Health technology assessment : HTA
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Health Technol Assess · Feb 2020
Clinical TrialVarenicline versus nicotine replacement therapy for long-term smoking cessation: an observational study using the Clinical Practice Research Datalink.
Smoking is the leading avoidable cause of illness and premature mortality. The first-line treatments for smoking cessation are nicotine replacement therapy and varenicline. Meta-analyses of experimental studies have shown that participants allocated to the varenicline group were 1.57 times (95% confidence interval 1.29 to 1.91 times) as likely to be abstinent 6 months after treatment as those allocated to the nicotine replacement therapy group. However, there is limited evidence about the effectiveness of varenicline when prescribed in primary care. We investigated the effectiveness and rate of adverse events of these medicines in the general population. ⋯ Not all of our code lists were validated, body mass index and Index of Multiple Deprivation had missing values, our results may suffer from residual confounding, and we had no information on treatment adherence.
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Health Technol Assess · Jan 2020
Randomized Controlled Trial Multicenter StudyGroup cognitive rehabilitation to reduce the psychological impact of multiple sclerosis on quality of life: the CRAMMS RCT.
People with multiple sclerosis have problems with memory and attention. The effectiveness of cognitive rehabilitation has not been established. ⋯ Future research should evaluate the selection of those who may benefit from cognitive rehabilitation.
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Health Technol Assess · Jan 2020
Randomized Controlled Trial Clinical TrialA group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT.
People with advanced dementia who live and die in nursing homes experience variable quality of life, care and dying. There is a need to identify appropriate, cost-effective interventions that facilitate high-quality end-of-life care provision. ⋯ In a full trial, consideration is needed of the appropriate outcome measure that is sensitive to different participant responses, and of clear implementation principles for this person-centred intervention in a nursing home context.
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Health Technol Assess · Jan 2020
Lead-I ECG for detecting atrial fibrillation in patients with an irregular pulse using single time point testing: a systematic review and economic evaluation.
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and is associated with an increased risk of stroke and congestive heart failure. Lead-I electrocardiogram (ECG) devices are handheld instruments that can be used to detect AF at a single time point in people who present with relevant signs or symptoms. ⋯ The National Institute for Health Research Health Technology Assessment programme.
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Health Technol Assess · Dec 2019
Multicenter Study Clinical TrialWhole-body MRI compared with standard pathways for staging metastatic disease in lung and colorectal cancer: the Streamline diagnostic accuracy studies.
Whole-body magnetic resonance imaging is advocated as an alternative to standard pathways for staging cancer. ⋯ In colorectal and non-small-cell lung cancer, the whole-body magnetic resonance imaging staging pathway has similar accuracy to standard staging pathways, is generally preferred by patients, improves staging efficiency and has lower staging costs. Future work should address the utility of whole-body magnetic resonance imaging for treatment response assessment.