Evidence Updates Homepage – Public Health Key Documents

The Health Care Team produce a monthly report on evidence updates. The methods used to identify potentially relevant evidence and circulate it each month can be viewed here.

Past months’ updates (plus this months in PDF format) can be accessed at the bottom of the page.

Public Health Key Documents December 2017

NIHR

Virtual chromoendoscopy for the real-time assessment of colorectal polyps in vivo: a systematic review and economic evaluation
VCE technologies, using HD systems without magnification, could potentially be used for the real-time assessment of diminutive colorectal polyps, if endoscopists have adequate experience and training.
Health Technology Assessment
Systematic search: Yes
December 2017
https://www.journalslibrary.nihr.ac.uk/hta/hta21790/#/abstract

Interventions for hyperhidrosis in secondary care: a systematic review and value-of-information analysis
There is moderate-quality evidence that botulinum toxin is effective on axillary hyperhidrosis symptoms, compared with placebo. There was weak but consistent evidence for iontophoresis for palmar hyperhidrosis. Evidence for other interventions was of low or very low quality.
Health Technology Assessment
Systematic search: Yes
December 2017
https://www.journalslibrary.nihr.ac.uk/hta/hta21800/#/abstract

Managing diabetes in people with dementia: a realist review
This review suggests that there is a need to prioritise quality of life, independence and patient and carer priorities over a more biomedical, target-driven approach. Much current research, particularly that specific to people living with dementia and diabetes, identifies deficiencies in, and problems with, current systems. Although we have highlighted the need for personalised care, continuity and family-centred approaches, there is much evidence to suggest that this is not currently happening.
Health Technology Assessment
Systematic search: Yes
December 2017
https://www.journalslibrary.nihr.ac.uk/hta/hta21750/#/abstract

Clinical effectiveness and cost-effectiveness of issuing longer versus shorter duration (3-month vs. 28-day) prescriptions in patients with chronic conditions: systematic review and economic modelling
Although the quality of the evidence was poor, this study found that longer prescriptions may be less costly overall, and may be associated with better adherence than 28-day prescriptions in patients with chronic conditions being treated in primary care.
Health Technology Assessment
Systematic search: Yes
December 2017
https://www.journalslibrary.nihr.ac.uk/hta/hta21780/#/abstract

KINGS FUND

Nil

Scottish Medicines Consortium

SMC advice: eliglustat (Cerdelga)
Eliglustat is accepted for use within NHS Scotland for the long-term treatment of adult patients with Gaucher disease type 1 (GD1) who are CYP2D6 poor metabolisers, intermediate metabolisers, or extensive metabolisers.
SMC advice
Systematic search: No
December 2017
http://www.scottishmedicines.org/SMC_Advice/Advice/1277_17_eliglustat_Cerdelga/eliglustat_Cerdelga

SMC advice: palbociclib (Ibrance)
Palbociclib is accepted for restricted use within NHS Scotland for treatment of hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative locally advanced or metastatic breast cancer. Palbociclib is restricted to use in combination with an aromatase inhibitor, or in combination with fulvestrant in women who have received prior endocrine therapy. In pre- or peri-menopausal women, the endocrine therapy should be combined with a luteinising hormone-releasing hormone (LHRH) agonist.
SMC advice
Systematic search: No
December 2017
http://www.scottishmedicines.org/SMC_Advice/Advice/1276_17_palbociclib_Ibrance/palbociclib_Ibrance

SMC advice: aviptadil/phentolamine mesilate (Invicorp)
Aviptadil/phentolamine is accepted for restricted use within NHS Scotland for the symptomatic treatment of erectile dysfunction in adult males due to neurogenic, vasculogenic, psychogenic, or mixed aetiology. Aviptadil/phentolamine is restricted to use in those who have failed on oral therapies (oral phosphodiesterase type-5 inhibitors) and other non-injectable formulations of erectile dysfunction medications.
SMC advice
Systematic search: No
December 2017
http://www.scottishmedicines.org/SMC_Advice/Advice/1284_17_aviptadil_phentolamine_mesilate_Invicorp/aviptadil_phentolamine_mesilate_Invicorp

SMC advice: brodalumab (Kyntheum)
Brodalumab is not recommended for use within NHS Scotland for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy.
SMC advice
Systematic search: No
December 2017
http://www.scottishmedicines.org/SMC_Advice/Advice/1283_17_brodalumab_Kyntheum/brodalumab_Kyntheum

SGHD

Supporting Children and Young People with Healthcare Needs in Schools
This guidance has been developed in partnership with a range of key stakeholders to
guide those working in and with NHS boards, education authorities and schools to
support children and young people affected by health issues which require
healthcare support in school. It is intended to act as a guide to the strategic and operational matters which should be considered as part of policy development. Scottish Government Guidance
Systematic search: No
December 2017
http://www.gov.scot/Publications/2017/12/3694

SIGN

Nil

HEALTH SCOTLAND

Health and wellbeing interventions in a school setting
This review and summary report examine the effectiveness of health and wellbeing interventions in a school setting to potentially reduce inequalities in educational outcomes.
Health Scotland review
Systematic search: Yes
December 2017
http://www.healthscotland.scot/publications/health-and-wellbeing-interventions-in-a-school-setting

NICE

TA496 Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Ribociclib, with an aromatase inhibitor, is recommended as an option for treating hormone receptor-positive, human epidermal growth factor receptor 2‑negative, locally advanced or metastatic breast cancer as initial endocrine-based therapy in adults.
NICE Technology Appraisal
Systematic search: Yes
December 2017
https://www.nice.org.uk/guidance/ta496

TA495: Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Palbociclib, with an aromatase inhibitor, is recommended as an option for treating hormone receptor-positive, human epidermal growth factor receptor 2-negative, locally advanced or metastatic breast cancer as initial endocrine-based therapy in adults.
NICE Technology Appraisal
Systematic search: Yes
December 2017
https://www.nice.org.uk/guidance/ta495

TA494 Naltrexone–bupropion for managing overweight and obesity
Naltrexone–bupropion is not recommended for managing overweight and obesity in adults alongside a reduced-calorie diet and increased physical activity.
NICE Technology Appraisal
Systematic search: Yes
December 2017
https://www.nice.org.uk/guidance/ta494

TA493 Cladribine tablets for treating relapsing–remitting multiple sclerosis
Cladribine tablets are recommended as an option for treating highly active multiple sclerosis in adults, only if the person has rapidly evolving severe relapsing–remitting multiple sclerosis (as defined), or relapsing–remitting multiple sclerosis that has responded inadequately to treatment with disease-modifying therapy (as defined).
NICE Technology Appraisal
Systematic search: Yes
December 2017
https://www.nice.org.uk/guidance/ta493

TA492 Atezolizumab for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
Atezolizumab is recommended for use within the Cancer Drugs Fund as an option for untreated locally advanced or metastatic urothelial carcinoma in adults, for whom cisplatin-based chemotherapy is unsuitable.
NICE Technology Appraisal
Systematic search: Yes
December 2017
https://www.nice.org.uk/guidance/ta492

CG128 Autism spectrum disorder in under 19s: recognition, referral and diagnosis
This guideline covers recognising and diagnosing autism spectrum disorder in children and young people from birth up to 19 years. It also covers referral. It aims to improve the experience of children, young people and those who care for them.
NICE Clinical Guidance
Systematic search: Yes
December 2017
https://www.nice.org.uk/guidance/cg128

EPPI Centre

Prevalence, diagnosis, treatment and prevention of Lyme disease: an evidence map and four systematic reviews
This series of systematic reviews addresses uncertainties about the incidence of Lyme disease in the UK, and the most effective ways to prevent, diagnose and treat it. The reviews also address the understanding and experiences of patients, clinicians, and researchers of diagnosis and treatment of Lyme disease.
Note: a NICE guideline on the diagnosis and treatment of Lyme disease is due for publication in April 2018.
Systematic review
Systematic search: Yes
December 2017
http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=3701

AHRQ (Agency for Healthcare Research and Quality – USA)

Treatments for Basal Cell and Squamous Cell Carcinoma of the Skin
Based on sparse evidence, surgical and radiation treatments have lower recurrence rates than other modalities for the treatment of low-risk BCC, and photodynamic therapy appears to have superior cosmetic outcomes.
AHRQ Research Synthesis
Systematic search: Yes
December 2017
https://effectivehealthcare.ahrq.gov/topics/skin-cancer/research

Management of Uterine Fibroids
A range of interventions are effective for reducing fibroid size and improving symptoms. Some medications and procedures also improve quality of life but there are few studies directly comparing interventions. The risk of encountering a leiomyosarcoma at the time of fibroid surgery is low, and the method of fibroid removal may influence survival. Evidence to guide choice of intervention is likely best when applied in the context of individual patient needs and preferences.
AHRQ Research Synthesis
Systematic search: Yes
December 2017
https://effectivehealthcare.ahrq.gov/topics/uterine-fibroids/research-2017

Effectiveness and Safety of Bronchial Thermoplasty in Management of Asthma
There is weak evidence that BT improves asthma control and quality of life measures compared to medical management alone. Stronger evidence found modest improvements in severe exacerbations and significantly fewer emergency department visits following BT but serious adverse events and post-procedure hospitalizations were more common.
AHRQ Research Synthesis
Systematic search: Yes
December 2017
https://effectivehealthcare.ahrq.gov/topics/asthma-nonpharmacologic-treatment/thermoplasty-systematic-review

The Clinical Utility of Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management
This systematic review provides the diagnostic accuracy measures of FeNO in people ages 5 years and older. Test performance is modestly better in steroid-naïve asthmatics, children, and non-smokers than the general population with suspected asthma. Algorithms that include FeNO measurements can help in monitoring response to anti-inflammatory, or long-term control medications, including dose titration, weaning, and treatment adherence
AHRQ Research Synthesis
Systematic search: Yes
December 2017
https://effectivehealthcare.ahrq.gov/topics/asthma-nitric-oxide/research

Health Foundation

Nil

Canadian Agency for Drugs and Technologies in Health (CADTH)

Alpha1-Proteinase Inhibitors for the Treatment of Alpha1-Antitrypsin Deficiency: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines
The evidence shows that the mean annual decline in lung density is significantly less with alpha1-proteinase inhibitors compared to placebo. The effect of alpha1-proteinase inhibitors on rate of decline in FEV1 and rates of exacerbations is variable, and conflicting findings are reported. Evidence-based guidelines recommend that alpha1-proteinase inhibitors may be considered in non-smokers or previous smokers with alpha1-antitrypsin deficiency with COPD who are receiving optimal pharmacological and non-pharmacological management.
CADTH Rapid Response Report
Systematic search: Limited
December 2017
https://www.cadth.ca/alpha1-proteinase-inhibitors-treatment-alpha1-antitrypsin-deficiency-review-clinical-effectiveness-0

Indwelling Voice Prostheses for Adults Following Laryngectomy: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines
The evidence on failure rates and patient satisfaction with regard to indwelling voice prostheses is weak and contradictory, from studies that are of overall poor quality. The lifespan of the same device varied between studies and between patients in the same study; this confusion was also apparent for prostheses designed to be stronger and more resistant to airflow. Patient responses in preference studies were diverse.
CADTH Rapid Response Report
Systematic search: Limited
December 2017
https://www.cadth.ca/indwelling-voice-prostheses-adults-following-laryngectomy-review-clinical-effectiveness-cost

PRECICE Intramedullary Limb Lengthening System: A Review of Clinical Effectiveness
Limited evidence appeared to support the use of the PRECICE nail, which was generally favoured or considered equivalent to either limb reconstruction system external fixation or the intramedullary skeletal kinetic distractor system for the outcomes assessed.
CADTH Rapid Response Report
Systematic search: Limited
December 2017
https://www.cadth.ca/precice-intramedullary-limb-lengthening-system-review-clinical-effectiveness

Prucalopride for Gastrointestinal Motility Disorders: A Review of Clinical Effectiveness
Strong evidence showed that prucalopride seems to be a beneficial pharmacotherapy in the treatment of chronic constipation, but with an increase in adverse event rates. Indirect comparison showed there was no significant difference in efficacy between prucalopride and other pharmacotherapies. Limited evidence found prucalopride is a safe and effective treatment to reduce the symptoms of post-operative ileus and chronic intestinal pseudo-obstruction.
CADTH Rapid Response Report
Systematic search: Limited
December 2017
https://www.cadth.ca/prucalopride-gastrointestinal-motility-disorders-review-clinical-effectiveness

McGill University Health Centre (Canada)

Nil

Health Information & Quality Authority (Ireland)

Nil

Campbell Collaboration

Nil

Glasgow Centre for Population Health

Building Connections: co-locating advice services in GPs and job centres
The Building Connections programme developed and tested approaches to delivering advice services (financial, mental health, social security advice, etc) in two general practices and two job centres in north east Glasgow. This report explores the Building Connections programme and the projects it supported, and presents an assessment of their impact. It also introduces a series of learning themes on the practicalities of collaborative working, with a specific focus on how this type of working is dependent upon the people involved, their relationships with one another and the structures, norms and working cultures of partner organisations. A series of recommendations for future work are also provided.
GCPH/Joseph Rowntree Foundation report
Systematic search: No
December 2017
http://www.gcph.co.uk/publications/745_building_connections_co-locating_advice_services_in_gps_and_job_centres

NICE FORWARD PLANNING – Publications due January 2018

Oesophago-gastric cancer
Clinical Guideline

Flu vaccination: increasing uptake
Public health guidance

Axial spondyloarthritis (non-radiographic) – golimumab
Single Technology Appraisal

Macular degeneration
Clinical Guideline

Pembrolizumab for urothelial cancer
Single Technology Appraisal

Lenvatinib with everolimus for previously treated advanced renal cell carcinoma
Single Technology Appraisal

Multiple myeloma (relapsed, refractory) – ixazomib citrate
Single Technology Appraisal

Elotuzumab for multiple myeloma
Single Technology Appraisal

Glecaprevir with pibrentasvir for treating chronic hepatitis C
Single Technology Appraisal

Ceritinib for untreated anaplastic lymphoma kinase positive non-small-cell lung cancer
Single Technology Appraisal

Pancreatic cancer: diagnosis and management in adults
Clinical Guideline

Lymphoma (mantle cell, relapsed, refractory) – ibrutinib
Single Technology Appraisal

Fulvestrant for untreated hormone-receptor positive metastatic breast cancer
Single Technology Appraisal

Suspected neurological conditions
Clinical Guideline

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