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Completed Systematic Reviews




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SRDR Project Indexing


Public Project Complete

Statistics: 184 Studies, 1 Key Question, 1 Extraction Form,
Date Published: Apr 05, 2021 03:12PM
Description: This is a Methods Research project that catalogs the various projects with publicly available data on the SRDR Webpage.
Contributor(s): Ian Saldanha, Bryant Smith
Funding Source: Agency for Healthcare Research and Quality
Methodology Description: None Provided

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Screening for Bacterial Vaginosis in Pregnant Adolescents and Women to Prevent Preterm Delivery


Public Project Complete

Statistics: 44 Studies, 5 Key Questions, 1 Extraction Form,
Date Published: Apr 05, 2021 03:11PM
Description: A review of the evidence about screening for bacterial vaginosis during pregnancy to prevent preterm delivery.
Contributor(s): The authors gratefully acknowledge the following individuals for their contributions to this project: Tina Fan, MD, MPH, AHRQ Medical Officer; Tracy Wolff, MD, MPH, AHRQ Associate Scientific Director; Quyen Ngo-Metzger, MD, MPH, Professor at Kaiser Permanente School of Medicine; current members of the U.S. Preventive Services Task Force; expert peer reviewers Mark Klebanoff, MD, MPH; John Thorp, MD; Valerie J. King, MD, MPH; and Julie van Schalkwyk, MD; two Federal partner reviewers; and RTI International–University of North Carolina EPC staff: Carol Woodell, BSPH; B. Lynn Whitener, DrPH; Sharon Barrell, MA; and Loraine Monroe.
DOI: DOI pending.
Funding Source: AHRQ
Methodology Description: We conducted a systematic review to evaluate the benefits and harms of screening and treatment for bacterial vaginosis during pregnancy to prevent preterm delivery and the diagnostic accuracy of tests used to screen for bacterial vaginosis. We searched 3 databases from January 1, 2006, through May 29, 2019, building on the literature included in the prior 2008 evidence review for the USPSTF. Because the previous reviews on this topic for the USPSTF did not include a systematic search for KQ 2 (diagnostic test accuracy), we conducted a separate PubMed search from inception through December 31, 2005, to supplement our main search for this update. Two investigators screened each abstract and full-text article for inclusion; abstracted data; and performed quality ratings, applicability ratings, and evidence grading. Where appropriate, we performed a quantitative synthesis by fitting the bivariate model to generate a summary receiver operating characteristics curve (SROC) and a pooled summary point estimate of sensitivity and specificity.

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Automated-Entry Patient Generated Health Data for Chronic Conditions: The Evidence on Health Outcomes


Public Project Complete

Statistics: 128 Studies, 50 Key Questions, 10 Extraction Forms,
Date Published: Feb 19, 2021 08:13PM
Description: Technical brief for AHRQ on the evidence for whether PGHD devices and apps improve health outcomes for chronic conditions
Contributor(s): Jonathan R. Treadwell, Ph.D., James T. Reston Ph.D., Benjamin Rouse, M.H.S., Joann Fontanarosa, Ph.D., Neha Patel, M.D., Nikhil K Mull, M.D.
DOI: DOI pending.
Funding Source: AHRQ
Methodology Description: None Provided

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The effect of IDH inhibitors in AML patients.


Public Project Complete

Statistics: 4 Studies, 2 Key Questions, 1 Extraction Form,
Date Published: Feb 14, 2021 06:29AM
Description: 12% of patients with AML harbor mutation at Isocitrate dehydrogenase enzyme (IDH).Mutations at these enzymes result in high level of R2 hydroxyglutarate which competes with 2-alpha-hydroxygluterate resulted in DNA and histone hypermethylation. DNA and histone hypermethylation inhibits cell differentiation and promotes leukemic transformation. Ivosidenib and Enasidenib are IDH inhibitors that promotes cell differentiation and showed promising activity in phase1 and 2 trials in relapse/refractory AML patients and in elderly patients who are not candidate for traditional induction regimens. In this systematic review and meta-analysis, we intend to integrate the results of phase1 and 2 trials that looked at the efficacy and the side effects of IDH inhibitor. Therefore,we will have a clearer picture regarding the efficacy and side effect of these medications.
Contributor(s): Yanal Alnimer, MD Ayman Qasrawi, MD Munthir Mansour, MD
DOI: DOI pending.
Funding Source: N/A
Methodology Description: We will use the ("Metaprop") package in R in order to integrate the results pertaining to the Objective response, Complete remission, and other response outcomes in addition to grade 3 and 4 Treatment Emergent Adverse Events (TEAE) in these trials.

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Interventions for Drug Use – Supplemental Report: A Systematic Review for the U.S. Preventive Services Task Force [Entered Retrospectively]


Public Project Complete

Statistics: 91 Studies, 6 Key Questions, 1 Extraction Form,
Date Published: Jan 20, 2021 09:44PM
Description: Background: A U.S. Preventive Services Task Force (USPSTF) report found no consistent evidence that counseling interventions are effective at reducing drug use or improving other health outcomes in populations whose drug use was identified through primary care-based screening with questions about drug use or drug-related risks (i.e., “screen-detected populations”). Evidence from studies of persons seeking or referred for treatment for substance use or with clinical signs or symptoms of substance use (i.e., “treatment-seeking populations”) might also be useful for informing assessments regarding screening in primary care settings. Purpose: This report updates a 2008 USPSTF report on screening for illicit drug use and supplements an updated USPSTF report on screening for any drug use, focusing on the benefits and harms of pharmacotherapy and psychosocial interventions for persons whose drug use was identified when seeking substance use treatment, when presenting with signs or symptoms of drug use, when screened for drug use in primary care or other settings with questions about drug use or drug-related risks, or other means. Data Sources: The Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Ovid MEDLINE, Embase, and PsycINFO from inception to September 2018; surveillance for new literature was conducted through November 22, 2019. Study Selection: We included trials of Food and Drug Administration (FDA)-approved pharmacotherapies for opioid use disorder (methadone, buprenorphine, and naltrexone) and trials of psychosocial interventions for persons engaging in opioid, stimulant, cannabis, and mixed drug or polysubstance use. We also included trials of preemptive prescribing of naloxone in primary care settings as a rescue medication for opioid-related overdose. Trials compared included interventions against placebo, a minimal intervention, waitlist control, or usual care, and evaluated outcomes at >3 months for drug use or other risky behaviors; health, social, and legal consequences of drug use; or harms of treatment. Data Extraction: One investigator abstracted data and a second investigator checked data abstraction for accuracy. Two investigators independently assessed study quality using methods developed by the USPSTF. Data Synthesis (Results): We included a total of 71 trials, with 19 trials of pharmacotherapies and 52 trials of psychosocial interventions. All trials of pharmacotherapies and 25 trials of psychosocial interventions were conducted in treatment-seeking populations. Psychosocial interventions commonly incorporated cognitive-behavioral or motivational interventions and ranged from brief interventions consisting of one or two sessions of no more than one hour to multiple treatment sessions over weeks or months. In most pharmacotherapy trials, drug use counseling was provided to all patients. No study evaluated benefits or harms of preemptive naloxone prescribed in primary care settings versus placebo or no naloxone as a rescue medication for opioid-related overdose. In treatment-seeking populations with opioid use disorder, naltrexone (12 trials; relative risk [RR] 0.73, 95% confidence interval [CI] 0.62 to 0.85; number needed to treat [NNT] 5.3) and opioid agonist therapy with methadone or buprenorphine (4 trials; RR 0.75, 95% CI 0.59 to 0.82; NNT 2.9) were associated with decreased risk of drug use relapse compared with placebo or no pharmacotherapy. Naltrexone and methadone/buprenorphine therapy were also associated with increased likelihood of retention in substance use treatment (9 trials; RR 1.71, 95% CI 1.13 to 2.49; NNT 6.7 and 7 trials; RR 2.58, 95% CI 1.78 to 4.59; NNT 2.6; respectively). Evidence on harms of pharmacotherapies was limited, but indicated no increased risk of serious adverse events. Psychosocial interventions were associated with increased likelihood of abstinence from drug use versus control conditions at 3 to 4 months (15 trials, RR 1.60, 95% CI 1.24 to 2.13; NNT 11) and at 6 to 12 months (14 trials; RR 1.25, 95% CI 1.11 to 1.52; NNT 17), based on trials primarily conducted in treatment-seeking populations. Psychosocial interventions were also associated with a greater decrease versus control conditions in the number of drug use days (19 trials; mean difference -0.49 day in the last 7 days, 95% CI -0.85 to -0.13) and a small but statistically significant greater decrease in drug use severity (16 trials; standard mean difference -0.18, 95% CI -0.32 to -0.05) at 3- to 4-month followup. There was no difference between psychosocial interventions versus controls on drug use days or severity at longer (6 to 12 month) followup. Effects of psychosocial interventions were generally stronger in trials of treatment-seeking than screen-detected populations, trials that evaluated cannabis use than other types of drug use, and trials of more intensive than brief interventions. Few trials evaluated effects of psychosocial interventions for opioid or stimulant use, and estimates were imprecise. Limitations: Limitations included restriction to English-language articles, statistical heterogeneity in pooled analyses, and little evidence on drug-related health, social, or legal outcomes; most trials had methodological limitations. Evidence was lacking on effectiveness of treatments for opioid use disorder related to prescription drug use or stimulant use and evidence was limited for adolescents or pregnant persons. Conclusions: Pharmacotherapy and psychosocial interventions are effective at improving drug use outcomes, but evidence of effectiveness remains primarily derived from trials conducted in treatment-seeking populations. Although the applicability of data from such trials to persons whose drug use is identified through primary care-based screening is uncertain, intervention trials that enrolled patients based on screening identified a spectrum of drug use, ranging from mild drug use to more severe, untreated disease. The applicability of current evidence on drug use interventions to screening might be greater for the subset of patients screened in primary care settings with severe, untreated drug use who could utilize pharmacotherapies or more intensive psychosocial interventions.
Contributor(s): Roger Chou, MD Tracy Dana, MLS Ian Blazina, MPH Sara Grusing, BA Rongwei Fu, PhD Christina Bougatsos, MPH
DOI: DOI pending.
Funding Source: This report is based on research conducted by the Pacific Northwest Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA-290-2015-00007-I, Task Order No. 4)
Methodology Description: Study Selection: We included trials of Food and Drug Administration (FDA)-approved pharmacotherapies for opioid use disorder (methadone, buprenorphine, and naltrexone) and trials of psychosocial interventions for persons engaging in opioid, stimulant, cannabis, and mixed drug or polysubstance use. We also included trials of preemptive prescribing of naloxone in primary care settings as a rescue medication for opioid-related overdose. Trials compared included interventions against placebo, a minimal intervention, waitlist control, or usual care, and evaluated outcomes at >3 months for drug use or other risky behaviors; health, social, and legal consequences of drug use; or harms of treatment. Data Extraction: One investigator abstracted data and a second investigator checked data abstraction for accuracy. Two investigators independently assessed study quality using methods developed by the USPSTF. Data Synthesis (Results): We included a total of 71 trials, with 19 trials of pharmacotherapies and 52 trials of psychosocial interventions. All trials of pharmacotherapies and 25 trials of psychosocial interventions were conducted in treatment-seeking populations. Psychosocial interventions commonly incorporated cognitive-behavioral or motivational interventions and ranged from brief interventions consisting of one or two sessions of no more than one hour to multiple treatment sessions over weeks or months. In most pharmacotherapy trials, drug use counseling was provided to all patients. No study evaluated benefits or harms of preemptive naloxone prescribed in primary care settings versus placebo or no naloxone as a rescue medication for opioid-related overdose. In treatment-seeking populations with opioid use disorder, naltrexone (12 trials; relative risk [RR] 0.73, 95% confidence interval [CI] 0.62 to 0.85; number needed to treat [NNT] 5.3) and opioid agonist therapy with methadone or buprenorphine (4 trials; RR 0.75, 95% CI 0.59 to 0.82; NNT 2.9) were associated with decreased risk of drug use relapse compared with placebo or no pharmacotherapy. Naltrexone and methadone/buprenorphine therapy were also associated with increased likelihood of retention in substance use treatment (9 trials; RR 1.71, 95% CI 1.13 to 2.49; NNT 6.7 and 7 trials; RR 2.58, 95% CI 1.78 to 4.59; NNT 2.6; respectively). Evidence on harms of pharmacotherapies was limited, but indicated no increased risk of serious adverse events. Psychosocial interventions were associated with increased likelihood of abstinence from drug use versus control conditions at 3 to 4 months (15 trials, RR 1.60, 95% CI 1.24 to 2.13; NNT 11) and at 6 to 12 months (14 trials; RR 1.25, 95% CI 1.11 to 1.52; NNT 17), based on trials primarily conducted in treatment-seeking populations. Psychosocial interventions were also associated with a greater decrease versus control conditions in the number of drug use days (19 trials; mean difference -0.49 day in the last 7 days, 95% CI -0.85 to -0.13) and a small but statistically significant greater decrease in drug use severity (16 trials; standard mean difference -0.18, 95% CI -0.32 to -0.05) at 3- to 4-month followup. There was no difference between psychosocial interventions versus controls on drug use days or severity at longer (6 to 12 month) followup. Effects of psychosocial interventions were generally stronger in trials of treatment-seeking than screen-detected populations, trials that evaluated cannabis use than other types of drug use, and trials of more intensive than brief interventions. Few trials evaluated effects of psychosocial interventions for opioid or stimulant use, and estimates were imprecise.

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