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 04/10/12 to 17/10/12, 102 new records were added to the DARE database.

Abstracts of the week - a selection

Accuracy of single progesterone test to predict early pregnancy outcome in women with pain or bleeding: meta-analysis of cohort studies. This review concluded that a single progesterone measurement for women in early pregnancy who presented with bleeding or pain and inconclusive ultrasound assessments could rule out a viable pregnancy. This was a generally well-conducted review and the conclusion is likely to be reliable.
Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the US Preventive Services Task Force. This review concluded that behavioural counselling interventions improved behavioural outcomes for adults with risky drinking. This was well-conducted review and although some studies may have been missed the conclusions are likely to be reliable.
Can home monitoring reduce mortality in infants at increased risk of sudden infant death syndrome? A systematic review. This review found that there was insufficient evidence that home monitoring of infants can reduce the incidence of sudden infant death syndrome. Reporting flaws mean that the results should be interpreted with some caution but the authors' conclusions on the paucity of good quality evidence are likely to be reliable.
Efficacy of executive function interventions after stroke: a systematic review. The review concluded that limited evidence suggested that stroke patients may possibly benefit from specific executive function training and learn compensatory strategies to reduce the consequences of executive impairments. Despite some review limitations, the authors' conclusions were suitably cautious in reflecting the evidence available and appear likely to be reliable.
Interventions to improve adherence to self-administered medications for chronic diseases in the United States: a systematic review. This review concluded that case management, patient education with behavioural support, and reducing out-of-pocket expenses each improved medication adherence for more than one condition. Whether they could be applied to or improve long-term adherence and health outcomes was uncertain. This was a well-conducted review, and the conclusions are likely to be reliable.
Iron replacement therapy in inflammatory bowel disease patients with iron deficiency anemia: a systematic review and meta-analysis. This review found small but significant benefits with intravenous administration of iron replacement compared to oral administration in patients with inflammatory bowel disease and iron deficiency anaemia. The authors acknowledged limitations in the evidence available and their cautious conclusions appear likely to be reliable.
Iron supplementation for the treatment of chronic heart failure and iron deficiency: systematic review and meta-analysis. The review concluded that intravenous iron therapy was associated with improved quality of life, reduced hospitalisations and increased walk distance in congestive heart failure patients with iron deficiency, without an increase in adverse events. The authors were suitably cautious in acknowledging the limitations of their results and their conclusions are likely to be reliable.
Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis. This generally well-conducted review concluded that opiate substitution as maintenance therapy reduced the risk of HIV infection among people who inject drugs. The authors acknowledged the limitations of the evidence, and that high levels of motivation to change behaviour participants of such studies may mean the results were not generalisable. These conclusions are likely to be reliable.
Systematic review and meta-analysis of antibiotic prophylaxis to prevent infections from chest drains in blunt and penetrating thoracic injuries. This review concluded that infectious complications were less likely to develop when antibiotic prophylaxis was given to patients with penetrating thoracic injuries that required chest drains. The review was generally well conducted and the authors’ conclusions appear to be reasonable, based on the evidence presented.
Bariatric surgery: A systematic review and network meta-analysis of randomized trials. The review concluded that bariatric surgery appeared substantially more effective than standard care for the treatment of severe obesity in adults. However, large and adequately powered, long-term RCTs were lacking. Based on the limited evidence available, the authors advised a cautious interpretation of their conclusions, which appear likely to be reliable.
Hemiarthroplasty and total hip arthroplasty for treating primary intracapsular fracture of the hip: a systematic review and cost-effectiveness analysis. The review concluded that in patients with displaced intracapsular fracture total hip arthroplasty was more effective than hemiarthroplasty in terms of function, pain, mobility and rates of revision but less effective than hemiarthroplasty in terms of rates of dislocation. The review was well-conducted and the authors' conclusions are likely to be reliable.