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.

Comparative Effectiveness Review of Human Acellular Dermal Matrix for Breast Reconstruction

Health Problem: In women without adequate local tissue and muscle envelopes following mastectomy, human acellular dermal matrix (HADM) provides an alternative to autologous tissue donation or more extensive dissection and may enable 1-stage breast reconstruction (BR).

Technology Description: Biologic meshes are extracellular collagen matrices derived fr…

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Comparative Effectiveness Review of Bariatric Surgeries for Treatment of Obesity in Adolescents

Health Problem: Child and adolescent obesity is a body mass index (BMI) at or above the sex-specific 95th percentile on BMI-for-age growth charts. Consequences of obesity in children and adolescents include type 2 diabetes mellitus, obstructive sleep apnea, hypertension, nonalcoholic fatty liver disease, hyperlipidemia, musculoskeletal disorders, endocrine conditions, psycholo…

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Comparative Effectiveness Review of Antimicrobial Central Line Dressings for the Prevention of Central Line-Associated Bloodstream Infections

Health Problem: Intravenous catheters provide essential venous access when treating patients who are acutely or chronically ill, but their use also increases the risk of complications such as central line-associated bloodstream infections (CLABSIs). CLABSIs occur when microorganisms gain access to the bloodstream via 1 of several different routes: catheter hub contamination, c…

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Comparative Effectiveness Review of Endoscopic Surgery for Carpal Tunnel Release: A Review of Reviews

Health Problem: Carpal tunnel syndrome (CTS) is a compression neuropathy of the median nerve at the wrist. It is characterized by increased pressure within the carpal tunnel and decreased function of the nerve. The estimated prevalence of CTS is 3.1% to 7.8% among adult workers, with higher prevalence among female and older-age workers.

Technology Description: <...

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Comparative Effectiveness Review of Patellofemoral Arthroplasty for Isolated Osteoarthritis of the Knee

Health Problem: Osteoarthritis (OA) refers to the destruction of cartilage, the protective covering overlying bones at joints such as the knee or hip. Isolated patellofemoral OA (PFOA) involves only the junction between the kneecap (patella) and the distal thighbone (femur). PFOA is caused by trauma, malalignment of the joint, age-related degeneration, congenital trochlear dys…

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Comparative Effectiveness Review of Percutaneous Tibial Nerve Stimulation for the Treatment of Symptomatic Non-Neurogenic Overactive Bladder

Percutaneous tibial nerve stimulation (PTNS), also known as posterior tibial nerve stimulation, is a minimally invasive form of electrical neuromodulation used to treat overactive bladder (OAB) syndrome and associated symptoms of urinary urgency, urinary frequency, and urge urinary incontinence (UUI).

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Comparative Effectiveness Review of Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR) for Aortic Stenosis in Lower Risk Patients

Health Problem: Aortic stenosis (AS) is the most common cause of aortic valve disease in older patients; approximately 7% of the population > 65 years of age is affected. The prevalence of AS is approximately 0.4% among adults aged ≥ 18 to 75 years in the United States. At younger ages, AS is most often related to bicuspid aortic valve but in older patients, AS is related t…

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Comparative Effectiveness Review of Mandibular Advancement Devices for Sleep Apnea: A Review of Reviews

Health Problem: Obstructive sleep apnea (OSA) is a chronic disorder that is characterized by repeated starting and stopping of breathing during sleep. Patients with OSA typically exhibit loud snoring followed by periods of silence and then snorting, choking, or gasping upon continuation of breathing. This often leads to fragmented sleep and daytime sleepiness. The estimated pr…

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Comparative Effectiveness Review of Recombinant Human Bone Morphogenetic Protein (rhBMP) for Use in Spinal Fusion

Health Problem: It is estimated that 1.5 million bone-grafting operations are performed annually in the United States. One major application of bone grafting is in lumbar and cervical spinal fusion. Spinal fusion is performed for a variety of reasons, including trauma, herniated intervertebral discs, and degenerative disease. Spinal fusion has traditionally been performed with…

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