The Centre for Reviews and Dissemination (CRD)

CRD is part of the National Institute for Health Research (NIHR) and is a department of the University of York. CRD, which was established in 1994, is one of the largest groups in the world engaged exclusively in evidence synthesis in the health field. CRD undertakes systematic reviews evaluating the research evidence on health and public health questions of national and international importance. They produce the DARE, NHS EED and HTA databases which are used extensively by health professionals, policy makers and researchers around the world. They also undertake methods research and produce internationally accepted guidelines for undertaking systematic reviews.

CRD databases updated
In the week of 01/11/12 to 07/11/12, 53 new records were added to the DARE database.

Abstracts of the week - a selection

Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis. This generally well-conducted review concluded that high fish consumption was significantly associated with a reduced risk of cerebrovascular disease, but long-chain omega-3 fatty acid supplements were not. The beneficial effects of fish might come from a wide range of nutrients found in them. The conclusions are likely to be reliable.
Comparative effectiveness of warfarin and new oral anticoagulants for the management of atrial fibrillation and venous thromboembolism: a systematic review. The authors concluded that new oral anticoagulants were effective for patients receiving long-term anticoagulation. The benefits compared with warfarin were small and varied depending on the control achieved with warfarin. This was generally a well-conducted review and the conclusions are likely to be reliable.
Comparison of drug-eluting stents with bare metal stents in patients with ST-segment elevation myocardial infarction. This review concluded that early generation drug-eluting stents for ST-segment elevation myocardial infarction reduced target-vessel revascularisation, with a trend towards fewer definite stent thromboses, during the first year, but they increased stent thromboses in later years. The review was well conducted, and conclusions seem to be reliable.
Dual-source computed tomography angiography for diagnosis and assessment of coronary artery disease: systematic review and meta-analysis. This generally well conducted and clearly reported review concluded that dual-source computed tomography angiography had a high diagnostic accuracy for significant coronary artery disease which was relatively robust to elevated heart rates. These conclusions are likely to be reliable. The authors suggest further large scale confirmatory studies before their results are applied in clinical practice.
Effects of psychotherapy for anxiety in children and adolescents: a meta-analytic review. This review concluded that there was sufficient evidence to recommend psychological therapy, specifically behavioural or cognitive-behavioural therapy, for treating anxiety disorders in children and adolescents. The review was generally performed well and the authors' main conclusion seems reliable despite a lack of power in many trials.
High-risk human papillomavirus testing versus cytology in predicting post-treatment disease in women treated for high-grade cervical disease: a systematic review and meta-analysis. This review concluded that the high-risk type human papillomavirus test should be included in post-treatment testing due to its higher sensitivity and similar specificity to cytology. Limitations of the included studies and analysis make the recommendation for the introduction into practice seem a little strong but the overall conclusion regarding relative accuracy seems appropriate.
Systematic review and meta-analysis of "inside-out" versus "outside-in" transobturator tapes in management of stress urinary incontinence in women. This review investigated differences in outcomes between inside-out and outside-in transobturator tension free vaginal tape approaches for the surgical treatment of female stress urinary incontinence and found no evidence of differences in efficacy or in women's quality of life. The authors' conclusions are likely to reliable given the limited evidence available and generally low study quality.
The accuracy of sentinel node biopsy in breast cancer patients with the history of previous surgical biopsy of the primary lesion: systematic review and meta-analysis of the literature. This review concluded that surgical biopsy of malignant breast lesions did not affect the detection rate of sentinel lymph node biopsy. False negative rate may be slightly higher in patients with previous surgical biopsy but the authors believed that the advantages of sentinel node biopsy outweighed this. These conclusions reflect the data presented and are likely to be reliable.
Statins and intracerebral hemorrhage: collaborative systematic review and meta-analysis. This review found no evidence that statins were associated with intracerebral haemorrhage, and if there was a risk, it was small and outweighed by the cardiovascular benefits of treatment. Based on the presented evidence, these conclusions appear to be reliable.
Systematic review and meta-analysis of the predictive value of C-reactive protein in postoperative infections. This review concluded that, along with other clinical interventions, C-reactive protein was considerably valuable in the prognosis/diagnosis of postoperative infections. This review had several limitations and it is unlikely that the summary estimates presented, or the strong conclusion, can be deemed reliable.
Systematic review of intravitreal bevacizumab injection for treatment of primary diabetic macular oedema. This review found that intravitreal injections of bevacizumab resulted in short-term improvements in visual acuity in patients with primary diabetic macular oedema. These benefits did not extend beyond 12 weeks. The review was based on a small number of studies but was well conducted and the authors' cautious conclusion is likely to be reliable.
The efficacy of HER2-targeted agents in metastatic breast cancer: a meta-analysis. The authors concluded that there was clear evidence of the benefit of adding HER2- targeted therapy to standard treatment in metastatic breast cancer. Trials in the meta-analysis differed in terms of partner drugs or HER2-agents yet delivered comparable outcomes. The underlying evidence had some limitations but on balance the authors conclusions are likely to be reliable.