1,357 results match your criteria Health Technology Assessment [Journal]


Extended-release naltrexone versus standard oral naltrexone versus placebo for opioid use disorder: the NEAT three-arm RCT.

Health Technol Assess 2019 Jan;23(3):1-72

National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Background: People recovering from heroin addiction need better treatments than are currently offered. The chronic relapsing nature of drug dependence means that helping a patient to achieve abstinence is often difficult. Naltrexone blocks the effects of ingested heroin; however, evidence is conflicting regarding the best delivery method. Read More

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http://dx.doi.org/10.3310/hta23030DOI Listing
January 2019
2 Reads
5.027 Impact Factor

Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis.

Health Technol Assess 2019 Jan;23(2):1-44

Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Background: Randomised controlled trials (RCTs) exploring the potential of vitamin D to prevent acute respiratory infections have yielded mixed results. Individual participant data (IPD) meta-analysis has the potential to identify factors that may explain this heterogeneity.

Objectives: To assess the overall effect of vitamin D supplementation on the risk of acute respiratory infections (ARIs) and to identify factors modifying this effect. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta23020
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http://dx.doi.org/10.3310/hta23020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369419PMC
January 2019
4 Reads

Faecal immunochemical tests versus colonoscopy for post-polypectomy surveillance: an accuracy, acceptability and economic study.

Health Technol Assess 2019 Jan;23(1):1-84

Bowel Cancer Screening Programme Southern Hub, Guildford, UK.

Background: In the UK, patients with one or two adenomas, of which at least one is ≥ 10 mm in size, or three or four small adenomas, are deemed to be at intermediate risk of colorectal cancer (CRC) and referred for surveillance colonoscopy 3 years post polypectomy. However, colonoscopy is costly, can cause discomfort and carries a small risk of complications.

Objectives: To determine whether or not annual faecal immunochemical tests (FITs) are effective, acceptable and cost saving compared with colonoscopy surveillance for detecting CRC and advanced adenomas (AAs). Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta23010
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http://dx.doi.org/10.3310/hta23010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340104PMC
January 2019
9 Reads

Enteral lactoferrin to prevent infection for very preterm infants: the ELFIN RCT.

Health Technol Assess 2018 12;22(74):1-60

Bradford Institute for Health Research, Bradford, UK.

Background: Infections acquired in hospital are an important cause of morbidity and mortality in very preterm infants. Several small trials have suggested that supplementing the enteral diet of very preterm infants with lactoferrin, an antimicrobial protein processed from cow's milk, prevents infections and associated complications.

Objective: To determine whether or not enteral supplementation with bovine lactoferrin (The Tatua Cooperative Dairy Company Ltd, Morrinsville, New Zealand) reduces the risk of late-onset infection (acquired > 72 hours after birth) and other morbidity and mortality in very preterm infants. Read More

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http://dx.doi.org/10.3310/hta22740DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322062PMC
December 2018
1 Read

Negative-pressure wound therapy versus standard dressings for adults with an open lower limb fracture: the WOLLF RCT.

Health Technol Assess 2018 12;22(73):1-162

Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.

Background: Open fractures of the lower limb occur when a broken bone penetrates the skin and is exposed to the outside environment. These are life-changing injuries. The risk of deep infection may be as high as 27%. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22730
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http://dx.doi.org/10.3310/hta22730DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322061PMC
December 2018
3 Reads

Contrast-enhanced ultrasound and/or colour duplex ultrasound for surveillance after endovascular abdominal aortic aneurysm repair: a systematic review and economic evaluation.

Health Technol Assess 2018 12;22(72):1-220

Regional Vascular Unit, Royal Liverpool University Hospital, Liverpool, UK.

Background: Endovascular abdominal aortic aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) is less invasive than open surgery, but may be associated with important complications. Patients receiving EVAR require long-term surveillance to detect abnormalities and direct treatments. Computed tomography angiography (CTA) has been the most common imaging modality adopted for EVAR surveillance, but it is associated with repeated radiation exposure and the risk of contrast-related nephropathy. Read More

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http://dx.doi.org/10.3310/hta22720DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311615PMC
December 2018
1 Read

A manual-based intervention for carers of people with dementia and sleep disturbances: an acceptability and feasibility RCT.

Health Technol Assess 2018 12;22(71):1-408

Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.

Background: It has been estimated that between 25% and 40% of people living with dementia suffer from sleep disturbances, and there are currently no known effective treatments. Sleep disturbances may be the direct result of dementia or due to other comorbidities, such as pain and limited mobility. If carers' sleep is also disturbed, carers too can become tired and stressed, and this sometimes results in the breakdown of care in the home. Read More

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http://dx.doi.org/10.3310/hta22710DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307368PMC
December 2018
2 Reads

Temporarily quadrupling the dose of inhaled steroid to prevent asthma exacerbations: FAST.

Health Technol Assess 2018 12;22(70):1-82

Respiratory Medicine, Nottingham NIHR Biomedical Research Centre, University of Nottingham, Nottingham, UK.

Background: Asthma exacerbations affect the quality of life of patients with asthma and have a major effect on the overall costs of asthma care. An asthma self-management plan that advises the temporary quadrupling of inhaled corticosteroid dose may prevent asthma exacerbations, but this needs to be confirmed before being adopted widely.

Objectives: To compare the clinical effectiveness and cost-effectiveness of an asthma self-management plan that advises patients to temporarily quadruple the dose of inhaled corticosteroid when asthma control starts to deteriorate with a standard self-management plan. Read More

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http://dx.doi.org/10.3310/hta22700DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307366PMC
December 2018
1 Read

Low-dose computed tomography for lung cancer screening in high-risk populations: a systematic review and economic evaluation.

Health Technol Assess 2018 11;22(69):1-276

Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.

Background: Diagnosis of lung cancer frequently occurs in its later stages. Low-dose computed tomography (LDCT) could detect lung cancer early.

Objectives: To estimate the clinical effectiveness and cost-effectiveness of LDCT lung cancer screening in high-risk populations. Read More

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http://dx.doi.org/10.3310/hta22690DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304730PMC
November 2018
5.027 Impact Factor

Amisulpride for very late-onset schizophrenia-like psychosis: the ATLAS three-arm RCT.

Health Technol Assess 2018 11;22(67):1-62

Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK.

Background: Very late-onset (aged ≥ 60 years) schizophrenia-like psychosis (VLOSLP) occurs frequently but no placebo-controlled, randomised trials have assessed the efficacy or risks of antipsychotic treatment. Most patients are not prescribed treatment.

Objectives: The study investigated whether or not low-dose amisulpride is superior to placebo in reducing psychosis symptoms over 12 weeks and if any benefit is maintained by continuing treatment thereafter. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22670
Publisher Site
http://dx.doi.org/10.3310/hta22670DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304731PMC
November 2018
7 Reads

Assessing prognosis and prediction of treatment response in early rheumatoid arthritis: systematic reviews.

Health Technol Assess 2018 11;22(66):1-294

School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.

Background: Rheumatoid arthritis (RA) is a chronic, debilitating disease associated with reduced quality of life and substantial costs. It is unclear which tests and assessment tools allow the best assessment of prognosis in people with early RA and whether or not variables predict the response of patients to different drug treatments.

Objective: To systematically review evidence on the use of selected tests and assessment tools in patients with early RA (1) in the evaluation of a prognosis (review 1) and (2) as predictive markers of treatment response (review 2). Read More

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http://dx.doi.org/10.3310/hta22660DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304732PMC
November 2018
3 Reads

Bariatric surgery, lifestyle interventions and orlistat for severe obesity: the REBALANCE mixed-methods systematic review and economic evaluation.

Health Technol Assess 2018 11;22(68):1-246

Health Psychology, University of Aberdeen, Aberdeen, UK.

Background: Adults with severe obesity [body mass index (BMI) of ≥ 35 kg/m] have an increased risk of comorbidities and psychological, social and economic consequences.

Objectives: Systematically review bariatric surgery, weight-management programmes (WMPs) and orlistat pharmacotherapy for adults with severe obesity, and evaluate the feasibility, acceptability, clinical effectiveness and cost-effectiveness of treatment.

Data Sources: Electronic databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials and the NHS Economic Evaluation Database were searched (last searched in May 2017). Read More

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http://dx.doi.org/10.3310/hta22680DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296173PMC
November 2018
1 Read

Structured lifestyle education to support weight loss for people with schizophrenia, schizoaffective disorder and first episode psychosis: the STEPWISE RCT.

Health Technol Assess 2018 11;22(65):1-160

Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK.

Background: Obesity is twice as common in people with schizophrenia as in the general population. The National Institute for Health and Care Excellence guidance recommends that people with psychosis or schizophrenia, especially those taking antipsychotics, be offered a healthy eating and physical activity programme by their mental health care provider. There is insufficient evidence to inform how these lifestyle services should be commissioned. Read More

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http://dx.doi.org/10.3310/hta22650DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296176PMC
November 2018
7 Reads

Prognostic models for identifying risk of poor outcome in people with acute ankle sprains: the SPRAINED development and external validation study.

Health Technol Assess 2018 11;22(64):1-112

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Background: Ankle sprains are very common injuries. Although recovery can occur within weeks, around one-third of patients have longer-term problems.

Objectives: To develop and externally validate a prognostic model for identifying people at increased risk of poor outcome after an acute ankle sprain. Read More

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http://dx.doi.org/10.3310/hta22640DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287171PMC
November 2018
1 Read

Combining mirtazapine with SSRIs or SNRIs for treatment-resistant depression: the MIR RCT.

Health Technol Assess 2018 11;22(63):1-136

Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.

Background: Depression is usually managed in primary care and antidepressants are often the first-line treatment, but only half of those treated respond to a single antidepressant.

Objectives: To investigate whether or not combining mirtazapine with serotonin-noradrenaline reuptake inhibitor (SNRI) or selective serotonin reuptake inhibitor (SSRI) antidepressants results in better patient outcomes and more efficient NHS care than SNRI or SSRI therapy alone in treatment-resistant depression (TRD).

Design: The MIR trial was a two-parallel-group, multicentre, pragmatic, placebo-controlled randomised trial with allocation at the level of the individual. Read More

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http://dx.doi.org/10.3310/hta22630DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287172PMC
November 2018
31 Reads

Brain and spinal stimulation therapies for phantom limb pain: a systematic review.

Health Technol Assess 2018 11;22(62):1-94

Centre for Reviews and Dissemination (CRD), University of York, York, UK.

Background: Although many treatments exist for phantom limb pain (PLP), the evidence supporting them is limited and there are no guidelines for PLP management. Brain and spinal cord neurostimulation therapies are targeted at patients with chronic PLP but have yet to be systematically reviewed.

Objective: To determine which types of brain and spinal stimulation therapy appear to be the best for treating chronic PLP. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22620
Publisher Site
http://dx.doi.org/10.3310/hta22620DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253324PMC
November 2018
9 Reads

Oral steroids for hearing loss associated with otitis media with effusion in children aged 2-8 years: the OSTRICH RCT.

Health Technol Assess 2018 11;22(61):1-114

Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.

Background: Children with hearing loss associated with otitis media with effusion (OME) are commonly managed through surgical intervention, hearing aids or watchful waiting. A safe, inexpensive, effective medical treatment would enhance treatment options. Small, poorly conducted trials have found a short-term benefit from oral steroids. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22610
Publisher Site
http://dx.doi.org/10.3310/hta22610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253325PMC
November 2018
4 Reads

Pharmacological and non-pharmacological interventions for non-respiratory sleep disturbance in children with neurodisabilities: a systematic review.

Health Technol Assess 2018 10;22(60):1-296

Blenheim House Child Development Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK.

Background: There is uncertainty about the most appropriate ways to manage non-respiratory sleep disturbances in children with neurodisabilities (NDs).

Objective: To assess the clinical effectiveness and safety of NHS-relevant pharmacological and non-pharmacological interventions to manage sleep disturbance in children and young people with NDs, who have non-respiratory sleep disturbance.

Data Sources: Sixteen databases, including The Cochrane Central Register of Controlled Trials, EMBASE and MEDLINE, were searched up to February 2017, and grey literature searches and hand-searches were conducted. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22600
Publisher Site
http://dx.doi.org/10.3310/hta22600DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231061PMC
October 2018
12 Reads
5.030 Impact Factor

Adjunctive rifampicin to reduce early mortality from Staphylococcus aureus bacteraemia: the ARREST RCT.

Health Technol Assess 2018 10;22(59):1-148

Nuffield Department of Medicine, University of Oxford, Oxford, UK.

Background: bacteraemia is a common and frequently fatal infection. Adjunctive rifampicin may enhance early killing, sterilise infected foci and blood faster, and thereby reduce the risk of dissemination, metastatic infection and death.

Objectives: To determine whether or not adjunctive rifampicin reduces bacteriological (microbiologically confirmed) failure/recurrence or death through 12 weeks from randomisation. Read More

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http://dx.doi.org/10.3310/hta22590DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231058PMC
October 2018
2 Reads

Abdominal massage plus advice, compared with advice only, for neurogenic bowel dysfunction in MS: a RCT.

Health Technol Assess 2018 10;22(58):1-134

Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK.

Background: Between 50% and 80% of people with multiple sclerosis (PwMS) experience neurogenic bowel dysfunction (NBD) (i.e. constipation and faecal incontinence) that affects quality of life and can lead to hospitalisation. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22580
Publisher Site
http://dx.doi.org/10.3310/hta22580DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231060PMC
October 2018
13 Reads

Adding emollient bath additives to standard eczema management for children with eczema: the BATHE RCT.

Health Technol Assess 2018 10;22(57):1-116

Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.

Background: Childhood eczema is very common. Treatment often includes emollient bath additives, despite there being little evidence of their effectiveness.

Objectives: To determine the clinical effectiveness and cost-effectiveness of emollient bath additives in the management of childhood eczema. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22570
Publisher Site
http://dx.doi.org/10.3310/hta22570DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231059PMC
October 2018
11 Reads

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study.

Health Technol Assess 2018 10;22(56):1-96

Tuberculosis Research Centre, National Heart and Lung Institute, Imperial College London, London, UK.

Background: Despite a recent decline in the annual incidence of tuberculosis (TB) in the UK, rates remain higher than in most Western European countries. The detection and treatment of latent TB infection (LTBI) is an essential component of the UK TB control programme.

Objectives: To assess the prognostic value and cost-effectiveness of the current two interferon gamma release assays (IGRAs) compared with the standard tuberculin skin test (TST) for predicting active TB among untreated individuals at increased risk of TB: (1) contacts of active TB cases and (2) new entrants to the UK from high-TB-burden countries. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22560
Publisher Site
http://dx.doi.org/10.3310/hta22560DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6216045PMC
October 2018
22 Reads

AVURT: aspirin versus placebo for the treatment of venous leg ulcers - a Phase II pilot randomised controlled trial.

Health Technol Assess 2018 10;22(55):1-138

Bristol Centre for Surgical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Bristol, Bristol, UK.

Background: Venous leg ulcers (VLUs) are the most common cause of leg ulceration, affecting 1 in 100 adults. VLUs may take many months to heal (25% fail to heal). Estimated prevalence is between 1% and 3% of the elderly population. Read More

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http://dx.doi.org/10.3310/hta22550DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204573PMC
October 2018
1 Read

Adjunctive colposcopy technologies for assessing suspected cervical abnormalities: systematic reviews and economic evaluation.

Health Technol Assess 2018 09;22(54):1-260

Centre for Reviews and Dissemination, University of York, York, UK.

Background: Dynamic Spectral Imaging System (DySIS)map (DySIS Medical Ltd, Edinburgh, UK) and ZedScan (Zilico Limited, Manchester, UK) can be used adjunctively with conventional colposcopy, which may improve the detection of cervical intraepithelial neoplasia (CIN) and cancer.

Objectives: To systematically review the evidence on the diagnostic accuracy, clinical effectiveness and implementation of DySISmap and ZedScan as adjuncts to standard colposcopy, and to develop a cost-effectiveness model.

Methods: Four parallel systematic reviews were performed on diagnostic accuracy, clinical effectiveness issues, implementation and economic analyses. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22540
Publisher Site
http://dx.doi.org/10.3310/hta22540DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204572PMC
September 2018
12 Reads

Behavioural activation versus guided self-help for depression in adults with learning disabilities: the BeatIt RCT.

Health Technol Assess 2018 09;22(53):1-130

Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.

Background: Depression is the most prevalent mental health problem among people with learning disabilities.

Objective: The trial investigated the clinical effectiveness and cost-effectiveness of behavioural activation for depression experienced by people with mild to moderate learning disabilities. The intervention was compared with a guided self-help intervention. Read More

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http://dx.doi.org/10.3310/hta22530DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6187110PMC
September 2018
19 Reads

Partial ablation versus radical prostatectomy in intermediate-risk prostate cancer: the PART feasibility RCT.

Health Technol Assess 2018 09;22(52):1-96

Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.

Background: Prostate cancer (PCa) is the most common cancer in men in the UK. Patients with intermediate-risk, clinically localised disease are offered radical treatments such as surgery or radiotherapy, which can result in severe side effects. A number of alternative partial ablation (PA) technologies that may reduce treatment burden are available; however the comparative effectiveness of these techniques has never been evaluated in a randomised controlled trial (RCT). Read More

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http://dx.doi.org/10.3310/hta22520DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6187111PMC
September 2018
4 Reads

Restricted fluid bolus versus current practice in children with septic shock: the FiSh feasibility study and pilot RCT.

Health Technol Assess 2018 09;22(51):1-106

Clinical Trials Unit, Intensive Care National Audit and Research Centre, London, UK.

Background: There has been no randomised controlled trial (RCT) of fluid bolus therapy in paediatric sepsis in the developed world despite evidence that excess fluid may be associated with harm.

Objectives: To determine the feasibility of the Fluids in Shock (FiSh) trial - a RCT comparing restricted fluid bolus (10 ml/kg) with current practice (20 ml/kg) in children with septic shock in the UK.

Design: (1) Qualitative feasibility study exploring parents' views about the pilot RCT. Read More

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http://dx.doi.org/10.3310/hta22510DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174327PMC
September 2018
4 Reads

Standing frames for children with cerebral palsy: a mixed-methods feasibility study.

Health Technol Assess 2018 09;22(50):1-232

Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.

Background: Standing frames are recommended as part of postural management for young people with cerebral palsy (CP) Gross Motor Function Classification System (GMFCS) level IV or V. They may have a variety of benefits, including improving bone mineral density, gastrointestinal function and social participation. The NHS needs to know if these benefits are real, given the cost implications of use and the reported negative effects (e. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22500
Publisher Site
http://dx.doi.org/10.3310/hta22500DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174326PMC
September 2018
6 Reads

Everolimus, lutetium-177 DOTATATE and sunitinib for advanced, unresectable or metastatic neuroendocrine tumours with disease progression: a systematic review and cost-effectiveness analysis.

Health Technol Assess 2018 09;22(49):1-326

Peninsula Technology Assessment Group (PenTAG), University of Exeter, Exeter, UK.

Background: Neuroendocrine tumours (NETs) are a group of heterogeneous cancers that develop in cells in the diffuse neuroendocrine system.

Objectives: To estimate the clinical effectiveness of three interventions [everolimus (Afinitor; Novartis International AG, Basel, Switzerland), lutetium-177 DOTATATE (177Lu-DOTATATE) (Lutathera; Imaging Equipment Ltd, Radstock, UK) and sunitinib (Sutent; Pfizer Inc., New York, NY, USA)] for treating unresectable or metastatic NETs with disease progression and establish the cost-effectiveness of these interventions. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22490
Publisher Site
http://dx.doi.org/10.3310/hta22490DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6151360PMC
September 2018
11 Reads

Triple versus guideline antiplatelet therapy to prevent recurrence after acute ischaemic stroke or transient ischaemic attack: the TARDIS RCT.

Health Technol Assess 2018 08;22(48):1-76

Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.

Background: Two antiplatelet agents are better than one for preventing recurrent stroke after acute ischaemic stroke or transient ischaemic attack (TIA). Therefore, intensive treatment with three agents might be better still, providing it does not cause undue bleeding.

Objective: To compare the safety and efficacy of intensive therapy with guideline antiplatelet therapy for acute ischaemic stroke and TIA. Read More

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http://dx.doi.org/10.3310/hta22480DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139477PMC
August 2018
17 Reads

Selecting pregnant or postpartum women with suspected pulmonary embolism for diagnostic imaging: the DiPEP diagnostic study with decision-analysis modelling.

Health Technol Assess 2018 08;22(47):1-230

School of Health and Related Research, University of Sheffield, Sheffield, UK.

Background: Pulmonary embolism (PE) is a leading cause of death in pregnancy and post partum, but the symptoms of PE are common in normal pregnancy. Simple diagnostic tests are needed to select women for diagnostic imaging.

Objective: To estimate the accuracy, effectiveness and cost-effectiveness of clinical features, decision rules and biomarkers for selecting pregnant or postpartum women with a suspected PE for imaging. Read More

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http://dx.doi.org/10.3310/hta22470DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139476PMC
August 2018
18 Reads

Treatment of extravasation injuries in infants and young children: a scoping review and survey.

Health Technol Assess 2018 08;22(46):1-112

Centre for Reviews and Dissemination, University of York, York, UK.

Background: Extravasation injuries are caused by unintended leakages of fluids or medicines from intravenous lines, but there is no consensus on the best treatment approaches.

Objectives: To identify which treatments may be best for treating extravasation injuries in infants and young children.

Design: Scoping review and survey of practice. Read More

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http://dx.doi.org/10.3310/hta22460DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139478PMC
August 2018
3 Reads

Therapeutic hypothermia to reduce intracranial pressure after traumatic brain injury: the Eurotherm3235 RCT.

Health Technol Assess 2018 08;22(45):1-134

Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.

Background: Traumatic brain injury (TBI) is a major cause of disability and death in young adults worldwide. It results in around 1 million hospital admissions annually in the European Union (EU), causes a majority of the 50,000 deaths from road traffic accidents and leaves a further ≈10,000 people severely disabled.

Objective: The Eurotherm3235 Trial was a pragmatic trial examining the effectiveness of hypothermia (32-35 °C) to reduce raised intracranial pressure (ICP) following severe TBI and reduce morbidity and mortality 6 months after TBI. Read More

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http://dx.doi.org/10.3310/hta22450DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139479PMC
August 2018
13 Reads

Risk scores to guide referral decisions for people with suspected ovarian cancer in secondary care: a systematic review and cost-effectiveness analysis.

Health Technol Assess 2018 08;22(44):1-264

School for Public Health and Primary Care, Care and Public Health Research Institute (CAPHRI), Maastricht University, the Netherlands.

Background: Ovarian cancer is the sixth most common cancer in UK women and can be difficult to diagnose, particularly in the early stages. Risk-scoring can help to guide referral to specialist centres.

Objectives: To assess the clinical and cost-effectiveness of risk scores to guide referral decisions for women with suspected ovarian cancer in secondary care. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22440
Publisher Site
http://dx.doi.org/10.3310/hta22440DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139475PMC
August 2018
8 Reads

Screening women aged 65 years or over for abdominal aortic aneurysm: a modelling study and health economic evaluation.

Health Technol Assess 2018 08;22(43):1-142

Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.

Background: Abdominal aortic aneurysm (AAA) screening programmes have been established for men in the UK to reduce deaths from AAA rupture. Whether or not screening should be extended to women is uncertain.

Objective: To evaluate the cost-effectiveness of population screening for AAAs in women and compare a range of screening options. Read More

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http://dx.doi.org/10.3310/hta22430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119819PMC
August 2018
10 Reads
5.030 Impact Factor

Continuous subcutaneous insulin infusion versus multiple daily injections in children and young people at diagnosis of type 1 diabetes: the SCIPI RCT.

Health Technol Assess 2018 08;22(42):1-112

Clinical Trials Research Centre, University of Liverpool, Liverpool, UK.

Background: The risk of developing long-term complications of type 1 diabetes (T1D) is related to glycaemic control and is reduced by the use of intensive insulin treatment regimens: multiple daily injections (MDI) (≥ 4) and continuous subcutaneous insulin infusion (CSII). Despite a lack of evidence that the more expensive treatment with CSII is superior to MDI, both treatments are used widely within the NHS.

Objectives: (1) To compare glycaemic control during treatment with CSII and MDI and (2) to determine safety and cost-effectiveness of the treatment, and quality of life (QoL) of the patients. Read More

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http://dx.doi.org/10.3310/hta22420DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119825PMC
August 2018
2 Reads

Nicotine preloading for smoking cessation: the Preloading RCT.

Health Technol Assess 2018 08;22(41):1-84

Institute of Environment, Health and Societies, Brunel University, Uxbridge, UK.

Background: Nicotine preloading means using nicotine replacement therapy prior to a quit date while smoking normally. The aim is to reduce the drive to smoke, thereby reducing cravings for smoking after quit day, which are the main cause of early relapse. A prior systematic review showed inconclusive and heterogeneous evidence that preloading was effective and little evidence of the mechanism of action, with no cost-effectiveness data. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22410
Publisher Site
http://dx.doi.org/10.3310/hta22410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6099332PMC
August 2018
20 Reads

MRI versus laparoscopy to diagnose the main causes of chronic pelvic pain in women: a test-accuracy study and economic evaluation.

Health Technol Assess 2018 07;22(40):1-92

Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK.

Background: Chronic pelvic pain (CPP) symptoms in women are variable and non-specific; establishing a differential diagnosis can be hard. A diagnostic laparoscopy is often performed, although a prior magnetic resonance imaging (MRI) scan may beneficial.

Objectives: To estimate the accuracy and added value of MRI in making diagnoses of (1) idiopathic CPP and (2) the main gynaecological causes of CPP. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22400
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http://dx.doi.org/10.3310/hta22400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6088265PMC
July 2018
13 Reads

Multiparametric MRI to improve detection of prostate cancer compared with transrectal ultrasound-guided prostate biopsy alone: the PROMIS study.

Health Technol Assess 2018 07;22(39):1-176

Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK.

Background: Men with suspected prostate cancer usually undergo transrectal ultrasound (TRUS)-guided prostate biopsy. TRUS-guided biopsy can cause side effects and has relatively poor diagnostic accuracy. Multiparametric magnetic resonance imaging (mpMRI) used as a triage test might allow men to avoid unnecessary TRUS-guided biopsy and improve diagnostic accuracy. Read More

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http://dx.doi.org/10.3310/hta22390DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077599PMC
July 2018
7 Reads

Improving the Quality of Dentistry (IQuaD): a cluster factorial randomised controlled trial comparing the effectiveness and cost-benefit of oral hygiene advice and/or periodontal instrumentation with routine care for the prevention and management of periodontal disease in dentate adults attending dental primary care.

Health Technol Assess 2018 07;22(38):1-144

NHS Education for Scotland, Edinburgh, UK.

Background: Periodontal disease is preventable but remains the most common oral disease worldwide, with major health and economic implications. Stakeholders lack reliable evidence of the relative clinical effectiveness and cost-effectiveness of different types of oral hygiene advice (OHA) and the optimal frequency of periodontal instrumentation (PI).

Objectives: To test clinical effectiveness and assess the economic value of the following strategies: personalised OHA versus routine OHA, 12-monthly PI (scale and polish) compared with 6-monthly PI, and no PI compared with 6-monthly PI. Read More

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http://dx.doi.org/10.3310/hta22380DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055082PMC
July 2018
17 Reads

A pedometer-based walking intervention in 45- to 75-year-olds, with and without practice nurse support: the PACE-UP three-arm cluster RCT.

Health Technol Assess 2018 06;22(37):1-274

Population Health Research Institute, St George's, University of London, London, UK.

Background: Guidelines recommend walking to increase moderate to vigorous physical activity (MVPA) for health benefits.

Objectives: To assess the effectiveness, cost-effectiveness and acceptability of a pedometer-based walking intervention in inactive adults, delivered postally or through dedicated practice nurse physical activity (PA) consultations.

Design: Parallel three-arm trial, cluster randomised by household. Read More

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http://dx.doi.org/10.3310/hta22370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046648PMC
June 2018
14 Reads

Pressure garment to prevent abnormal scarring after burn injury in adults and children: the PEGASUS feasibility RCT and mixed-methods study.

Health Technol Assess 2018 06;22(36):1-162

Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Background: Eleven million people suffer a fire-related injury worldwide every year, and 71% have significant scarring. Pressure garment therapy (PGT) is a standard part of burn scar management, but there is little evidence of its clinical effectiveness or cost-effectiveness.

Objective: To identify the barriers to, and the facilitators of, conducting a randomised controlled trial (RCT) of burn scar management with and without PGT and test whether or not such a trial is feasible. Read More

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https://www.journalslibrary.nihr.ac.uk/hta/hta22360
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http://dx.doi.org/10.3310/hta22360DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036406PMC
June 2018
24 Reads

Does progesterone prophylaxis to prevent preterm labour improve outcome? A randomised double-blind placebo-controlled trial (OPPTIMUM).

Health Technol Assess 2018 06;22(35):1-304

Centre for Healthcare Randomised Trials, Health Services Research Unit, University of Aberdeen, Aberdeen, UK.

Background: Progesterone prophylaxis is widely used to prevent preterm birth but is not licensed and there is little information on long-term outcome.

Objective: To determine the effect of progesterone prophylaxis in women at high risk of preterm birth on obstetric, neonatal and childhood outcomes.

Design: Double-blind, randomised placebo-controlled trial. Read More

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http://dx.doi.org/10.3310/hta22350DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036405PMC
June 2018
4 Reads

Alternative tumour necrosis factor inhibitors (TNFi) or abatacept or rituximab following failure of initial TNFi in rheumatoid arthritis: the SWITCH RCT.

Health Technol Assess 2018 06;22(34):1-280

Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

Background: Rheumatoid arthritis (RA), the most common autoimmune disease in the UK, is a chronic systemic inflammatory arthritis that affects 0.8% of the UK population.

Objectives: To determine whether or not an alternative class of biologic disease-modifying antirheumatic drugs (bDMARDs) are comparable to rituximab in terms of efficacy and safety outcomes in patients with RA in whom initial tumour necrosis factor inhibitor (TNFi) bDMARD and methotrexate (MTX) therapy failed because of inefficacy. Read More

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http://dx.doi.org/10.3310/hta22340DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026806PMC
June 2018
8 Reads

Early, specialist vocational rehabilitation to facilitate return to work after traumatic brain injury: the FRESH feasibility RCT.

Health Technol Assess 2018 05;22(33):1-124

Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK.

Background: Up to 160,000 people incur traumatic brain injury (TBI) each year in the UK. TBI can have profound effects on many areas of human functioning, including participation in work. There is limited evidence of the clinical effectiveness and cost-effectiveness of vocational rehabilitation (VR) after injury to promote early return to work (RTW) following TBI. Read More

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http://dx.doi.org/10.3310/hta22330DOI Listing
May 2018
4 Reads

The future for diagnostic tests of acute kidney injury in critical care: evidence synthesis, care pathway analysis and research prioritisation.

Health Technol Assess 2018 05;22(32):1-274

Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Background: Acute kidney injury (AKI) is highly prevalent in hospital inpatient populations, leading to significant mortality and morbidity, reduced quality of life and high short- and long-term health-care costs for the NHS. New diagnostic tests may offer an earlier diagnosis or improved care, but evidence of benefit to patients and of value to the NHS is required before national adoption.

Objectives: To evaluate the potential for AKI in vitro diagnostic tests to enhance the NHS care of patients admitted to the intensive care unit (ICU) and identify an efficient supporting research strategy. Read More

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http://dx.doi.org/10.3310/hta22320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6004543PMC
May 2018
22 Reads
5.030 Impact Factor

Strategy of endovascular versus open repair for patients with clinical diagnosis of ruptured abdominal aortic aneurysm: the IMPROVE RCT.

Health Technol Assess 2018 05;22(31):1-122

Vascular Surgery Research Group, Imperial College London, London, UK.

Background: Ruptured abdominal aortic aneurysm (AAA) is a common vascular emergency. The mortality from emergency endovascular repair may be much lower than the 40-50% reported for open surgery.

Objective: To assess whether or not a strategy of endovascular repair compared with open repair reduces 30-day and mid-term mortality (including costs and cost-effectiveness) among patients with a suspected ruptured AAA. Read More

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http://dx.doi.org/10.3310/hta22310DOI Listing
May 2018
3 Reads

Enhanced psychological care in cardiac rehabilitation services for patients with new-onset depression: the CADENCE feasibility study and pilot RCT.

Health Technol Assess 2018 05;22(30):1-220

Primary Care Research Group, University of Exeter Medical School, Exeter, UK.

Background: Around 19% of people screened by UK cardiac rehabilitation programmes report having moderate or severe symptoms of depression. These individuals are at an increased risk of cardiac mortality and morbidity, reduced quality of life and increased use of health resources compared with their non-depressed counterparts. Maximising psychological health is a goal of cardiac rehabilitation, but psychological care is patchy. Read More

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http://dx.doi.org/10.3310/hta22300DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6004545PMC
May 2018
13 Reads

What works to increase attendance for diabetic retinopathy screening? An evidence synthesis and economic analysis.

Health Technol Assess 2018 05;22(29):1-160

Clinical Epidemiology Program, Ottawa Hospital Research Institute,Ottawa, ON,Canada.

Background: Diabetic retinopathy screening (DRS) is effective but uptake is suboptimal.

Objectives: To determine the effectiveness of quality improvement (QI) interventions for DRS attendance; describe the interventions in terms of QI components and behaviour change techniques (BCTs); identify theoretical determinants of attendance; investigate coherence between BCTs identified in interventions and determinants of attendance; and determine the cost-effectiveness of QI components and BCTs for improving DRS.

Data Sources And Review Methods: Phase 1 - systematic review of randomised controlled trials (RCTs) evaluating interventions to increase DRS attendance (The Cochrane Library, MEDLINE, EMBASE and trials registers to February 2017) and coding intervention content to classify QI components and BCTs. Read More

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http://dx.doi.org/10.3310/hta22290DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6004544PMC
May 2018
6 Reads

Aerobic and strength training exercise programme for cognitive impairment in people with mild to moderate dementia: the DAPA RCT.

Health Technol Assess 2018 05;22(28):1-202

Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Background: Approximately 670,000 people in the UK have dementia. Previous literature suggests that physical exercise could slow dementia symptom progression.

Objectives: To estimate the clinical effectiveness and cost-effectiveness of a bespoke exercise programme, in addition to usual care, on the cognitive impairment (primary outcome), function and health-related quality of life (HRQoL) of people with mild to moderate dementia (MMD) and carer burden and HRQoL. Read More

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http://dx.doi.org/10.3310/hta22280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994643PMC
May 2018
7 Reads