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 cost-effectiveness

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_medicines/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_medicines/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-behavior-disorder-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-non-muscle-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 In-Patients 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-tranquilization-patients-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-central-catheters-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-and-safety-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-clinical-effectiveness-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