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 weeks of 03/01/13 to 23/01/13, 65 new records were added to the DARE database.

Abstracts of the week - a selection

Automated dose dispensing service for primary healthcare patients: a systematic review. This review evaluated the impact of automated dose dispensing on appropriateness of medication use and medication safety in primary healthcare settings. The authors concluded that evidence was limited and further research was necessary to draw sound conclusions. This was a largely well-conducted review and the authors' conclusions seem reliable.
Benefits of beta blockers in patients with heart failure and reduced ejection fraction: network meta-analysis. This well-conducted review concluded that beta-blockers (as a class) reduced mortality in patients with heart failure, but no obvious differences were found between individual beta-blockers; further head-to-head comparisons were needed. The authors' conclusions appear to reflect the evidence presented and are likely to be reliable.
Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. This review found that sugar intake affected body weight, apparently due to changes in overall energy intake. Despite some concerns over potential for bias in the studies and possible publication bias, the author’s conclusions are likely to be reliable.
A meta-analysis of paclitaxel-based chemotherapies administered once every week compared with once every 3 weeks first-line treatment of advanced non-small-cell lung cancer. This review concluded that there were no significant differences between weekly paclitaxel-based chemotherapy compared with the standard once every three weeks schedule in the first-line treatment of advanced non-small-cell lung cancer. The review used appropriate methods and the authors' conclusions seem to be reliable.
Association of blood transfusion with increased mortality in myocardial infarction: a meta-analysis and diversity-adjusted study sequential analysis. The authors concluded that blood transfusion or a liberal blood transfusion strategy compared with no blood transfusion or a restricted blood transfusion strategy was associated with higher all-cause mortality. The authors’ conclusions reflect the evidence presented and seem reliable.
A systematic review and meta-analysis of randomised controlled trials comparing endovenous ablation and surgical intervention in patients with varicose vein. Primary failure and recurrence in endovenous laser ablation and radiofrequency ablation were non-significantly different compared with surgery. Patients treated with endovenous techniques had lower haematoma, less wound infection, less pain and quicker return to normal activities. The review had some limitations but overall the authors' conclusions are likely to be reliable.
Cancer risk with folic acid supplements: a systematic review and meta-analysis. The authors concluded that there was a borderline significantly increased risk of cancer, and a moderately significantly increased risk of prostate cancer, with folic acid supplementation, compared with control groups. The limitations of the data mean that the applicability of the results is uncertain, but this was a well-conducted review and the authors' conclusions appear to be reliable.
Caudal epidural injections in the management of chronic low back pain: a systematic appraisal of the literature. This review concluded that there was good evidence for short-term and long-term pain relief with local anaesthetic and steroids for chronic pain emanating as a result of disc herniation or radiculitis and fair evidence for pain relief with local anaesthetic only. These conclusions reflect the evidence presented and are likely to be reliable.
Does performance-based remuneration for individual health care practitioners affect patient care? A systematic review. The authors concluded that Pay-for-Performance modestly improved preventive activities, such as immunisation rates, but there was little evidence that it was effective for other outcomes. Implementation of these schemes should be experimental. This was a well-conducted review and the authors' conclusions reflect the findings and seem reliable.
Effect of statins on venous thromboembolic events: a meta-analysis of published and unpublished evidence from randomised controlled trials. The evidence did not support the suggestion that statins (or high doses of statins) substantially reduced the risk of venous thromboembolism, but a modest, clinically relevant, reduction in risk, could not be ruled out. There was some uncertainty around the methods, but those that were reported were good. The conclusions reflect the evidence and are likely to be reliable.
Educational interventions by pharmacists to patients with chronic pain: systematic review and meta-analysis. This well-conducted review concluded that pharmacist-delivered educational interventions seemed to reduce adverse events and improve satisfaction but their clinical benefit on pain intensity was debatable. The findings supported a proof of concept but further research was needed. The authors were suitably cautious in reflecting the limited evidence available and their conclusions appear likely to be reliable.
Inhaled nitric oxide in preterm infants. This review found that there was a small reduction in the composite outcome of death or bronchopulmonary dysplasia at 36 weeks postmenstrual age, for infants treated with inhaled nitric oxide, compared with controls, but no reduction in death or bronchopulmonary dysplasia considered separately. These conclusions are clearly based on the evidence presented, and are likely to be reliable.