Rapid Response
Subscribe (RSS)
Results 1 - 20 of 1940
-
Rapid Response
Forced Air Warming Units for Adults Undergoing Surgery: Clinical Evidence
May 7, 2013
Research Type Medical Devices Question 1. What is the clinical evidence for the risk of infection related to the use of forced air warming units used intraoperatively?
2. What is the clinical evidence for the use of forced air warming units before or after draping?Key Messages Two non-randomized studies were identified regarding the risk of infection related to the intraoperative use of forced air warming units and with associated surgical draping. Request Type Summary of Abstracts -
Rapid Response
Non-Pharmacological Therapies for the Treatment of Insomnia in Adults: Clinical Evidence and Guidelines
April 29, 2013
Research Type Neurological Disease Question 1. What are the alternate insomnia therapies versus pharmacologic interventions used in adults diagnosed with insomnia?
2. What are the clinical benefits of using alternate insomnia therapies versus pharmacological interventions in adults diagnosed with insomnia?
3. What are the guidelines surrounding the use of alternate insomnia therapies in adults diagnosed with insomnia?Key Messages Twelve systematic reviews and meta-analyses, 31 randomized controlled trials, and one evidence-based guideline were identified regarding non-pharmacological therapies for the treatment of insomnia in adults. Due to the volume of literature identified, only citations published between 2011 and 2013 were included. Request Type Reference List -
Rapid Response
Transcatheter Aortic Valve Replacement in Severe Aortic Stenosis: A Review of Comparative Durability and Clinical Effectiveness Beyond 12 Months
April 26, 2013
Question What is the evidence for the long-term (> 12 months) durability and clinical effectiveness of TAVR in patients with severe aortic stenosis compared with SAVR or standard therapy? Key Messages In follow-up longer than 12 months, findings support the use of TAVR as an alternative to conventional surgery in selected high-risk patients with aortic stenosis, with similar clinical outcomes such as mortality and rehospitalization rates, neurologic events, and myocardial infarction. Major vascular complications and neurologic events were more frequent with TAVR. The two methods, TAVR and SAVR, had similar echocardiographic hemodynamic findings. Compared with standard treatment, TAVR was superior with regard to long-term clinical outcomes and improved symptoms. A meta-analysis of larger trials with sensitivity analyses on study design, sample size, baseline characteristics, and surgeon’s experience is needed to reconfirm the findings. Request Type Peer-Reviewed Summary with Critical Appraisal -
Rapid Response
Brentuximab for Refractory CD30+ Hodgkin's Lymphoma: Clinical and Cost-Effectiveness
April 23, 2013
Research Type Emerging Issues - Biologics Question 1. What is the clinical effectiveness of brentuximab for patients with refractory CD30+ Hodgkins lymphoma?
2. What is the cost effectiveness of brentuximab for patients with refractory CD30+ Hodgkins lymphoma?Key Messages Six non-randomized studies were identified regarding the clinical effectiveness of brentuximab for patients with refractory CD30+ Hodgkins lymphoma. No economic evaluations were identified. Request Type Summary of Abstracts -
Rapid Response
Administration of Anesthesia by Anesthesiologists Versus Non-Physicians for Patients Undergoing Cataract Surgery: Clinical Effectiveness, Cost-Effectiveness, and Guidelines
April 22, 2013
Research Type Other Work Question 1. What is the clinical evidence regarding the utilization of anesthesiologists versus non-physicians providing anesthetic care during cataract surgery?
2. What is the cost-effectiveness regarding the utilization of anesthesiologists versus non-physicians providing anesthetic care during cataract surgery?
3. What are the guidelines regarding the utilization of anesthesiologists versus non-physicians providing anesthetic care during cataract surgery?Key Messages One non-randomized study and one evidence-based guideline were identified regarding the administration of anesthesia by anesthesiologists versus non-physicians for patients undergoing cataract surgery. Request Type Summary of Abstracts -
Rapid Response
Beta Human Chorionic Gonadotropin Test for Detection of Early Pregnancy: Clinical Effectiveness, Cost-Effectiveness, and Guidelines
April 15, 2013
Research Type Other Work Question 1. What is the evidence for the diagnostic accuracy of the Beta Human Chorionic Gonadotropin (BhcG) test for detecting early pregnancy?
2. What is the cost-effectiveness regarding the use of the BhcG test prior to surgery, for detecting early pregnancy?
3. What are the evidence-based guidelines regarding the use of the BhcG test prior to surgery, for detecting early pregnancy?Key Messages Two non-randomized studies and two evidence-based guidelines were identified regarding the use of the BhCG test prior to surgery, for detecting early pregnancy prior to surgery or medical treatment. Request Type Reference List -
Rapid Response
Compression Bandage Measurement Devices for the use in Adult Patients with Chronic Venous Insufficiency: Clinical Effectiveness
April 10, 2013
Research Type Medical Devices Question 1. What is the clinical evidence regarding the effectiveness of compression bandage measurement devices to determine extent and amount of pressure from compression wrapping procedures in adults with chronic venous insufficiency? Key Messages One non-randomized study was identified regarding the effectiveness of compression bandage measurement devices to determine extent and amount of pressure from compression wrapping procedures. Request Type Summary of Abstracts -
Rapid Response
Techniques for Renal Biopsy: Guidelines
April 10, 2013
Research Type Other Work Question 1. What are the evidence-based guidelines regarding best practice for renal biopsy? Key Messages One systematic review and four evidence-based guidelines were identified regarding best practices for renal biopsy in hospitalized patients. Request Type Summary of Abstracts -
Rapid Response
Vitamin D Supplementation in Long-Term Care Residents: Clinical Evidence and Guidelines
April 4, 2013
Research Type Other Work Question 1. What is the evidence for the clinical effectiveness of vitamin D supplementation for the prevention of falls and fractures in elderly patients residing in long-term care facilities?
2. What are the guidelines for dosing and frequency of vitamin D supplementation in elderly patients residing in long-term care facilities?Key Messages Three systematic reviews, two randomized controlled trials, and one non-randomized study were identified regarding the clinical effectiveness of vitamin D supplementation for the prevention of falls and fractures in elderly patients residing in long-term care facilities. Request Type Reference List -
Rapid Response
Cataract Surgery Performed in Settings Other Than Hospital Operating Rooms: Clinical Effectiveness, Cost-Effectiveness, and Guidelines
March 28, 2013
Research Type Other Work Question 1. What is the evidence regarding cataract surgery performed in hospital operating rooms compared to other settings? Key Messages No relevant literature was identified regarding cataract surgery performed in other settings compared to hospital operating rooms. Request Type Summary of Abstracts -
Rapid Response
Fecal Bacteriotherapy for Patients with Recurrent C. Difficile: Clinical Effectiveness and Guidelines
March 25, 2013
Research Type Other Work Question 1. What is the clinical effectiveness of fecal bacteriotherapy for patients with recurrent C. difficile infection?
2. What are the evidence-based guidelines regarding the use of fecal bacteriotherapy for patients with C. diffcile infection?Key Messages Three systematic reviews, one randomized controlled trial, and six non-randomized studies were identified regarding the clinical effectiveness of fecal bacteriotherapy for patients with recurrent C. difficile infection. No evidence-based guidelines were identified. Request Type Summary of Abstracts -
Rapid Response
Techniques for the Management of Temporary Epicardial Pacemaker Leads: Clinical Evidence, Safety, and Guidelines
March 22, 2013
Research Type Cardiovascular Disease including Cerebrovascular Question 1. What is the clinical evidence regarding interventions to cover or ground exposed temporary epicardial pacemaker leads when they are not in use?
2. What is the clinical evidence regarding the safety of exposed temporary epicardial pacemaker leads?
3. What are the evidence-based guidelines regarding the care and management of temporary epicardial pacemaker leads following open heart surgery in adults?Key Messages No relevant literature was identified regarding interventions to cover or ground exposed temporary epicardial pacemaker leads when they are not in use. Request Type Summary of Abstracts -
Rapid Response
Tricyclic Antidepressants, Clonidine, Venlafaxine, and Modafinil for the Treatment of Attention-Deficit/Hyperactivity Disorder in Adults: A Review of the Clinical Evidence
March 21, 2013
Research Type Mental Health Question 1.What is the clinical effectiveness of tricyclic antidepressants for the treatment of adults with Attention Deficit Hyperactivity Disorder?2. What is the clinical effectiveness of clonidine for the treatment of adults with Attention Deficit Hyperactivity Disorder?3. What is the clinical effectiveness of venlafaxine for the treatment of adults with Attention Deficit Hyperactivity Disorder? 4. What is the clinical effectiveness of modafinil for the treatment of adults with Attention Deficit Hyperactivity Disorder? Key Messages Findings from available evidence showed a reduction in ADHD symptoms from baseline values for patients receiving either venlafaxine or placebo but the difference between the two groups was not statistically significant, despite a larger number of patients on venlafaxine who met treatment response criteria. The efficacy of modafinil in reducing ADHD symptoms is not significantly different than d-amphetamine, and the superiority of modafinil over placebo is not consistent across trials. There was no evidence on the clinical effectiveness of TCAs and clonidine in the treatment of adults with ADHD. Limited and short-term evidence caution the interpretation of the findings. Randomized controlled studies with extended follow-up periods are needed to confirm the lasting beneficial effects of non-stimulants in the long term and to guide treatment decisions. Request Type Summary with Critical Appraisal -
Rapid Response
Probiotics in Infants: Clinical Effectiveness, Safety and Guidelines
March 20, 2013
Research Type Other Work Question 1. What is the clinical effectiveness of probiotics for infants?
2. What is the evidence for the safety and harms of probiotics for infants?
3. What are the evidence-based guidelines regarding the use of probiotics in infants?Key Messages Eight systematic reviews, fourteen randomized controlled trials, and two evidence-based guidelines were identified regarding the use, clinical effectiveness, and safety and harms of probiotics for infants. Request Type Summary of Abstracts -
Rapid Response
Rasburicase for Adults with Acute Tumor Lysis Syndrome: A Review of Clinical and Cost Effectiveness and Safety
March 20, 2013
Research Type Other Work Question 1. What is the evidence for the clinical effectiveness of rasburicase for adults with acute tumor lysis syndrome to reduce or eliminate the need for hemodialysis?
2. What is the evidence for the safety of rasburicase for adults with acute tumor lysis syndrome?
3. What is the evidence for the cost-effectiveness of rasburicase compared with allopurinol or hydration for adults with acute tumor lysis syndrome to reduce or eliminate the need for hemodialysis?Key Messages Rasburicase was found to lower uric acid levels in adult cancer patients who had, or were at risk for developing, hyperuricemia or tumour lysis syndrome (TLS). Rasburicase was found to be well tolerated in adult cancer patients, with a low rate of adverse events, renal failure, or need for hemodialysis. No evidence on the cost effectiveness of rasburicase compared with allopurinol or hydration for adults with acute TLS was identified. Request Type Summary with Critical Appraisal -
Rapid Response
Patient Lifts and Transfer Equipment for Preventing Pressure Ulcers: A Review of Clinical and Cost-Effectiveness and Guidelines
March 19, 2013
Research Type Medical Devices Question 1. What is the clinical effectiveness of patient lifts and transfer equipment for the prevention of pressure ulcers?
2. What is the cost-effectiveness of patient lifts and transfer equipment for the prevention of pressure ulcers?
3. What are the guidelines for the use of patient lifts and transfer equipment to prevent pressure ulcers?Key Messages There was no evidence in the literature searched pertaining to the clinical or cost-effectiveness of patient lifts and transfer equipment for the prevention of pressure ulcers. In addition, the various guidelines identified did not address in their recommendations the use of these turning devices to prevent pressure ulcers. Appendix 2 provides additional references pertaining to out-of-scope interventions, such as various turning regimens and multidisciplinary teams. Request Type Summary with Critical Appraisal -
Rapid Response
Esophageal Doppler Ultrasound-Based Cardiac Output Monitoring for Adults undergoing Surgery: A Review of Clinical and Cost-Effectiveness
March 18, 2013
Research Type Medical Devices Question 1. What is the clinical-effectiveness of intraoperative use of esophageal Doppler ultrasound-based cardiac output monitoring devices in adult patients undergoing surgery?
2. What is the cost-effectiveness of intraoperative use of esophageal Doppler ultrasound-based cardiac output monitoring devices in adult patients undergoing surgeryKey Messages No studies were identified which compared esophageal Doppler monitoring (EDM) with methods specifically using an arterial line or arterial catheter. In most instances, available evidence suggested a trend towards reduction in length of hospital stay, complication rates and mortality for intraoperative fluid management strategies using EDM compared to those using central venous pressure monitoring (CVP) or conventional clinical assessment (CAA), in adults undergoing surgery. However results need to be interpreted with caution as the differences were not statistically significant in several instances. Strategies with EDM combined with CVP or CAA appeared to be more cost-effective than strategies which involved CVP or CAA alone or in combination in the absence of EDM. Request Type Summary with Critical Appraisal -
Rapid Response
Blood Glucose Monitors and Test Strips: A Review of the Comparative Clinical Evidence and Cost-Effectiveness — An Update
March 15, 2013
Research Type Endocrine Disorders with a focus on Diabetes Question 1. What is the comparative clinical effectiveness of the available blood glucose monitors and test strips in Canada for patients with diabetes? 2. What factors in blood glucose monitors and test strips are related to better patient outcomes? 3. What are the most cost-effective models of blood glucose monitors and test strips for patients with diabetes? Key Messages Several blood glucose monitors are available in Canada. Comparative studies of five of these monitors were identified and the devices were shown to be clinically accurate. No evidence on the cost-effectiveness of blood glucose monitors and test strips for patients with diabetes was found. Request Type Summary with Critical Appraisal -
Rapid Response
Drug Therapies for Immunosuppression in Adult Patients Following Islet Cell
March 14, 2013
Research Type Endocrine Disorders with a focus on Diabetes Question 1. What is the clinical effectiveness of common drug therapies for immunosuppression in adult patients following islet cell transplantation for the treatment of diabetes?
2. What is the cost-effectiveness of common drug therapies for immunosuppression in adult patients following islet cell transplantation for the treatment of diabetes?Key Messages Seven non-randomized studies were identified regarding the clinical effectiveness of common drug therapies for immunosuppression in adult patients following islet cell transplantation for the treatment of diabetes. No relevant cost studies were identified. Request Type Summary of Abstracts -
Rapid Response
JC Virus Antibody Testing for Patients with MS: A Review of the Diagnostic Accuracy and Guidelines
March 14, 2013
Research Type Devices and Systems Question 1. What is the diagnostic accuracy of tests for JC virus antibodies in patients with multiple sclerosis? 2. What are the evidence-based guidelines and testing algorithms for JC virus antibodies in patients with MS? Key Messages Anti-JCV antibody assays were able to identify anti-JCV antibodies in approximately 50-60% of natalizumab-treated MS patients or MS patients considering treatment with natalizumab. The StratifyJCV test was found to have a low false negative rate when urinary JCV-DNA was used as a positive reference. No evidence-based guidelines and testing algorithms for JCV antibodies in patients with MS were identified. Request Type Summary with Critical Appraisal