Health technology assessment : HTA
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Health Technol Assess · Jun 2019
Randomized Controlled Trial Multicenter Study Pragmatic Clinical TrialNocturnal temperature-controlled laminar airflow device for adults with severe allergic asthma: the LASER RCT.
Severe asthma exacerbations are costly to patients and the NHS, and occur frequently in severely allergic patients. ⋯ Within the limits of the data, no consistent benefits of the active device were demonstrated, and the differences observed were not sufficient to make the device cost-effective. The types of patients who may benefit from the TLA device, and the reasons for large reductions in exacerbation frequency in severe asthma trials, which also incorporate other methods of recording exacerbations, need to be explored.
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Health Technol Assess · Apr 2019
Randomized Controlled Trial Multicenter Study Clinical TrialA group memory rehabilitation programme for people with traumatic brain injuries: the ReMemBrIn RCT.
People with traumatic brain injuries (TBIs) commonly report memory impairments. These are persistent, debilitating and reduce quality of life, but patients do not routinely receive memory rehabilitation after discharge from hospital. ⋯ The group memory rehabilitation delivered in this trial is very unlikely to lead to clinical benefits or to be a cost-effective treatment for people with TBI in the community. Future studies should examine the selection of participants who may benefit most from memory rehabilitation.
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Health Technol Assess · Mar 2019
Randomized Controlled Trial Multicenter Study Clinical TrialGoal-oriented cognitive rehabilitation for early-stage Alzheimer's and related dementias: the GREAT RCT.
Cognitive rehabilitation (CR) is an individualised, person-centred intervention for people with mild to moderate dementia that addresses the impact of cognitive impairment on everyday functioning. ⋯ Next steps will focus on the implementation of CR into NHS and social care services and on extending the approach to people with rarer forms of dementia.
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Health Technol Assess · Dec 2018
Multicenter Study Pragmatic Clinical TrialNegative-pressure wound therapy versus standard dressings for adults with an open lower limb fracture: the WOLLF RCT.
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%. The type of dressing applied after surgical debridement could potentially reduce the risk of infection in the open-fracture wound. ⋯ Future work should investigate alternative strategies to reduce the incidence of infection and improve outcomes for patients with an open fracture of the lower limb. Two specific areas of potentially great benefit are (1) the use of topical antibiotic preparations in the open-fracture wound and (2) the role of orthopaedic implants with antimicrobial coatings when fixing the associated fracture.
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Health Technol Assess · Dec 2018
Multicenter Study Clinical Trial Pragmatic Clinical TrialTemporarily quadrupling the dose of inhaled steroid to prevent asthma exacerbations: FAST.
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. ⋯ To effectively implement asthma self-management plans that advise a temporary quadrupling of inhaled steroid at asthma deterioration into routine practice.