Evidence based practice updates - 10 January 2013

New guidelines, research and other tools and updates on evidence based techniques and processes from across the UK. For more information about this theme see Quality and Safety e-Bulletin: evidence based practice.

Some of the resources linked to are in PDF format - see how to access PDF files.

Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program: Evaluation and treatment of Cryptoorchidism. "Both laparoscopic and open surgical techniques are effective for moving undescended testicles to a normal position in the scrotum ... However, no specific imaging technique is able to consistently determine the presence or absence of testicles or the location of undescended testicles, the review found." 

Arthritis Research: Complementary and alternative medicines for the treatment of rheumatoid arthritis, osteoarthritis and fibromyalgia. A new report into the effectiveness of the complementary therapies that are commonly used for treating arthritis and other musculoskeletal conditions has found there is a lack of scientific evidence to support their use. The report has revealed that many of the therapies have not been subjected to a clinical trial or may have only been tested in a single study. The findings present a mixed picture, with some therapies being effective, but not for all conditions. 

BBC: Spit test ‘improves’ asthma care. According to a study a simple spit test could identify thousands of children with severe asthma who are taking medication which will never help them.

BBC: Diet drinks’ ‘link to depression’ questioned. Experts are questioning whether diet drinks could raise depression risk after US research in more than 250,000 people found depression was more common among frequent consumers of artificially sweetened beverages.

BMC Health Services Research: Assessing research impact in academic clinical medicine: a study using Research Excellence Framework pilot impact indicators. In the United Kingdom, the Higher Education Funding Council for England (HEFCE) developed proposals for the Research Excellence Framework (REF) to allocate public research funding to higher education institutions, inter alia, on the basis of the social and economic impact of their research. In this study the impact indicators proposed in the 2010 REF impact pilot exercise are critically reviewed and appraised using insights from the relevant literature and empirical data collected for the University of Oxford's REF pilot submission in clinical medicine.

BMC Medical Informatics & Decision Making: Measuring the quality of Patients' goals and action plans: development and validation of a novel tool. This study aimed to develop and test reliability, validity, and utility of the Goal-Setting Evaluation Tool for Diabetes (GET-D). It found that "GET-D can reliably and validly rate the quality of goals and action plans. It holds promise as a measure of intervention fidelity for clinical interventions that promote diabetes self-management behaviors to improve clinical outcomes."  

BMC Public Health: Current experience with applying the GRADE approach to public health interventions: an empirical study. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach has been adopted by many national and international organisations as a systematic and transparent framework for evidence-based guideline development. The study findings "suggest that GRADE principles are applicable to public health and well-received but also highlight common challenges. They provide a starting point for exploring options for improvements and, where applicable, testing these across different types of public health interventions."  

BMJ: Nutritional content of supermarket ready meals and recipes by television chefs in the United Kingdom: cross sectional study. The study concludes that "neither recipes created by television chefs nor ready meals sold by three of the leading UK supermarkets complied with WHO recommendations. Recipes were less healthy than ready meals, containing significantly more energy, protein, fat, and saturated fat, and less fibre per portion than the ready meals."

Healthcare Improvement Scotland: What is the clinical and cost effectiveness of temporal artery thermometers compared with infrared in-ear thermometers for temperature measurement in routine clinical practice? In response to an enquiry from NHS Forth Valley a number of questions relating to the clinical effectiveness of temporal artery thermometers (TATs) were scoped.

Implementation Science: Strategies to enhance venous thromboprophylaxis in hospitalized medical patients (SENTRY): a pilot cluster randomized trial. “Venous thromboembolism (VTE) is a common preventable cause of mortality in hospitalized medical patients. Despite rigorous randomized trials generating strong recommendations for anticoagulant use to prevent VTE, nearly 40% of medical patients receive inappropriate thromboprophylaxis. Knowledge-translation strategies are needed to bridge this gap.”

National Institute for Health Research (NIHR): Dementia research. On 21 December 2012, the Health Secretary Jeremy Hunt announced £22 million of NIHR funding, for twenty one successful research projects that will pioneer dementia diagnosis and ground breaking treatments. Details of the 21 projects are available.

NHS Evidence: Evidence updates: Psychosis with coexisting substance misuse (PDF 320.3KB). A summary of selected new evidence relevant to NICE clinical guideline 120 ‘Psychosis with coexisting substance misuse: assessment and management in adults and young people’ published in 2011. 

NICE: Developing and updating local formularies. NICE has published the first in a new series of guidance that provides advice and guides good practice for those involved in handling, prescribing, commissioning and decision-making about medicines. The NICE good practice guide on the development and updating of local formularies has been designed to help organisations develop and update local formularies that reflect local needs, reduce variation in prescribing, and allow rapid uptake of innovative medicines and treatments, in accordance with statutory requirements.
Developing and updating local formularies: NICE good practice guidance.  

NICE: NICE announces its Collaborating Centre for Social Care. NICE has awarded a contract to the Social Care Institute for Excellence (SCIE), and its partner organisations, to support the development, adoption and dissemination of its social care guidance and quality standards from 1 April, as the NICE Collaborating Centre for Social Care. Developing social care guidance and quality standards is a new responsibility for NICE, as outlined in the government's Health and Social Care Act (2012). From 1 April, NICE will expand its remit and to reflect this, will be known as the National Institute for Health and Care Excellence (NICE).

NICE: Consultation on Quality and Outcomes Framework (QOF) indicators. Comments are being sought on 14 new potential QOF indicators across six domains: hypertension, dementia, coronary heart disease, diabetes, peripheral arterial disease and stroke. The consultation will close at 5.00pm on Monday 4th February 2013.

NICE: How NICE can help Clinical Commissioning Groups deliver high quality care. NICE has been working to align their guidance, advice and standards so that they can help CCGs to successfully deliver clinical and cost effective services for the patients that they serve.

PLOS One: Experiences of domestic violence and mental disorders: a systematic review and meta-analysis. The study based on research conducted by King’s College Institute of Psychiatry in collaboration with the University of Bristol, concludes that “there is a high prevalence and increased likelihood of being a victim of domestic violence in men and women across all diagnostic categories, compared to people without disorders”. 
University of Bristol news.   

Public Health Wales: Young homeless people need greater support in accessing health services. An evidence review by Public Health Wales suggests that homeless young people are more likely to use accident and emergency services or be admitted to hospital than their housed peers, and that they need more help in accessing appropriate health services.