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Ontario Health Technology Assessment Series

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https://www.readbyqxmd.com/read/28232854/percutaneous-ventricular-assist-devices-a-health-technology-assessment
#1
(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
#2
(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
#3
(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
#4
(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
#5
(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
#6
(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
#7
(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
#8
(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
#9
(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
https://www.readbyqxmd.com/read/27468324/composite-tissue-transplant-of-hand-or-arm-a-health-technology-assessment
#10
(no author information available yet)
BACKGROUND: Injuries to arms and legs following severe trauma can result in the loss of large regions of tissue, disrupting healing and function and sometimes leading to amputation of the damaged limb. People experiencing amputations of the hand or arm could potentially benefit from composite tissue transplant, which is being performed in some countries. Currently, there are no composite tissue transplant programs in Canada. METHODS: We conducted a systematic review of the literature, with no restriction on study design, examining the effectiveness and cost-effectiveness of hand and arm transplant...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27298655/vertebral-augmentation-involving-vertebroplasty-or-kyphoplasty-for-cancer-related-vertebral-compression-fractures-a-systematic-review
#11
REVIEW
(no author information available yet)
BACKGROUND: Cancers that metastasize to the spine and primary cancers such as multiple myeloma can result in vertebral compression fractures or instability. Conservative strategies, including bed rest, bracing, and analgesic use, can be ineffective, resulting in continued pain and progressive functional disability limiting mobility and self-care. Surgery is not usually an option for cancer patients in advanced disease states because of their poor medical health or functional status and limited life expectancy...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27293494/vertebral-augmentation-involving-vertebroplasty-or-kyphoplasty-for-cancer-related-vertebral-compression-fractures-an-economic-analysis
#12
(no author information available yet)
BACKGROUND: Untreated vertebral compression fractures can have serious clinical consequences and impose a considerable impact on patients' quality of life and on caregivers. Since non-surgical management of these fractures has limited effectiveness, vertebral augmentation procedures are gaining acceptance in clinical practice for pain control and fracture stabilization. The objective of this analysis was to determine the cost-effectiveness and budgetary impact of kyphoplasty or vertebroplasty compared with non-surgical management for the treatment of vertebral compression fractures in patients with cancer...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27279928/skin-testing-for-allergic-rhinitis-a-health-technology-assessment
#13
REVIEW
(no author information available yet)
BACKGROUND: Allergic rhinitis is the most common type of allergy worldwide. The accuracy of skin testing for allergic rhinitis is still debated. This health technology assessment had two objectives: to determine the diagnostic accuracy of skin-prick and intradermal testing in patients with suspected allergic rhinitis and to estimate the costs to the Ontario health system of skin testing for allergic rhinitis. METHODS: We searched All Ovid MEDLINE, Embase, and 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 for studies that evaluated the diagnostic accuracy of skin-prick and intradermal testing for allergic rhinitis using nasal provocation as the reference standard...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27110317/repetitive-transcranial-magnetic-stimulation-for-treatment-resistant-depression-an-economic-analysis
#14
(no author information available yet)
BACKGROUND: Major depressive disorder (MDD, 10% over a person's lifetime) is common and costly to the health system. Unfortunately, many MDD cases are resistant to treatment with antidepressant drugs and require other treatment to reduce or eliminate depression. Electroconvulsive therapy (ECT) has long been used to treat persons with treatment-resistant depression (TRD). Despite its effectiveness, ECT has side effects that make patients intolerant to the treatment, or they refuse to use it...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27099645/interventions-to-improve-access-to-primary-care-for-people-who-are-homeless-a-systematic-review
#15
REVIEW
(no author information available yet)
BACKGROUND: People who are homeless encounter barriers to primary care despite having greater needs for health care, on average, than people who are not homeless. We evaluated the effectiveness of interventions to improve access to primary care for people who are homeless. METHODS: We performed a systematic review to identify studies in English published between January 1, 1995, and July 8, 2015, comparing interventions to improve access to a primary care provider with usual care among people who are homeless...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27099644/minimal-residual-disease-evaluation-in-childhood-acute-lymphoblastic-leukemia-an-economic-analysis
#16
REVIEW
(no author information available yet)
BACKGROUND: Minimal residual disease (MRD) testing by higher performance techniques such as flow cytometry and polymerase chain reaction (PCR) can be used to detect the proportion of remaining leukemic cells in bone marrow or peripheral blood during and after the first phases of chemotherapy in children with acute lymphoblastic leukemia (ALL). The results of MRD testing are used to reclassify these patients and guide changes in treatment according to their future risk of relapse. We conducted a systematic review of the economic literature, cost-effectiveness analysis, and budget-impact analysis to ascertain the cost-effectiveness and economic impact of MRD testing by flow cytometry for management of childhood precursor B-cell ALL in Ontario...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27099643/minimal-residual-disease-evaluation-in-childhood-acute-lymphoblastic-leukemia-a-clinical-evidence-review
#17
REVIEW
(no author information available yet)
BACKGROUND: Leukemia accounts for nearly a third of childhood cancers in Canada, with acute lymphoblastic leukemia (ALL) comprising nearly 80% of cases. Identification of prognostic factors that allow risk stratification and tailored treatment have improved overall survival. However, nearly a quarter of patients considered standard risk on the basis of conventional prognostic factors still relapse, and relapse is associated with increased morbidity and mortality. Relapse is thought to result from extremely low levels of leukemic cells left over once complete remission is reached, termed minimal residual disease (MRD)...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27099642/repetitive-transcranial-magnetic-stimulation-for-treatment-resistant-depression-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
REVIEW
(no author information available yet)
BACKGROUND: To date, several randomized controlled trials (RCTs) have shown the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depression. OBJECTIVE: This analysis examined the antidepressant efficacy of rTMS in patients with treatment-resistant unipolar depression. METHODS: A literature search was performed for RCTs published from January 1, 1994, to November 20, 2014. The search was updated on March 1, 2015...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27026799/mechanical-thrombectomy-in-patients-with-acute-ischemic-stroke-a-health-technology-assessment
#19
(no author information available yet)
BACKGROUND: In Ontario, current treatment for eligible patients who have an acute ischemic stroke is intravenous thrombolysis (IVT). However, there are some limitations and contraindications to IVT, and outcomes may not be favourable for patients with stroke caused by a proximal intracranial occlusion. An alternative is mechanical thrombectomy with newer devices, and a number of recent studies have suggested that this treatment is more effective for improving functional independence and clinical outcomes...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27026798/left-ventricular-assist-devices-for-destination-therapy-a-health-technology-assessment
#20
REVIEW
(no author information available yet)
BACKGROUND: Left ventricular assist devices (LVADs) provide circulatory support to assist the damaged left ventricle in patients with end-stage heart failure. Implantation of an LVAD is sometimes a last resort for patients with end stage heart failure who are ineligible for heart transplantation (destination therapy). First-generation LVADs used pulsatile pumps to mimic the natural pulsing action of the heart. Implanted second-generation LVADs use a rapidly spinning rotor to produce a continuous flow of blood into the systemic arterial system...
2016: Ontario Health Technology Assessment Series
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