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 27/09/12 to 03/10/12, 39 new records were added to the DARE database.

Abstracts of the week - a selection

• Angiotensin receptor blockers for prevention of new-onset type 2 diabetes: a meta-analysis of 59,862 patients. The review found that angiotensin receptor blockers reduced the incidence of new-onset diabetes in patients with cardiovascular disease or risk factors. Despite some limitations in the review methodology and the evidence base, these conclusions appear reliable.
• Efficacy and safety of micafungin for invasive candida infections: a meta-analysis of randomized controlled trials. This review found that micafungin may offer a better safety and tolerability profile than several other antifungal agents in the prevention and treatment of invasive candida infections. The authors' conclusions were based on the evidence presented and are likely to be reliable.
• Meta-analysis of psychosocial interventions to reduce pain in patients with cancer. This review concluded that psychosocial interventions had medium-size effects on pain severity and interference in cancer patients and this supported use of quality-controlled psychosocial interventions in a multimodal approach to pain management. Apart from a risk of language bias this was a well-conducted review. The conclusions seem reliable but pain severity was reported in only four studies.
• Use of new-generation oral anticoagulant agents in patients receiving antiplatelet therapy after an acute coronary syndrome: systematic review and meta-analysis of randomised controlled trials.  This review concluded that use of orally activated Xa antagonist or direct thrombin inhibitors after acute coronary syndrome significantly increased major bleeding which might offset ischaemic benefits in patients receiving antiplatelet therapy. Despite potential for missed studies and the unknown quality of the included studies, the results across the studies are consistent and support the authors conclusions.
• Efficacy of low-dose bupivacaine in spinal anaesthesia for caesarean delivery: systematic review and meta-analysis. The review concluded that low dose bupivacaine for Caesarean delivery spinal anaesthesia compromised anaesthetic efficacy despite the benefit of lower maternal hypotension and nausea/vomiting. The review was well conducted and the results seem reliable; however, an arbitrary cut-off value for low dose bupivacaine means that a degree of caution is warranted when interpreting the authors’ conclusions.
• Metal-on-metal or metal-on-polyethylene for total hip arthroplasty: a meta-analysis of prospective randomized studies. The authors concluded that there was insufficient evidence to identify any clinical advantage of metal-on-metal compared with metal-on-polyethylene total hip replacement. The authors acknowledged the small number of trials and that most trials were underpowered and of short duration. This was a generally well-conducted review and the authors’ conclusions appear to be reliable.

Website: University of York Centre for Reviews and Dissemination