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Rapid Response
Flow Rates for the Administration of Intravenous Fluids in Pediatric Patients: Clinical Evidence, Safety, and Guidelines
February 14, 2012
Question 1. What is the clinical evidence regarding the safest infusion rate for intravenous fluids delivered by central or peripheral venous catheters in pediatric patients?
2. What is the clinical evidence regarding the safest infusion rate for intravenous fluids delivered by intravenous lines in pediatric patients?
3. What is the clinical evidence regarding the infusion rate for intravenous fluids at which heparin should be added to maintain the patency of central or peripheral venous catheters for pediatric patients?
4. What is the clinical evidence regarding the infusion rate for intravenous fluids at which heparin should be added to maintain the patency of intravenous lines for pediatric patients?
5. What are the evidence based guidelines regarding flow rates for intravenous fluids in order to maintain patency in pediatric patients?Key Messages No relevant literature was identified regarding the safest infusion rates for intravenous fluids or the infusion rate for intravenous fluids at which heparin should be added to maintain the patency of intravenous lines in pediatric patients. Request Type Summary of Abstracts -
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Removable Rigid Dressings for Leg Amputation: A Review of the Clinical Effectiveness, Cost Effectiveness and Guidelines
February 13, 2012
Question 1. What is the clinical effectiveness of removable rigid dressings for postoperative management of patients undergoing leg amputation?
2. What is the cost effectiveness of removable rigid dressings for postoperative management of patients undergoing leg amputation?
3. What are the evidence-based guidelines for the use of removable rigid dressings for postoperative management of patients undergoing leg amputation?Key Messages One study suggested that removable rigid dressings are similar to rigid dressings when comparing time from amputation to prosthesis and wound healing rate. No evidence was identified on the cost-effectiveness or guidelines for use of removable rigid dressings. Request Type Summary with Critical Appraisal -
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Human Growth Hormone Treatment for Prader-Willi Syndrome in Adolescent and Adult Patients: Clinical Evidence, Safety, and Guidelines
February 13, 2012
Question 1. What is the clinical evidence for the use of human growth hormone treatment for Prader-Willi syndrome in adolescent and adult patients?
2. What is the clinical safety of human growth hormone treatment for Prader-Willi syndrome in adolescent and adult patients?
3. What are the evidence-based guidelines for the use of human growth hormone treatment for Prader-Willi syndrome in adolescent and adult patients?Key Messages The evidence suggests that, with appropriate control and careful monitoring, human growth hormone treatment is a safe and effective treatment option in adolescent and adult patients with Prader-Willi syndrome. Request Type Summary of Abstracts -
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Care of Patients with Multiple Sclerosis: Guidelines
February 10, 2012
Question 1. What are the evidence-based guidelines and recommendations for the full spectrum of care of patients with multiple sclerosis? Key Messages Extensive evidence for the full spectrum of care of patients with multiple sclerosis was identified. Numerous treatment options exist for the different forms of multiple sclerosis and its associated co-morbidities. Limited evidence was identified pertaining to evidence-based guidelines and recommendations. Request Type Reference List -
Rapid Response
ShapeMatch Technology for Individuals requiring Orthopedic Knee Arthroplasty: Clinical Effectiveness, Safety, and Costs
February 8, 2012
Question 1. What is the clinical effectiveness of ShapeMatch technology for individuals requiring orthopedic knee arthroplasty?
2. What is the clinical evidence on the safety of ShapeMatch technology for individuals requiring orthopedic knee arthroplasty?
3. What is the cost-effectiveness of ShapeMatch technology for individuals requiring orthopedic knee arthroplasty?Key Messages No evidence was identified regarding the clinical effectiveness, safety, or cost-effectiveness of ShapeMatch technology for individuals requiring orthopedic knee arthroplasty. Request Type Reference List -
Rapid Response
Second Hand Smoke and Pregnant Women: Clinical Evidence
February 7, 2012
Question 1. What is the clinical evidence regarding the effect of second hand smoke on the health of pregnant women and their unborn children? Key Messages The evidence identified suggests maternal exposure to second hand smoke may result in negative outcomes for both mothers and their unborn children. Request Type Summary of Abstracts -
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Antivirals for Pandemic Influenza: A Review of the Clinical Effectiveness
February 6, 2012
Question 1. What is the clinical evidence regarding the benefits and harms of the use of antivirals to treat H1N1 and H5N1 pandemic influenza including early initiation of therapy?
2. What is the clinical evidence regarding the benefits and harms of the use of antivirals as prophylaxis for H1N1 and H5N1 pandemic influenza?
3. What is the comparative clinical effectiveness of early initiation antiviral treatment compared with initiation at 36 to 48 hours for H1N1 and H5N1 pandemic influenza?Key Messages There is limited evidence that oseltamivir is clinically effective for the treatment of pandemic influenza A(H1N1) and limited evidence that it is especially effective with treatment within 48 hours of symptom onset. There is insufficient evidence to make a definitive conclusion regarding the clinical effectiveness of antivirals for prophylaxis or treatment of pandemic influenza A(H1N1), and no evidence was identified regarding antiviral treatment for human avian influenza A(H5N1). Request Type Summary with Critical Appraisal -
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Smoking Cessation Interventions for Youth: Clinical Evidence and Guidelines
February 6, 2012
Question 1. What is the clinical evidence regarding non-pharmacologic smoking cessation interventions for youth?
2. What are the evidence-based guidelines regarding non-pharmacologic smoking cessation interventions for youth?Key Messages Evidence suggests that non-pharmacologic smoking cessation interventions for youth can be effective for promoting smoking cessation behaviours. Request Type Summary of Abstracts -
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Assessment of High Sensitivity Cardiac Troponin T Assay for the Rapid Diagnosis of Acute Coronary Syndrome and Acute Myocardial Infarction in the Emergency Room
February 3, 2012
Question 1. What is the comparative sensitivity and specificity of cTnT and hs-cTnT?
2. What is the comparative sensitivity and specificity of cTnI and hs-cTnT?
3. What is the comparative clinical impact of using hs-cTnT, cTnT, or cTnI?
4. What is the comparative economic impact of using hs-cTnT, cTnT, or cTnI?Key Messages High sensitivity cardiac troponin T (cTnT) showed a higher sensitivity but lower specificity in the diagnosis of acute coronary syndrome and acute myocardial infarction compared with conventional cTnT. High sensitivity cTnT was found to have similar diagnostic value compared with cardiac troponin I (cTnI). The long term comparative clinical impact and the cost effectiveness of using high sensitivity cTnT, conventional cTnT and cTnI remain to be established. Request Type Summary with Critical Appraisal -
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Nurse Practitioners in Long-Term Care Facilities: Clinical and Cost Effectiveness and Guidelines
February 1, 2012
Question 1. What is the clinical effectiveness of having nurse practitioners in long-term care facilities?
2. What is the cost effectiveness of having nurse practitioners in long-term care facilities?
3. What are the evidence-based guidelines of having nurse practitioners in long-term care facilities?Key Messages The evidence identified suggests that the implementation of nurse practitioners in long-term care facilities may result in an increase in family satisfaction and improved health services. Request Type Summary of Abstracts -
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Botulinum Toxin A for Migraine Headaches: Clinical Effectiveness
January 31, 2012
Question 1. What is the clinical effectiveness of botulinum toxin A for reduction in pain and improvement of functioning in patients with migraine headache? Key Messages Evidence is inconclusive regarding the clinical effectiveness of botulinum toxin A for reduction in pain and improvement of functioning in patients with migraine headache. Request Type Reference List -
Rapid Response
Silastic versus Foley Urinary Catheters: Comparative clinical effectiveness
January 26, 2012
Research Type Devices and Systems Question 1. What is the comparative clinical effectiveness of silastic versus foley catheters for reducing urinary tract infections in patients with indwelling catheters lasting longer than 30 days? Key Messages No evidence was identified comparing the clinical effectiveness of Silastic versus Foley catheters for reducing urinary tract infection in patients with indwelling catheters. Request Type Reference List ...
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Rapid Response
Prophylactic Cefazolin versus Other Antibiotics: Comparative Clinical Effectiveness
January 26, 2012
Research Type Prophylactic Cefazolin versus Other Antibiotics: Comparative Clinical Effectiveness Question What is the comparative clinical effectiveness of cephazolin versus other antibiotics for reducing post surgical infection Key Messages The evidence suggests the effectiveness of cefazolin for the reduction of postsurgical infection may vary depending upon the type of surgery being performed and the clinical condition being studied. Request Type Reference List -
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Use of Monitors to Disseminate Public Health Information in the Emergency Department: Clinical Evidence and Guidelines
January 26, 2012
Question 1. What is the clinical evidence regarding the use of monitors to disseminate or display public health information to patients in emergency department waiting areas?
2. What are the evidence-based guidelines and best practice regarding the use of monitors to disseminate or display public health information to patients in emergency department waiting areas?Key Messages No relevant literature was found regarding the use of monitors to disseminate or display public health information to patients in emergency department waiting areas. Request Type Summary of Abstracts -
Rapid Response
Topical Oxygen Treatment for Wound Healing: A Review of Clinical and Cost-Effectiveness
January 25, 2012
Research Type Drugs Question 1. What is the clinical effectiveness of topical oxygen treatment for wound healing compared to hyperbaric oxygen treatment (HBOT) or conventional wound care? 2. What is the cost-effectiveness of topical oxygen treatment for wound healing compared to HBOT or conventional wound care? Key Messages While TWO2 heals 80% of diabetic foot ulcers (DFU), refractory venous ulcers (RVU) and chronic wounds without recurrence, its place in therapy can not be fully determined as the absence of randomization and blinding prevent direct comparison between groups. No evidence was found regarding the cost-effectiveness of TWO2 compared with HBOT or conventional wound care. Request Type Summary with Critical Appraisal -
Rapid Response
Administration of HIV Medication to Women in Labour with High Risk of HIV Infection: Clinical Evidence, Safety, and Guidelines
January 25, 2012
Question 1. What is the evidence regarding the clinical benefit of the administration of HIV medication to women in labour who have unconfirmed but high risk of HIV infection?
2. What is the safety of the administration of HIV medication to women in labour who have unconfirmed but high risk of HIV infection?
3. What are the evidence-based guidelines regarding the administration of HIV medication to women in labour who have unconfirmed but high risk of HIV infection?
4. What are the evidence-based guidelines regarding changes in practice or methods for childbirth in women who have unconfirmed but high likelihood of HIV infection??Key Messages Limited information was identified regarding medication administration and childbirth methods for women in labour who have unconfirmed but high risk of HIV infection. Request Type Summary of Abstracts -
Rapid Response
Using Separate Operating Rooms for Different Surgical Procedures to Control the Spread of Infection: Clinical Effectiveness and Guidelines
January 20, 2012
Question 1. What is the clinical evidence regarding the safety of performing orthopedic surgery in the same operating room that was used for general surgery the previous day?
2. What is the clinical effectiveness of using separate operating rooms for different surgical procedures in controlling the spread of infection?
3. What are the evidence-based guidelines regarding the use of separate operating rooms for different surgical procedures??Key Messages No evidence was identified regarding the safety and effectiveness of using separate operating rooms for different surgical procedures to control the spread of infection. Request Type Reference List -
Rapid Response
Using Cost and Peer Group Utilization Data to Change Physician Behaviour Regarding Diagnostic Test Ordering: Effectiveness
January 19, 2012
Question 1. What is the clinical effectiveness of sharing cost data to change physician behaviour regarding diagnostic test ordering?
2. What is the clinical effectiveness of sharing peer group utilization data to change physician behaviour regarding diagnostic test ordering?
3. What is the comparative clinical effectiveness of sharing cost data versus sharing peer group utilization data to change physician behaviour regarding diagnostic test ordering?Key Messages Limited evidence suggests that sharing cost data with physicians may reduce the number of diagnostic tests ordered resulting in cost savings; no information is available on the effectiveness of sharing peer group utilization data. Request Type Reference List -
Rapid Response
Standard Equipment for the Usual Care of Bariatric Patients: A Review of the Clinical Evidence and Guidelines
January 19, 2012
Question 1. What is the clinical evidence regarding the types of standard equipment required for the usual care of bariatric patients?
2. What are the evidence-based guidelines regarding the types of equipment required for the usual care of bariatric patients?Key Messages No evidence was identified regarding standard equipment required for the usual care of bariatric patients. One guideline recommends the provision of facilities and equipment capable of accommodating the size and weight of obese patients, based on limited empirical evidence. Request Type Summary with Critical Appraisal -
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Sterilization Equipment and Requirements for Endoscopy Equipment: A Review of the Clinical Evidence and Guidelines
January 19, 2012
Question 1. What is the clinical evidence regarding sterilization and sanitation of endoscopy equipment?
2. What are the evidence-based guidelines regarding theKey Messages Gastrointestinal endoscopes are consistently classified as semi-critical items, and require a minimum of high-level disinfection. Inconsistent evidence exists regarding the processing of cystoscopes and bronchoscopes. Request Type Summary with Critical Appraisal