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The Systematic Review Data Repository (SRDR) is a powerful and easy-to-use tool for the extraction and management of data for systematic review or meta-analysis. It is also an open and searchable archive of systematic reviews and their data.
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Recently Completed and Deposited Reports Data

Noninvasive, Nonpharmacological Treatment for Chronic Pain: A Systematic Review [Entered Retrospectively]


Public Report Complete
Statistics: 206 Studies, 5 Key Questions, 5 Extraction Forms,
Date Created: Mar 30, 2018 04:20PM
Description: Structured Abstract Objectives. Many interventions are available to manage chronic pain; understanding the durability of treatment effects may assist with treatment selection. We sought to assess which noninvasive, nonpharmacological treatment for selected chronic pain conditions are associated with persistent improvement in function and pain outcomes at least 1 month after the completion of treatment. Data sources. Electronic databases (Ovid MEDLINE®, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews), through November 2017, reference lists, and ClinicalTrials.gov. Review methods. Using predefined criteria, we selected randomized controlled trials of noninvasive, nonpharmacological treatments for five common chronic pain conditions (chronic low back pain, chronic neck pain, osteoarthritis of the knee, hip, or hand, fibromyalgia, and tension headache) that addressed efficacy or harms compared with usual care, no treatment, waitlist, placebo, or sham intervention; compared with pharmacological therapy; or compared with exercise. Study quality was assessed, data extracted, and results summarized for function and pain. Only trials reporting results for at least 1 month post-intervention were included. We focused on the persistence of effects at short term (1 to < 6 months following treatment completion), intermediate term (≥6 to <12 months), and long term (≥12 months). Results. 218 publications (202 trials) were included. Many included trials were small. Evidence on outcomes beyond 1 year after treatment completion was sparse. Most trials enrolled patients with moderate baseline pain intensity (e.g., >5 on a 0 to 10 point numeric rating scale) and duration of symptoms ranging from 3 months to >15 years. The most common comparison was against usual care. Chronic low back pain: At short term, massage, yoga, and psychological therapies (primarily cognitive behavioral therapy [CBT]) (Strength of evidence [SOE]: Moderate) and exercise, acupuncture, spinal manipulation, and multidisciplinary rehabilitation (SOE: Low) were associated with slight improvements in function compared with usual care or inactive controls. Except for spinal manipulation, these interventions also improved pain. Effects on intermediate term function were sustained for yoga, spinal manipulation, multidisciplinary rehabilitation (SOE: Low), and psychological therapies (SOE: Moderate). Improvements in pain continued into intermediate term for exercise, massage and yoga (moderate effect, SOE: Low), mindfulness-based stress reduction (small effect, SOE: Low), spinal manipulation, psychological therapies, and multidisciplinary rehabilitation (small effects, SOE: Moderate). For acupuncture, there was no difference in pain at intermediate term, but a slight improvement at long term (SOE: Low). Psychological therapies were associated with slightly greater improvement than usual care or an attention control on both function and pain at short-term, intermediate-term, and long-term followup (SOE: Moderate). At short and intermediate term, multidisciplinary rehabilitation slightly improved pain compared with exercise (SOE: Moderate). High-intensity multidisciplinary rehabilitation (≥20 hours/week or >80 hours total) was not clearly better than nonhigh-intensity programs. Chronic neck pain: At short- and intermediate-terms, acupuncture and Alexander Technique were associated with slightly improved function compared with usual care (both interventions), sham acupuncture, or sham laser (SOE: Low), but no improvement in pain was seen at any time (SOE: Low). Short-term, low-level laser therapy was associated with moderate improvement in function and pain (SOE: Moderate). Combination exercise (any 3 of the following: muscle performance, mobility, muscle re-education, aerobic) demonstrated a slight improvement in pain and function short and long-term (SOE: Low). Osteoarthritis: For knee osteoarthritis, at short-term exercise and ultrasound demonstrated small short-term improvements in function compared with usual care, an attention control or sham procedure (SOE: Moderate for exercise, Low for ultrasound), which persisted into the intermediate term only for exercise (SOE: Low). Exercise was also associated with moderate improvement in pain (SOE: Low). Long term, the small improvement in function seen with exercise persisted, but there was no clear effect on pain (SOE: Low). Evidence was sparse on interventions for hip and hand osteoarthritis. Exercise for hip osteoarthritis was associated with slightly greater function and pain improvement than usual care short term (SOE: Low). The effect on function was sustained intermediate term (SOE: Low). Fibromyalgia: In the short term, acupuncture (SOE: Moderate), CBT, tai chi, qigong, and exercise (SOE: Low) were associated with slight improvements in function compared with an attention control, sham, no treatment or usual care. Exercise (SOE: Moderate) and CBT improved pain slightly and tai chi and qigong (SOE: Low) improved pain moderately in the short term. At intermediate term for exercise (SOE: Moderate), acupuncture and CBT (SOE: Low), slight functional improvements persisted and were also seen for myofascial release massage and multidisciplinary rehabilitation (SOE: Low); pain was improved slightly with multidisciplinary rehabilitation in the intermediate-term (SOE: Low). In the long term, small improvements in function continued for multidisciplinary rehabilitation but not for exercise or massage (SOE: Low for all); massage (SOE: Low) improved long-term pain slightly but no clear impact on pain for exercise (SOE: Moderate) or multidisciplinary rehabilitation (SOE: Low) was seen. Short-term CBT was associated with a slight improvement in function but not pain compared with pregabalin. Chronic tension headache: Evidence was sparse and the majority of trials were of poor quality. Spinal manipulation slightly improved function and moderately improved pain short-term versus usual care and laser acupuncture was associated with slight pain improvement short term compared with sham (SOE Low). There was no evidence suggesting increased risk for serious treatment-related harms for any of the interventions, although data on harms were limited. Conclusions. Exercise, multidisciplinary rehabilitation, acupuncture, cognitive behavioral therapy, and mind-body practices were most consistently associated with durable slight to moderate improvements in function and pain for specific chronic pain conditions. Our findings provided some support for clinical strategies that focused on use of nonpharmacological therapies for specific chronic pain conditions. Additional comparative research on sustainability of effects beyond the immediate post-treatment period is needed, particularly for conditions other than low back pain.

Nonsurgical Treatments for Urinary Incontinence in Adult Women: A Systematic Review Update


Public Report Complete
Statistics: 105 Studies, 1 Key Question, 1 Extraction Form,
Date Created: Jul 11, 2017 01:28PM
Description: SR of nonsurgical interventions for stress, urgency, and mixed urinary incontinence in women (excluding neuropathic UI and children). Network meta-analysis of "urinary incontinence outcomes" ("cure", improvement, and satisfaction with the level of incontinence achieved). Qualitative review of quality of life outcomes. Summary of adverse events. This is an update of a 2012 review done by the Minnesota EPC. Available data from eligible studies included in the prior review are uploaded as separate files.

Environmental sanitary interventions for preventing active trachoma (2012)


Public Report Complete
Statistics: 6 Studies, 1 Key Question, 1 Extraction Form,
Date Created: Sep 07, 2016 12:17AM
Description: OBJECTIVES: To assess the evidence for the effectiveness of environmental sanitary measures on the prevalence of active trachoma in endemic areas.

Noninvasive, Nonpharmacological Treatment for Chronic Pain: A Systematic Review [Entered Retrospectively]


Public Report Complete
Statistics: 206 Studies, 5 Key Questions, 5 Extraction Forms,
Date Created: Mar 30, 2018 04:20PM
Description: Structured Abstract Objectives. Many interventions are available to manage chronic pain; understanding the durability of treatment effects may assist with treatment selection. We sought to assess which noninvasive, nonpharmacological treatment for selected chronic pain conditions are associated with persistent improvement in function and pain outcomes at least 1 month after the completion of treatment. Data sources. Electronic databases (Ovid MEDLINE®, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews), through November 2017, reference lists, and ClinicalTrials.gov. Review methods. Using predefined criteria, we selected randomized controlled trials of noninvasive, nonpharmacological treatments for five common chronic pain conditions (chronic low back pain, chronic neck pain, osteoarthritis of the knee, hip, or hand, fibromyalgia, and tension headache) that addressed efficacy or harms compared with usual care, no treatment, waitlist, placebo, or sham intervention; compared with pharmacological therapy; or compared with exercise. Study quality was assessed, data extracted, and results summarized for function and pain. Only trials reporting results for at least 1 month post-intervention were included. We focused on the persistence of effects at short term (1 to < 6 months following treatment completion), intermediate term (≥6 to <12 months), and long term (≥12 months). Results. 218 publications (202 trials) were included. Many included trials were small. Evidence on outcomes beyond 1 year after treatment completion was sparse. Most trials enrolled patients with moderate baseline pain intensity (e.g., >5 on a 0 to 10 point numeric rating scale) and duration of symptoms ranging from 3 months to >15 years. The most common comparison was against usual care. Chronic low back pain: At short term, massage, yoga, and psychological therapies (primarily cognitive behavioral therapy [CBT]) (Strength of evidence [SOE]: Moderate) and exercise, acupuncture, spinal manipulation, and multidisciplinary rehabilitation (SOE: Low) were associated with slight improvements in function compared with usual care or inactive controls. Except for spinal manipulation, these interventions also improved pain. Effects on intermediate term function were sustained for yoga, spinal manipulation, multidisciplinary rehabilitation (SOE: Low), and psychological therapies (SOE: Moderate). Improvements in pain continued into intermediate term for exercise, massage and yoga (moderate effect, SOE: Low), mindfulness-based stress reduction (small effect, SOE: Low), spinal manipulation, psychological therapies, and multidisciplinary rehabilitation (small effects, SOE: Moderate). For acupuncture, there was no difference in pain at intermediate term, but a slight improvement at long term (SOE: Low). Psychological therapies were associated with slightly greater improvement than usual care or an attention control on both function and pain at short-term, intermediate-term, and long-term followup (SOE: Moderate). At short and intermediate term, multidisciplinary rehabilitation slightly improved pain compared with exercise (SOE: Moderate). High-intensity multidisciplinary rehabilitation (≥20 hours/week or >80 hours total) was not clearly better than nonhigh-intensity programs. Chronic neck pain: At short- and intermediate-terms, acupuncture and Alexander Technique were associated with slightly improved function compared with usual care (both interventions), sham acupuncture, or sham laser (SOE: Low), but no improvement in pain was seen at any time (SOE: Low). Short-term, low-level laser therapy was associated with moderate improvement in function and pain (SOE: Moderate). Combination exercise (any 3 of the following: muscle performance, mobility, muscle re-education, aerobic) demonstrated a slight improvement in pain and function short and long-term (SOE: Low). Osteoarthritis: For knee osteoarthritis, at short-term exercise and ultrasound demonstrated small short-term improvements in function compared with usual care, an attention control or sham procedure (SOE: Moderate for exercise, Low for ultrasound), which persisted into the intermediate term only for exercise (SOE: Low). Exercise was also associated with moderate improvement in pain (SOE: Low). Long term, the small improvement in function seen with exercise persisted, but there was no clear effect on pain (SOE: Low). Evidence was sparse on interventions for hip and hand osteoarthritis. Exercise for hip osteoarthritis was associated with slightly greater function and pain improvement than usual care short term (SOE: Low). The effect on function was sustained intermediate term (SOE: Low). Fibromyalgia: In the short term, acupuncture (SOE: Moderate), CBT, tai chi, qigong, and exercise (SOE: Low) were associated with slight improvements in function compared with an attention control, sham, no treatment or usual care. Exercise (SOE: Moderate) and CBT improved pain slightly and tai chi and qigong (SOE: Low) improved pain moderately in the short term. At intermediate term for exercise (SOE: Moderate), acupuncture and CBT (SOE: Low), slight functional improvements persisted and were also seen for myofascial release massage and multidisciplinary rehabilitation (SOE: Low); pain was improved slightly with multidisciplinary rehabilitation in the intermediate-term (SOE: Low). In the long term, small improvements in function continued for multidisciplinary rehabilitation but not for exercise or massage (SOE: Low for all); massage (SOE: Low) improved long-term pain slightly but no clear impact on pain for exercise (SOE: Moderate) or multidisciplinary rehabilitation (SOE: Low) was seen. Short-term CBT was associated with a slight improvement in function but not pain compared with pregabalin. Chronic tension headache: Evidence was sparse and the majority of trials were of poor quality. Spinal manipulation slightly improved function and moderately improved pain short-term versus usual care and laser acupuncture was associated with slight pain improvement short term compared with sham (SOE Low). There was no evidence suggesting increased risk for serious treatment-related harms for any of the interventions, although data on harms were limited. Conclusions. Exercise, multidisciplinary rehabilitation, acupuncture, cognitive behavioral therapy, and mind-body practices were most consistently associated with durable slight to moderate improvements in function and pain for specific chronic pain conditions. Our findings provided some support for clinical strategies that focused on use of nonpharmacological therapies for specific chronic pain conditions. Additional comparative research on sustainability of effects beyond the immediate post-treatment period is needed, particularly for conditions other than low back pain.

Diet-Related Fibers and Human Health Outcomes, Version 4.0


Public Report Complete
Statistics: 1044 Studies, 1 Key Question, 1 Extraction Form,
Date Created: Jan 07, 2018 07:07PM
Description: The objectives of this database are to: 1. Systematically compile and provide access to primary, English-language, peer-reviewed science linking dietary fiber intake in humans to one or more of 10 potential health benefits 2. Provide researchers with a tool to understand how different fibers are characterized in studies 3. Facilitate researchers in identifying gaps in the current research 4. Create a database to serve as a starting foundation of primary human literature for conducting evidence-based reviews and meta-analyses 5. Efficiently assist researchers in identifying fibers of interest. This database should serve as a foundation for future work. Specific inclusion and exclusion criteria, detailed in the user manual, were applied in determining database eligibility; thus, this database is not intended to serve as a sole source for identifying all possible fiber literature for the purposes of conducting a meta-analysis or systematic review. This database contains Population, Intervention, Comparator, and Outcome (PICO) data to help users formulate and narrow the focus of their research question. It is expected that secondary searches will be conducted to augment this database.

Definition of Treatment-Resistant Depression in the Medicare Population


Public Report Complete
Statistics: 197 Studies, 11 Key Questions, 2 Extraction Forms,
Date Created: Nov 22, 2017 01:45PM
Description: The purpose of this technology assessment is to review the current definitions of treatment-resistant depression (TRD), to assess how closely current TRD treatment studies fit the most common definition, and to suggest how to improve TRD treatment research.



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The data contained in this project are distributed under the terms of the Creative Commons Attribution-NonCommerical license, which permits the use, dissemination, and reproduction in any medium, provided the original work is properly cited, and that the use is non-commercial and otherwise in compliance with the license. See: https://creativecommons.org/licenses/by-nc/3.0/