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Ontario Health Technology Assessment Series

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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
#1
(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
#2
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
#3
(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
#4
(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
#5
(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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#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. 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
#15
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
https://www.readbyqxmd.com/read/27468324/composite-tissue-transplant-of-hand-or-arm-a-health-technology-assessment
#16
REVIEW
(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
#17
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
#18
REVIEW
(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
#19
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
#20
REVIEW
(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
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