Public Health Key Documents October 2015
NIHR
Collagenase clostridium histolyticum for the treatment of Dupuytren's
contracture: systematic review and economic evaluation
Collagenase was significantly better than placebo. There was no evidence that
collagenase was clinically better or worse than surgical treatments. Limited
fasciectomy was the most cost-effective choice to treat moderate to severe
contractures, whereas collagenase was not, based on a naive indirect comparison of
clinical effectiveness.
Health Technology Appraisal
Systematic search: Yes
October 2015
http://www.journalslibrary.nihr.ac.uk/hta/volume-19/issue-90#abstract
The clinical effectiveness and cost-effectiveness of the PROGENSA® prostate
cancer antigen 3 assay and the Prostate Health Index in the diagnosis of prostate
cancer: a systematic review and economic evaluation
The clinical benefit of using the PCA3 assay or the phi in combination with existing
tests, scans and clinical judgement has not yet been confirmed. The results from the
cost-effectiveness analyses indicate that the use of these tests in the NHS would not
be cost-effective.
Health Technology Appraisal
Systematic search: Yes
October 2015
http://www.journalslibrary.nihr.ac.uk/hta/volume-19/issue-87#abstract
Educational interventions to improve quality of life in people with chronic
inflammatory skin diseases: systematic reviews of clinical effectiveness and costeffectiveness
There is uncertainty regarding whether educational interventions addressing issues
that could improve HRQoL in people with chronic skin conditions are effective.
Tentative conclusions about the best approach to delivering these kinds of
interventions are that face-to-face, group, sessions may be beneficial; however, text
messages may also be effective. Delivery over a period of time and by a
multidisciplinary team may also be associated with positive outcomes. There is
uncertainty over whether or not educational interventions are cost-effective.
Health Technology Appraisal
Systematic search: Yes
October 2015
http://www.journalslibrary.nihr.ac.uk/hta/volume-19/issue-86#abstract
The cost-effectiveness of domiciliary non-invasive ventilation in patients with
end-stage chronic obstructive pulmonary disease: a systematic review and
economic evaluation
The cost-effectiveness of domiciliary NIV remains uncertain and the findings in this
report are sensitive to emergent data. Further evidence is required to identify patients
most likely to benefit from domiciliary NIV and to establish optimum time points for
starting NIV and equipment settings.
Health Technology Appraisal
Systematic search: Yes
October 2015
http://www.journalslibrary.nihr.ac.uk/hta/volume-19/issue-81#abstract
KINGS FUND
Nil
HIS
Comment on: NICE STA 359: Idelalisib for treating chronic lymphocytic
leukaemia
Idelalisib (Zydelig®) is accepted for restricted use within NHS Scotland in
combination with rituximab for the treatment of adult patients with chronic
lymphocytic leukaemia (CLL) who have received at least one prior therapy, or as first
line treatment in the presence of 17p deletion or TP53 mutation in patients unsuitable
for chemo-immunotherapy.
SMC Advice
Systematic search: No
October 2015
http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicin
es/stas/appraisal_359.aspx
HIS Evidence note 55
Is magnetic resonance guided focused ultrasound surgery (MRgFUS) for the
treatment of uterine fibroids clinically effective, safe and cost effective compared with
uterine artery embolisation, myomectomy and hysterectomy?
There is currently insufficient published evidence to support definitive conclusions on
the clinical effectiveness and safety of MRgFUS compared with UAE, myomectomy
or abdominal hysterectomy for the treatment of uterine fibroids.
HIS Evidence Note
Systematic search: Limited
October 2015
http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicin
es/shtg_-_evidence_notes/evidence_note_55.aspx
SGHD
The Scottish Independent Review of the Use, Safety and Efficacy of Transvaginal
Mesh Implants in the Treatment of Stress Urinary Incontinence and Pelvic
Organ Prolapse in Women
This report outlines the work of the Independent Review (IR) of the use, safety and
efficacy of transvaginal mesh implants in the treatment of stress urinary incontinence
(SUI) and pelvic organ prolapse (POP) in women. It is an interim report as the
publication of further pieces of work are awaited. However as the main programme of
work has been completed the IR has been able to draw conclusions and make
recommendations.
Scottish Government Review
Systematic search: Limited
October 2015
http://www.gov.scot/Publications/2015/10/8485/downloads#res486661
SIGN
Next guidelines due “Spring 2016”
HEALTH SCOTLAND
Nil
NICE
TA358 Tolvaptan for treating autosomal dominant polycystic kidney disease
Tolvaptan is recommended as an option for treating autosomal dominant polycystic
kidney disease in adults to slow the progression of cyst development and renal
insufficiency only if they have chronic kidney disease stage 2 or 3 at the start of
treatment and there is evidence of rapidly progressing disease.
NICE Guidance
Systematic search: Yes
October 2015
http://www.nice.org.uk/guidance/ta358
TA359 Idelalisib for treating chronic lymphocytic leukaemia
Idelalisib, in combination with rituximab, is recommended for untreated chronic
lymphocytic leukaemia in adults with a 17p deletion or TP53 mutation or for chronic
lymphocytic leukaemia in adults when the disease has been treated but has relapsed
within 24 months.
NICE Guidance
Systematic search: Yes
October 2015
http://www.nice.org.uk/guidance/ta359
TA360 Paclitaxel as albumin-bound nanoparticles in combination with
gemcitabine for previously untreated metastatic pancreatic cancer
Paclitaxel as albumin‑bound nanoparticles in combination with gemcitabine is not
recommended for adults with previously untreated metastatic adenocarcinoma of the
pancreas.
NICE Guidance
Systematic search: Yes
October 2015
http://www.nice.org.uk/guidance/ta360
NG16 Dementia, disability and frailty in later life – mid-life approaches to delay
or prevent onset
This guideline covers mid-life approaches to delay or prevent the onset of dementia,
disability and frailty in later life. The guideline aims to increase the amount of time
that people can be independent, healthy and active in later life.
NICE Guidance
Systematic search: Yes
October 2015
http://www.nice.org.uk/guidance/ng16
DG18 Procalcitonin testing for diagnosing and monitoring sepsis (ADVIA
Centaur BRAHMS PCT assay, BRAHMS PCT Sensitive Kryptor assay, Elecsys
BRAHMS PCT assay, LIAISON BRAHMS PCT assay and VIDAS BRAHMS
PCT assay)
The procalcitonin tests show promise but there is currently insufficient evidence to
recommend their routine adoption in the NHS. Further research on procalcitonin tests
is recommended for guiding decisions to stop antibiotic treatment in people with
confirmed or highly suspected sepsis in the intensive care unit or start and stop
antibiotic treatment in people with suspected bacterial infection presenting to the
emergency department.
NICE Diagnostic Guidance
Systematic search: Yes
October 2015
http://www.nice.org.uk/guidance/dg18
TA357 Pembrolizumab for treating advanced melanoma after disease
progression with ipilimumab
Pembrolizumab is recommended as an option for treating advanced (unresectable or
metastatic) melanoma in adults only after the disease has progressed with ipilimumab
and, for BRAF V600 mutation‑positive disease, a BRAF or MEK inhibitor
NICE Guidance
Systematic search: Yes
October 2015
http://www.nice.org.uk/guidance/ta357
NHS EVIDENCE: PUBLIC HEALTH EVIDENCE AWARENESS BULLETIN
Even a low-dose of moderate-to-vigorous physical activity reduces mortality by
22% in adults aged ≥60 years: a systematic review and meta-analysis
A dose of MVPA below current recommendations reduced mortality by 22% in older
adults. A further increase in physical activity dose improved these benefits in a linear
fashion. Older adults should be encouraged to include even low doses of MVPA in
their daily lives.
British Journal of Sports Medicine
Antimicrobial stewardship: The effectiveness of educational interventions to
change risk-related behaviours in the general population: A systematic review
The review, commissioned by NICE, considered educational interventions targeting
individuals, communities or the general public delivered via any mode. Specifically, it
aimed to address which educational interventions are effective and cost-effective in
changing the public's behaviour to ensure they only ask for antimicrobials when
appropriate and use them correctly, and which educational interventions are effective
and cost-effective in changing the public's behaviour to prevent infection and reduce
the spread of antimicrobial resistance?
RAND Europe RR-1066-NICE
EPPI Centre
Nil
AHRQ (Agency for Healthcare Research and Quality - USA)
Psychosocial and Pharmacologic Interventions for Disruptive Behavior in
Children and Adolescents
This review generally suggests that psychosocial interventions for children with DBD
that are either multicomponent interventions or interventions that include only a
parent component appear likely to be more effective at reducing disruptive child
behaviors than interventions that include only a child component or control
conditions. Very few studies directly support the effectiveness of pharmacologic
interventions for children with DBD, but small studies of antipsychotics and
stimulants report positive effects in the very short term.
AHRQ Research Synthesis
Systematic Search: Yes
October 2015
http://www.effectivehealthcare.ahrq.gov/ehc/products/555/2133/disruptive-behaviordisorder-report-151019.pdf
Emerging Approaches to Diagnosis and Treatment of Non–Muscle-Invasive
Bladder Cancer
Urinary biomarkers are falsely negative in a substantial proportion of patients with
bladder cancer, and additional research is needed to clarify advantages of fluorescent
cystoscopy over white light cystoscopy. Intravesical therapy reduces risk of bladder
cancer recurrence versus no intravesical therapy. BCG is the only intravesical therapy
shown to be associated with decreased risk of bladder cancer progression, but it is
associated with a high rate of adverse events.
AHRQ Research Synthesis
Systematic Search: Yes
October 2015
http://www.effectivehealthcare.ahrq.gov/ehc/products/571/2137/bladder-cancer-nonmuscle-invasive-report-151025.pdf
Health Foundation
Nil
Canadian Agency for Drugs and Technologies in Health (CADTH)
Use of Antipsychotics and/or Benzodiazepines as Rapid Tranquilization in InPatients of Mental Facilities and Emergency Departments: A Review of the
Clinical Effectiveness and Guidelines
There is generally inconsistent evidence regarding the comparative efficacy and safety
of antipsychotics and benzodiazepines. There is evidence that intramuscular
haloperidol is less effective and more harmful than other therapies. One guideline
suggests using IM lorazepam or a combination of IM haloperidol and promethazine as
rapid tranquilization for adults in in-patient psychiatric or emergency department
settings, and IM lorazepam for children and young people.
CADTH Rapid Response Report
Systematic search: Limited
October 2015
https://www.cadth.ca/use-antipsychotics-andor-benzodiazepines-rapid-tranquilizationpatients-mental-facilities-and
Extension Tubing Changes for Peripherally Inserted Central Catheters: A
Review of the Clinical Evidence and Guidelines [community setting]
Two evidence-based guidelines suggested replacing administration sets for all
vascular access devices (VADs), including PICCs, no more frequently than at 72-hour
intervals if in continuous use. One guideline suggested replacing VAD administration
sets every 24 hours if in intermittent use. Both guidelines suggested more frequent
replacing of VAD administration sets (e.g., every four to 24 hours) for infusates that
contain lipid emulsions, blood, or blood products.
CADTH Rapid Response Report
Systematic search: Limited
October 2015
https://www.cadth.ca/extension-tubing-changes-peripherally-inserted-centralcatheters-review-clinical-evidence-and
Long-term Nabilone Use: A Review of the Clinical Effectiveness and Safety
Nabilone was more effective than placebo in improving PTSD-associated nightmares
and quality of life, neuropathic pain related to MS and diabetes, and spasticity due to
spinal cord injury for four to nine weeks of treatment, though there limited numbers
of participants in each trial
CADTH Rapid Response Report
Systematic search: Limited
October 2015
https://www.cadth.ca/long-term-nabilone-use-review-clinical-effectiveness-andsafety-0
Telemedicine Consultations for Patients in Long Term Care: A Review of
Clinical Effectiveness, Cost-Effectiveness, and Guidelines
There is some evidence that telehealth administered through videoconferencing is
reliable and effective to achieve glycemic control and to provide needed health care
services to elderly residents of long-term facilities in the area of general medicine,
geriatrics, psychiatry and neurology. Implementation of telehealth in long-term care
facilities resulted in a significant reduction in travel time for both residents and
clinicians, and was effective in increasing the number of patients reviewed, while
reducing the frequency of residents' visits to hospitals and clinics. Physicians, nursing
home residents, and staff were highly satisfied with telehealth consultations.
CADTH Rapid Response Report
Systematic search: Limited
October 2015
https://www.cadth.ca/telemedicine-consultations-patientslong-term-care
Telemedicine for the Treatment of Urgent Conditions: A Review of Clinical
Effectiveness, Cost-Effectiveness, and Guidelines
Limited evidence suggests that telemedicine may facilitate a reduction of resource use
in the emergency mental health population and increase quality of care in the
critically ill pediatric population.
CADTH Rapid Response Report
Systematic search: Limited
October 2015
https://www.cadth.ca/telemedicine-treatment-urgent-conditions-review-clinicaleffectiveness-cost-effectiveness-and
Endovascular Therapy for Patients with Ischemic Stroke: A Review of the
Clinical and Cost-Effectiveness and Guidelines
Studies published in 2015 reported better rates of favourable outcomes and increased
rates of mortality for patients who had EVT compared with those that had IV
thrombolysis alone. Studies published earlier show no statistically significant
difference between the two treatment configurations. Limited evidence from
economic studies suggests that EVT is cost-effective relative to IV tPA under specific
conditions. The evidence-based guidelines recommend the use of EVT, primarily in
patients who are contraindicated to IV thrombolysis.
CADTH Rapid Response Report
Systematic search: Limited
October 2015
https://www.cadth.ca/endovascular-therapy-for-patients-with-ischemic-stroke
McGill University Health Centre (Canada)
Nil
Health Information & Quality Authority (Ireland)
Nil
Campbell Collaboration
Nil
NICE FORWARD PLANNING – Publications due November 2015
Hepatitis C (chronic)-daclatasvir
Single Technology Appraisal
Ombitasvir-paritaprevir-ritonavir with or without dasabuvir for treating
chronic hepatitis C
Single Technology Appraisal
Children's attachment
Clinical Guideline
Transfusion
Clinical Guideline
Skin cancer: the VivaScope 1500 and 3000 systems for detecting and monitoring
skin lesions
Diagnostic Technology
Venous thromboembolic diseases - management (Standing Committee B update)
Clinical Guideline
Transitions between inpatient hospital settings and community or care home
settings for adults with social care needs
Social Care
Osteoporosis (prevention) - bisphosphonates
Multiple Technology Appraisal
Older people - independence and mental wellbeing
Public health guidance
Breast cancer (early) - intrabeam radiotherapy system
Single Technology Appraisal
Menopause
Clinical Guideline
Preterm labour and birth
Clinical Guideline
Headaches
Clinical Guideline
Melanoma (unresectable, metastatic, ipilimumab naive) – pembrolizumab
Single Technology Appraisal
Hepatitis C (chronic, genotype 1) - ledipasvir-sofosbuvir
Single Technology Appraisal