NHS Evidence - Eyes on Evidence - November 2012

. . . providing easy access to a comprehensive evidence base for everyone in health and social care who takes decisions about treatments or the use of resources.  A monthly bulletin is produced, Eyes on Evidence; the issue for November 2012 includes:

  1. Long-term outcomes after prenatal exposure to chemotherapy.  A European multicentre observational cohort study suggests that prenatal exposure to chemotherapy may not harm development. Children of women exposed to chemotherapy while pregnant develop as well as children in the general population. However, given the small sample size, caution is advised when interpreting the results.
  2. Difference in blood pressure readings between arms.  A growing body of evidence suggests that a difference in systolic blood pressure of 10 mmHg or more or 15 mmHg or more between arms could identify patients at high risk of asymptomatic peripheral vascular disease and mortality, who might benefit from further assessment. Current NICE guidance recommends that blood pressure should routinely be checked in both arms as part of an initial assessment for hypertension.
  3. A multidisciplinary approach to treating tinnitus.  Results of a randomised controlled trial suggest a multidisciplinary approach to treating tinnitus combining cognitive behaviour therapy with sound-based tinnitus retraining therapy is significantly more effective than currently available treatments at reducing symptoms and improving quality of life.
  4. Relative risk of self-monitoring warfarin therapy.  Results of a meta-analysis show that self-monitoring of warfarin reduces the risk of thromboembolic events compared with usual care, and has no major effect on bleeding complications or mortality. Cost-effectiveness was not assessed in this study.
  5. Accreditation News.  At its September meeting the NICE Accreditation Advisory Committee accredited 2 guidance programmes.

Website:  NHS Eyes on Evidence