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Completed Systematic Reviews




Medical Therapies for Children with Autism Spectrum Disorder—An Update


Public Project Complete

Statistics: 109 Studies, 6 Key Questions, 1 Extraction Form,
Date Published: Mar 21, 2019 09:12AM
Description: This review was conducted to evaluate the comparative effectiveness and safety of medical interventions (defined broadly as interventions involving the administration of external substances to the body or use of external, non-behavioral procedures to treat symptoms of ASD) for children with Autism Spectrum Disorder (ASD). This report is a update on a previous report from 2011.
Contributor(s): Edwin Williamson, MD Nila Sathe, MA, MLIS Jeff Andrews, MD Shanthi Krishnaswami, MPH, MBBS Melissa McPheeters, PhD, MPH Christopher Fonnesbeck, PhD Kevin Sanders, MD Amy Weitlauf, PhD Zachary Warren, PhD
Funding Source: None Provided
Methodology Description: We included comparative studies of medical interventions that included at least 10 children with ASD between 2 and 12 years old. Two investigators independently screened studies and rated risk of bias. We extracted and summarized data qualitatively given significant heterogeneity. We also assessed strength of the evidence (SOE) and considered cumulative data from eligible studies included in our 2011 review of ASD therapies and newly published studies.

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Interventions Targeting Sensory Challenges in Children with Autism Spectrum Disorder (ASD)—An Update


Public Project Complete

Statistics: 24 Studies, 6 Key Questions, 1 Extraction Form,
Date Published: Mar 21, 2019 09:12AM
Description: This review was conducted to evaluate the effectiveness and safety of interventions targeting sensory challenges in children with Autism Spectrum Disorder (ASD). This report is a update on a previous report from 2011.
Contributor(s): Amy S. Weitlauf, PhD Nila A, Sathe, MA, MLIS Melissa L. McPheeters, PhD, MPH Zachary Warren, PhD
Funding Source: None Provided
Methodology Description: We included studies comparing interventions incorporating sensory-focused modalities with alternate treatments or no treatment. Studies had to include at least 10 children with ASD between 2 and 12 years old. Two investigators independently screened studies and rated risk of bias. We extracted and summarized data qualitatively given significant heterogeneity. We also assessed strength of the evidence (SOE).

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Management of Uterine Fibroids


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Statistics: 109 Studies, 4 Key Questions, 1 Extraction Form,
Date Published: Mar 21, 2019 09:12AM
Description: We assessed the evidence about management of uterine fibroids. Specifically, we sought to determine effectiveness of interventions, risks of harm, and whether individual or fibroid characteristics influence outcomes.
Contributor(s): Katherine E. Hartmann, MD, PhD Christopher Fonnesbeck, PhD Tanya Surawicz, MPH Shanthi Krishnaswami, MBBS, MPH Jeffrey C. Andrews, MD Jo Ellen Wilson, MD, MPH Digna Velez-Edwards, PhD, MS Shannon Kugley, MLIS
Funding Source: None Provided
Methodology Description: We included studies published in English from January 1985 to September 2016. We identified randomized clinical trials to assess outcomes and harms of interventions. We used data from trials in a meta-analysis to estimate likelihood and timing of subsequent interventions for fibroids based on initial type of intervention. To describe risk of unrecognized leiomyosarcoma, we included studies that allowed calculation of prevalence of leiomyosarcoma discovered at the time of surgery for masses believed to be fibroids. We also identified publications that indicated operative approach to removal of leiomyosarcoma tissue and included survival data. We extracted data, assessed risk of bias, and rated the strength of the evidence for informing care.

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Interventions for central serous chorioretinopathy: a network meta-analysis


Public Project Complete

Statistics: 60 Studies, 1 Key Question, 1 Extraction Form,
Date Published: Mar 21, 2019 09:12AM
Description: The purpose of this form is to abstract data from reports corresponding to a study included in a systematic review.
Contributor(s): Salehi M, Wenick AS, Law HA, Evans JR, Gehlbach P
Funding Source: National Eye Institute, National Institutes of Health
Methodology Description: Network meta-analysis

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Tonsillectomy for Obstructive Sleep-Disordered Breathing or Recurrent Throat Infection in Children


Public Project Complete

Statistics: 242 Studies, 1 Key Question, 1 Extraction Form,
Date Published: Mar 21, 2019 09:12AM
Description: We anticipate this report will be of primary value to organizations that develop guidelines for tonsillectomy, to clinicians who provide care for children with indications for tonsillectomy, and for families making treatment decisions. Children who are candidates for tonsillectomy may be treated by clinicians including pediatricians, otolaryngologists, sleep medicine physicians, allergists, family physicians, anesthesiologists, infectious disease physicians, nurse practitioners, physician assistants, and nurses. This report supplies practitioners and researchers up-to-date information about the current state of evidence and assesses the quality of studies that aim to determine the outcomes and safety of tonsillectomy.
Contributor(s): David Francis Nila Sathe Anna Morad Siva Chinnadurai Atia Jordan Chris Fonnesbeck Shanthi Krishnaswami Melissa McPheeters
Funding Source: None Provided
Methodology Description: Working from the nomination, we drafted the initial key questions (KQ) and analytic frameworks and refined them with input from key informants representing the fields of pediatrics, otolaryngology, anesthesiology, and sleep medicine. We also spoke with a caregiver representative. We also developed population, interventions, outcomes, timing, and settings (PICOTS) criteria for intervention KQ. We identified technical experts on the topic to provide assistance during the project. The Technical Expert Panel (TEP), representing the fields of pediatrics, otolaryngology, anesthesiology, infectious disease, and sleep medicine, contributed to the AHRQ’s broader goals of (1) creating and maintaining science partnerships as well as public-private partnerships and (2) meeting the needs of an array of potential users of its products. Thus, the TEP was both an additional resource and a sounding board during the project. The TEP included eight members serving as technical or clinical experts. To ensure comprehensive retrieval of relevant studies of therapies for children undergoing tonsillectomy, we used three key databases: the MEDLINE® medical literature database via the PubMed® interface; EMBASE (Excerpta Medica Database), an international biomedical and pharmacological literature database via the Ovid® interface; and the Cochrane Library. Search strategies for KQs applied a combination of controlled vocabulary (Medical Subject Headings [MeSH] and Emtree headings) to focus specifically on tonsillectomy and harms of interventions. Team data extractors shared the task of initially entering information into the evidence tables. A second team member also reviewed the articles and edited all initial entries for accuracy, completeness, and consistency. A senior reviewer reconciled disagreements concerning the information reported.

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