NHS Evidence - Eyes on Evidence - September 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 September 2012 includes:

  1. Changes needed to cope with multimorbidity.  Having two or more medical conditions is common and not simply a feature of old age. More research is needed to enable guidance producers to adequately address the healthcare needs of people with multimorbidity.
  2. Ethnicity may influence signs of suicide risk.  Research suggests possible cultural differences in expressing mental distress and symptoms, which could mean that traditional signals currently used by clinicians to assess suicide risk may not be indicative of the actual risk in certain populations.
  3. Anti-EGFR agents can increase risk of venous thromboembolism (VTE).  A meta-analysis shows patients who are being treated for cancer with anti-epidermal growth factor receptor agents, cetuximab and panitumab, are at increased risk of VTE. Evidence is not sufficient to give primary thromboprophylaxis to all patients receiving these treatments, but clinicians should be aware of the increased risk and monitor patients accordingly.
  4. Aspirin for secondary prevention of VTE after warfarin prophylaxis is discontinued.  Compared with placebo, ongoing low-dose daily aspirin substantially reduced the risk of recurrence of VTE in people who had already completed 6 to 18 months of oral anticoagulation, with no increased risk of major bleeds.
  5. Doubts cast on carotid intima-media thickness progression as a predictor of cardiovascular events.  A large meta-analysis concludes that the association between carotid intima-media thickness (cIMT) progression and cardiovascular risk in the general population is unproven, despite a strong association between single cIMT measurement and cardiovascular disease. This raises questions over the use of cIMT progression as a surrogate marker for cardiovascular disease in clinical trials.

Website:  NHS Eyes on Evidence