Comparative Effectiveness Reviews

Comparative Effectiveness Reviews are a comprehensive and systematic review and critical analysis of available evidence for TWO or MORE medical technologies in a given class for which there are several published clinical trials and a substantial body of evidence. This report details an entire technology class for which there are one or more technology.

Hybrid Maze Procedure for Atrial Fibrillation

Health Problem: Atrial fibrillation (AF) is a supraventricular, accelerated heart rhythm characterized by uncoordinated atrial activation that leads to inefficient, irregular atrial contraction. According to 2010 data, approximately 2.7 to 6.1 million people in the United States have AF. In both men and women, AF is associated with a signific…

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Comparative Effectiveness Review of Radioactive Yttrium-90 Microspheres for Treatment of Primary Unresectable Liver Cancer

Health Problem: Hepatocellular carcinoma (HCC) is the most common liver malignancy in the United States, accounting for approximately 90% of primary liver cancers. The definitive therapies for HCC are surgical resection, tumor ablation, and liver transplantation; however, most patients are not eligible for these therapies due to the overall burden or severity of their dis…

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Comparative Effectiveness Review of Mini Gastric Bypass–One Anastomosis Gastric Bypass for the Treatment of Obesity: A Review of Reviews

Health Problem: Obesity is a common condition in the United States, where approximately 37.7% of adults aged 20 years and older are considered obese. Data from 2013 to 2014 show a rate of obesity of 17.2% among younger individuals aged 2 to 19 years. Morbid obesity is associated with substantively elevated morbidity and mortality due to comorbid conditions, including type…

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Comparative Effectiveness Review of Functional Electrical Stimulation (FES) for Upper Extremity Rehabilitation Post Stroke

Health Problem: In the United States, stroke afflicts 795,000 individuals each year, with 610,000 being a first stroke and 185,000 being recurrent stroke. Stroke causes 140,000 deaths annually. It is estimated that 29% to 75% of stroke survivors experience upper extremity impairments and stroke reduces mobility in more than 50% of survivors age 65 years and older.

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Comparative Effectiveness Review of Lumbar Total Disc Replacement for Degenerative Disc Disease

Health Problem: It is estimated that 60% to 80% of the adult population in the United States will experience clinically significant low back pain (LBP) at some point in time. The vast majority of LBP is mechanical in nature, i.e., arising from anatomic structures of the spine. Nonspecific chronic LBP may be attributed to normal degenerative changes in the intervertebral discs …

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Comparative Effectiveness Review of Image-Based Computer-Aided Navigation for Total Knee Arthroplasty

Health Problem: Osteoarthritis of the knee is the primary indication for total knee arthroplasty (TKA) in the United States. Many TKA recipients are unsatisfied with the amount of pain relief and functional improvement they have long term. Malalignment of the implant has particularly been associated with poor clinical outcomes, early implant loosening, premature implant wear, …

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Comparative Effectiveness Review of Cold Compression Therapy for Patients Undergoing Total Knee Arthroplasty

Health Problem: Acute postoperative pain and swelling is common following total knee arthroplasty (TKA). Inadequately controlled pain negatively affects quality of life and recovery of function and may result in an increase in morbidity, recovery time, opioid use, and risk of complications or persistent postsurgical pain. According to 2010 data, approximately 4.7 million peopl…

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