Barry Wright, Pasco Fearon, Megan Garside, Eleni Tsappis, Elaine Amoah, Danya Glaser, Victoria Allgar, Helen Minnis, Matthew Woolgar, Rachel Churchill, Dean McMillan, Peter Fonagy, Alison O'Sullivan, Michelle McHale
BACKGROUND: Attachment refers to an infant's innate tendency to seek comfort from their caregiver. Research shows that attachment is important in promoting healthy social and emotional development. Many parenting interventions have been developed to improve attachment outcomes for children. However, numerous interventions used in routine practice have a limited evidence base, meaning that we cannot be sure if they are helpful or harmful. OBJECTIVES: This research aimed to conduct a large-scale survey to identify what interventions are being used in UK services to improve child attachment; conduct a systematic review to evaluate the evidence for parenting attachment interventions; and develop recommendations for future research and practice...
February 2023: Health Technology Assessment: HTA
Susan Channon, Elinor Coulman, Rebecca Cannings-John, Josie Henley, Mandy Lau, Fiona Lugg-Widger, Heather Strange, Freya Davies, Julia Sanders, Caroline Scherf, Zoë Couzens, Leah Morantz
BACKGROUND: Women with overweight (a body mass index of ≥ 25 kg/m2 ) or obesity (a body mass index of ≥ 30 kg/m2 ) are at greater risk of experiencing complications during pregnancy and labour than women with a healthy weight. Women who remove their long-acting reversible contraception (i.e. coils or implants) are one of the few groups of people who contact services as part of their preparation for conception, creating an opportunity to offer a weight loss intervention...
January 2023: Health Technology Assessment: HTA
Hema Mistry, Jodie Enderby, Rachel Court, Lena Al-Khudairy, Chidozie Nduka, G J Melendez-Torres, Sian Taylor-Phillips, Aileen Clarke, Olalekan A Uthman
BACKGROUND: Cardiovascular diseases are the leading cause of morbidity and mortality worldwide. The aim of the study was to guide researchers and commissioners of cardiovascular disease preventative services towards possible cost-effective interventions by reviewing published economic analyses of interventions for the primary prevention of cardiovascular disease, conducted for or within the UK NHS. METHODS: In January 2021, electronic searches of MEDLINE and Embase were carried out to find economic evaluations of cardiovascular disease preventative services...
December 9, 2022: Health Technology Assessment: HTA
Katie Thomson, Stephen Rice, Oluwatomi Arisa, Eugenie Johnson, Louise Tanner, Christopher Marshall, Tumi Sotire, Catherine Richmond, Hannah O'Keefe, Wael Mohammed, Margot Gosney, Anne Raffle, Barbara Hanratty, Claire T McEvoy, Dawn Craig, Sheena E Ramsay
BACKGROUND: Malnutrition worsens the health of frail older adults. Current treatments for malnutrition may include prescribed oral nutritional supplements, which are multinutrient products containing macronutrients and micronutrients. OBJECTIVE: To assess the effectiveness and cost-effectiveness of oral nutritional supplements (with or without other dietary interventions) in frail older people who are malnourished or at risk of malnutrition. DATA SOURCES: MEDLINE, EMBASE, Cochrane Library, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and grey literature were searched from inception to 13 September 2021...
December 2022: Health Technology Assessment: HTA
Noemi Lois, Christina Campbell, Norman Waugh, Augusto Azuara-Blanco, Mandy Maredza, Hema Mistry, Danny McAuley, Nachiketa Acharya, Tariq M Aslam, Clare Bailey, Victor Chong, Louise Downey, Haralabos Eleftheriadis, Samia Fatum, Sheena George, Faruque Ghanchi, Markus Groppe, Robin Hamilton, Geeta Menon, Ahmed Saad, Sobha Sivaprasad, Marianne Shiew, David H Steel, James Stephen Talks, Paul Doherty, Clíona McDowell, Mike Clarke
BACKGROUND: The National Institute for Health and Care Excellence recommends macular laser to treat diabetic macular oedema with a central retinal subfield thickness of < 400 µm on optical coherence tomography. The DIAMONDS (DIAbetic Macular Oedema aNd Diode Subthreshold micropulse laser) trial compared standard threshold macular laser with subthreshold micropulse laser to treat diabetic macular oedema suitable for macular laser. OBJECTIVES: Determining the clinical effectiveness, safety and cost-effectiveness of subthreshold micropulse laser compared with standard threshold macular laser to treat diabetic macular oedema with a central retinal subfield thickness of < 400 µm...
December 2022: Health Technology Assessment: HTA
Ana Duarte, Mark Corbett, Hollie Melton, Melissa Harden, Stephen Palmer, Marta Soares, Mark Simmonds
BACKGROUND: EarlyCDT Lung (Oncimmune Holdings plc, Nottingham, UK) is a blood test to assess malignancy risk in people with solid pulmonary nodules. It measures the presence of seven lung cancer-associated autoantibodies. Elevated levels of these autoantibodies may indicate malignant disease. The results of the test might be used to modify the risk of malignancy estimated by existing risk calculators, including the Brock and Herder models. OBJECTIVES: The objectives were to determine the diagnostic accuracy, clinical effectiveness and cost-effectiveness of EarlyCDT Lung; and to develop a conceptual model and identify evidence requirements for a robust cost-effectiveness analysis...
December 2022: Health Technology Assessment: HTA
Eric Lim, Rosie A Harris, Holly E McKeon, Timothy Jp Batchelor, Joel Dunning, Michael Shackcloth, Vladimir Anikin, Babu Naidu, Elizabeth Belcher, Mahmoud Loubani, Vipin Zamvar, Lucy Dabner, Timothy Brush, Elizabeth A Stokes, Sarah Wordsworth, Sangeetha Paramasivan, Alba Realpe, Daisy Elliott, Jane Blazeby, Chris A Rogers
BACKGROUND: Lung cancer is the leading cause of cancer death. Surgery remains the main method of managing early-stage disease. Minimal-access video-assisted thoracoscopic surgery results in less tissue trauma than open surgery; however, it is not known if it improves patient outcomes. OBJECTIVE: To compare the clinical effectiveness and cost-effectiveness of video-assisted thoracoscopic surgery lobectomy with open surgery for the treatment of lung cancer. DESIGN, SETTING AND PARTICIPANTS: A multicentre, superiority, parallel-group, randomised controlled trial with blinding of participants (until hospital discharge) and outcome assessors conducted in nine NHS hospitals...
December 2022: Health Technology Assessment: HTA
Mohamed Abdel-Fattah, David Cooper, Tracey Davidson, Mary Kilonzo, Dwayne Boyers, Kiron Bhal, Alison McDonald, Judith Wardle, James N'Dow, Graeme MacLennan, John Norrie
BACKGROUND: Stress urinary incontinence is the most common type of urinary incontinence in premenopausal women. Until recently, synthetic mid-urethral slings (mesh/tape) were the standard surgical treatment, if conservative management failed. Adjustable anchored single-incision mini-slings are newer, use less mesh and may reduce perioperative morbidity, but it is unclear how their success rates and safety compare with those of standard tension-free mid-urethral slings. OBJECTIVE: The objective was to compare tension-free standard mid-urethral slings with adjustable anchored single-incision mini-slings among women with stress urinary incontinence requiring surgical intervention, in terms of patient-reported effectiveness, health-related quality of life, safety and cost-effectiveness...
December 2022: Health Technology Assessment: HTA
Michael Nugent, Valerie Bryant, Chrissie Butcher, Holly Fisher, Sean Gill, Rebecca Goranova, Shaun Hiu, Lyndsay Lindley, James O'Hara, Yemi Oluboyede, Joanne Patterson, Tim Rapley, Tomos Robinson, Nikki Rousseau, Vicky Ryan, Ramkumar Shanmugasundaram, Linda Sharp, Ruby Smith Whelan, Deborah D Stocken, Laura Ternent, Janet Wilson, Jenn Walker
BACKGROUND: Oral mucositis is a debilitating and painful complication of head and neck cancer irradiation that is characterised by inflammation of the mucous membranes, erythema and ulceration. Oral mucositis affects 6000 head and neck cancer patients per year in England and Wales. Current treatments have not proven to be effective. International studies suggest that low-level laser therapy may be an effective treatment. OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of low-level laser therapy in the management of oral mucositis in head and neck cancer irradiation...
December 2022: Health Technology Assessment: HTA
Olalekan A Uthman, Rachel Court, Jodie Enderby, Lena Al-Khudairy, Chidozie Nduka, Hema Mistry, G J Melendez-Torres, Sian Taylor-Phillips, Aileen Clarke
BACKGROUND: As part of our ongoing systematic review of complex interventions for the primary prevention of cardiovascular diseases, we have developed and evaluated automated machine-learning classifiers for title and abstract screening. The aim was to develop a high-performing algorithm comparable to human screening. METHODS: We followed a three-phase process to develop and test an automated machine learning-based classifier for screening potential studies on interventions for primary prevention of cardiovascular disease...
November 30, 2022: Health Technology Assessment: HTA
Lucy C Chappell, Peter Brocklehurst, Marcus Green, Pollyanna Hardy, Rachael Hunter, Alice Beardmore-Gray, Ursula Bowler, Anna Brockbank, Virginia Chiocchia, Alice Cox, Kate Duhig, Jessica Fleminger, Carolyn Gill, Melanie Greenland, Eleanor Hendy, Ann Kennedy, Paul Leeson, Louise Linsell, Fergus P McCarthy, Jamie O'Driscoll, Anna Placzek, Lucilla Poston, Stephen Robson, Pauline Rushby, Jane Sandall, Laura Scholtz, Paul T Seed, Jenie Sparkes, Kayleigh Stanbury, Sue Tohill, Basky Thilaganathan, John Townend, Edmund Juszczak, Neil Marlow, Andrew Shennan
BACKGROUND: In women with late preterm pre-eclampsia (i.e. at 34+0 to 36+6 weeks' gestation), the optimal delivery time is unclear because limitation of maternal-fetal disease progression needs to be balanced against infant complications. The aim of this trial was to determine whether or not planned earlier initiation of delivery reduces maternal adverse outcomes without substantial worsening of perinatal or infant outcomes, compared with expectant management, in women with late preterm pre-eclampsia...
November 30, 2022: Health Technology Assessment: HTA
Martha Mc Elwenspoek, Howard Thom, Athena L Sheppard, Edna Keeney, Rachel O'Donnell, Joni Jackson, Cristina Roadevin, Sarah Dawson, Deborah Lane, Jo Stubbs, Hazel Everitt, Jessica C Watson, Alastair D Hay, Peter Gillett, Gerry Robins, Hayley E Jones, Sue Mallett, Penny F Whiting
BACKGROUND: Coeliac disease is an autoimmune disorder triggered by ingesting gluten. It affects approximately 1% of the UK population, but only one in three people is thought to have a diagnosis. Untreated coeliac disease may lead to malnutrition, anaemia, osteoporosis and lymphoma. OBJECTIVES: The objectives were to define at-risk groups and determine the cost-effectiveness of active case-finding strategies in primary care. DESIGN: (1) Systematic review of the accuracy of potential diagnostic indicators for coeliac disease...
October 2022: Health Technology Assessment: HTA
Sion Glyn-Jones, Muhammad K Javaid, David Beard, Julia Newton, Robert Kerslake, Callum McBryde, Tim Board, Susan J Dutton, Melina Dritsaki, Vikas Khanduja, Magbor Akanni, Shaun Sexton, John Skinner, Nicholas Peckham, Ruth Knight, Ines Rombach, Loretta Davies, Vicki Barber
BACKGROUND: People with avascular necrosis of the hip have very limited treatment options currently available to stop the progression of this disease; this often results in the need for a hip replacement. There is some weak evidence that a class of drugs called bisphosphonates may delay the course of the disease, and this trial was commissioned and set up to provide robust evidence regarding the use of bisphosphonates in adults aged ≥ 18 years with this condition. OBJECTIVES: The aim of the Managing Avascular Necrosis Treatments: an Interventional Study ( MANTIS ) trial was to evaluate the clinical effectiveness and cost-effectiveness of a 12-month course of alendronate in the treatment of avascular necrosis...
October 2022: Health Technology Assessment: HTA
Barry Wright, Lucy Tindall, Alexander J Scott, Ellen Lee, Katie Biggs, Cindy Cooper, Penny Bee, Han-I Wang, Lina Gega, Emily Hayward, Kiera Solaiman, M Dawn Teare, Thompson Davis, Karina Lovell, Jon Wilson, Dean McMillan, Amy Barr, Hannah Edwards, Jennifer Lomas, Chris Turtle, Steve Parrott, Catarina Teige, Tim Chater, Rebecca Hargate, Shehzad Ali, Sarah Parkinson, Simon Gilbody, David Marshall
BACKGROUND: Up to 10% of children and young people have a specific phobia that can significantly affect their mental health, development and daily functioning. Cognitive-behavioural therapy-based interventions remain the dominant treatment, but limitations to their provision warrant investigation into low-intensity alternatives. One-session treatment is one such alternative that shares cognitive-behavioural therapy principles but has a shorter treatment period. OBJECTIVE: This research investigated the non-inferiority of one-session treatment to cognitive-behavioural therapy for treating specific phobias in children and young people...
October 2022: Health Technology Assessment: HTA
Elizabeth Coates, Nyantara Wickramasekera, Amy Barr, Phil Shackley, Matthew Lee, Daniel Hind, Christopher Probert, Shaji Sebastian, Nikki Totton, Sue Blackwell, Hugh Bedford, Nicola Dames, Alan Lobo
BACKGROUND: Corticosteroids are a mainstay of the treatment of moderately severe relapses of ulcerative colitis, yet almost 50% of patients do not respond fully to these and risk prolonged steroid use and side effects. There is a lack of clarity about the definitions of steroid resistance, the optimum choice of treatment, and patient and health-care professional treatment preferences. OBJECTIVES: The overall aim of this research was to understand how steroid-resistant ulcerative colitis is managed in adult secondary care and how current practice compares with patient and health-care professional preferences...
October 2022: Health Technology Assessment: HTA
Rakesh Heer, Rebecca Lewis, Anne Duncan, Steven Penegar, Thenmalar Vadiveloo, Emma Clark, Ge Yu, Paramananthan Mariappan, Joanne Cresswell, John McGrath, James N'Dow, Ghulam Nabi, Hugh Mostafid, John Kelly, Craig Ramsay, Henry Lazarowicz, Angela Allan, Matthew Breckons, Karen Campbell, Louise Campbell, Andy Feber, Alison McDonald, John Norrie, Giovany Orozco-Leal, Stephen Rice, Zafer Tandogdu, Ernest Taylor, Laura Wilson, Luke Vale, Graeme MacLennan, Emma Hall
BACKGROUND: Around 7500 people are diagnosed with non-muscle-invasive bladder cancer in the UK annually. Recurrence following transurethral resection of bladder tumour is common, and the intensive monitoring schedule required after initial treatment has associated costs for patients and the NHS. In photodynamic diagnosis, before transurethral resection of bladder tumour, a photosensitiser that is preferentially absorbed by tumour cells is instilled intravesically. Transurethral resection of bladder tumour is then conducted under blue light, causing the photosensitiser to fluoresce...
October 2022: Health Technology Assessment: HTA
Solomon Tesfaye, Gordon Sloan, Jennifer Petrie, David White, Mike Bradburn, Tracey Young, Satyan Rajbhandari, Sanjeev Sharma, Gerry Rayman, Ravikanth Gouni, Uazman Alam, Steven A Julious, Cindy Cooper, Amanda Loban, Katie Sutherland, Rachel Glover, Simon Waterhouse, Emily Turton, Michelle Horspool, Rajiv Gandhi, Deirdre Maguire, Edward Jude, Syed Haris Ahmed, Prashanth Vas, Christian Hariman, Claire McDougall, Marion Devers, Vasileios Tsatlidis, Martin Johnson, Didier Bouhassira, David L Bennett, Dinesh Selvarajah
BACKGROUND: The mainstay of treatment for diabetic peripheral neuropathic pain is pharmacotherapy, but the current National Institute for Health and Care Excellence guideline is not based on robust evidence, as the treatments and their combinations have not been directly compared. OBJECTIVES: To determine the most clinically beneficial, cost-effective and tolerated treatment pathway for diabetic peripheral neuropathic pain. DESIGN: A randomised crossover trial with health economic analysis...
October 2022: Health Technology Assessment: HTA
David Jayne, Michael Walsh, Peter A Merkel, Chen Au Peh, Wladimir Szpirt, Xavier Puéchal, Shouichi Fujimoto, Carmel Hawley, Nader Khalidi, Rachel Jones, Oliver Flossmann, Ron Wald, Louis Girard, Adeera Levin, Gina Gregorini, Lorraine Harper, William Clark, Christian Pagnoux, Ulrich Specks, Lucy Smyth, Toshiko Ito-Ihara, Janak de Zoysa, Biljana Brezina, Andrea Mazzetti, Carol A McAlear, Donna Reidlinger, Samir Mehta, Natalie Ives, Elizabeth A Brettell, Hugh Jarrett, Keith Wheatley, Elizabeth Broadhurst, Alina Casian, Charles D Pusey
BACKGROUND: Anti-neutrophil cytoplasm antibody-associated vasculitis is a multisystem, autoimmune disease that causes organ failure and death. Physical removal of pathogenic autoantibodies by plasma exchange is recommended for severe presentations, along with high-dose glucocorticoids, but glucocorticoid toxicity contributes to morbidity and mortality. The lack of a robust evidence base to guide the use of plasma exchange and glucocorticoid dosing contributes to variation in practice and suboptimal outcomes...
September 2022: Health Technology Assessment: HTA
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Nick Curzen, Liza Keating, Attila Kardos, Dirk Felmeden, Robert J Lee, Praveen Thokala, Steff C Lewis, David E Newby
BACKGROUND: Acute coronary syndrome is a common medical emergency. The optimal strategy to investigate patients who are at intermediate risk of acute coronary syndrome has not been fully determined. OBJECTIVE: To investigate the role of early computed tomography coronary angiography in the investigation and treatment of adults presenting with suspected acute coronary syndrome. DESIGN: A prospective, multicentre, open, parallel-group randomised controlled trial with blinded end-point adjudication...
August 2022: Health Technology Assessment: HTA
Sally Hopewell, David J Keene, Peter Heine, Ioana R Marian, Melina Dritsaki, Lucy Cureton, Susan J Dutton, Helen Dakin, Andrew Carr, Willie Hamilton, Zara Hansen, Anju Jaggi, Chris Littlewood, Karen Barker, Alastair Gray, Sarah E Lamb
No abstract text is available yet for this article.
August 2022: Health Technology Assessment: HTA
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.