Health technology assessment : HTA
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Health Technol Assess · Sep 2017
Review Meta AnalysisMolecular testing for Lynch syndrome in people with colorectal cancer: systematic reviews and economic evaluation.
Inherited mutations in deoxyribonucleic acid (DNA) mismatch repair (MMR) genes lead to an increased risk of colorectal cancer (CRC), gynaecological cancers and other cancers, known as Lynch syndrome (LS). Risk-reducing interventions can be offered to individuals with known LS-causing mutations. The mutations can be identified by comprehensive testing of the MMR genes, but this would be prohibitively expensive in the general population. Tumour-based tests - microsatellite instability (MSI) and MMR immunohistochemistry (IHC) - are used in CRC patients to identify individuals at high risk of LS for genetic testing. MLH1 (MutL homologue 1) promoter methylation and BRAF V600E testing can be conducted on tumour material to rule out certain sporadic cancers. ⋯ The National Institute for Health Research Health Technology Assessment programme.
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Health Technol Assess · Sep 2017
Multicenter Study Pragmatic Clinical TrialA Very Early Rehabilitation Trial after stroke (AVERT): a Phase III, multicentre, randomised controlled trial.
Mobilising patients early after stroke [early mobilisation (EM)] is thought to contribute to the beneficial effects of stroke unit care but it is poorly defined and lacks direct evidence of benefit. ⋯ These results informed a new trial proposal [A Very Early Rehabilitation Trial - DOSE (AVERT-DOSE)] aiming to determine the optimal frequency and dose of EM.