MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Clinical Evidence' source. Sun, 08 Jan 2012 18:26:19 +0100 http://www.medworm.com/index.php?rid=5401552&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0217%2F0217.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Rhythm control versus rate control New evidence added. Categorisation unchanged (Trade-off between benefits and harms). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5401552 Thu, 10 Nov 2011 23:00:00 +0100 5401552 http://www.medworm.com/index.php?rid=5363229&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmeh%2F1002%2F1002.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Antidepressants in adults New evidence added. Categorisation changed from Likely to be beneficial to Beneficial. New evidence; conclusion confirmed for: CBT in adults New evidence added. Categorisation unchanged (Beneficial). Applied relaxation in adults New evidence added. Categorisation unchanged (Likely to be beneficial). Benzodiazepines in adults New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Hydroxyzine in adults New evidence added. Categorisation unchanged (Likely to be beneficial). An... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5363229 Thu, 27 Oct 2011 23:00:00 +0100 5363229 http://www.medworm.com/index.php?rid=5337684&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F1008%2F1008.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Fluoxetine New evidence added. Categorisation unchanged (Beneficial). Citalopram/escitalopram in children and adolescents New evidence added. Categorisation unchanged (Unknown effectiveness) because evidence remains insufficient to judge the effects of this intervention. Fluvoxamine in children and adolescents New evidence added on harms only. Categorisation unchanged (Unknown effectiveness) because evidence remains insufficient to judge the effects of this intervention. Paroxetine in children and adolescents New evidence added on harms only. Categorisation unchanged (Unlikely to be beneficial). ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5337684 Fri, 21 Oct 2011 23:00:00 +0100 5337684 http://www.medworm.com/index.php?rid=5324850&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fsld%2F2302%2F2302.jsp%3Frss%3Dtrue New option(s) added for: Antidepressants New option added. Categorised as Unknown Effectiveness as we found no RCT evidence to assess the effects of this intervention. New evidence; conclusions changed for: CBT New evidence added, categorisation changed (Unknown effectiveness to Beneficial). New evidence; conclusion confirmed for: Exercise programmes New evidence added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient evidence to judge the effects of this intervention. Timed exposure to bright light New evidence added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient evid... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5324850 Tue, 11 Oct 2011 23:00:00 +0100 5324850 http://www.medworm.com/index.php?rid=5227723&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0319%2F0319.jsp%3Frss%3Dtrue New option(s) added for: Immunoglobulin New option added with one systematic review and 4 RCTs. Categorised as beneficial. New evidence; conclusion confirmed for: Hospital phototherapy New evidence added. Categorisation unchanged (Beneficial). Exchange transfusion New evidence added. Categorisation unchanged (Likely to be beneficial by consensus) because new evidence comparing single volume exchange transfusion (SVET) versus double volume exchange transfusion (DVET) was insufficient to judge... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5227723 Thu, 15 Sep 2011 23:00:00 +0100 5227723 http://www.medworm.com/index.php?rid=5164053&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsh%2F1801%2F1801.jsp%3Frss%3Dtrue New option(s) added for: Transurethral Holmium laser resection/enucleation (HoLEP) New option added. Categorised as Likely to be beneficial. Transurethral electrovaporisation of the prostate (TUEVP) New option added. Categorised as Likely to be beneficial. New evidence; conclusions changed for: Saw palmetto plant (Serenoa repens) extracts Search updated for already included systematic review. New evidence added to the already reported review, which alters its previous conclusions. Categorisation changed from Likely to be beneficial to Unlikely to be beneficial. Transurethral microwave thermotherapy (TUMT) New evidence added, which suggests that transurethral microwave th... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5164053 Fri, 26 Aug 2011 23:00:00 +0100 5164053 http://www.medworm.com/index.php?rid=5164052&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdia%2F0602%2F0602.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Education New evidence added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient good-quality evidence to assess the effects of education on diabetic foot ulcers and amputations. Pressure off-loading (total-contact or non-removable cast) New evidence added. Categorisation unchanged (Likely to be beneficial). Systemic hyperbaric oxygen (infected ulcers) New evidence added. Categorisation unchanged (Likely to be beneficial). Topical growth factors New evidence added. Categorisation unchanged (Likely to be beneficial). Debridement or wound dressings One systematic review updated, new evid... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5164052 Fri, 26 Aug 2011 23:00:00 +0100 5164052 http://www.medworm.com/index.php?rid=5164055&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fskd%2F1715%2F1715.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Ciclopirox (topical) New evidence added. Categorisation unchanged (Likely to be beneficial). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5164055 Tue, 23 Aug 2011 23:00:00 +0100 5164055 http://www.medworm.com/index.php?rid=5164054&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frdc%2F1507%2F1507.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Prolonged-use antibiotics New evidence added. Categorisation unchanged (Likely to be beneficial). Anticholinergic therapy One previously included systematic review updated; no new data added. Categorisation unchanged (Unknown effectiveness). Bronchopulmonary hygiene physical therapy (airway-clearance techniques) New evidence added. Categorisation unchanged (Unknown effectiveness) because evidence is insufficient (only 1 small RCT) to judge the effects of bronchopulmonary hygiene physical therapy. Hyperosmolar agents (inhaled) One previously included systematic review updated; no new data added. Categorisation unchanged (Unknown effectiveness). Leukotrien... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5164054 Tue, 23 Aug 2011 23:00:00 +0100 5164054 http://www.medworm.com/index.php?rid=5070945&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0818%2F0818.jsp%3Frss%3Dtrue New option(s) added for: Conisation plus lymphadenectomy for stage Ia2 and low-volume stage Ib New option added. Categorised as Unknown effectiveness, as we found no RCT evidence to assess the effects of this comparison. Simple hysterectomy plus lymphadenectomy versus radical hysterectomy plus lymphadenectomy New option added. Categorised as Unknown effectiveness, as we found no RCT evidence to assess the effects of this comparison. New evidence; conclusion confirmed for: HPV vaccine New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient long-term data on the effects of the vaccine in reducing rates of cervical cancer. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5070945 Wed, 27 Jul 2011 23:00:00 +0100 5070945 http://www.medworm.com/index.php?rid=5022173&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frdc%2F1512%2F1512.jsp%3Frss%3Dtrue New option(s) added for: Adding anti-IgE treatment to inhaled corticosteroids plus long-acting beta2 agonists plus either leukotriene antagonists, theophylline, or oral corticosteroids, alone or in any combination, in people with severe, chronic asthma New option added. Categorised as Likely to be beneficial. New evidence; conclusion confirmed for: Low-dose inhaled corticosteroids in people with chronic asthma New evidence added. Categorisation unchanged (Beneficial). Adding long-acting inhaled beta2 agonists to inhaled corticosteroids in people with mild-to-moderate chronic asthma that is partly or poorly controlled by inhaled corticosteroids alone New evidence added... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5022173 Wed, 13 Jul 2011 19:21:43 +0100 5022173 http://www.medworm.com/index.php?rid=5022174&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsh%2F1802%2F1802.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Alpha-blockers for chronic abacterial prostatitis/chronic pelvic pain syndrome New evidence added. Categorisation changed from Likely to be beneficial to Unknown effectiveness (as a new large RCT found no significant difference between alfuzosin and placebo, by contrast with previous, smaller trials). New evidence; conclusion confirmed for: Antimicrobial drugs (oral) for chronic bacterial prostatitis New evidence added. Categorisation unchanged (Likely to be beneficial). NSAIDs for chronic abacterial prostatitis/chronic pelvic pain syndrome New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient evidence to judge this interve... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=5022174 Tue, 12 Jul 2011 23:00:00 +0100 5022174 http://www.medworm.com/index.php?rid=4978499&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsh%2F1803%2F1803.jsp%3Frss%3Dtrue New option(s) added for: Tadalafil in men with cardiovascular disease New option added. Categorised as Unknown effectiveness, as we found no RCT evidence to assess the effects of this intervention. Vardenafil in men with cardiovascular disease New option added. Categorised as Unknown effectiveness, as we found no RCT evidence to assess the effects of this intervention. Tadalafil in men with spinal cord injury New option added. Categorised as Likely to be beneficial. Vardenafil in men with spinal cord injury New option added. Categorised as Unknown effectiveness, as we found no RCT evidence to assess the effects of this intervention Tadalafil in men with prostate cancer or undergoing prostatect... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4978499 Wed, 29 Jun 2011 19:28:22 +0100 4978499 http://www.medworm.com/index.php?rid=4971450&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsd%2F1117%2F1117.jsp%3Frss%3Dtrue New option(s) added for: Autologous whole blood injections New option added. Categorised as Unknown effectiveness, as we found no RCT evidence to assess the effects of this intervention. Platelet-rich plasma injections New option added. Categorised as Unknown effectiveness, as we found no RCT evidence to assess the effects of this intervention. Manipulation New option added with two systematic reviews. Categorised as Unknown effectiveness, as there remains insufficient good-quality evidence to assess the effects of manipulation on tennis elbow. Combination physical therapies New option added with 5 systematic reviews. Categorised as Unknown effectiveness, as th... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4971450 Mon, 27 Jun 2011 22:11:40 +0100 4971450 http://www.medworm.com/index.php?rid=4978500&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frda%2F1508%2F1508.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Antibiotics versus placebo and versus other non-antibiotic treatments New evidence added. Search updated for already included systematic review and evidence re-evaluated in line with new inclusion criteria for this Clinical Evidence review. Categorisation unchanged (Trade-off between benefits and harms). Antihistamines Search updated for already included systematic review and evidence re-evaluated in line with new inclusion criteria for this Clinical Evidence review. New evidence added. Categorisation unchanged (Unknown effectiveness), as the poor quality of the trials identified means that there remains insufficient evidence to judge the effects of this intervention. ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4978500 Mon, 20 Jun 2011 23:00:00 +0100 4978500 http://www.medworm.com/index.php?rid=4924446&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fnud%2F1211%2F1211.jsp%3Frss%3Dtrue New option(s) added for: Muscle relaxants for focal dystonia New option added. Categorised as Unknown effectiveness, as we found no RCT evidence to assess the effects of this intervention. Muscle relaxants for generalised dystonia New option added. Categorised as Unknown effectiveness, as we found no RCT evidence to assess the effects of this intervention. New evidence; conclusions changed for: Physiotherapy for focal dystonia New evidence added. Existing evidence re-evaluated in line with new stricter inclusion criteria, and two small case series in children with cervical dystonia (previously supporting a categorisation of Likely to be beneficial) were excluded from the benefits and harms section. Categoris... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4924446 Mon, 13 Jun 2011 23:00:00 +0100 4924446 http://www.medworm.com/index.php?rid=4905144&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frdc%2F1502%2F1502.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Anticholinergics New evidence added. Categorisation unchanged (Beneficial). Beta2 agonists (inhaled) New evidence added. Categorisation unchanged (Beneficial). Theophylline New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Corticosteroids (inhaled) New evidence added. Categorisation unchanged (Beneficial). Corticosteroids plus long-acting beta2 agonists New evidence added. Categorisation unchanged (Beneficial). Mucolytics New evidence added. Ca... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4905144 Mon, 06 Jun 2011 23:00:00 +0100 4905144 http://www.medworm.com/index.php?rid=4865495&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsd%2F1101%2F1101.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: CBT New evidence added. Categorisation unchanged (Beneficial). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4865495 Thu, 26 May 2011 18:36:06 +0100 4865495 http://www.medworm.com/index.php?rid=4865497&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmeh%2F1003%2F1003.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Prescription antidepressant drugs (tricyclic antidepressants [including low-dose tricyclic antidepressants], SSRIs, monoamine oxidase inhibitors, or venlafaxine) versus placebo in mild to moderate or severe depression New evidence added. Categorisation unchanged (Beneficial). Tricyclic antidepressants versus each other and other prescription antidepressant drugs (SSRIs, monoamine oxidase inhibitors, or venlafaxine) in mild to moderate or severe depression New evidence added. Categorisation unchanged (Beneficia... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4865497 Wed, 25 May 2011 23:00:00 +0100 4865497 http://www.medworm.com/index.php?rid=4865496&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Feyd%2F0702%2F0702.jsp%3Frss%3Dtrue New option(s) added for: Vascular endothelial growth factor inhibitors (injection): New option added with one systematic review and 4 RCTs. Categorised as Likely to be beneficial. New evidence; conclusion confirmed for: Peripheral retinal laser photocoagulation in people with proliferative retinopathy New evidence added. Categorisation unchanged (Beneficial). Photocoagulation in people with clinically significant macular oedema New evidence added. Categorisation unchanged (Beneficial). Grid photocoagulation to zones of retinal thickening in people with diffuse maculopathy ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4865496 Wed, 25 May 2011 23:00:00 +0100 4865496 http://www.medworm.com/index.php?rid=4865498&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fskd%2F1716%2F1716.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Probiotics One systematic review added (search date 2007), which identified 12 RCTs comparing probiotics versus placebo or no treatment. The review found no significant difference between probiotics and placebo or no treatment in parent-reported, participant-reported, or investigator-reported eczema severity. It also found no significant difference between probiotics compared with no treatment in patients' quality of life. Therefore, categorisation changed from Unknown effectiveness to Unlikely to be beneficial. New evidence; conclusion confirmed for: Emollients (alone or plus topical corticosteroids) One RCT added comparing emollient versus placebo cream, and three RCTs added comparing... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4865498 Tue, 17 May 2011 23:00:00 +0100 4865498 http://www.medworm.com/index.php?rid=4833152&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fpos%2F2102%2F2102.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Atropine New evidence added. Categorisation unchanged (Likely to be beneficial). Activated charcoal (single or multiple dose) New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient evidence to judge the effects of this intervention. Gastric lavage New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient evidence to judge the effects of this intervention. Oximes New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient evidence to judge the effects of this intervention. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4833152 Tue, 17 May 2011 23:00:00 +0100 4833152 http://www.medworm.com/index.php?rid=4833151&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsd%2F1120%2F1120.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Colchicine (oral) for treating acute gout New evidence added. Categorisation changed from Unknown effectiveness to Likely to be beneficial. New evidence; conclusion confirmed for: Corticosteroids New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient evidence to judge the effects of this intervention. NSAIDs New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient evidence to judge the effects of this intervention. Xanthine oxidase inhibitors New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient evidence to judge the ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4833151 Tue, 17 May 2011 23:00:00 +0100 4833151 http://www.medworm.com/index.php?rid=4783725&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwnd%2F1901%2F1901.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Pressure-relieving overlays on operating tables to prevent pressure ulcers Search updated for an already included systematic review. New evidence added. Categorisation changed from Unknown effectiveness to Likely to be beneficial. Low-air-loss hydrotherapy beds to prevent pressure ulcers Search updated for an already included systematic review. No new evidence added. Existing evidence reassessed. Categorisation changed from Unlikely to be beneficial to Unknown effectiveness, as there remains insufficient evidence to judge the effects of this intervention. New evidence; conclusion confirmed for: Foam alternatives versus standard foam mattresses to prevent pressure ulcers... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4783725 Thu, 28 Apr 2011 23:00:00 +0100 4783725 http://www.medworm.com/index.php?rid=4716241&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fseh%2F1603%2F1603.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Antiviral treatment (oral) versus no treatment for an acute recurrent episode of genital herpes in people with HIV Two RCTs added; categorisation changed from Likely to be beneficial by consensus to Likely to be beneficial (based on RCT evidence). New evidence; conclusion confirmed for: Antiviral maintenance treatment (oral) in late pregnancy (at least 36 weeks' gestation) in women with a history of genital herpes New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient evidence to judge whether antivirals reduce the rate of transmission of infection because of the rarity of neonatal transmission of herpes simplex virus (HSV) from wome... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4716241 Fri, 15 Apr 2011 20:32:09 +0100 4716241 http://www.medworm.com/index.php?rid=4699373&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fpac%2F1401%2F1401.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Restrictive versus routine use of episiotomy New evidence added. Categorisation unchanged (Beneficial). Continuous support during labour New evidence added. Categorisation unchanged (Beneficial). Sustained breath holding (Valsalva) method of pushing in the second stage of labour New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient evidence to judge effects of this intervention. Water births New evidence added. Categorisation unchanged (Unknown effectiveness), as RCTs found were of variable methodological quality and used small sample sizes, which make it difficult to judge effects of this intervention. ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4699373 Mon, 11 Apr 2011 23:00:00 +0100 4699373 http://www.medworm.com/index.php?rid=4699372&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0912%2F0912.jsp%3Frss%3Dtrue New option(s) added for: Live attenuated varicella vaccine for prevention in healthy children exposed to varicella zoster virus New option. Categorised as Likely to be beneficial. Live attenuated varicella vaccine for prevention in healthy adults exposed to varicella zoster virus New option. Categorised as Unknown effectiveness. Live attenuated varicella vaccine for prevention in immunocompromised children New option. Categorised as Trade-off between benefits and harms by consensus. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4699372 Mon, 11 Apr 2011 23:00:00 +0100 4699372 http://www.medworm.com/index.php?rid=4699371&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0318%2F0318.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Paracetamol New evidence added. Categorisation unchanged (Likely to be beneficial). NSAIDs New evidence added. Categorisation unchanged (Likely to be beneficial). 5HT1 antagonists New evidence added. Categorisation unchanged (Beneficial). Topiramate New evidence added. Categorisation unchanged (Unknown effectiveness) as the RCTs identified gave conflicting results. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4699371 Mon, 11 Apr 2011 23:00:00 +0100 4699371 http://www.medworm.com/index.php?rid=4699370&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0308%2F0308.jsp%3Frss%3Dtrue New option(s) added for: Continuous positive airway pressure New option added with one RCT. Categorised as (Unknown effectiveness) as there remains insufficient good-quality evidence to assess the effects of CPAP for bronchiolitis. Fluid management New option added. We found no RCTs. Categorised as Unknown effectiveness. Antibiotics New option added with one systematic review and one RCT. Categorised as Unlikely to be beneficial. Oxygen New option added with two RCTs. Categorised as (Unknown effectiveness) as there remains insufficient good-quality evidence to assess the effects of oxygen treatment for bronchiolitis. Heliox New option added with one systematic review and on... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4699370 Mon, 11 Apr 2011 23:00:00 +0100 4699370 http://www.medworm.com/index.php?rid=4678280&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0313%2F0313.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Oral sweet solutions New evidence added. Categorisation unchanged (Likely to be beneficial). Pacifiers New evidence added. Categorisation unchanged (Likely to be beneficial). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4678280 Tue, 05 Apr 2011 22:46:49 +0100 4678280 http://www.medworm.com/index.php?rid=4678283&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frda%2F1513%2F1513.jsp%3Frss%3Dtrue New option(s) added for: Formoterol inhaled (a long-acting beta2 agonist) New option added. Categorised as Likely to be beneficial. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4678283 Mon, 04 Apr 2011 23:00:00 +0100 4678283 http://www.medworm.com/index.php?rid=4678282&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fpac%2F1410%2F1410.jsp%3Frss%3Dtrue Conclusions confirmed (Likely to be beneficial). Oxytocin New evidence added. Categorisation unchanged (Beneficial). Carboprost injection New evidence added. Categorisation unchanged (Trade off between benefits and harms). Oxytocin plus ergometrine New evidence added. Categorisation unchanged (Trade off between benefits and harms). Misoprostol (sublingual) New evidence added. Categorisation changed from Unknown effectiveness to Trade off between benefits and harms. Misoprostol (oral) New evidence added. Categorisation changed from Likely to be ineffective or harmful to Unlikely to be beneficial to be consistent with the categorisation of vaginal mi... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4678282 Mon, 04 Apr 2011 23:00:00 +0100 4678282 http://www.medworm.com/index.php?rid=4678281&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0325%2F0325.jsp%3Frss%3Dtrue New option(s) added for: Bariatric surgery New option added. Categorised as Unknown effectiveness as we found no RCT evidence to assess its effects. New evidence; conclusion confirmed for: Multifactorial interventions New evidence added. Categorisation unchanged (Likely to be beneficial). Behavioural interventions alone No new evidence added. Existing evidence reassessed in line with new stricter inclusion criteria and one small RCT excluded. Categorisation unchanged (Unknown effectiveness). Diet alone New evidence added. Categorisation unchanged (Unknown effectiveness) as... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4678281 Mon, 04 Apr 2011 23:00:00 +0100 4678281 http://www.medworm.com/index.php?rid=4645927&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fskd%2F1717%2F1717.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Corticosteroids (topical) in adults New evidence added. Categorisation unchanged (Beneficial). Immunomodulators (topical) in adults New evidence added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient evidence to judge the effects of this intervention. Levamisole (oral) in adults New evidence added. Categorisation unchanged (Beneficial). Vitamin D analogues (topical) in adults New evidence added. Categorisation unchanged (Unlikely to be beneficial). PUVA (oral) in adults New evidence added. Categorisation unchanged (Likely to be beneficial). Ultraviolet B (narrowband) in adults New evidence adde... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4645927 Mon, 28 Mar 2011 23:00:00 +0100 4645927 http://www.medworm.com/index.php?rid=4645926&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fknd%2F2001%2F2001.jsp%3Frss%3Dtrue New option(s) added for: Early versus late renal replacement therapy New option added with two systematic reviews and one observational study. Categorised as Unknown effectiveness as results from systematic reviews conflict. Extended daily dialysis New option added with one systematic review. Categorised as Unknown effectiveness as there remains insufficient evidence to judge this intervention. New evidence; conclusions changed for: N-Acetylcysteine New evidence added. Categorisation of N-acetylcysteine changed from Likely to be beneficial to Unknown effectiveness as the reviews pooled heterogenous trials. Con... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4645926 Mon, 28 Mar 2011 23:00:00 +0100 4645926 http://www.medworm.com/index.php?rid=4645925&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdsd%2F0404%2F0404.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Radical versus conservative lymphadenectomy New evidence added. Categorisation changed from Unknown effectiveness to radical lymphadenectomy being Unlikely to be beneficial compared with conservative lymphadenectomy. New evidence; conclusion confirmed for: Adjuvant chemotherapy New evidence added. Categorisation unchanged (Likely to be beneficial). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4645925 Mon, 28 Mar 2011 23:00:00 +0100 4645925 http://www.medworm.com/index.php?rid=4596872&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frda%2F1510%2F1510.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Decongestants for short-term relief One systematic review and one RCT added. Categorisation of decongestants for short-term relief unchanged (Likely to be beneficial). Decongestants for long-term relief One RCT added. Categorisation of decongestants for long-term relief unchanged (Unknown effectiveness). Decongestants plus antihistamines One systematic review added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient data to assess this intervention. Analgesic or anti-inflammatory drugs One systematic review added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient data to assess this intervention. ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4596872 Wed, 16 Mar 2011 18:27:24 +0100 4596872 http://www.medworm.com/index.php?rid=4582960&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fseh%2F1604%2F1604.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Single-dose antibiotic regimens (men and non-pregnant women) New evidence added. Categorisation unchanged (Beneficial). Single-dose antibiotic regimens (in pregnancy) One Cochrane systematic review updated. Categorisation unchanged (Beneficial). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4582960 Mon, 14 Mar 2011 23:00:00 +0100 4582960 http://www.medworm.com/index.php?rid=4582959&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdsd%2F0405%2F0405.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Rifaximin New evidence added. Categorisation unchanged (Likely to be beneficial). Mesalazine for uncomplicated disease New evidence added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient data to judge this intervention. Medical treatment for acute diverticulitis New evidence added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient data to judge this intervention. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4582959 Mon, 14 Mar 2011 23:00:00 +0100 4582959 http://www.medworm.com/index.php?rid=4582958&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F1119%2F1119.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Moxisylyte One systematic review added, which reports one RCT comparing moxisylyte versus placebo. It found that moxisylyte may reduce the frequency of attacks in primary Raynaud's phenomenon. Categorisation unchanged (Unknown effectiveness), as there remain insufficient data to draw conclusions. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4582958 Mon, 14 Mar 2011 23:00:00 +0100 4582958 http://www.medworm.com/index.php?rid=4555883&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fnud%2F1204%2F1204.jsp%3Frss%3Dtrue New option(s) added for: Hyperbaric oxygen therapy New option added with one RCT comparing hyperbaric oxygen versus corticosteroids. The RCT found that a higher proportion of people completely recovered with hyperbaric oxygen compared with corticosteroids. It also reported that time to complete recovery was faster with hyperbaric oxygen. Categorised as Unknown effectiveness as there remains insufficient high-quality evidence to assess the effects of hyperbaric oxygen for people with Bell's palsy. New evidence; conclusion confirmed for: Corticosteroids Two systematic reviews added. Both reviews and two large RCTs included in the reviews found that corticosteroids improved rates of complete recovery of facial function... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4555883 Mon, 07 Mar 2011 23:00:00 +0100 4555883 http://www.medworm.com/index.php?rid=4555882&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0913%2F0913.jsp%3Frss%3Dtrue New option(s) added for: Dihydroartemisinin (intravenous) versus quinine New option added. Categorised as Unknown effectiveness as we found no RCT evidence to assess its effects. Dihydroartemisinin (intramuscular) versus quinine New option added. Categorised as Unknown effectiveness as we found no RCT evidence to assess its effects. Dihydroartemisinin (intravenous) versus artesunate (intravenous) New option added. Categorised as Unknown effectiveness as we found no RCT evidence to assess its effects. Dihydroartemisinin (intramuscular) versus artesunate (intramuscular) New option added. Categorised as Unknown effectiveness as we found no RCT evidence to assess its effects. Artemisinin derivativ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4555882 Mon, 07 Mar 2011 23:00:00 +0100 4555882 http://www.medworm.com/index.php?rid=4503432&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0813%2F0813.jsp%3Frss%3Dtrue New option(s) added for: Progestogens (intrauterine) New option added. Categorised as Unknown effectiveness as we found no RCTs to assess its effects in women with primary dysmenorrhoea. New evidence; conclusions changed for: Behavioural interventions New evidence added. Categorisation changed from Unknown effectiveness to Likely to be beneficial. Contraception (combined oral) New evidence added. Categorisation changed from Unknown effectiveness to Likely to be beneficial. Herbal remedies other than toki-shakuyaku-san New evidence added. Categorisation changed (from Unknown effectiveness to Likely to be beneficial). New evidence; conclusion confi... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4503432 Mon, 21 Feb 2011 23:00:00 +0100 4503432 http://www.medworm.com/index.php?rid=4503431&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0219%2F0219.jsp%3Frss%3Dtrue New option(s) added for: Advice to reduce sodium intake alone New option added. Categorised as Likely to be beneficial. Advice to reduce and/or modify fat intake alone New option added. Categorised as Unknown effectiveness. Advice to increase fruit and vegetable intake alone New option added. Categorised as Unknown effectiveness. Advice to increase fibre intake alone New option added. Categorised as Unknown effectiveness. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4503431 Mon, 21 Feb 2011 23:00:00 +0100 4503431 http://www.medworm.com/index.php?rid=4485139&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0901%2F0901.jsp%3Frss%3Dtrue New option(s) added for: Zinc supplementation for diarrhoea in resource-poor countries New option added. Categorised as Unknown effectiveness as we found no RCT evidence to assess its effects. Vitamin A supplementation in acute diarrhoea in resource-poor countries New option added. Categorised as Unknown effectiveness as we found no RCT evidence to assess its effects. New evidence; conclusions changed for: Antibiotics plus antimotility agents for travellers' diarrhoea New evidence added. Categorisation changed from Unknown effectiveness to Likely to be beneficial. New evidence; conclusion confirmed for: Oral rehydration solutions for mild-to-moderate diarrhoea in resour... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4485139 Tue, 15 Feb 2011 23:00:00 +0100 4485139 http://www.medworm.com/index.php?rid=4485138&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Feyd%2F0708%2F0708.jsp%3Frss%3Dtrue New option(s) added for: Cataract surgery (phaco or manual extracapsular extraction) in people with chronic uveitis: New option. Categorised as Unknown effectiveness. Different methods of medical control of uveitis at the time of cataract surgery New option. Categorised as unknown effectiveness. New evidence; conclusion confirmed for: Phaco extracapsular extraction: New evidence added. Categorisation unchanged (Beneficial). Adding diabetic retinopathy treatment to cataract surgery New evidence added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient evidence to judge this intervention. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4485138 Tue, 15 Feb 2011 23:00:00 +0100 4485138 http://www.medworm.com/index.php?rid=4485137&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0210%2F0210.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Propafenone for rhythm control New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Amiodarone for rhythm control New evidence added.Categorisation unchanged (Trade-off between benefits and harms). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4485137 Tue, 15 Feb 2011 23:00:00 +0100 4485137 http://www.medworm.com/index.php?rid=4473923&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fpac%2F1402%2F1402.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Antiplatelet drugs New evidence added. Categorisation unchanged (Beneficial) Calcium supplementation New evidence added. Categorisation unchanged (Beneficial). Antioxidants (under question on the effects of preventive interventions in women at risk of pre-eclampsia) New evidence added. Categorisation of antioxidants unchanged (Unknown effectiveness). Marine oil (fish oil), and other prostaglandin precursors (evening primrose oil) New evidence added. Categorisation unchanged (Unknown effectiveness). Glyceryl trinitrate versus placebo/no treatment: New evidence added. Categorisation unchanged (Unknown effectiveness). ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4473923 Mon, 14 Feb 2011 20:28:59 +0100 4473923 http://www.medworm.com/index.php?rid=4473924&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0102%2F0102.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Radiotherapy after breast-conserving surgery (for ductal carcinoma in situ) One systematic review added, which found that radiotherapy after breast-conserving surgery for ductal carcinoma in situ significantly reduced ipsilateral recurrence at up to 10.5 years of follow-up. Categorisation changed from Likely to be beneficial to Beneficial because of confirmation given in systematic review and maintenance of benefit with long-term follow-up. Adjuvant taxanes (for primary operable breast cancer) One systematic review and three subsequent RCTs added, which found that taxane-based therapies improved disease-free survival and overall survival compared with anthracycline-based regimens. Catego... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4473924 Tue, 08 Feb 2011 23:00:00 +0100 4473924 http://www.medworm.com/index.php?rid=4443065&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0312%2F0312.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Atomoxetine New evidence added. Categorisation unchanged (Likely to be beneficial). Methylphenidate New evidence added. Categorisation unchanged (Likely to be beneficial). Clonidine New evidence added. Categorisation unchanged (Likely to be beneficial). Modafinil New evidence added. Categorisation unchanged (Likely to be beneficial). Omega-3 polyunsaturated fatty acid compounds (fish oils) New evidence added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient RCT evidence to judge effects of this in... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4443065 Fri, 04 Feb 2011 23:00:00 +0100 4443065 http://www.medworm.com/index.php?rid=4425724&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fpac%2F1409%2F1409.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Progesterone in unexplained recurrent miscarriage Updated version of already included review added; no new evidence found. Categorisation unchanged (Unknown effectiveness) as there remains insufficient evidence to judge effects of this intervention. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4425724 Tue, 01 Feb 2011 23:00:00 +0100 4425724 http://www.medworm.com/index.php?rid=4425725&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0305%2F0305.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Desmopressin plus enuresis alarm New evidence added. Categorisation changed from Unknown effectiveness to Unlikely to be beneficial. New evidence; conclusion confirmed for: Desmopressin New evidence added. Categorisation unchanged (Beneficial). Dry bed training New evidence added. Categorisation unchanged (Unknown effectiveness). Dry bed training plus enuresis alarm New evidence added. Categorisation unchanged (Beneficial). Tricyclic drugs (imipramine, desipramine) New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Anticholinergic drugs (oxybutynin, tolte... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4425725 Mon, 31 Jan 2011 23:00:00 +0100 4425725 http://www.medworm.com/index.php?rid=4401760&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsh%2F1807%2F1807.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Surveillance New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Different adjuvant radiotherapy regimens New evidence added. Categorisation unchanged (Beneficial). Different number of cycles of adjuvant chemotherapy New evidence added. Categorisation unchanged (Unknown effectiveness), as there remains insufficient evidence to define the optimum number of cycles of adjuvant chemotherapy to use. Chemotherapy using etoposide plus cisplatin (with or without bleomycin) One systematic review updated; no new evidence added. Categorisation unchanged (Likely to be beneficial). Chemotherapy using vinblastine plus cisplatin plus ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4401760 Tue, 25 Jan 2011 23:00:00 +0100 4401760 http://www.medworm.com/index.php?rid=4364329&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0812%2F0812.jsp%3Frss%3Dtrue New option(s) added for: Oral NSAIDs Categorised as Unknown effectiveness as we found insufficient RCT evidence to assess their effects. Contraceptive (combined oral) New option. Categorised as Unknown effectiveness as we found no RCT evidence to assess its effects. New evidence; conclusion confirmed for: Toremifene New evidence added. Categorisation unchanged (Trade-off between benefits and harms). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4364329 Mon, 17 Jan 2011 23:00:00 +0100 4364329 http://www.medworm.com/index.php?rid=4364328&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frda%2F1505%2F1505.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Pleurodesis: New evidence added. Categorisation unchanged (trade-off between benefits and harms). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4364328 Mon, 17 Jan 2011 23:00:00 +0100 4364328 http://www.medworm.com/index.php?rid=4364327&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0923%2F0923.jsp%3Frss%3Dtrue New option(s) added for: Topical antimicrobials other than mupirocin nasal ointment, antiseptic body washes, chlorhexidine-neomycin nasal cream, and tea tree oil preparations New option. Categorised as unknown effectiveness, as we found no RCT evidence to assess its effects. New evidence; conclusions changed for: Tea tree oil preparations New evidence added. Categorisation changed from Unlikely to be beneficial to Unknown effectiveness. New evidence; conclusion confirmed for: Mupirocin nasal ointment New evidence added. Categorisation unchanged (likely to be beneficial). Antiseptic body washes New evidence added. Categorisation unchanged (unknown effec... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4364327 Mon, 17 Jan 2011 23:00:00 +0100 4364327 http://www.medworm.com/index.php?rid=4364326&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fhiv%2F0909%2F0909.jsp%3Frss%3Dtrue New option(s) added for: Micronutrient supplements New option added for which we found one RCT assessing the effects of selenium supplementation. The RCT did not report on prevention of mother-to-child transmission (MTCT) of HIV, but reported on infant mortality. The RCT found that selenium reduced infant mortality between 6 weeks and 6 months; however, the result was of borderline significance. The RCT found no significant difference between selenium and placebo in infant mortality at 6 weeks and maternal mortality at 6 months. As the RCT did not report on MTCT, categorised set as Unknown effectiveness. New evidence; conclusions changed for: Different methods of infant feeding One RCT added comparing early, abrupt cessation... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4364326 Mon, 17 Jan 2011 23:00:00 +0100 4364326 http://www.medworm.com/index.php?rid=4357048&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0807%2F0807.jsp%3Frss%3Dtrue New option(s) added for: Different switch antibiotic regimens versus each other New option added. No evidence found. Categorised as Unknown effectiveness. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4357048 Thu, 13 Jan 2011 23:00:00 +0100 4357048 http://www.medworm.com/index.php?rid=4357047&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frda%2F1509%2F1509.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Corticosteroids to reduce symptoms of acute infective sore throat One new systematic review added suggesting that, in people taking antibiotics, corticosteroids reduce symptoms. Categorisation changed from Trade-off between benefits and harms to Likely to be beneficial in adults who are also taking antibiotics. Effects in children are uncertain. New evidence; conclusion confirmed for: Antibiotics to reduce symptoms of acute infective sore throat One previously included systematic review updated; benefits and harms data enhanced, categorisation unchanged (Trade-off between benefits and harms). Antibiotics to prevent complications of acute infective sore throat One previo... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4357047 Thu, 13 Jan 2011 23:00:00 +0100 4357047 http://www.medworm.com/index.php?rid=4357046&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0918%2F0918.jsp%3Frss%3Dtrue New option(s) added for: Nitazoxanide New option. Categorised as Likely to be beneficial. Diloxanide New option. Categorised as Unlikely to be beneficial. Diiodohydroxyquinoline New option. Categorised as Unlikely to be beneficial. New evidence; conclusions changed for: Metronidazole New evidence added. Categorisation changed from Unlikely to be beneficial to Likely to be beneficial. New evidence; conclusion confirmed for: Secnidazole New evidence added. Categorisation unchanged (Likely to be beneficial). Ornidazole New evidence added. Categorisation unchanged (Likely to be beneficial). Tinidazole New evidence added... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4357046 Thu, 13 Jan 2011 23:00:00 +0100 4357046 http://www.medworm.com/index.php?rid=4357045&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0311%2F0311.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Antiseptic cream One RCT added comparing antiseptic cream plus cautery versus antiseptic cream alone. Categorisation unchanged (Likely to be beneficial). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4357045 Thu, 13 Jan 2011 23:00:00 +0100 4357045 http://www.medworm.com/index.php?rid=4339561&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0502%2F0502.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Corticosteroids (intranasal) versus placebo One RCT added, which compared intranasal mometasone versus placebo in 217 children aged 4 to 11 years. The RCT found no significant difference between intranasal mometasone and placebo in resolution of otitis media in at least one ear at 1 or 3 months as assessed by tympanometry. The sample was from primary care and so generalisable to most children. The cases were bilateral, but the histories were typical of those presenting in primary care. Categorisation changed from Unknown effectiveness to Unlikely to be beneficial. New evidence; conclusion confirmed for: Adenoidectomy One systematic review added (search date 2009). The revie... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4339561 Wed, 12 Jan 2011 23:00:00 +0100 4339561 http://www.medworm.com/index.php?rid=4339562&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0814%2F0814.jsp%3Frss%3Dtrue New option(s) added for: Uterine artery embolisation: New option added with one systematic review and 4 subsequent RCTs. Categorised as likely to be beneficial. New evidence; conclusion confirmed for: GnRHa plus tibolone versus GnRHa alone: New evidence added. Categorisation unchanged (Likely to be beneficial). Gonadorelin analogues alone: New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Laparoscopic myomectomy: New evidence added. Categorisation unchanged (Beneficial). Laparoscopically assisted vaginal hysterectomy: New evidence added. Categorisation unchanged (Likely to be ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4339562 Tue, 11 Jan 2011 23:00:00 +0100 4339562 http://www.medworm.com/index.php?rid=4333155&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdsd%2F0408%2F0408.jsp%3Frss%3Dtrue New option(s) added for: Stapling versus endoloops in laparoscopic appendicectomy New option. Categorised as Likely to be beneficial. Natural orifice surgery versus laparoscopic surgery New option. Categorised as Unknown effectiveness as we found no RCT evidence to assess its effects. New evidence; conclusion confirmed for: Antibiotics versus surgery New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Laparoscopic surgery versus open surgery (in adults) New evidence added. Categorisation unchanged (Trade-off between benefits and harms). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4333155 Fri, 07 Jan 2011 23:00:00 +0100 4333155 http://www.medworm.com/index.php?rid=4333154&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0202%2F0202.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Adding low molecular weight heparin to thrombolytics New evidence added. Categorisation unchanged (Likely to be beneficial). Adding unfractionated heparin to thrombolytics New evidence added. Categorisation unchanged (Unlikely to be beneficial). Glycoprotein IIb/IIIa inhibitors New evidence added. Categorisation unchanged (Trade-off between benefits and harms). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4333154 Fri, 07 Jan 2011 23:00:00 +0100 4333154 http://www.medworm.com/index.php?rid=4333157&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fskd%2F1714%2F1714.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Adapalene (topical) New evidence added. Categorisation unchanged (Likely to be beneficial). Doxycycline (oral) New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Lymecycline (oral) New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Minocycline (oral) New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Tetracycline (oral) New evidence added. Categorisation unchanged (Trade-off between benefits and harms). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4333157 Wed, 05 Jan 2011 23:00:00 +0100 4333157 http://www.medworm.com/index.php?rid=4333156&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0212%2F0212.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Injection sclerotherapy New evidence added. Categorisation changed from Unknown effectiveness to Likely to be beneficial. New evidence; conclusion confirmed for: Compression stockings New evidence added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient evidence to judge the effects of this intervention. Surgery (stripping) New evidence added. Categorisation unchanged (Likely to be beneficial). Radiofrequency ablation New evidence added. Categorisation unchanged (Unknown effectiveness) as there remains insufficient evidence to judge the effects of this in... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4333156 Wed, 05 Jan 2011 23:00:00 +0100 4333156 http://www.medworm.com/index.php?rid=4276328&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fskd%2F1718%2F1718.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Combination cytotoxic chemotherapy New evidence added. Categorisation unchanged (Unlikely to be beneficial). Dacarbazine or temozolomide New evidence added. Categorisation unchanged (Trade-off between benefits and harms). Adding interferon alfa to chemotherapy New evidence added. Categorisation unchanged (Unlikely to be beneficial). Adding interferon alfa plus interleukin-2 to cytotoxic chemotherapy New evidence added. Categorisation unchanged (Unlikely to be beneficial). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4276328 Tue, 21 Dec 2010 18:29:09 +0100 4276328 http://www.medworm.com/index.php?rid=4254828&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fskd%2F1713%2F1713.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Ketoconazole (scalp) One RCT added comparing ketoconazole 2% versus ciclopirox olamine 1.5% versus placebo. The RCT, which was primarily set up to assess the effectiveness of ciclopirox olamine, found that ketoconazole reduced scaling, itching, erythema, and global severity compared with placebo. Categorisation unchanged (Beneficial). Topical corticosteroids One RCT added comparing clobetasol propionate 0.05% shampoo applied for 2.5, 5, and 10 minutes versus placebo. The RCT found that clobetasol propionate 0.05% applied twice weekly for 2.5, 5, or 10 minutes improved total severity score compared with placebo; that clobetasol propionate 0.05% applied twice weekly for 5 minutes improved erythema and itchin... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4254828 Tue, 07 Dec 2010 23:00:00 +0100 4254828 http://www.medworm.com/index.php?rid=4221826&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0215%2F0215.jsp%3Frss%3Dtrue New option(s) added for: Ezetimibe in people at low risk New option for which we identified no systematic review or RCTs in people at low risk of CHD events. Categorisation set at Unknown effectiveness. Ezetimibe in people at medium risk New option for which we identified no systematic review or RCTs in people at medium risk of CHD events. Categorisation set at Unknown effectiveness. Ezetimibe in people at high risk New option for which we identified no systematic review or RCTs in people at high risk of CHD events. Categorisation set at Unknown effectiveness. New evidence; conclusion confirmed for: Statins in people at low risk of CHD One further report of an already reported RCT analysed... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4221826 Wed, 01 Dec 2010 23:00:00 +0100 4221826 http://www.medworm.com/index.php?rid=4216217&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frda%2F1511%2F1511.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Low tidal-volume mechanical ventilation One already reported systematic review updated (search date 2006) and new data added to the benefits section. The overall conclusions of the review remain the same. Two further reports added to the comments section as background data. Categorisation unchanged (Beneficial). Positive end expiratory pressure (PEEP) Two systematic reviews added comparing the effects of high PEEP versus low PEEP in people with ARDS/ALI. Interpretation of the results was complicated owing to possible confounding factors arising from clinical heterogeneity between the included RCTs (differences between the protocols employed and participants included with regard to disease... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4216217 Tue, 30 Nov 2010 23:00:00 +0100 4216217 http://www.medworm.com/index.php?rid=4216216&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdsd%2F0416%2F0416.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Aminosalicylates to maintain remission One review updated. No further data added. One systematic review added comparing mesalazine (1–4 g/day) versus placebo. It found that mesalazine significantly increased the proportion of people who maintained medically induced remission. Categorisation changed from Likely to be ineffective or harmful to Likely to be beneficial. Fish oil One systematic review added comparing fish oil versus placebo. The review reported that a larger proportion of people taking fish oil than placebo maintained remission, based on a pooled analysis of 6 RCTs; however, the review also reported that the RCTs included in the pooled analysis were clinically and statistically heterogeneous. ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4216216 Tue, 30 Nov 2010 23:00:00 +0100 4216216 http://www.medworm.com/index.php?rid=4209624&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0307%2F0307.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Bystander cardiopulmonary resuscitation: One prospective observational study added. The study reported that bystander cardiopulmonary resuscitation was not associated with increased survival in out-of-hospital paediatric cardiac arrest. Categorisation unchanged (Likely to be beneficial). Intubation versus bag–mask ventilation: One systematic review of out-of-hospital emergency intubation added. The review included only one paediatric trial, which was already included in this review. No new data added; therefore, categorisation unchanged (Unknown effectiveness). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4209624 Thu, 25 Nov 2010 23:00:00 +0100 4209624 http://www.medworm.com/index.php?rid=4209625&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0324%2F0324.jsp%3Frss%3Dtrue New search performed and critically appraised; no new evidence selected for inclusion. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4209625 Wed, 24 Nov 2010 23:00:00 +0100 4209625 http://www.medworm.com/index.php?rid=4198304&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fbly%2F2401%2F2401.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: CHOP 21 One new systematic review added, which found no new RCTs meeting Clinical Evidence inclusion criteria. Existing evidence re-evaluated and one RCT excluded because it included radiotherapy in the treatment arm. Further notes added to the comments section. Categorisation unchanged (Beneficial). CHOP 21 plus rituximab One systematic review added, which supersedes an earlier systematic review and also includes two RCTs previously reported in this Clinical Evidence review. No new evidence added from this newly added review. Categorisation unchanged (Beneficial). CHOP 14 One new systematic review added, which supersedes a previously reported systematic review as it found the same RCTs.Ca... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4198304 Mon, 15 Nov 2010 23:00:00 +0100 4198304 http://www.medworm.com/index.php?rid=4169317&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0209%2F0209.jsp%3Frss%3Dtrue New option(s) added for: Factor Xa inhibitors: New option, for which we identified one RCT. The RCT found no significant difference between fondaparinux and enoxaparin in mortality or MI at 30 days, 90 days, and 6 months. Fondaparinux was associated with less major bleeding compared with enoxaparin. A further report of the RCT found no significant difference in mortality or MI at 30 days between fondaparinux and enoxaparin in people concomitantly treated with a glycoprotein IIb/IIIa inhibitor. However, in people concomitantly treated with a thienopyridine, fondaparinux reduced mortality compared with enoxaparin, although there was no significant difference in MI between the two groups. Categorised as Likely to be beneficial. New evidence; conclusion ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4169317 Mon, 15 Nov 2010 23:00:00 +0100 4169317 http://www.medworm.com/index.php?rid=4173236&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0819%2F0819.jsp%3Frss%3Dtrue New option(s) added for: Tubal flushing for infertility associated with endometriosis New option added for which we found one systematic review that identified one RCT.The RCT found that tubal flushing with oil soluble contrast media increased the pregnancy rate and live birth rate in minimal to mild endometriosis in the first 6 months. Categorised as Likely to be beneficial as the results of the single RCT are supported by further data of the benefits of tubal flushing for infertility of any cause. Clomifene in unexplained fertility New option, for which we found two systematic reviews and one three-armed RCT. One review and subsequent RCT found no significant difference between clomifene and no treatment/placebo in pregnancy rate or l... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4173236 Thu, 11 Nov 2010 23:00:00 +0100 4173236 http://www.medworm.com/index.php?rid=4136301&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0922%2F0922.jsp%3Frss%3Dtrue New option(s) added for: Tigecycline New option added, for which we found one RCT.It found similar clinical cure rates and microbiological cure rates with tigecycline and vancomycin in people with serious MRSA infections. Categorised as Unknown effectiveness as we cannot draw conclusions from a single RCT. Pristinamycin New option added, for which we found no systematic review or RCTs. Categorised as unknown effectiveness. New evidence; conclusion confirmed for: Linezolid One systematic review added comparing linezolid versus vancomycin, which included six RCTs previously reported separately in this Clinical Evidence review. One subsequent RCT also added.The review and RCT presented results for infection at ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4136301 Thu, 28 Oct 2010 23:00:00 +0100 4136301 http://www.medworm.com/index.php?rid=4083534&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fpos%2F2103%2F2103.jsp%3Frss%3Dtrue New search performed and critically appraised; no new evidence selected for inclusion. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4083534 Tue, 12 Oct 2010 23:00:00 +0100 4083534 http://www.medworm.com/index.php?rid=4083536&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsd%2F1116%2F1116.jsp%3Frss%3Dtrue New option(s) added for: Intradiscal electrothermal therapy (IDETT) We found four systematic reviews that all reported the same two RCTs. The RCTs included in the reviews reported conflicting results for IDETT compared with placebo for both pain and function outcomes. Categorised as Unknown effectiveness. Radiofrequency denervation We found one systematic review comparing radiofrequency denervation versus sham treatment/placebo. The RCTs included in the review found conflicting results for radiofrequency denervation for both pain and function in people with presumed facet joint or discogenic low back pain. Categorised as Unknown effectiveness. Fusion surgery We found four systematic revie... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4083536 Fri, 08 Oct 2010 23:00:00 +0100 4083536 http://www.medworm.com/index.php?rid=4083535&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0905%2F0905.jsp%3Frss%3Dtrue New option(s) added for: Herpes zoster vaccines for prevention herpes zoster and subsequent postherpetic neuralgia: We found two RCTs comparing herpes zoster vaccines versus placebo or no treatment. The first RCT found that zoster vaccine reduced the number of confirmed cases of herpes zoster at a mean follow-up time of 3.12 years, and reduced the incidence of herpes zoster per 1000 person-years. It found that zoster vaccine reduced the herpes zoster burden of illness at a mean of 3.12 years. The RCT also found that zoster vaccine reduced the number of cases of postherpetic neuralgia at a mean follow-up time of 3.12 years, and decreased the incidence of postherpetic neuralgia per 1000 person-years. The second RCT only reported harms; it found that advers... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4083535 Fri, 08 Oct 2010 23:00:00 +0100 4083535 http://www.medworm.com/index.php?rid=4019975&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F2304%2F2304.jsp%3Frss%3Dtrue New option(s) added for: Behavioural therapy plus antihistamines for dyssomnia New option for which we found no systematic reviews or RCTs. Therefore categorised as Unknown effectiveness. Benzodiazepines for parasomnias New option for which we found no systematic reviews or RCTs. Therefore categorised as Unknown effectiveness. 5-hydroxytryptophan for parasomnias New option for which we found no systematic review or RCTs of sufficient quality. Therefore categorised as Unknown effectiveness. New evidence; conclusion confirmed for: Extinction and graduated extinction for dyssomnia in otherwise healthy children One systematic review added (search date 2005),which compared extinction and graduat... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4019975 Mon, 27 Sep 2010 23:00:00 +0100 4019975 http://www.medworm.com/index.php?rid=4019974&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0323%2F0323.jsp%3Frss%3Dtrue New search performed and critically appraised; no new evidence selected for inclusion. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4019974 Mon, 27 Sep 2010 23:00:00 +0100 4019974 http://www.medworm.com/index.php?rid=3963380&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0811%2F0811.jsp%3Frss%3Dtrue New option(s) added for: Chemotherapy plus bevacizumab for first-line treatment New option for which we identified one open-label RCT.The RCT found that adding bevacizumab to paclitaxel increased response rates and improved progression-free survival compared with paclitaxel alone but did not increase overall survival. Categorised as Unknown effectiveness as cannot draw conclusions from a single RCT. Chemotherapy plus tyrosine kinase inhibitor for first-line treatment in women with overexpressed HER2/neu oncogene New option for which we found one RCT. The RCT found that adding lapatinib to paclitaxel increased time to disease progression, progression-free survival, and response rates in women who were HER2 positive compared with paclitaxel alone b... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3963380 Wed, 08 Sep 2010 23:00:00 +0100 3963380 http://www.medworm.com/index.php?rid=3887094&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frda%2F1503%2F1503.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Influenza vaccine One already reported systematic review updated (search date 2006) and additional absolute data added to benefits and harms. The overall findings of the updated review remain the same. Categorisation unchanged (Likely to be beneficial). Pneumococcal vaccine One previously reported systematic review updated (search date 2007). Overall conclusions of the review remain the same. Categorisation of pneumococcal vaccine (for all-cause pneumonia and mortality in immunocompetent adults) unchanged (Unlikely to be beneficial). Antibiotics in outpatients One already reported systematic review updated (search date 2009) and new data added to benefits and harms. The overall conclusio... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3887094 Wed, 18 Aug 2010 23:00:00 +0100 3887094 http://www.medworm.com/index.php?rid=3874330&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0802%2F0802.jsp%3Frss%3Dtrue New option(s) added for: Aromatase inhibitors: New option for which we found two systematic reviews assessing the effects of aromatase inhibitors. The reviews identified no RCTs. Categorised as Unknown effectiveness. New evidence; conclusion confirmed for: Combined oral contraceptives at diagnosis: One systematic review and two RCTs added. One RCT compared combined oral contraceptives versus placebo. It found that oral contraceptives reduced dysmenorrhoea severity but not non-menstrual pain compared with placebo. The review and second RCT compared combined oral contraceptive versus progestogens. They found similar reductions in dysmenorrhoea, non-menstrual pelvic pain, deep dyspareunia, and dyschezia from... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3874330 Fri, 13 Aug 2010 23:00:00 +0100 3874330 http://www.medworm.com/index.php?rid=4209626&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fent%2F0510%2F0510.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Topical antibacterials (with or without corticosteroids): One systematic review and one additional RCT added; benefits and harms data enhanced; categorisation unchanged (Likely to be beneficial). The review found no significant difference between topical quinolone antibiotics and topical non-quinolone antibiotics in clinical cure rate at 14 to 28 days. However, the analysis included some RCTs comparing quinolone antibiotics and non-quinolone antibiotics in combination with corticosteroids, which may affect the generalisability of the results. The additional RCT found that a larger proportion of people had inactive disease at 4 weeks after treatment with neomycin–dexamethasone–glacial acetic acid compared with glacial ace... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=4209626 Tue, 03 Aug 2010 23:00:00 +0100 4209626 http://www.medworm.com/index.php?rid=3863571&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fpac%2F1411%2F1411.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Rutosides for haemorrhoids in pregnant women One updated systematic review identified no new evidence on the effects of rutosides in the treatment of haemorrhoids in pregnant women. One updated systematic review reported only in the harms section identified no new evidence on the adverse effects of rutosides. Categorisation unchanged (Likely to be beneficial). Anaesthetics (topical) for haemorrhoids in pregnant women One updated systematic review identified no new evidence on the effects of anaesthetics in the treatment of haemorrhoids in pregnant women. Categorisation unchanged (Unknown effectiveness). Bulk-forming laxatives for haemorrhoids in pregnant women One updated systematic review... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3863571 Tue, 03 Aug 2010 23:00:00 +0100 3863571 http://www.medworm.com/index.php?rid=3782110&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Forh%2F1301%2F1301.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: CBT One new systematic review added, which identified one already included RCT. Categorisation unchanged (Likely to be beneficial). Benzodiazepines One new systematic review added, which identified one already included RCT. Categorisation unchanged (Trade-off between benefits and harms). Antidepressants One new systematic review added, which identified one already included RCT. Categorisation unchanged (Unknown effectiveness). Benzydamine hydrochloride One new systematic review added, which identified one already included RCT. Categorisation unchanged (Unknown effectiveness). Dietary supplements One systematic review added, which identified three already... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3782110 Mon, 19 Jul 2010 23:00:00 +0100 3782110 http://www.medworm.com/index.php?rid=3782109&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmeh%2F1009%2F1009.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: CBT for bulimia nervosa One systematic review updated, no new RCTs added from this systematic review. Categorisation unchanged (Likely to be beneficial). CBT plus exposure/response prevention therapy One systematic review updated, no new evidence found. Categorisation unchanged (Unknown effectiveness). Pure or unguided self-help CBT One systematic review updated, no new RCTs found. Categorisation unchanged (Unknown-effectiveness). Guided self-help CBT One systematic review added. It found one RCT, which did not meet Clinical Evidence inclusion criteria for this review. Categorisation unchanged (Unknown effectiveness). Interpersonal psychotherapy One syst... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3782109 Mon, 19 Jul 2010 23:00:00 +0100 3782109 http://www.medworm.com/index.php?rid=3782108&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fknd%2F2002%2F2002.jsp%3Frss%3Dtrue New option(s) added for: Statins in people with end-stage renal disease and normal lipid profiles: New option for which we found one systematic review and two RCTs. The systematic review found no significant difference between statins and placebo in all-cause mortality and cardiovascular mortality, but reported that statins significantly reduced non-fatal cardiovascular events. The first RCT found that atorvastatin significantly reduced the composite outcome of all cardiac events (cardiovascular mortality, non-fatal MI, and interventions to treat coronary heart disease) compared with placebo, but found no significant difference in the non-composite outcomes of all-cause mortality, cardiovascular mortality, non-fatal MI, and non-fatal stroke. Th... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3782108 Mon, 19 Jul 2010 23:00:00 +0100 3782108 http://www.medworm.com/index.php?rid=3782107&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fend%2F0611%2F0611.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Antithyroid drugs for primary hyperthyroidism: One systematic review assessing different durations of treatment updated. The review found no additional RCTs, therefore no new data were added. Categorisation unchanged (Likely to be beneficial). Radioactive iodine for primary hyperthyroidism: One RCT added comparing iodine-131 versus medical treatment for 18 months. The RCT found that iodine-131 increased the risk of thyroid-associated ophthalmopathy compared with medical treatment. Categorisation unchanged (Likely to be beneficial). Antithyroid drugs plus thyroxine for primary hyperthyroidism: One systematic review updated. The review did not include any additional RCTs, therefore no new d... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3782107 Mon, 19 Jul 2010 23:00:00 +0100 3782107 http://www.medworm.com/index.php?rid=3752135&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0903%2F0903.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Electronic mosquito repellents in non-pregnant adult travellers Option title clarified. Changed from electronic buzzers to electronic mosquito repellents. One systematic review (search date 2009) added, which found no RCTs reporting on clinical outcomes. The review identified 10 field entomological studies that reported mosquitoes landing on skin as an outcome. Details of these studies added to the comments section as background data. Categorisation unchanged (Unknown effectiveness). Insecticide-treated nets in non-pregnant adult travellers One cluster RCT in long-term residents using long-lasting insecticidal nets added. Benefits and harms sections enhanced. Overall conclusions the same as before. Categori... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3752135 Mon, 12 Jul 2010 23:00:00 +0100 3752135 http://www.medworm.com/index.php?rid=3735250&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fend%2F0606%2F0606.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Glycaemic control in early nephropathy, type 2 diabetes One large RCT added to the comments section found that intensive glucose control reduced renal complications (new or worsening nephropathy) compared with standard control in people with type 2 diabetes, most of whom did not have a diagnosis of nephropathy. The RCT did not carry out a subgroup analysis of people with early or late nephropathy and small numbers of this subgroup mean that the overall results of the trial may not be generalisable to our population of interest. Therefore we have not reported the RCT in full in our benefits and harms sections. Categorisation unchanged (Unknown effectiveness). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3735250 Thu, 08 Jul 2010 23:00:00 +0100 3735250 http://www.medworm.com/index.php?rid=3731491&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fhiv%2F0908%2F0908.jsp%3Frss%3Dtrue New option(s) added for: Discontinuing secondary prophylaxis for PCP or toxoplasmosis New option for which we found three RCTs. Categorised as Likely to be beneficial based both on RCTs and observational evidence. Discontinuing secondary prophylaxis for CMV New option for which we found no RCTs. However, categorised as Likely to be beneficial as there is consensus that discontinuation is safe in people receiving highly active antiretroviral treatment (HAART) if the CD4 cell count is greater than 100 to 150/mm3 for more than 6 months and regular eye tests are undertaken. Discontinuing secondary prophylaxis for MAC New option for which we found no RCTs. However, categorised as Likely to be beneficial as there ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3731491 Mon, 28 Jun 2010 23:00:00 +0100 3731491 http://www.medworm.com/index.php?rid=3712101&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fnud%2F1214%2F1214.jsp%3Frss%3Dtrue Conclusion unchanged. Categorisation unchanged (Unknown effectiveness). Educational programmes for people with partial or generalised epilepsy One systematic review, search date updated, no new evidence found. Categorisation unchanged (Likely to be beneficial). Relaxation plus behavioural modification therapy for people with partial or generalised epilepsy One systematic review, search date updated, no new evidence found. Categorisation unchanged (Unknown effectiveness). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3712101 Mon, 28 Jun 2010 23:00:00 +0100 3712101 http://www.medworm.com/index.php?rid=3708473&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsd%2F1108%2F1108.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Topical NSAIDs versus placebo: One systematic review added comparing topical NSAIDs versus placebo in people with osteoarthritis reached the same conclusions as previously cited review as it found many of the same RCTs. While topical NSAIDs reduce pain compared with placebo at 1 week, the pain reduction is likely to be clinically unimportant to patients. Categorisation unchanged (Unknown effectiveness). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3708473 Mon, 28 Jun 2010 23:00:00 +0100 3708473 http://www.medworm.com/index.php?rid=3708472&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0915%2F0915.jsp%3Frss%3Dtrue New option(s) added for: Chemoprophylaxis with single-dose rifampicin New option for which we found one RCT comparing chemoprophylaxis with single-dose rifampicin versus placebo in contacts of people with leprosy. It found that rifampicin reduced the number of contacts with a diagnosis of leprosy at 1 to 2 years compared with placebo, but it found no significant difference between the groups in new cases of leprosy at 3 to 4 years. Categorised as Beneficial. New evidence; conclusion confirmed for: Bacillus Calmette–Guerin One systematic review (search date 2006) added, which compared Bacillus Calmette–Guerin (BCG) versus placebo or no treatment , and one RCT added, which compared BCG revaccination versus no BCG revaccinat... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3708472 Mon, 28 Jun 2010 23:00:00 +0100 3708472 http://www.medworm.com/index.php?rid=3708471&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0906%2F0906.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Antiparasitic drugs in pregnancy One updated systematic review identified no new evidence on the effects of antiparasitic drugs versus no treatment. Categorisation unchanged (Unknown effectiveness). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3708471 Mon, 28 Jun 2010 23:00:00 +0100 3708471 http://www.medworm.com/index.php?rid=3708469&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdsd%2F0413%2F0413.jsp%3Frss%3Dtrue New option(s) added for: Lubiprostone: New option. Two RCTs identified comparing lubiprostone versus placebo. The first RCT compared lubiprostone (24, 48, or 72 micrograms/day) versus placebo for 3 weeks.The RCT found that all three doses of lubiprostone increased the number of spontaneous bowel movements (SBMs) compared with placebo . During week 1 of the study, the RCT found that 48 and 72 micrograms daily lubiprostone increased SBMs compared with placebo, but there was no significant difference between 25 micrograms daily lubiprostone and placebo. During week 2 of the study, the RCT found that all three doses of lubiprostone increased SBMs compared with placebo; however, there was no significant difference between groups at week 3. The RCT found t... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3708469 Mon, 28 Jun 2010 23:00:00 +0100 3708469 http://www.medworm.com/index.php?rid=3712102&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fnud%2F1201%2F1201.jsp%3Frss%3Dtrue New option(s) added for: Levetiracetam New option added for which we found no RCTs satisfying Clinical Evidence inclusion criteria. Categorised as Likely to be beneficial, based on consensus. Gabapentin New option added for which we no RCTs satisfying Clinical Evidence inclusion criteria. Categorised as Likely to be beneficial, based on consensus. Addition of second-line antiepileptics (in drug-resistant generalised epilepsy) New option added for which we found three RCTs. One RCT found that adding lamotrigine to usual drug treatment reduced seizures in people with generalised tonic clonic or absence seizures, compared with adding placebo to usual drug treatment. Two RCTs found that adding levetiracetam to us... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3712102 Tue, 22 Jun 2010 23:00:00 +0100 3712102 http://www.medworm.com/index.php?rid=3708474&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fnud%2F1210%2F1210.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Hyperventilation: One updated systematic review found no new evidence on the effects of hyperventilation. Categorisation unchanged (Unknown effectiveness). Hypothermia (therapeutic): One systematic review updated. The review found no significant difference between hypothermia and normothermia in rates of mortality. The review found conflicting evidence on unfavourable outcomes (including death, vegetative state, or severe disability). In a meta-analysis of RCTs of any quality, the review found that hypothermia reduced the risk of unfavourable outcomes compared with normothermia. However, a subgroup analysis of high-quality RCTs found no significant difference between groups for unfavourable outcomes. Catego... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3708474 Thu, 10 Jun 2010 23:00:00 +0100 3708474 http://www.medworm.com/index.php?rid=3627462&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsd%2F1110%2F1110.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Conservative versus operative treatment for most types of hip fracture One updated systematic review found no new evidence on the effects of conservative treatment versus operative treatment. Categorisation unchanged (Unlikely to be beneficial). Internal fixation versus arthroplasty for intracapsular hip fracture One systematic review added reached similar conclusions to previously reported reviews (internal fixation is associated with a higher rate of re-operation compared with arthroplasty and no significant difference between treatments in mortality at 1 year); this review supports previously reported evidence. We have previously identified a larger review that identified the same RCTs, and so a... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3627462 Fri, 28 May 2010 23:00:00 +0100 3627462 http://www.medworm.com/index.php?rid=3583419&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsd%2F1115%2F1115.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Immobilisation One RCT added, comparing three different types of immobilisation versus functional treatment for 10 days, at 1, 3 and 9 months' follow-up. It found that below-knee cast improved ankle function, pain, and the physical component of the SF-12 questionnaire at 1-month follow-up, and improved ankle function, pain, activities of daily living, and ability to do sports at 3 months' follow-up compared with functional treatment. It found that an ankle brace improved ankle function and the mental health component of the SF-12 questionnaire at 3 months' follow-up compared with functional treatment. However, it found no significant difference between any type of immobilisation and functional treatment for any other outcome... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3583419 Thu, 13 May 2010 23:00:00 +0100 3583419 http://www.medworm.com/index.php?rid=3531980&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fskd%2F1709%2F1709.jsp%3Frss%3Dtrue New search performed and critically appraised; no new evidence selected for inclusion. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3531980 Tue, 04 May 2010 23:00:00 +0100 3531980 http://www.medworm.com/index.php?rid=3513160&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdsd%2F0401%2F0401.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Preoperative radiotherapy in people with rectal cancer One systematic review added and one subsequent report of an RCT included in the review added, which compared the effects of preoperative radiotherapy plus surgery versus surgery alone. Two further RCTs added, which compared the effects of preoperative radiotherapy regimens versus postoperative radiotherapy regimens. Categorisation changed in light of additional evidence. Preoperative radiotherapy in people with rectal cancer categorised as Beneficial (changed from Trade off between benefits and harms). New evidence; conclusion confirmed for: Adjuvant systemic chemotherapy Previous option restructured to include only adjuvan... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3513160 Tue, 27 Apr 2010 23:00:00 +0100 3513160 http://www.medworm.com/index.php?rid=3506225&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fseh%2F1607%2F1607.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Erythromycin or amoxicillin (multiple-dose regimens) for pregnant women One systematic review added comparing erythromycin versus azithromycin; the review found no significant difference between azithromycin and erythromycin in rate of microbiological cure. Although rate of cure was higher with azithromycin, erythromycin was associated with a high cure rate. The review found that erythromycin was associated with a higher rate of GI adverse effects. Categorisation unchanged (Likely to be beneficial). Antibiotics (single dose) for pregnant women One systematic review added comparing azithromycin versus erythromycin; the review found no significant difference between azithromycin and erythromycin in rate of mi... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3506225 Thu, 22 Apr 2010 23:00:00 +0100 3506225 http://www.medworm.com/index.php?rid=3455543&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0201%2F0201.jsp%3Frss%3Dtrue New option(s) added for: Decompressive hemicraniectomy New option added, for which we found three RCTs, all of which were terminated early. The first RCT found lower mortality with decompressive craniectomy plus standard medical treatment compared with standard medical treatment but found no significant difference between groups in the primary outcome of moderate disability or better at 6 months.The second RCT found higher survival at 30 days with hemicraniectomy plus conservative treatment compared with conservative treatment alone .The third RCT found lower mortality in the surgical group compared with the best medical group at 1 year but it found no significant difference between groups in the proportion of people with a poor outcome (modifi... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3455543 Fri, 09 Apr 2010 23:00:00 +0100 3455543 http://www.medworm.com/index.php?rid=3451316&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Forh%2F1302%2F1302.jsp%3Frss%3Dtrue New option(s) added for: Active surveillance of asymptomatic impacted wisdom teeth New option for which we found no systematic review, RCTs, or prospective cohort studies with a control group. Categorised as "Unknown effectiveness". New evidence; conclusion confirmed for: Extraction of impacted wisdom teeth: different surgical methods Five RCTs added comparing different surgical techniques versus each other. None of the RCTs found a definitive benefit for one technique compared with another. Considered with previously reported evidence, it remains unclear whether any individual surgical method is more effective than another. Categorisation unchanged (Unknown effectiveness). (Source: Cli... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3451316 Thu, 08 Apr 2010 23:00:00 +0100 3451316 http://www.medworm.com/index.php?rid=3451318&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fspc%2F2407%2F2407.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Opioid antagonists: One systematic review and five subsequent RCTs added. The review and subsequent RCTs found that oral alvimopam, subcutaneous methylnaltrexone, and naloxone combined with prolonged-release oxycodone improved bowel movements compared with placebo or no treatment. Categorisation unchanged (Beneficial). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3451318 Tue, 06 Apr 2010 23:00:00 +0100 3451318 http://www.medworm.com/index.php?rid=3451317&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fskd%2F1719%2F1719.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Cryotherapy (response/recurrence within 1 year of treatment): One RCT added comparing cryotherapy versus photodynamic therapy. The RCT found no difference between groups for treatment response at 3 months or rates of recurrence at 1 year. Categorisation unchanged (Likely to be beneficial). Imiquimod 5% cream (response/recurrence within 1 year of treatment): Two RCTs added. The first RCT compared imiquimod 5% cream once daily for 6 weeks prior to Mohs' micrographic surgery (MMS) versus vehicle cream once daily for 6 weeks prior to MMS. The RCT found that a higher proportion of people were histologically free of tumour on complete tissue block sectioning at MMS with imiquimod 5% cream compared with ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3451317 Tue, 06 Apr 2010 23:00:00 +0100 3451317 http://www.medworm.com/index.php?rid=3430991&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0207%2F0207.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Vitamin B supplements (including folate) Two systematic reviews and one RCT comparing folate versus placebo added, which all found no significant difference in rates of stroke between folate and placebo. Categorisation changed from Unknown effectiveness to Unlikely to be beneficial. New evidence; conclusion confirmed for: One systematic review added, which found that antiplatelet therapy for acute ischaemic stroke reduced the incidence of recurrent ischaemic stroke from 21 days' to 6 months' follow-up. Categorisation unchanged (Beneficial). Blood pressure reduction One new RCT added, comparing telmisartan versus placebo in people with a history of ischaemic stroke, which found no... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3430991 Mon, 29 Mar 2010 23:00:00 +0100 3430991 http://www.medworm.com/index.php?rid=3413395&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdsd%2F0407%2F0407.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Nitric acid donors (topical glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate) One RCT added comparing glyceryl trinitrate, diltiazem, and no treatment; one RCT added comparing glyceryl trinitrate, isosorbide mononitrate, and placebo gels; one RCT added comparing a glyceryl trinitrate suppository versus a placebo suppository; one RCT added comparing intra-anal application of glyceryl trinitrate using a rectal cannula versus perianal application using a gloved finger; one RCT added comparing topical glyceryl trinitrate versus oral nifedipine; one RCT added comparing glyceryl trinitrate ointment versus botulinum A toxin; and one RCT added comparing glyceryl trinitrate ointment versus lateral internal sphinctero... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3413395 Wed, 24 Mar 2010 23:00:00 +0100 3413395 http://www.medworm.com/index.php?rid=3413396&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmsd%2F1114%2F1114.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Nerve and tendon gliding exercises One systematic review (search date 2008) and one subsequent RCT added, which compared nerve and/or tendon gliding exercises plus wrist splints versus wrist splints alone. The systematic review and subsequent RCT found no significant differences between nerve and/or tendon gliding exercises plus wrist splints and wrist splints alone in most outcomes for symptom severity and hand function. Categorisation therefore changed from "Unknown effectiveness" to "Unlikely to be beneficial". New evidence; conclusion confirmed for: Corticosteroids (local injection) One systematic review updated (search date 2006) and one systematic review added (search date 2006). ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3413396 Tue, 23 Mar 2010 23:00:00 +0100 3413396 http://www.medworm.com/index.php?rid=3380737&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fnud%2F1209%2F1209.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Slow ascent (or acclimatisation) for prevention One small quasi-RCT added comparing ascent from 3730 m to 7546 m over 15 days (rapid ascent) versus over 19 days (slow ascent) found that climbers following the slow-ascent protocol had lower acute mountain sickness scores compared with those following the faster-ascent protocol. However, the RCT had methodological flaws (low follow-up at some assessments, and variations in protocol). Evidence reassessed at update. Categorisation changed to Likely to be beneficial by consensus (previously Beneficial by consensus). New evidence; conclusion confirmed for: Acetazolamide for prevention One RCT added found that acetazolamide reduced the propor... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3380737 Thu, 18 Mar 2010 23:00:00 +0100 3380737 http://www.medworm.com/index.php?rid=3367946&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Feyd%2F0704%2F0704.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Empirical treatment with topical antibiotics in people with suspected bacterial conjunctivitis One RCT with weak methods added comparing moxifloxacin versus combination trimethoprim/polymyxin. The RCT found that moxifloxacin increased clinical and microbiological cure rates compared with trimethoprim/polymyxin, which ran contrary to findings of multiple other RCTs that found equivalent effectiveness for these outcomes when different antibiotics were compared with each other. Categorisation unchanged (Likely to be beneficial). Antibiotics (topical) in people with culture-positive non-gonococcal bacterial conjunctivitis Five RCTs added. The first three RCTs compared top... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3367946 Mon, 15 Mar 2010 23:00:00 +0100 3367946 http://www.medworm.com/index.php?rid=3308874&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0804%2F0804.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Tibolone Two RCTs added comparing tibolone versus placebo. The first RCT found that tibolone (both 1.25 and 2.5 mg) reduced the frequency and severity of hot flushes at 12 weeks. The second RCT evaluated the risk of breast cancer recurrence with tibolone, and was stopped early after finding that tibolone significantly increased the rate of breast cancer at a median follow-up of 3.5 years.Categorisation changed (from Beneficial to Trade-off between benefits and harms). New evidence; conclusion confirmed for: Oestrogens alone Three RCTs evaluating vasomotor symptoms added. All three RCTs found that oestrogen reduced hot-flush frequency and severity compared with placeb... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3308874 Thu, 25 Feb 2010 23:00:00 +0100 3308874 http://www.medworm.com/index.php?rid=3308873&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0204%2F0204.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Angiotensin II receptor blockers for diastolic heart failure One RCT added comparing irbesartan versus placebo found no significant difference between irbesartan and placebo in all-cause mortality or in hospital admission for cardiovascular causes at a mean follow-up of 49.5 months. Evidence for effect of irbesartan on hospital admission for cardiovascular disease differs from evidence previously reported for candesartan for this outcome. Effects of angiotensin II receptor blockers as a class in treatment of diastolic heart failure is unclear. Categorisation changed from Likely to be beneficial to Unknown effectiveness. New evidence; conclusion confirmed for: Multidisciplinary intervent... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3308873 Thu, 25 Feb 2010 23:00:00 +0100 3308873 http://www.medworm.com/index.php?rid=3285691&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0214%2F0214.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Potassium supplementation One systematic review added found no significant difference at 8 to 16 weeks between potassium supplementation and placebo in improvement in systolic and diastolic blood pressure, although the difference between groups for both outcomes was large.The authors of the review also commented that follow-up of some of the RCTs included in the meta-analysis may have been too short to draw conclusions on the effectiveness of potassium supplementation. The findings and conclusion reached by the review differ from systematic review evidence previously presented. One review and one RCT added assessing the effects of combined mineral supplementation on blood pressure found no significant difference between place... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3285691 Thu, 18 Feb 2010 23:00:00 +0100 3285691 http://www.medworm.com/index.php?rid=3271939&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fend%2F0604%2F0604.jsp%3Frss%3Dtrue New option(s) added for: Diethylpropion New option for which we found one systematic review. The review found less weight loss with diethylpropion compared with phentermine. Data were from one small RCT and effects of diethylpropion in weight loss are unclear. Categorised as Unknown effectiveness. Mazindol New option for which we found no evidence. Categorised as Unknown effectiveness. Bariatric surgery New option for which we found one systematic review. The review identified two RCTs and three cohort studies assessing the effects of various bariatric surgical techniques (gastric banding, gastric bypass, vertical banded gastroplasty, biliopancreatic diversion, and sleeve gastrectomy) in people with morbid obesity. All studies ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3271939 Thu, 11 Feb 2010 23:00:00 +0100 3271939 http://www.medworm.com/index.php?rid=3260751&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fnud%2F1212%2F1212.jsp%3Frss%3Dtrue New option(s) added for: Zolmitriptan (intranasal) to abort cluster headache New option for which we found two RCTs. Both RCTs found that intranasal zolmitriptan improved headache relief and pain at 30 minutes compared with placebo. Categorised as Beneficial. New evidence; conclusion confirmed for: High-dose and high-flow-rate oxygen One systematic review added identified no new evidence assessing the effects of high-dose and high-flow-rate oxygen to abort cluster headache. Categorisation unchanged (Likely to be beneficial by consensus). Hyperbaric oxygen One systematic review added identified no new evidence assessing the effects of hyperbaric oxygen to abort cluster headache. Categorisation uncha... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3260751 Tue, 09 Feb 2010 23:00:00 +0100 3260751 http://www.medworm.com/index.php?rid=3260750&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0306%2F0306.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Prophylactic antibiotics One systematic review (search date 2006) and two subsequent RCTs added, which compared antibiotic prophylaxis versus no treatment. The systematic review included children with primary vesicoureteric reflux (VUR), and identified one RCT; the first subsequent RCT included children with febrile UTI and primary VUR; and the second subsequent RCT included children with a febrile UTI, with or without VUR. The systematic review and subsequent RCTs found no significant differences in the recurrence of febrile UTI and parenchymal defects between antibiotic prophylaxis and no treatment. One further RCT added, which compared trimethoprim–sulfamethoxazole versus nitrofurantoin in children with a previ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3260750 Tue, 09 Feb 2010 23:00:00 +0100 3260750 http://www.medworm.com/index.php?rid=3256726&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0309%2F0309.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Simethicone versus placebo: One systematic review added comparing the effects of simethicone versus placebo on duration of crying or presence of colic in infants. This review superseded two earlier reviews, but added no further evidence. Categorisation unchanged (Unknown effectiveness) as there remains insufficient good-quality evidence to assess simethicone. Spinal manipulation versus simethicone: One systematic review added, which included the same RCT as the previously included review, therefore no new data was added. Categorisation unchanged (Unknown effectiveness). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3256726 Fri, 05 Feb 2010 23:00:00 +0100 3256726 http://www.medworm.com/index.php?rid=3233422&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmeh%2F1005%2F1005.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Fluoxetine to treat PTSD Two RCTs added found no significant difference between fluoxetine and placebo in PTSD symptoms at the end of treatment (8–12 weeks). One of the RCTs also found no significant difference between fluoxetine and placebo in the proportion of people no longer meeting diagnostic criteria for PTSD at the end of treatment. One RCT compared fluoxetine versus eye movement desensitisation and reprocessing (EMDR). It found no significant difference between treatments in PTSD symptoms at the end of treatment. However, EMDR was found to be more effective at sustaining improvement in symptoms at 6 months compared with fluoxetine. Evidence added at update suggests effects of fluoxetine in treating PTSD ar... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3233422 Wed, 03 Feb 2010 14:43:06 +0100 3233422 http://www.medworm.com/index.php?rid=3233421&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0921%2F0921.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Interferon plus ribavirin in treatment-naïve people One systematic review added found that a significantly smaller proportion of people achieved SVR with interferon plus ribavirin compared with peginterferon plus ribavirin. Although evidence suggests that interferon plus ribavirin is less effective than peginterferon plus ribavirin, there is evidence that combination interferon treatment is more effective than interferon monotherapy. Categorisation unchanged (Beneficial). Peginterferon plus ribavirin in treatment-naïve people One RCT added found that peginterferon plus ribavirin (dose based on patient's weight) increased the proportion of people achieving sustained virological response (SVR) compared with... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3233421 Wed, 03 Feb 2010 14:43:03 +0100 3233421 http://www.medworm.com/index.php?rid=3233424&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Frdc%2F1501%2F1501.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Education about acute asthma One systematic review (search date 2006) added comparing education versus usual care in adults who had attended an emergency department for asthma exacerbation. It found that education reduced hospital admissions compared with usual care, but it found no significant difference in subsequent presentations to emergency departments, primary care physician urgent visits, primary care physician call outs, quality of life, physical limitations caused by asthma, or lung function, between education and control. Evidence added at update does not support evidence previously reported on effects of education about asthma. Considering evidence added at update, categorisation changed from "Beneficial" to "Unkno... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3233424 Thu, 21 Jan 2010 23:00:00 +0100 3233424 http://www.medworm.com/index.php?rid=3161333&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fpac%2F1404%2F1404.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Magnesium sulphate: Two systematic reviews added to the comments section. The first review reported that the percentage of women with a successful delay of delivery by 48 hours was 53% with control/placebo and 89% with magnesium sulphate. The percentage of women with successful delay of labour until 37 weeks was 36% with control/placebo and 42% with magnesium sulphate. Neonatal mortality occurred in 2% with placebo and 1% with magnesium sulphate. Overall rates of adverse effects were 1% with placebo and 3% with magnesium sulphate. However, no direct comparisons were made in this review. The second review reported that magnesium sulphate given before preterm delivery for neuroprotection has demonstrated a reduction in... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3161333 Mon, 11 Jan 2010 23:00:00 +0100 3161333 http://www.medworm.com/index.php?rid=3154770&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0815%2F0815.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Imidazoles (intravaginal): One systematic review added comparing intravaginal imidazoles versus oral fluconazole or itraconazole. The review found no significant difference between intravaginal treatment and oral treatment in clinical cure at short- and long-term follow-up, or mycological cure at short-term follow-up. However, intravaginal imidazoles were less effective than oral treatment with fluconazole or itraconazole for achieving long-term mycological cure. Categorisation of intravaginal imidazoles unchanged (Beneficial). Fluconazole (oral): One systematic review added comparing oral fluconazole versus oral itraconazole. The review found no significant difference between groups for clinical or mycolog... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3154770 Tue, 05 Jan 2010 23:00:00 +0100 3154770 http://www.medworm.com/index.php?rid=3154769&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fend%2F0605%2F0605.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Levothyroxine (L-thyroxine) plus liothyronine for clinical (overt) hypothyroidism One systematic review added comparing L-thyroxine alone versus a combination of L-thyroxine plus liothyronine (L-tri-iodothyronine) in people with primary hypothyroidism. The review added no further data than already included and also found no difference between groups in psychiatric symptoms. Categorisation unchanged (Unlikely to be beneficial). Levothyroxine (L-thyroxine) for subclinical hypothyroidism One systematic review added comparing thyroid hormone replacement versus placebo or no treatment. The review found that hormone replacement improved general symptoms and cognitive function compared with placebo or n... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3154769 Tue, 05 Jan 2010 23:00:00 +0100 3154769 http://www.medworm.com/index.php?rid=3154768&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdsd%2F0410%2F0410.jsp%3Frss%3Dtrue New evidence; conclusions changed for: CBT Two systematic reviews and one RCT added. These supersede three older previously reported systematic reviews, as they provided more information, included many of the same studies, and reached similar conclusions. Categorisation changed from Unknown effectiveness to Likely to be beneficial. Hypnotherapy Two systematic reviews added. These supersede a previously reported early narrative systematic review as they include some of the same studies, provide more information, and reach similar conclusions. One of the new systematic reviews carried out a meta-analysis and found that hypnotherapy reduced global symptoms or abdominal pain compared with placebo.Categorisation changed ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3154768 Tue, 05 Jan 2010 23:00:00 +0100 3154768 http://www.medworm.com/index.php?rid=3112963&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0806%2F0806.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Progesterone: One systematic review (2 RCTs; 281 women) found no overall improvement in premenstrual symptoms in women taking luteal-phase progesterone for 2 to 4 months compared with placebo. Categorisation changed from Trade-off between benefits and harms to Unknown effectiveness. New evidence; conclusion confirmed for: SSRIs: One systematic review and one subsequent RCT added to benefits and harms, both of which found that SSRIs improved premenstrual symptoms, but were associated with a number of adverse effects, including nausea, insomnia, headache, asthenia, and decreased libido. Categorisation unchanged (Trade-off between benefits and harms). Oral contra... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3112963 Mon, 21 Dec 2009 23:00:00 +0100 3112963 http://www.medworm.com/index.php?rid=3112962&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fchd%2F0316%2F0316.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Monovalent measles immunisation or combined MMR immunisation versus placebo or no immunisation: Three self-controlled case series added to harms, which found increased rates of febrile convulsions, idiopathic thrombocytopenic purpura (ITP), fever, rash, and diarrhoea after MMR immunisation. One self-controlled case series added to harms, which found no cases of aseptic meningitis after MMR immunisation containing RIT 4385 mumps immunisation strain. Categorised as Beneficial. Monovalent rubella immunisation or combined MMR immunisation versus placebo or no immunisation : One population-based study added to benefits, which found that endemic cases of rubella were rare in the USA between 2001 and 2004. One cas... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3112962 Mon, 21 Dec 2009 23:00:00 +0100 3112962 http://www.medworm.com/index.php?rid=3054420&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwoh%2F0817%2F0817.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Anterior colporrhaphy with mesh reinforcement versus traditional anterior colporrhaphy One systematic review updated, reporting no additional RCTs, so no new data added. Three subsequent RCTs added. One RCT found that anterior colporrhaphy with porcine skin collagen implant at 1-year follow-up was more effective than anterior colporrhaphy without implant in preventing anatomical anterior recurrence. Two RCTs found that anterior colporrhaphy with polypropylene mesh was more effective than anterior colporrhaphy without mesh in preventing cystocoele recurrence at 1 year. Categorisation unchanged (Beneficial). (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3054420 Mon, 30 Nov 2009 23:00:00 +0100 3054420 http://www.medworm.com/index.php?rid=3035165&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fnud%2F1213%2F1213.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Endovascular coiling versus surgical clipping One follow-up report of an included RCT added, which found that endovascular coiling increased retreatment rates for the same aneurysm compared with surgical clipping at 4.5 to 12 years, but it did not assess the significance of the difference between groups. Categorisation unchanged (Beneficial). Nimodipine (oral) One systematic review updated with new data from RCTs. The review confirmed its previous conclusion that oral nimodipine reduced clinical signs of secondary ischaemic, radiological signs of cerebral infarction, and the combined outcome of dependence or death compared with placebo or no treatment. It found no significant difference in mortality between... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3035165 Mon, 23 Nov 2009 23:00:00 +0100 3035165 http://www.medworm.com/index.php?rid=3035164&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0211%2F0211.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Cilostazol One systematic review added, including RCTs already reported in this Clinical Evidence review. Evidence re-evaluated. Categorisation changed from Trade-off between benefits and harms to Likely to be beneficial. New evidence; conclusion confirmed for: Antiplatelet agents One systematic review added, reporting that antiplatelet agents (aspirin or aspirin plus dipyridamole) reduced arterial occlusion of both venous and artificial peripheral bypass grafts versus placebo at 12 months. It found no significant difference in GI adverse effects, or major bleeding between groups. One RCT added, reporting lower MI rates with clopidogrel plus aspirin versus placebo plus aspirin after 26 m... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3035164 Mon, 23 Nov 2009 23:00:00 +0100 3035164 http://www.medworm.com/index.php?rid=3032214&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fent%2F0509%2F0509.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Intranasal antihistamines (azelastine) Four RCTs added comparing intranasal azelastine versus placebo. Three of the RCTs found that azelastine reduced nasal symptom severity compared with placebo, but one found no significant difference between groups.Two further RCTs added, which found no significant difference between azelastine and oral cetirizine in nasal symptom severity; one of the RCTs found that azelastine improved quality of life scores compared with cetirizine.One small RCT added comparing azelastine with oral loratadine, which found no significant difference between groups in nasal symptom severity.Categorisation changed (from Unknown effectiveness to Ben... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3032214 Wed, 18 Nov 2009 23:00:00 +0100 3032214 http://www.medworm.com/index.php?rid=3032215&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fent%2F0506%2F0506.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Antidepressant drugs for tinnitus One RCT added comparing sertraline (25 mg/day for 1 week followed by 50 mg/day for 15 weeks) versus placebo. It found that sertraline improved tinnitus severity and loudness, clinician-rated anxiety, participant-rated anxiety, and participant-rated depression compared with placebo. However, it found no significant difference between sertraline and placebo in tinnitus annoyance and clinician-rated depression. Considering all evidence reported, potential benefits of antidepressant drugs in the treatment of tinnitus are unclear. Categorisation changed from Trade-off between benefits and harms to Unknown effectiveness. New evidence; conclusion confirmed for: ... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=3032215 Thu, 12 Nov 2009 23:00:00 +0100 3032215 http://www.medworm.com/index.php?rid=2975266&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdia%2F0608%2F0608.jsp%3Frss%3Dtrue New search performed and critically appraised; no new evidence selected for inclusion. (Source: Clinical Evidence) Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2975266 Mon, 09 Nov 2009 23:00:00 +0100 2975266 http://www.medworm.com/index.php?rid=2968949&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fhiv%2F0920%2F0920.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Early initiation of highly active antiretroviral treatment Two cohort studies added. One prospective study found mortality was increased the longer HAART initiation was delayed after starting antituberculosis treatment, and found decreased mortality in people with bacteriologically confirmed tuberculosis, who started HAART within the first 120 days of antituberculosis treatment versus people who started HAART later than this. Another study (retrospective from 1996 to 2000; prospective from 2000 to 2004) found better survival in people who started HAART within 2 months of starting antituberculous treatment versus people who started HAART more than 3 months after antituberculous treatment.Categorisation unchanged (un... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2968949 Thu, 05 Nov 2009 23:00:00 +0100 2968949 http://www.medworm.com/index.php?rid=2932718&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fwnd%2F1903%2F1903.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Alginate dressing One systematic review added (search date 2008), which found no RCTs that met Clinical Evidence inclusion criteria. Categorisation unchanged (Unknown effectiveness). Chlorhexidine-impregnated paraffin gauze dressing One systematic review added (search date 2008), which did not pool data, and found no additional RCTs to those previously reported in this Clinical Evidence review. Categorisation unchanged (Unknown effectiveness). Foam dressing One systematic review added (search date 2008),which found no RCTs. Categorisation unchanged (Unknown effectiveness). Hydrocolloid dressing One systematic review added (search date 2008), which did not pool data and fo... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2932718 Tue, 27 Oct 2009 23:00:00 +0100 2932718 http://www.medworm.com/index.php?rid=2932721&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmeh%2F1017%2F1017.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Single- or multiple-session brief intervention in hazardous or harmful drinkers in primary care One systematic review and one subsequent RCT added comparing single- or multiple-session brief interventions with either control or extended interventions. Categorisation unchanged (Beneficial). Brief intervention (single- or multiple-session) in emergency departments One systematic review and one subsequent RCT added comparing single-session brief intervention (BI) with control. The review found no significant difference between single-session BI and control in quantity of or frequency of alcohol consumption, but found that single-session BI significantly decreased the number of alcohol-related injuries compared... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2932721 Mon, 26 Oct 2009 23:00:00 +0100 2932721 http://www.medworm.com/index.php?rid=2932720&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fknd%2F2004%2F2004.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Statins versus placebo or no treatment One systematic review and two subsequent RCTs added. The review found that statins reduced all-cause mortality and cardiovascular mortality compared with placebo or no treatment. The first subsequent RCT found that simvastatin decreased all-cause mortality, major coronary events, and the composite outcome of death from coronary disease and non-fatal MI compared with placebo. The second subsequent RCT found no significant difference between pravastatin and placebo or no treatment in rates of progression to end-stage renal disease (ESRD), composite outcome of ESRD or 50% decrease in glomerular filtration rate (GFR), or the composite outcome of ESRD or 25% decrease in GFR. Categor... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2932720 Mon, 26 Oct 2009 23:00:00 +0100 2932720 http://www.medworm.com/index.php?rid=2932719&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fent%2F0503%2F0503.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Tonsillectomy versus no surgery in adults One systematic review added identifying one RCT that met Clinical Evidence inclusion criteria. The RCT found that tonsillectomy reduced the frequency and duration of sore throat at 5 to 6 months, but had short follow-up. Categorisation unchanged (Trade-off between benefits and harms). New evidence; conclusion confirmed for: Tonsillectomy versus no surgery in children One systematic review updated (4 RCTs; 564 children), which found that tonsillectomy reduced the number of episodes of sore throat, and duration of sore throat compared with standard care at 1 to 3 years. Categorisation unchanged (Trade-off between benefits and harms). (Source: Clini... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2932719 Mon, 26 Oct 2009 23:00:00 +0100 2932719 http://www.medworm.com/index.php?rid=2860445&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fdsd%2F0406%2F0406.jsp%3Frss%3Dtrue New option(s) added for: H pylori eradication treatments (quadruple regimens compared with triple regimens as second-line treatment) New option for which we found three RCTs. The RCTs found that quadruple regimens as second-line therapies were more effective than triple regimens at eradicating H pylori. Most triple regimens given did not contain a nitroimidazole. Categorised as Likely to be beneficial. H pylori eradication treatments (sequential regimens compared with triple regimens as first-line treatment) New option for which we found one systematic review. The review found sequential therapy was more effective at increasing H pylori eradication rates compared with proton pump inhibitor triple regimen... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2860445 Thu, 01 Oct 2009 23:00:00 +0100 2860445 http://www.medworm.com/index.php?rid=2826253&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fskd%2F1710%2F1710.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Photodynamic treatment One systematic review added. It found that photodynamic treatment was more effective at wart clearance than placebo or cryotherapy, and that neutral red photodynamic treatment and proflavine photodynamic treatment have similar effects. Categorisation unchanged (Likely to be beneficial). Intralesional bleomycin Data from one systematic review updated, and one RCT added. The RCT found that intralesional bleomycin increased wart clearance compared with placebo. Categorisation unchanged (unknown effectiveness). Duct tape occlusion One systematic review and two RCTs (3 publications) added. The systematic review found no significant difference in wart c... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2826253 Thu, 24 Sep 2009 16:44:22 +0100 2826253 http://www.medworm.com/index.php?rid=2826256&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fskd%2F1704%2F1704.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Oral antiviral agents to prevent recurrence One systematic review added (search date 2008),which did not pool data. It found three RCTs and one pooled analysis of two further RCTs that were already reported in this Clinical Evidence review. No new data added from the new review. Categorisation unchanged (Likely to be beneficial). Topical antiviral agents to prevent recurrence One systematic review added (search date 2008), which identified two RCTs. The review did not pool data, and the results of the RCT were reported from the original papers. Benefits and harms section enhanced. Categorisation unchanged (Unknown effectiveness). Sunscreen One systematic review added (search date... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2826256 Wed, 23 Sep 2009 23:00:00 +0100 2826256 http://www.medworm.com/index.php?rid=2826255&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Find%2F0916%2F0916.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Universal vaccination of infants Two observational studies added, which found that universal vaccination of infants reduced the proportion of hepatitis B carriers compared with no vaccination. Categorised as Beneficial. Selective vaccination of high-risk individuals No new evidence on effects of selective vaccination of high-risk individuals. One retrospective cohort study added to harms found no evidence of a link between autoimmune thyroid disease and hepatitis B vaccine. Categorised as Likely to be beneficial. Universal vaccination of infants No new evidence on the effects of universal vaccination of infants added. One retrospective cohort study added to harms found no eviden... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2826255 Wed, 23 Sep 2009 23:00:00 +0100 2826255 http://www.medworm.com/index.php?rid=2802289&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Feyd%2F0709%2F0709.jsp%3Frss%3Dtrue New evidence; conclusion confirmed for: Glasses One cohort study added found that visual acuity was better at 1 year in over two-thirds of children who wore glasses. Categorisation unchanged (Likely to be beneficial, based on consensus). Occlusion (patching) Three systematic reviews added identified the same RCTs as previously found by Clinical Evidence. One further RCT identified found no significant difference in visual acuity at 18 weeks between 12 and 6 hours' prescribed occlusion, but added to the evidence for a dose response when actual hours of received occlusion can be measured. Categorisation unchanged; occlusion in combination with penalisation and near-vision tasks categorised as Beneficial compared with glasses alo... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2802289 Wed, 16 Sep 2009 23:00:00 +0100 2802289 http://www.medworm.com/index.php?rid=2798530&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fcvd%2F0206%2F0206.jsp%3Frss%3Dtrue New evidence; conclusions changed for: Anticoagulants in addition to antiplatelet treatments: Two systematic reviews added comparing intensive warfarin plus aspirin versus aspirin alone. Both reviews found that warfarin plus aspirin decreased the risk of non-fatal MI and stroke, but increased the risk of major bleeding compared with aspirin alone in people with acute coronary syndrome. The evidence supports the recategorisation from Likely to be ineffective or harmful to Trade-off between benefits and harms. Fish oil consumption (from oily fish or capsules): Two systematic reviews added comparing advice to increase fish oil consumption or fish oil consumption versus control. The reviews found that increased fish oil consumptio... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2798530 Mon, 07 Sep 2009 23:00:00 +0100 2798530 http://www.medworm.com/index.php?rid=2776378&cid=s_30442_22_f&fid=30442&url=http%3A%2F%2Fclinicalevidence.bmj.com%2Fceweb%2Fconditions%2Fmeh%2F1004%2F1004.jsp%3Frss%3Dtrue New option(s) added for: Behavioural therapy in children and adolescents New option added, for which we found no data satisfying Clinical Evidence inclusion criteria. Categorised as Unknown effectiveness. Cognitive therapy or CBT in children and adolescents New option added, for which one systematic review and two RCTs were added. The systematic review found that CBT improved OCD symptoms versus waiting list control or placebo. However, it found no significant difference between CBT and SRIs. One RCT found no significant difference between intensive once a weekday CBT and once-weekly CBT in improvement of OCD symptoms. Categorised as Beneficial. SRIs in children and adolescents New option added, for which two systemati... Clinical Evidence journals http://www.medworm.com/rss/comments.php?id=2776378 Thu, 03 Sep 2009 23:00:00 +0100 2776378