Health technology assessment : HTA
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Health Technol Assess · Nov 2018
Meta AnalysisLow-dose computed tomography for lung cancer screening in high-risk populations: a systematic review and economic evaluation.
Diagnosis of lung cancer frequently occurs in its later stages. Low-dose computed tomography (LDCT) could detect lung cancer early. ⋯ The National Institute for Health Research Health Technology Assessment programme.
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Health Technol Assess · Nov 2018
Randomized Controlled Trial Clinical TrialStructured lifestyle education to support weight loss for people with schizophrenia, schizoaffective disorder and first episode psychosis: the STEPWISE RCT.
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. ⋯ Despite the challenges of undertaking clinical research in this population, the trial successfully recruited and retained participants, indicating a high level of interest in weight management interventions; however, the STEPWISE intervention was neither clinically effective nor cost-effective. Further research will be required to define how overweight and obesity in people with schizophrenia should be managed. The trial results suggest that lifestyle programmes for people with schizophrenia may need greater resourcing than for other populations, and interventions that have been shown to be effective in other populations, such as people with diabetes mellitus, are not necessarily effective in people with schizophrenia.
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Health Technol Assess · Nov 2018
Randomized Controlled Trial Multicenter Study Clinical Trial Observational StudyPrognostic models for identifying risk of poor outcome in people with acute ankle sprains: the SPRAINED development and external validation study.
Ankle sprains are very common injuries. Although recovery can occur within weeks, around one-third of patients have longer-term problems. ⋯ Further model refinement, including recalibration or identifying additional predictors, may be required. The effect of implementing and using either model in clinical practice, in terms of acceptability and uptake by clinicians and on patient outcomes, should be investigated.
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Health Technol Assess · Nov 2018
Randomized Controlled Trial Multicenter StudyCombining mirtazapine with SSRIs or SNRIs for treatment-resistant depression: the MIR RCT.
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. ⋯ Treatment-resistant depression remains an area of important, unmet need, with limited evidence of effective treatments. Promising interventions include augmentation with atypical antipsychotics and treatment using transcranial magnetic stimulation.
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Health Technol Assess · Nov 2018
Brain and spinal stimulation therapies for phantom limb pain: a systematic review.
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. ⋯ The National Institute for Health Research Health Technology Assessment programme.