Health technology assessment : HTA
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Health Technol Assess · Oct 2007
Randomized Controlled Trial Multicenter StudyA randomised controlled trial examining the longer-term outcomes of standard versus new antiepileptic drugs. The SANAD trial.
To compare clinicians' choice of one of the standard epilepsy drug treatments (carbamazepine or valproate) versus appropriate comparator new drugs. ⋯ The evidence suggests that LTG may be a clinical and cost-effective alternative to the existing standard drug treatment, CBZ, for patients diagnosed as having partial seizures. For patients with idiopathic generalised epilepsy or difficult to classify epilepsy, VPS remains the clinically most effective drug, although TPM may be a cost-effective alternative for some patients. Three new antiepileptic drugs have recently been licensed in the UK for the treatment of epilepsy (levetiracetam, zonisamide and pregabalin), therefore these drugs should be compared in a similarly designed trial.
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Health Technol Assess · Oct 2007
Randomized Controlled Trial Comparative Study Clinical TrialAcceptability, benefit and costs of early screening for hearing disability: a study of potential screening tests and models.
To show that hearing loss has such a high prevalence in the older population to justify screening, if effective and acceptable methods are available; and that population take-up and benefit can make a measurable outcome difference in quality of life. ⋯ A simple systematic screen, using an audiometric screening instrument, has been shown to be acceptable to people in the age range 55-74 years, is likely to provide substantial benefit and may be cost-effective to those in that target group. Hearing screening appears to meet the National Screening Committee's criteria in most respects, provided screening is targeted at those with at least 35 dB HL better ear average. Based on the research carried out here there is sufficient evidence to support a larger and more definitive study of hearing screening. Further research into who should be referred for and benefit from audiological assessment and provision of hearing aid in a primary care trust setting is needed as is investigation into screening devices and the various aspects of introducing such a programme.