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Source: Ontario Health Technology Assessment Series

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Total 960 results found since Jan 2013.

Constraint-induced movement therapy for rehabilitation of arm dysfunction after stroke in adults: an evidence-based analysis.
Authors: Medical Advisory Secretariat, Health Quality Ontario Abstract OBJECTIVE: The purpose of this evidence-based analysis is to determine the effectiveness and cost of CIMT for persons with arm dysfunction after a stroke. CLINICAL NEED: CONDITION AND TARGET POPULATION A stroke is a sudden loss of brain function caused by the interruption of blood flow to the brain (ischemic stroke) or the rupture of blood vessels in the brain (hemorrhagic stroke). A stroke can affect any number of areas including the ability to move, see, remember, speak, reason, and read and write. Stroke is the leading cause of adult neur...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Collagen cross-linking using riboflavin and ultraviolet-a for corneal thinning disorders: an evidence-based analysis.
Authors: Pron G, Ieraci L, Kaulback K, Medical Advisory Secretariat, Health Quality Ontario Abstract OBJECTIVE: The main objectives for this evidence-based analysis were to determine the safety and effectiveness of photochemical corneal collagen cross-linking with riboflavin (vitamin B(2)) and ultraviolet-A radiation, referred to as CXL, for the management of corneal thinning disease conditions. The comparative safety and effectiveness of corneal cross-linking with other minimally invasive treatments such as intrastromal corneal rings was also reviewed. The Medical Advisory Secretariat (MAS) evidence-based analysis...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Continuous glucose monitoring for patients with diabetes: an evidence-based analysis.
Authors: Health Quality Ontario Abstract OBJECTIVE: To determine the effectiveness and cost-effectiveness of continuous glucose monitoring combined with self-monitoring of blood glucose compared with self-monitoring of blood glucose alone in the management of diabetes. CLINICAL NEED: CONDITION AND TARGET POPULATION Diabetes is a chronic metabolic disorder that interferes with the body's ability to produce or effectively use insulin. In 2005, an estimated 816,000 Ontarians had diabetes representing 8.8% of the province's population. Type 1 or juvenile onset diabetes is a life-long disorder that commonly manifest...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Clinical utility of serologic testing for celiac disease in asymptomatic patients: an evidence-based analysis.
The objective of this evidence-based analysis was to evaluate the clinical utility of serologic testing for celiac disease in asymptomatic individuals presenting with one of the non-gastrointestinal conditions evaluated in this report. The clinical utility was based on the effects of a gluten-free diet (GFD) on outcomes specific to each of these conditions. The prevalence of celiac disease in asymptomatic individuals and one of these non-gastrointestinal conditions was also evaluated. CLINICAL NEED AND TARGET POPULATION: CELIAC DISEASE: Celiac disease is an autoimmune disease characterized by a chronic inflammatory sta...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Diurnal tension curves for assessing the development or progression of glaucoma: an evidence-based analysis.
CONCLUSION: There is very low quality evidence (retrospective studies, patients on different treatments) for the use of a diurnal tension curve or single measurements to assess short or long-term IOP fluctuation or mean as a risk factor for the development or progression of glaucoma. There is very low quality evidence (expert opinion) whether the use of a diurnal tension curve is beneficial for glaucoma suspects or patients with progressive glaucoma, despite normal single office IOP measurements, and leads to a more effective disease management strategy. PMID: 23074414 [PubMed]
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Single photon emission computed tomography for the diagnosis of coronary artery disease: an evidence-based analysis.
The objective of the analysis is to determine the diagnostic accuracy of single photon emission tomography (SPECT) in the diagnosis of coronary artery disease (CAD) compared to the reference standard of coronary angiography (CA). The analysis is primarily meant to allow for indirect comparisons between non-invasive strategies for the diagnosis of CAD, using CA as a reference standard. SPECT: Cardiac SPECT, or myocardial perfusion scintigraphy (MPS), is a widely used nuclear, non-invasive image acquisition technique for investigating ischemic heart disease. SPECT is currently appropriate for all aspects of detecting and man...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Endovascular laser therapy for varicose veins: an evidence-based analysis.
The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost-effectiveness of endovascular laser therapy (ELT) for the treatment of primary symptomatic varicose veins (VV). BACKGROUND: The Ontario Health Technology Advisory Committee (OHTAC) met on November 27, 2009 to review the safety, effectiveness, durability and cost-effectiveness of ELT for the treatment of primary VV based on an evidence-based review by the Medical Advisory Secretariat (MAS). CLINICAL CONDITION: VV are tortuous, twisted, or elongated veins. This can be due...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Extracorporeal lung support technologies - bridge to recovery and bridge to lung transplantation in adult patients: an evidence-based analysis.
The objective of this analysis was to assess the effectiveness, safety, and cost-effectiveness of extracorporeal lung support technologies in the improvement of pulmonary gas exchange and the survival of adult patients with acute pulmonary failure and those with end-stage chronic progressive lung disease as a bridge to lung transplantation (LTx). The application of these technologies in primary graft dysfunction (PGD) after LTx is beyond the scope of this review and is not discussed. CLINICAL APPLICATIONS OF EXTRACORPOREAL LUNG SUPPORT: Extracorporeal lung support technologies [i.e., Interventional Lung Assist (ILA) and ex...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Cancer screening with digital mammography for women at average risk for breast cancer, magnetic resonance imaging (MRI) for women at high risk: an evidence-based analysis.
Authors: Health Quality Ontario Abstract OBJECTIVE: The purpose of this review is to determine the effectiveness of 2 separate modalities, digital mammography (DM) and magnetic resonance imaging (MRI), relative to film mammography (FM), in the screening of women asymptomatic for breast cancer. A third analysis assesses the effectiveness and safety of the combination of MRI plus mammography (MRI plus FM) in screening of women at high risk. An economic analysis was also conducted. RESEARCH QUESTIONS: How does the sensitivity and specificity of DM compare to FM?How does the sensitivity and specificity of MRI compa...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Robotic-assisted minimally invasive surgery for gynecologic and urologic oncology: an evidence-based analysis.
Authors: Health Quality Ontario Abstract OBJECTIVE: An application was received to review the evidence on the 'The Da Vinci Surgical System' for the treatment of gynecologic malignancies (e.g. endometrial and cervical cancers). Limitations to the current standard of care include the lack of trained physicians on minimally invasive surgery and limited access to minimally invasive surgery for patients. The potential benefits of 'The Da Vinci Surgical System' include improved technical manipulation and physician uptake leading to increased surgeries, and treatment and management of these cancers. The demand for roboti...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Neuroimaging for the evaluation of chronic headaches: an evidence-based analysis.
The objectives of this evidence based review are: i) To determine the effectiveness of computed tomography (CT) and magnetic resonance imaging (MRI) scans in the evaluation of persons with a chronic headache and a normal neurological examination.ii) To determine the comparative effectiveness of CT and MRI scans for detecting significant intracranial abnormalities in persons with chronic headache and a normal neurological exam.iii) To determine the budget impact of CT and MRI scans for persons with a chronic headache and a normal neurological exam. CLINICAL NEED: CONDITION AND TARGET POPULATION Headaches disorders are g...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

5-Aminolevulinic Acid Hydrochloride (5-ALA)-Guided Surgical Resection of High-Grade Gliomas: A Health Technology Assessment.
Conclusions: 5-ALA-guided surgical resection appears to improve the extent of resection of high-grade gliomas compared with surgery using standard white-light microscopy (GRADE: Low). The evidence suggests 5-ALA-guided resection may improve overall survival; however, we cannot exclude the possibility of no effect (Grade: Low). 5-ALA may improve 6-month progression-free survival, although the results are highly uncertain (GRADE: Very low). There is an uncertain impact on overall or neurological adverse events (GRADE: Very low). We did not identify any economic studies conducted from the perspective of the Ontario or Canadia...
Source: Ontario Health Technology Assessment Series - March 22, 2020 Category: General Medicine Tags: Ont Health Technol Assess Ser Source Type: research

Cardiopulmonary Resuscitation in Patients With Terminal Illness: An Evidence-Based Analysis.
CONCLUSIONS: Survival after CPR depends on the severity of illness, type and number of health conditions, functional dependence, and multiple CPRs. PMID: 26339301 [PubMed - in process]
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Endovascular radiofrequency ablation for varicose veins: an evidence-based analysis.
The objective of the MAS evidence review was to conduct a systematic review of the available evidence on the safety, effectiveness, durability and cost-effectiveness of endovascular radiofrequency ablation (RFA) for the treatment of primary symptomatic varicose veins. BACKGROUND: The Ontario Health Technology Advisory Committee (OHTAC) met on August 26th, 2010 to review the safety, effectiveness, durability, and cost-effectiveness of RFA for the treatment of primary symptomatic varicose veins based on an evidence-based review by the Medical Advisory Secretariat (MAS). CLINICAL CONDITION: Varicose veins (VV) are tortuou...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Stress echocardiography for the diagnosis of coronary artery disease: an evidence-based analysis.
The objective of the analysis is to determine the diagnostic accuracy of stress echocardiography (ECHO) in the diagnosis of patients with suspected coronary artery disease (CAD) compared to coronary angiography (CA). STRESS ECHOCARDIOGRAPHY: Stress ECHO is a non-invasive technology that images the heart using ultrasound. It is one of the most commonly employed imaging techniques for investigating a variety of cardiac abnormalities in both community and hospital settings. A complete ECHO exam includes M-mode, 2-dimensional (2-D) images and Doppler imaging. In order to diagnosis CAD and assess whether myocardial ischemia is ...
Source: Ontario Health Technology Assessment Series - December 20, 2015 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research