Medical Technology Directory

health technology evaluations at your fingertips

Hayes Medical Technology Directory is a comprehensive collection of in-depth health technology assessment reports designed to support evidence-based policies, guideline development, and technology acquisition. Below is a brief sampling of our Directory publications.

View a sampling of our Directory reports.

Transcatheter Closure of Prosthetic Aortic or Mitral Paravalvular Leaks

September 14, 2017 Medical Technology Directory

Rationale: Medical therapy can ameliorate symptoms associated with aortic or mitral prosthetic paravalvular leaks (PVLs). However, repeat cardiac surgery is associated with increased morbidity and mortality, with added risk secondary to paravalvular tissue friability and heavy calcification. Thus, percutaneous closure of prosthetic PVLs is under investigation as an alternative to open surgical repair of these defects. Technology Description: Transcatheter closure (TC) or percutaneous closure of prosthetic PVLs is a complex interventional cardiology procedure that involves the deployment of a wire mesh occluding device into the heart across or through each PVL site to close it. Controversy: A major controversy related to this...

The Clinical Utility of Lumbar Discography for Assessing Low Back Pain: Impact on Patient Management and Health Outcomes

September 7, 2017 Medical Technology Directory

Rationale: Discography evaluates the suspected culprit discs with abnormal morphology and, as a control, normal discs. In theory, the combination of imaging that demonstrates disc degeneration or internal disc disruption and provoking the patient’s usual pain confirms a tested disc as a source of pain. Technology Description: Discography involves image-guided injection of a contrast agent into the nucleus of 1 or more lumbar discs individually to provoke a pain response that reproduces the patient’s usual pain and reveal morphological disc abnormalities via the pattern of contrast spread. Performed under fluoroscopic guidance, discography involves inserting a needle into the center of an...

Adoptive Immunotherapy using Genetically Modified Lymphocytes for Lymphoproliferative Disorders or Hematological Malignancies

September 7, 2017 Medical Technology Directory

Rationale: CAR T cells and genetically engineered TCR T cells are targeted, personalized therapies for malignancies and other neoplastic disorders, including hematological cancers and lymphoproliferative diseases. Although alternative treatments, including chemotherapy, radiation, monoclonal antibodies, hematopoietic stem cell transplants (HSCTs), and adoptive immunotherapy with tumor-infiltrating lymphocytes (TILs), have been used with varying success, all carry the risk of treatment failure, negative off-target effects, and fatal complications. CAR T and TCR T cells are highly tumor-specific and tumor-reactive, personalized, gene transfer-based technologies that may overcome issues surrounding immune tolerance for tumor-specific T cells.   Technology Description: CAR T cells and genetically engineered TCR T...

Comparative Effectiveness of Endovenous Laser Therapy Versus Conventional Surgery for Symptomatic Varicose Veins: A Review of Reviews

September 7, 2017 Medical Technology Directory

Purpose of Technology: The goal of endovenous laser ablation (EVLA) is to use laser energy to seal off the damaged portions of varicose veins, prevent further varicose vein formation, eliminate associated discomfort, and improve cosmetic appearance. This therapy is intended primarily for the treatment of varicose veins that result from great saphenous vein (GSV), small saphenous vein (SSV), or saphenofemoral junction (SFJ) reflux. Rationale: Compared with conventional vein stripping or ligation procedures, EVLA may reduce postoperative morbidity, as well as shorten recovery time. Controversy: There is a need to compare alternative treatments with conventional surgery with respect to rates of retreatment and...

Comparative Effectiveness Review of Robotically Assisted Hysterectomy

August 31, 2017 Medical Technology Directory

Purpose of Technology: Robotically assisted hysterectomy (RAH) is intended for the minimally invasive removal of the uterus as a treatment for various medical conditions, including benign conditions such as endometriosis, uterine fibroids, and uterine prolapse. It is also used to treat and stage malignant conditions such as cervical and endometrial cancers. Rationale: Robotic surgical systems were developed to address the limitations of conventional laparoscopic surgery. The advantages of robotic technology over conventional laparoscopic techniques are the 3-dimensional (3D), panoramic, high-resolution view with depth perception, and the surgeon’s ability to directly control a stable visual field with increased magnification. Controversy: The number of...