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Completed Systematic Reviews




Management of Acute Diverticulitis


Public Project Complete

Statistics: 81 Studies, 4 Key Questions, 2 Extraction Forms,
Date Published: Jan 08, 2021 08:15PM
Description: Purpose of the Review The American College of Physicians (ACP) nominated the topic of management of acute diverticulitis to the Agency for Healthcare Research and Quality for systematic review. 45, 46 The ACP develops guidelines based on the needs of its members and the internal medicine community.47 The scope of the current systematic review was developed to support the ACP in its effort to create a new clinical practice guideline that will address diagnosis and staging of acute diverticulitis, nonsurgical treatment of acute diverticulitis, colorectal cancer screening in people with a history of diverticulitis, and interventions to prevent recurrence of acute diverticulitis. Specifically, (1) the systematic review will summarize existing systematic reviews on the test accuracy of CT imaging for diagnosis and staging of acute diverticulitis and conduct a de novo review of harms related to false positive, false negative, and incidental findings on CT imaging for suspected acute diverticulitis; (2) it will address effectiveness, comparative effectiveness, and harms of hospitalization for acute uncomplicated diverticulitis, antibiotics use for acute complicated or uncomplicated diverticulitis, and interventional radiology techniques for acute complicated diverticulitis; (3) it will review the benefits and harms of colonoscopy in people with a history of diverticulitis; and (4) it will evaluate pharmacologic, nonpharmacologic, and elective surgical interventions to prevent recurrent diverticulitis. Of note, this review will not evaluate the need for, or the choice of, surgery for the patient with acute diverticulitis. The intended audience includes guideline developers, clinicians and other providers of care for patients with diverticulitis, healthcare policy makers, and patients.
Contributor(s): Brown Evidence-based Practice Center
DOI: DOI pending.
Funding Source: AHRQ
Methodology Description: Systematic Review

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Treatments for Acute Pain: A Systematic Review


Public Project Complete

Statistics: 190 Studies, 9 Key Questions, 1 Extraction Form,
Date Published: Jan 06, 2021 03:46PM
Description: To evaluate the effectiveness and comparative effectiveness of opioid, nonopioid pharmacologic, and nonpharmacologic therapy in patients with specific types of acute pain, including effects on pain, function, quality of life, adverse events, and long-term use of opioids.
Contributor(s): Roger Chou, M.D. Jesse Wagner, M.A. Azrah Y. Ahmed, B.A. Ian Blazina, M.P.H. Erika Brodt, B.S. David I. Buckley, M.D., M.P.H. Tamara P. Cheney, M.D. Esther Choo, M.D., M.P.H. Tracy Dana, M.L.S. Debra Gordon, R.N., D.N.P., FANN Saurabh Khandelwal , M.D. Shelby Kantner, B.A. Marian S. McDonagh, Pharm.D. Christine Sedgley, M.D.S., M.D.Sc., FRACDS, MRACDS (ENDO), FACD, Ph.D. Andrea C. Skelly, Ph.D., M.P.H.
DOI: DOI pending.
Funding Source: AHRQ Contract No. 290-2015-00009-I
Methodology Description: Electronic databases (Ovid® MEDLINE®, PsycINFO®, Embase®, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews) were searched through August 5, 2020 for relevant publications. Searches were supplemented by reviewing reference lists and a Federal Register Notice. Randomized controlled trials (RCTs) of opioid therapy versus nonopioid pharmacologic or nonpharmacologic therapy, nonopioid therapy versus nonpharmacologic therapy, nonpharmacologic therapy versus inactive controls (placebo, sham therapy, attention control, or a minimal intervention), and head-to-head trials of nonopioid pharmacologic and nonpharmacologic therapy were selected using predefined criteria and dual review. Observational studies on the association between being prescribed opioids for acute pain versus no opioids and on factors influencing opioid prescribing for acute pain conditions were also included. This review focused on eight acute pain conditions: low back pain, neck pain, other musculoskeletal pain, neuropathic pain, postoperative pain (excluding inpatient management of pain after major surgical procedures), dental pain, pain due to kidney stones, and pain due to sickle cell disease. The review focused on outpatient management or therapy initiated shortly before discharge (e.g., after surgery or in emergency department). Outcomes were analyzed at <1 day, 1 day to <1 week, 1 week to <2 weeks, 2 to <4 weeks, and ≥4 weeks. Meta-analyses were conducted on pharmacologic therapy for dental pain and kidney stone pain and likelihood of repeat or rescue medication use and adverse events. Otherwise, meta-analyses were not conducted due to small number of studies, methodological limitations and study heterogeneity. The magnitude of effects was classified as small, moderate or large using previously defined criteria, and strength of evidence was assessed.

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Resource Allocation and Pandemic Response: An Evidence Synthesis to Inform Decision-Making


Public Project Complete

Statistics: 201 Studies, 1 Key Question, 1 Extraction Form,
Date Published: Nov 19, 2020 09:20PM
Description: None Provided
Contributor(s): Susanne Hempel, Rita V. Burke, Michael Hochman, Gina Thompson, Annie Brothers, Jennifer Shin, Aneesa Motala, Jody Larkin, and Jeanne Ringel Creator: amotala (Aneesa Motala)
DOI: DOI pending.
Funding Source: Agency for Healthcare Research and Quality
Methodology Description: We searched the databases PubMed, Web of Science, and Cochrane Database of Systematic Reviews on May 4, 2020. The search strategy is documented in Appendix A (p. 33). We included empirical studies and simulations evvaluating strategies for policy makers as well as consensus guidelines to allocate scarce resources. Studies had to address the allocation of scarce resources and interventions had to be aimed at policy makers such as local public health officials rather than individual clinicians.

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Omega-3 Fatty Acids and Cardiovascular Disease: An Updated Systematic Review


Public Project Complete

Statistics: 119 Studies, 2 Key Questions, 2 Extraction Forms,
Date Published: Nov 19, 2020 02:56PM
Description: The effect and association of omega−3 fatty acids (n-3 FA) intake and biomarker levels with cardiovascular (CV) clinical and intermediate outcomes remains controversial. We update prior Evidence Reports of n-3 FA and clinical and intermediate CV disease (CVD) outcomes.
Contributor(s): Ethan M. Balk, M.D., M.P.H. Gaelen P. Adam, M.L.I.S. Valerie Langberg, Sc.M. Christopher Halladay, B.A., Sc.M. Mei Chung, M.P.H., Ph.D. Lin Lin, M.A., Sc.M. Sarah Robertson, B.S. Agustin Yip, M.D. Dale Steele, M.D. Bryant T. Smith, M.P.H., C.P.H. Joseph Lau, M.D. Alice H. Lichtenstein, D.Sc. Thomas A. Trikalinos, M.D., Ph.D.
DOI: DOI pending.
Funding Source: AHRQ (Contract No. 290-2012-00012-I)
Methodology Description: We included randomized controlled trials (RCTs) of any n-3 FA intake compared to no, lower, or other n-3 FA intake with an outcome of interest conducted in healthy adults, those at risk for CVD, or those with CVD. We also included prospective observational studies of the association between baseline n-3 FA intake or biomarker level and followup outcomes. We required 1 year or more of followup for clinical outcomes and 4 weeks for intermediate outcomes (blood pressure [BP] and lipids).

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Management of Primary Headache During Pregnancy


Public Project Complete

Statistics: 52 Studies, 4 Key Questions, 2 Extraction Forms,
Date Published: Nov 09, 2020 04:26PM
Description: This systematic review will assess the prevention and treatment of primary headache during pregnancy, postpartum, and breastfeeding.
Contributor(s): Brown University Evidence-based Practice Center
DOI: DOI pending.
Funding Source: Agency for Healthcare Research and Quality
Methodology Description: A full systematic review

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