Die 5 Minuten Evidenz - Cochrane Ausgabe 2
Ausgabe 2/2008 der Cochrane Library
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| Frauen | Diabetes |
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Ausgewählte Updates mit veränderter klinischer Konsequenz: |
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Abdominal lift for laparoscopic cholecystectomy
20 Studien, N=706
Nachteilig ist das Pneumoperitoneum nur bei Personen, die stark in ihrer cardiopulmonalen Funktion eingeschränkt sind.
Laparoscopic Entry Techniques
17 RCTs, N= 3040
Kein Vorteil einer speziellen Technik. Nichtanheben der Bauchdecke beim Eingehen mit der Verresnadel senkt die Zahl der nicht erfolgreichen Zugänge, ohne die Komplikationen zu erhöhen.
Es gibt nicht die „bessere Technik“. Zwischen den verschiedenen Techniken gibt es keine wichtigen Unterschiede.
Long-term results of laparoscopic colorectal cancer resection
33 Studien, N= 3346
Kein Nachtiel der laparoskopischen Resektion im long term outcome gegen open colectomy.
Bone grafts and bone substitutes for treating distal radial fractures in adults
7 Studien, N über 600
Bone scaffolding may improve anatomical outcome compared with plaster cast alone but there is insufficient evidence to conclude on functional outcome and safety; or for other comparisons.
Antacids for preventing oesophagogastric variceal bleeding and rebleeding in cirrhotic patients
Keine RCTS
Keine klinisch verwertbare Evidenz gefunden.
Interventions for treating wrist fractures in children
10 Studien, N= 827
Although surgery helped prevent redisplacement of some types of fractures, the long-term benefit was not confirmed. However, further trials on these three issues are needed to obtain more conclusive evidence.
Adjuvant treatment of anaplastic oligodendrogliomas and oligoastrocytomas
2 Studien
Anaplastische Oligodendrogliome und Oligoastrocytome werden traditionell nach der Chirurgie bestrahlt.
Chemotherapie: Two RCTs have found that, although the addition of procarbazine, lomustine, and vincristine (PCV) chemotherapy to standard treatment does not prolong survival, it does delay progression of these tumors.
Reconstructive Techniques After Rectal Resection for Rectal Cancer
9 RCTs, N= 473
In several randomized controlled trials, the CJP has been shown to be superior to the SCA in bowel function outcomes in patients with rectal cancer for at least 18 months after gastrointestinal continuity is re-established.
Antibiotics to reduce post-tonsillectomy morbidity
9 Studien
The review suggests that there is little or no evidence that antibiotics reduce the main morbid outcomes following tonsillectomy (i.e. pain, the need for analgesia or secondary haemorrhage rates).
Intravenous versus inhalation anaesthesia for one-lung ventilation
9 Studien, N= 291
Keine Studie berichtete zum Endpunkt.
Neurologie Depression, Nerven, Psychose
Interventions to improve occupational health in depressed people
11 RCTs, N= 2.556
Currently no evidence of an effect of medication alone, enhanced primary care, psychological interventions or the combination of those with medication on reducing work disability (sickness absence) of depressed workers in depressed workers.
Omega-3 fatty acids for bipolar disorder
5 RCTs
Only one study, involving 75 participants, provided data for analysis, and showed a benefit of active treatment over control for depression symptom levels (WMD -3.93, 95% CI -7.00 to -0.86)and Clinical Global Impression scores (WMD -0.75, 95% CI -1.33 to -0.17) but not for mania (WMD -2.81, 95% CI -7.68 to 1.90). No serious adverse effects were reported in the five studies.
Psychostimulants for depression
24 RCTs niederer Qualität
There is some evidence that in the short-term, PS reduce symptoms of depression.
Psychotherapy for depression among incurable cancer patients
6 RCTs, N= 517
Psychotherapy was associated with a significant decrease in depression score (SMD = -0.44, 95% CI = -0.08 to -0.80).
Paliperidone for schizophrenia
5 RCTs, N= 1647
In short-term studies, oral paliperidone is an antipsychotic that is more efficacious than placebo.
Anticonvulsants for cocaine dependence
15 Studien, N= 1066
Zurzeit keine Evidenz für den Einsatz von Antikonvulsantien.
Antiepileptic drugs for preventing seizures in people with brain tumors
The evidence is neutral, neither for nor against seizure prophylaxis, in people with brain tumors.
Keine ersichtliche Wirkung auf den Zeitpunkt des ersten Anfalls.
Bei “Prophylaxe“ mit Antiepileptika ist die NNH 3 (RR 6.10, 95% CI 1.10 to 34.63; P = 0.046).
Clobazam as an add-on in the management of refractory epilepsy
Four cross-over Studien, N=196
Clobazam als add-on treatment reduziert wohl die Anfallshäufigkeit besonders bei partial onset seizures.
Dopamine agonist therapy in early Parkinson's disease
29 Studien, N= 5247
Die motorischen Komplikationen sind mit Agonisten im Vergleich zu Levodopa reduziert, aber wichtige Nebenwirkungen sind erhöht. Zur Zeit scheint das Abwägen schwierig.
Fitness training for cardiorespiratory conditioning after traumatic brain injury
6 Studien, N=303
Aufgrund der Studienqualität und der wenigen Teilnehmer ist keine definitive Aussage möglich.
Locomotor training for walking after spinal cord injury
4 RCTs, N= 222
There is insufficient evidence from RCTs to conclude that any one locomotor training strategy improves walking function more than another for people with SCI.
Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment
11 Studien bei über 55 Jährigen
Der Zusammenhang von Erhöhung der cardiorespiratorischen Fitness (> 10%) und Besserung einiger cognitiven Fähigkeiten scheint mittelfristig gegeben zu sein.
Huperzine A for Alzheimer's disease
6 Studien, N=454
There is inadequate evidence to make any recommendation about its use.
Antenatal lower genital tract infection screening and treatment programs for preventing preterm delivery
Eine hochqualitative Studie, N=4155
Preterm birth before 37 weeks was significantly lower in the intervention group (3% versus 5% in the control group) with a relative risk (RR) of 0.55 (95% confidence interval (CI) 0.41 to 0.75).
Möglicher Bias: Verblindung war nicht aufrecht zu erhalten, deshalb könnten Frauen mit Infektionen besser betreut sein.
Dietary advice in pregnancy for preventing gestational diabetes mellitus
3 Studien, N= 107, high-fibre diets oder low glycaemic index (LGI) versus high glycaemic index:
LGI Diät scheint ausgewählten Pat. zu nutzen und weniger makrosome Kinder zur Folge zu haben.
Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes
1 trials mit den Kindern von 2989 Müttern
Es hat keine Nachteile für Mutter und Kind, es gibt einen erhöhten Eisenload, der in bestimmten wie unterentwickelten Regionen von Vorteil ist. Kurzfristig sind auch Nachteile da, da der Neugeborenenikterus verstärkt sein kann. Phototherapie sollte zur Verfügung stehen.
Immediate start of hormonal contraceptives for contraception
Fünf Studien mit unterschiedlichen Medikamenten.
Das Warten auf die nächste Blutung vor dem Start der Antikonzeptiva scheint keine Nachteile bezüglich Compliance oder Zahl der ungewollten Schwangerschaften zu haben.
Das Warten ist aber nicht erforderlich (Depot MPA).
Monitoring of stimulated cycles in assisted reproduction (IVF and ICSI)
2 Studien, N= 411
Eine Auswertung auf den primären Endpunkt (Geburt) bot keine der beiden Studien.
Bei begrenzter klinischer Sicherheit scheinen Ultraschallmonitoring und Ultraschall plus Hormonbestimmungen ähnlich erfolgreich (bezüglich Schwangerschaftsraten).
Oestrogens for preventing recurrent urinary tract infection in postmenopausal women
9 Studien, N= 3345
Orale Östrogene reduzierten die Fälle an UTI nicht gegen Placebo (4 studies, 2798 women: RR 1.08, 95% CI 0.88 to 1.33).
Vaginale Östrogene könnten klinischen Effekt haben (two small studies): RR for one was 0.25 (95% CI 0.13 to 0.50) and 0.64 (95% CI 0.47 to 0.86) in the second.
Strategies for communicating contraceptive effectiveness
5 Studien
Keine Goldstandardmethode bekannt, um Frauen über die für sie geeignete Kontrazeption zu informieren.
Maintenance agonist treatments for opiate dependent pregnant women
3 Studien, N= 96
The present review found few differences in newborn or maternal outcomes for pregnant opiate-addicted women who were maintained on methadone, buprenorphine or oral slow morphine from a mean gestational age of 23 weeks to delivery.
Topotecan for ovarian cancer
6 Studien mit niederer Qualität, N= 1323
Topotecan appears to have a similar level of effectiveness as paclitaxel and PLD, though with different patterns of side effects.
Antiangiogenic therapy with anti-vascular endothelial growth factor modalities for neovascular age-related macular degeneration
5 RCTs of good methodological quality
Pegaptanib and ranibizumab are beneficial for treatment of neovascular AMD, with few adverse effects.
Interventions for strabismic amblyopia
2 Studien
Occlusion, whilst wearing necessary refractive correction, appears to be more effective than refractive correction alone in the treatment of strabismic amblyopia.
APentoxifylline for diabetic retinopathy
No publication fulfilled the inclusion criteria.
No sound research has examined the treatment of diabetic retinopathy with pentoxyfilline.
Anticoagulation for the long term treatment of venous thromboembolism in patients with cancer
8 RCTs
6 RCTs showed that LMWH, compared to VKA provided no statistically significant survival benefit, HR = 0.96 (95% CI 0.81 to 1.14) but a statistically significant reduction in VTE (HR = 0.47; 95% CI = 0.32 to 0.71).
Antiplatelet drugs for polycythaemia vera and essential thrombocythaemia
2 trials, N=630
The available evidence suggests that the use of aspirin is associated with a statistically non-significant reduction in the risk of fatal thrombotic events, without an increased risk of major bleeding.
Heparin versus placebo for acute coronary syndromes
8 trials, N=3118
Patients treated with heparins had similar risk of mortality, revascularization, recurrent angina, major bleeding and thrombocytopenia. However, those treated with heparins had decreased risk of MI and a higher incidence of minor bleeding.
Chinese herbal medicine Huangqi type formulations for nephrotic syndrome
3 trials, N=128
Limited by the lack of high quality clinical studies, we are unable to recommend Huangqi type formulations for NS.
Danshen (Chinese medicinal herb) preparations for acute myocardial infarction
6 trials, N=2368
Evidence from RCTs is insufficient and of low quality.
Naftidrofuryl for intermittent claudication
7 trials, N=1266
Naftidrofuryl has a statistically significant and clinically meaningful effect of improving walking distance in the six months after initiation of therapy for people with intermittent claudication.
Oral vasodilators for primary Raynaud's phenomenon
8 trials, N=290
There is no evidence for an effect of vasodilator drugs on primary Raynaud's phenomenon.
Therapy-based rehabilitation services for patients living at home more than one year after stroke
5 Studien, N= 487
Inconclusive evidence whether therapy-based rehabilitation intervention one year after stroke was able to influence any relevant patient or carer outcome. Trials varied in design, type of interventions provided, quality, and outcomes assessed.
Tailored interventions based on exhaled nitric oxide versus clinical symptoms for asthma in children and adults
4 Studien
Tailoring the dose of inhaled corticosteroids show only modest differences. The role of utilising exhaled nitric oxide to tailor the dose of inhaled corticosteroids is currently uncertain.
Duration of intravenous antibiotic therapy in people with cystic fibrosis
Keine RCTs
There are no clear guidelines on the optimum duration of intravenous antibiotic treatment.
Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases
47 Studien, N= 2532
Breathing training, walking aids, NMES and CWV appear to be effective non-pharmacological interventions for relieving breathlessness in advanced stages of disease.
Emergency intubation for acutely ill and injured patients
3 RCTS
The efficacy of emergency intubation as currently practised has not been rigorously studied.
Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases
67 RCTs, N= 232.550
No evidence to support antioxidant supplements for primary or secondary prevention. Vitamin A, beta-carotene, and vitamin E may increase mortality. Antioxidant supplements need to be considered medicinal products and should undergo sufficient evaluation before marketing.
Vitamin C for preventing and treating tetanus
A single, non randomised, poorly reported trial of vitamin C as a treatment for tetanus suggests a considerable reduction in mortality.
Ciclesonide versus other inhaled steroids for chronic asthma in children and adults
21 Studien, N= 7243
Some support to ciclesonide as an equivalent therapy to other ICS at similar nominal doses.
Ciclesonide versus placebo for chronic asthma in adults and children
18 Studien, N= 6343
Short term ciclesonide improves lung function and symptoms, but longer term impact on exacerbations and adverse events are currently uncertain.
Allopurinol for preventing mortality and morbidity in newborn infants with suspected hypoxic-ischaemic encephalopathy
3 Studien, N= 114
The available data are not sufficient to determine whether allopurinol has clinically important benefits.
Clinical pathways for chronic cough in children
no studies
Recommendations for the use of clinical pathways for the treatment of chronic cough in children cannot be made.
Cognitive-behavioural interventions for preventing youth gang involvement for children and young people (7-16)
No evidence from randomised controlled trials or quasi-randomised controlled trials exists regarding the effectiveness of cognitive-behavioural interventions for gang prevention.
Commercial versus home-made spacers in delivering bronchodilator therapy for acute therapy in children
6 Studien, N= 658
Overall, this review supports did not identify a difference between these two methods for delivering bronchodilator therapy to children with acute asthma or lower airways obstruction attacks.
Culture-specific programs for children and adults from minority groups who have asthma
3 Studien, N= 396
Further trials are required to answer this question conclusively.
Financial benefits for child health and well-being in low income or socially disadvantaged families in developed world countries
9 Studien, N>25.000
The review set out to examine the potential of financial support to poor families to improve circumstances for children.
Household interventions for prevention of domestic lead exposure in children
18 Studien, N= 6343
12 Studien, N=2239
Currently there is no evidence of effectiveness for household interventions for education or dust control measures in reducing blood lead levels in children as a population health measure.
Opportunities provision for preventing youth gang involvement for children and young people (7-16)
No evidence from randomised controlled trials or quasi-randomised controlled trials currently exists regarding the effectiveness of opportunities provision for gang prevention.
Short-course versus long-course antibiotic therapy for non-severe community-acquired pneumonia in children aged 2 months to 59 months
3 Studien, N= 5763
The evidence of this review suggests that a short course (three days) of antibiotic therapy is as effective as a longer treatment (five days) for non-severe pneumonia in children under five years of age.
Surfactant for pulmonary hemorrhage in neonates
No randomized or quasi-randomized trials that evaluated the effect of surfactant in PH were identified.
Dietary advice in pregnancy for preventing gestational diabetes mellitus
3 Studien, N= 107, high-fibre diets oder low glycaemic index (LGI) versus high glycaemic index:
LGI Diät scheint ausgewählten Pat. zu nutzen und weniger makrosome Kinder zur Folge zu haben.
Dipeptidyl peptidase-4 (DPP-4) inhibitors for type 2 diabetes mellitus
25 Studien guter Qualität mit 6743 Probanden mit Sitagliptin und 6121 mit Vildagliptin
DPP-4 inhibitors have some theoretical advantages over existing therapies with oral antidiabetic compounds but should currently be restricted to individual patients. Long-term data especially on cardiovascular outcomes and safety are urgently needed before widespread use of these new agents.
Exercise for the management of cancer-related fatigue in adults
28 Studien, N= 2083, meist Brustkrebspatienten
exercise was statistically more effective than the control intervention (SMD -0.23, 95% Confidence Interval (CIs) -0.33 to -0.13).
Further research is required to determine the optimal type, intensity and timing of an exercise intervention.
Exercise therapy in juvenile idiopathic arthritis
3 Studien, N=212
Bei wenig Studien kein bedeutender klinischer Effekt: functional ability (n = 198; WMD -0.07, 95% CI -0.22 to 0.08), quality of life (CHQ-PhS: n = 115; WMD -3.96, 95% CI -8.91 to 1.00) and aerobic capacity (n = 124; WMD 0.04, 95% CI -0.11 to 0.19).
The results suggest that the outcome measures all favoured the exercise therapy but none were statistically significant. None of the studies reported negative effects of the exercise therapy.
Fitness training for cardiorespiratory conditioning after traumatic brain injury
6 Studien, N=303
Aufgrund der Studienqualität und der wenigen Teilnehmer ist keine definitive Aussage möglich.
Therapeutic exercise for people with amyotrophic lateral sclerosis or motor neuron disease
2 RCTs, N=52
The only studies detected were too small to determine to what extent strengthening exercises for people with ALS are beneficial, or whether exercise is harmful.
Multidisciplinary rehabilitation programmes following joint replacement at the hip and knee in chronic arthropathy
5 Studien, N= 619
Silver level evidence that following hip or knee joint replacement, early multidisciplinary rehabilitation can improve outcomes at the level of activity and participation.
Mistletoe therapy in oncology
21 Studien
The evidence from RCTs to support the view that the application of mistletoe extracts has impact on survival or leads to an improved ability to fight cancer or to withstand anticancer treatments is weak.
Palliative endobronchial brachytherapy for non-small cell lung cancer
13 RCTs
We were not able to provide conclusive evidence to recommend EBB with EBRT, chemotherapy or Nd-YAG laser.
Pancreaticoduodenectomy (classic Whipple) versus pylorus-preserving pancreaticoduodenectomy (pp Whipple) for surgical treatment of periampullary and pancreatic carcinoma
7 Studien
There is no evidence of relevant differences in mortality, morbidity and survival between the PPW and the CW.
Topotecan for ovarian cancer
6 Studien mit niederer Qualität, N= 1323
Topotecan appears to have a similar level of effectiveness as paclitaxel and PLD, though with different patterns of side effects.
Five-alpha-reductase Inhibitors for prostate cancer prevention
5 Studien, wobei eine dominiert
5ARI reduce prostate cancer risk but may increase the risk of high-grade disease in men who are undergoing regular screening for prostate cancer using prostate specific antigen and digital rectal examination.
Traditional corticosteroids for induction of remission in Crohn's disease
2 Studien
Corticosteroids are effective at inducing remission in patients with Crohn's disease.
Unfractionated or low-molecular weight heparin for induction of remission in ulcerative colitis
2 Studien
There is no evidence to support the use of UFH or LMWH for the treatment of active UC.
Interventions for alopecia areata
17 Studien, N= 540
Keine RCTs für “gängige” Therapien gefunden.
Considering the possibility of spontaneous remission especially for those in the early stages of the disease, the options of not being treated therapeutically or, depending on individual preference wearing a wig may be alternative ways of dealing with this condition.
Sustained-Release Naltrexone For Opioid Dependence
1 Studie, N= 60
Insufficient evidence to evaluate the effectiveness of sustained-release naltrexone for treatment of opioid dependence.
Mu-opioid antagonists for opioid-induced bowel dysfunction
23 Studien, N= 2871
Meta-analysis demonstrated that methylnaltrexone and alvimopan were better than placebo in reversing opioid-induced increased gastrointestinal transit time and constipation, and that alvimopan appears to be safe and efficacious in treating postoperative ileus.
Medically assisted hydration for palliative care patients
2 Studien, N= 93
Insufficient good quality studies to make any recommendations
Personal assistance for adults (19-64) with both physical and intellectual impairments
2 Studien, N= 1002
Personal assistance is expensive and difficult to organise, but its total cost relative to other services is unknown.
Recombinant interferon beta or glatiramer acetate for delaying conversion of the first demyelinating event to multiple sclerosis
3 Studien, N= 1160
The efficacy of IFN beta treatment on preventing the conversion from CIS to CDMS was confirmed over two years of follow-up.
Systemic corticosteroids for acute gout
Three head to head trials involving 148 patients
There is inconclusive evidence for the efficacy and effectiveness of systemic corticosteroids in the treatment of acute gout. Patients with gout did not report serious adverse effects from systemic corticosteroids, when used short term.
Ausgewählte Updates mit veränderter klinischer Konsequenz:
Anti-histamines for prolonged non-specific cough in children
In contrast to recommendations in adults with chronic cough, anti-histamines cannot be recommended as empirical therapy for children with chronic cough.
Continuous heparin infusion to prevent thrombosis and catheter occlusion in neonates with peripherally placed percutaneous central venous catheters
Evidence from this systematic review support the prophylactic use of heparin for PCVC in neonates at a dose of 0.5 IU/kg/hr.
Corticosteroids for the prevention and treatment of post-extubation stridor in neonates, children and adults
Using corticosteroids to prevent (or treat) stridor after extubation has not proven effective for neonates, children or adults. However, given the consistent trends towards benefit, this intervention does merit further study.
Chemoprophylaxis and intermittent treatment for preventing malaria in children
Preschool children taking antimalarial drugs regularly are less likely to get malaria or severe anaemia.
Antibiotics for acute maxillary sinusitis
Antibiotics have a small treatment effect in patients with uncomplicated acute sinusitis in a primary care setting with symptoms for more than seven days. However, 80% of participants treated without antibiotics improve within two weeks. Clinicians need to weigh the small benefits of antibiotic treatment against the potential for adverse effects at both the individual and general population level.
Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients
Prophylaxis with antiviral medications reduces CMV disease and CMV-associated mortality in solid organ transplant recipients.
Barrier agents for adhesion prevention after gynaecological surgery
Interceed reduces the incidence of adhesion formation following laparoscopy and laparotomy, but there are insufficient data to support its use to improve pregnancy rates.
There was no evidence of effectiveness of Seprafilm and Fibrin sheet in preventing adhesion formation.
Cervical insemination versus intra-uterine insemination of donor sperm for subfertility
The results support the use of IUI rather than CI in stimulated cycles using cryopreserved sperm for donor insemination.
Evening Primrose Oil or other essential fatty acids for the treatment of pre-menstrual syndrome (PMS)
Excisional surgery versus ablative surgery for ovarian endometriomata
There is good evidence that excisional surgery for endometriomata provides for a more favourable outcome than drainage and ablation.
Chinese herbal medicine for primary dysmenorrhoea
The review found promising evidence for the use of Chinese herbal medicine in reducing menstrual pain in the treatment of primary dysmenorrhoea, compared to conventional medicine such as NSAIDs and the oral contraceptive pill, acupuncture and heat compression.
Interventions for emergency contraception
Mifepristone middle dose (25-50 mg) was superior to other hormonal regimens.
Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence
Buprenorphine is an effective intervention for use in the maintenance treatment of heroin dependence, but it is less effective than methadone delivererd at adequate dosages.
Substitution treatment of injecting opioid users for prevention of HIV infection
Oral substitution treatment for injecting opioid users reduces drug-related behaviours with a high risk of HIV transmission, but has less effect on sex-related risk behaviours.
Bypass surgery for chronic lower limb ischaemia
There is not enough evidence to favour bypass surgery over angioplasty to treat chronic limb ischaemia.
Intermittent pneumatic compression for treating venous leg ulcers
Intermittent pneumatic compression (IPC) is better for healing leg ulcers than no compression but it is uncertain if it improves healing when bandages or hosiery are already used. ,
Cardioprotective interventions for cancer patients receiving anthracyclines
We conclude that if the risk of cardiac damage is expected to be high, it might be justified to use dexrazoxane in patients with cancer treated with anthracyclines.
Cyclobenzaprine for the treatment of myofascial pain
House dust mite control measures for asthma
Chemical and physical methods aimed at reducing exposure to house dust mite allergens cannot be recommended. It is doubtful whether further studies, similar to the ones in our review, are worthwhile.
Intra-pleural fibrinolytic therapy versus conservative management in the treatment of adult parapneumonic effusions and empyema
Intrapleural fibrinolytic therapy confers significant benefit in reducing the requirement for surgical intervention for patients in the early studies included in this review but not in the more recently published Maskell study.
Rocuronium versus succinylcholine for rapid sequence induction intubation
Succinylcholine created superior intubation conditions to rocuronium when comparing both excellent and clinically acceptable intubating conditions.
Information
Information provision for stroke patients and their caregivers
There is not much evidence that providing information had effects on other aspects of patient or carer stroke recovery such as independence or social activities.
Interventions for enhancing medication adherence
Even with the most effective methods for long-term treatments, improvements in drug use or health were not large. Several studies showed that telling people about adverse effects of their medications did not affect their use of the medications.
Physician advice for smoking cessation
Simple advice has a small effect on cessation rates. Assuming an unassisted quit rate of 2 to 3%, a brief advice intervention can increase quitting by a further 1to 3%.
Interventions for replacing missing teeth: treatment of perimplantitis
In conclusion, at present, there is too little evidence to determine which is the most effective way to treat perimplantitis. This is not to say that currently used interventions are not effective.
Interventions for treating collagenous colitis
Budesonide is effective for inducing and maintaining clinical and histological response in patients with collagenous colitis.
Interventions for treating lymphocytic colitis
This review demonstrates that budesonide may be effective for treating chronic diarrhea associated with lymphocytic colitis over a six week period.
Low level laser therapy for nonspecific low-back pain
There are insufficient data to draw firm conclusions on the clinical effect of LLLT for low-back pain.
Lumbar supports for prevention and treatment of low back pain
There is moderate evidence that lumbar supports are not more effective than no intervention or training in preventing low-back pain, and conflicting evidence whether they are effective supplements to other preventive interventions. It remains unclear whether lumbar supports are more effective than no or other interventions for treating low-back pain.
Gluten- and casein-free diets for autistic spectrum disorder
Research has shown of high rates of use of complementary and alternative therapies (CAM) for children with autism including gluten and/or casein exclusion diets. Current evidence for efficacy of these diets is poor.
Life skills programmes for chronic mental illnesses
Currently there is no good evidence to suggest life skills programmes are effective for people with chronic mental illnesses
Pharmacological and nutritional treatment for McArdle disease (Glycogen Storage Disease type V)
There is no evidence of significant benefit from any specific nutritional or pharmacological treatment in McArdle disease.
Resection versus no intervention or other surgical interventions for colorectal cancer liver metastases
There is currently insufficient evidence to support a single approach
Types of urethral catheters for management of short-term voiding problems in hospitalised adults
The results suggest that the use of silver alloy indwelling catheters for catheterising hospitalised adults short-term reduces the risk of catheter acquired urinary tract infection.
Vaccines for preventing influenza in healthy children
It was surprising to find only one study of inactivated vaccine in children under two years, given current recommendations to vaccinate healthy children from six months old in the USA and Canada.
Vaccines for preventing influenza in people with asthma
Evidence from recently published trials indicates that there is no significant increase in asthma exacerbations immediately after vaccination
