restore partial functional vision in patients with profound vision loss from advanced retinitis pigmentosa. At present, it is the only treatment option approved by Health Canada for this patient population. In June 2016, Health Quality Ontario published a health technology assessment of the Argus II retinal prosthesis system for patients with advanced retinitis pigmentosa...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28989556/fibreglass-total-contact-casting-removable-cast-walkers-and-irremovable-cast-walkers-to-treat-diabetic-neuropathic-foot-ulcers-a-health-technology-assessment
#4
(no author information available yet)
BACKGROUND: Diabetic neuropathic foot ulcers are a risk factor for lower leg amputation. Many experts recommend offloading with fibreglass total contact casting, removable cast walkers, and irremovable cast walkers as a way to treat these ulcers. METHODS: We completed a health technology assessment, which included an evaluation of clinical benefits and harms, value for money, and patient preferences for offloading devices. We performed a systematic literature search on August 17, 2016, to identify randomized controlled trials that compared fibreglass total contact casting, removable cast walkers, and irremovable cast walkers with other treatments (offloading or non-offloading) in patients with diabetic neuropathic foot ulcers...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28757906/lumbosacral-dorsal-rhizotomy-for-spastic-cerebral-palsy-a-health-technology-assessment
#5
(no author information available yet)
BACKGROUND: Cerebral palsy, a spectrum of neuromuscular conditions caused by abnormal brain development or early damage to the brain, is the most common cause of childhood physical disability. Lumbosacral dorsal rhizotomy is a neurosurgical procedure that permanently decreases spasticity and is always followed by physical therapy. The objectives of this health technology assessment were to evaluate the clinical effectiveness, safety, cost effectiveness, and family perspectives of dorsal rhizotomy...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28638496/effect-of-early-follow-up-after-hospital-discharge-on-outcomes-in-patients-with-heart-failure-or-chronic-obstructive-pulmonary-disease-a-systematic-review
#6
(no author information available yet)
BACKGROUND: Transitions in care can increase patients' vulnerability to adverse events. In particular, patients admitted for heart failure or chronic obstructive pulmonary disorder (COPD) have high rates of readmission and return emergency department visits. Heart failure patients have the highest 30-day readmission rates in Canada, and COPD patients comprise the highest volume of readmissions. Combined, these two conditions account for the largest number of emergency department returns...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28572868/prostate-cancer-patient-perspectives-on-the-use-of-information-in-treatment-decision-making-a-systematic-review-and-qualitative-meta-synthesis
#7
Sujane Kandasamy, Ahmad Firas Khalid, Umair Majid, Meredith Vanstone
BACKGROUND: Men with low- to intermediate-risk prostate cancer are typically asked to choose from a variety of treatment options, including active surveillance, radical prostatectomy, or brachytherapy. The Prolaris cell cycle progression test is intended to provide additional information on personal risk status to assist men with prostate cancer in their choice of treatment. To assist with assessing that new technology, this report synthesizes qualitative research on how men with prostate cancer use information to make decisions about treatment options...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28572867/prolaris-cell-cycle-progression-test-for-localized-prostate-cancer-a-health-technology-assessment
#8
(no author information available yet)
BACKGROUND: Prostate cancer is very common and many localized tumours are non-aggressive. Determining which cancers are aggressive is important for choosing the most appropriate treatment (e.g., surgery, radiation, active surveillance). Current clinical risk stratification is reliable in forecasting the prognosis of groups of men with similar clinical and pathologic characteristics, but there is residual uncertainty at the individual level. The Prolaris cell cycle progression (CCP) test, a genomic test that estimates how fast tumour cells are proliferating, could potentially be used to improve the accuracy of individual risk assessment...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28572866/hyperbaric-oxygen-therapy-for-the-treatment-of-diabetic-foot-ulcers-a-health-technology-assessment
#9
(no author information available yet)
BACKGROUND: About 15% to 25% of people with diabetes will develop a foot ulcer. These wounds are often resistant to healing; therefore, people with diabetes experience lower limb amputation at about 20 times the rate of people without diabetes. If an ulcer does not heal with standard wound care, other therapeutic interventions are offered, one of which is hyperbaric oxygen therapy (HBOT). However, the effectiveness of this therapy is not clearly known. The objectives of this health technology assessment were to assess the safety, clinical effectiveness, and cost-effectiveness of standard wound care plus HBOT versus standard wound care alone for the treatment of diabetic foot ulcers...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28515818/pharmacogenomic-testing-for-psychotropic-medication-selection-a-systematic-review-of-the-assurex-genesight-psychotropic-test
#10
(no author information available yet)
BACKGROUND: A large proportion of the Ontario population lives with a diagnosed mental illness. Nearly 5% of Ontarians have major depressive disorder, and another 5% have another type of depressive disorder, bipolar disorder, schizophrenia, anxiety, or some other disorder not otherwise specified. Medications are commonly used to treat mental illness, but choosing the right medication for each patient is challenging, and more than 40% of patients discontinue their medication within 90 days because of adverse effects or lack of response...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28326148/patient-safety-learning-systems-a-systematic-review-and-qualitative-synthesis
#11
REVIEW
(no author information available yet)
BACKGROUND: A patient safety learning system (sometimes called a critical incident reporting system) refers to structured reporting, collation, and analysis of critical incidents. To inform a provincial working group's recommendations for an Ontario Patient Safety Event Learning System, a systematic review was undertaken to determine design features that would optimize its adoption into the health care system and would inform implementation strategies. METHODS: The objective of this review was to address two research questions: (a) what are the barriers to and facilitators of successful adoption of a patient safety learning system reported by health professionals and (b) what design components maximize successful adoption and implementation? To answer the first question, we used a published systematic review...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28232854/percutaneous-ventricular-assist-devices-a-health-technology-assessment
#12
REVIEW
(no author information available yet)
BACKGROUND: Percutaneous coronary intervention (PCI)-using a catheter to place a stent to keep blood vessels open-is increasingly used for high-risk patients who cannot undergo surgery. Cardiogenic shock (when the heart suddenly cannot pump enough blood) is associated with a high mortality rate. The percutaneous ventricular assist device can help control blood pressure and increase blood flow in these high-risk conditions. This health technology assessment examined the benefits, harms, and budget impact of the Impella percutaneous ventricular assist device in high-risk PCI and cardiogenic shock...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28194254/long-term-continuous-ambulatory-ecg-monitors-and-external-cardiac-loop-recorders-for-cardiac-arrhythmia-a-health-technology-assessment
#13
REVIEW
(no author information available yet)
BACKGROUND: Ambulatory electrocardiography (ECG) monitors are often used to detect cardiac arrhythmia. For patients with symptoms, an external cardiac loop recorder will often be recommended. The improved recording capacity of newer Holter monitors and similar devices, collectively known as longterm continuous ambulatory ECG monitors, suggests that they will perform just as well as, or better than, external loop recorders. This health technology assessment aimed to evaluate the effectiveness, cost-effectiveness, and budget impact of longterm continuous ECG monitors compared with external loop recorders in detecting symptoms of cardiac arrhythmia...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27990198/magnetic-resonance-imaging-as-an-adjunct-to-mammography-for-breast-cancer-screening-in-women-at-less-than-high-risk-for-breast-cancer-a-health-technology-assessment
#14
REVIEW
(no author information available yet)
BACKGROUND: Screening with mammography can detect breast cancer early, before clinical symptoms appear. Some cancers, however, are not captured with mammography screening alone. Among women at high risk for breast cancer, magnetic resonance imaging (MRI) has been suggested as a safe adjunct (supplemental) screening tool that can detect breast cancers missed on screening mammography, potentially reducing the number of deaths associated with the disease. However, the use of adjunct screening tests may also increase the number of false-positive test results, which may lead to unnecessary follow-up testing, as well as patient stress and anxiety...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27990197/transcatheter-aortic-valve-implantation-for-treatment-of-aortic-valve-stenosis-a-health-technology-assessment
#15
COMPARATIVE STUDY
(no author information available yet)
BACKGROUND: Surgical aortic valve replacement (SAVR) is the gold standard for treating aortic valve stenosis. It is a major operation that requires sternotomy and the use of a heart-lung bypass machine, but in appropriately selected patients with symptomatic, severe aortic valve stenosis, the benefits of SAVR usually outweigh the harms. Transcatheter aortic valve implantation (TAVI) is a less invasive procedure that allows an artificial valve to be implanted over the poorly functioning valve...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27990196/levonorgestrel-releasing-intrauterine-system-52-mg-for-idiopathic-heavy-menstrual-bleeding-a-health-technology-assessment
#16
REVIEW
(no author information available yet)
BACKGROUND: Heavy menstrual bleeding affects as many as one in three women and has negative physical, economic, and psychosocial impacts including activity limitations and reduced quality of life. The goal of treatment is to make menstruation manageable, and options include medical therapy or surgery such as endometrial ablation or hysterectomy. This review examined the evidence of effectiveness and cost-effectiveness of the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) as a treatment alternative for idiopathic heavy menstrual bleeding...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27516814/fecal-microbiota-therapy-for-clostridium-difficile-infection-a-health-technology-assessment
#17
REVIEW
(no author information available yet)
BACKGROUND: Fecal microbiota therapy is increasingly being used to treat patients with Clostridium difficile infection. This health technology assessment primarily evaluated the effectiveness and cost-effectiveness of fecal microbiota therapy compared with the usual treatment (antibiotic therapy). METHODS: We performed a literature search using Ovid MEDLINE, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, CRD Health Technology Assessment Database, Cochrane Central Register of Controlled Trials, and NHS Economic Evaluation Database...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27468327/women-s-experiences-of-inaccurate-breast-cancer-screening-results-a-systematic-review-and-qualitative-meta-synthesis
#18
REVIEW
(no author information available yet)
BACKGROUND: Adjunct screening with ultrasound has the potential to detect breast cancers that may not be visible on screening mammography. The use of adjunct ultrasonography is thought to be a safe and inexpensive approach to improving the sensitivity of screening with mammography alone, but potentially at the expense of increasing the rate of false-positive findings. The objective of this review was to examine women's experiences of inaccurate breast cancer screening results and how they affect perceptions of breast cancer screening technologies...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27468326/ultrasound-as-an-adjunct-to-mammography-for-breast-cancer-screening-a-health-technology-assessment
#19
REVIEW
(no author information available yet)
BACKGROUND: Screening with mammography can detect breast cancer early, before clinical symptoms appear. Some cancers, however, are not captured with mammography screening alone. Ultrasound has been suggested as a safe adjunct screening tool that can detect breast cancers missed on mammography. We investigated the benefits, harms, cost-effectiveness, and cost burden of ultrasound as an adjunct to mammography compared with mammography alone for screening women at average risk and at high risk for breast cancer...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27468325/retinal-prosthesis-system-for-advanced-retinitis-pigmentosa-a-health-technology-assessment
#20
REVIEW
(no author information available yet)
BACKGROUND: Retinitis pigmentosa is a group of genetic disorders that involves the breakdown and loss of photoreceptors in the retina, resulting in progressive retinal degeneration and eventual blindness. The Argus II Retinal Prosthesis System is the only currently available surgical implantable device approved by Health Canada. It has been shown to improve visual function in patients with severe visual loss from advanced retinitis pigmentosa. The objective of this analysis was to examine the clinical effectiveness, cost-effectiveness, budget impact, and safety of the Argus II system in improving visual function, as well as exploring patient experiences with the system...
2016: Ontario Health Technology Assessment Series
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