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 18/10/12 to 24/10/12, 81 new records were added to the DARE database.

Abstracts of the week - a selection

• Additional use of trimetazidine in patients with chronic heart failure: a meta-analysis.  This review concluded that trimetazidine may have decreased hospitalisation for cardiac causes, improved clinical symptoms and cardiac function, and ameliorated left ventricular modelling in patients with chronic heart failure. Despite some uncertainties in the methods used to select studies, the authors cautious conclusions reflect the evidence presented and are likely to be reliable.
• D-dimer testing in the diagnosis of cerebral vein thrombosis: a systematic review and a meta-analysis of the literature.  This generally well-conducted review concluded that D-dimer may be a useful diagnostic tool in the management of patients with suspected cerebral vein thrombosis. Although based on a relatively small number of studies and participants, the authors' conclusions reflected the available data and are likely to be reliable.
• Effect of teriparatide on bone mineral density and fracture in postmenopausal osteoporosis: meta-analysis of randomised controlled trials.  This review found that teriparatide was effective in the treatment of postmenopausal osteoporosis, with reductions in risks of fracture and improvements in bone mineral density. Although the quality of the studies was generally low, the authors' conclusions are likely to be reliable.
• Effects of cognitive therapy versus interpersonal psychotherapy in patients with major depressive disorder: a systematic review of randomized clinical trials with meta-analyses and trial sequential analyses.  This review concluded that cognitive therapy and interpersonal psychotherapy did not appear to differ in their reduction of depressive symptoms in people with major depressive disorder. Further trials with low risks of bias and error were needed and should report adverse events. This was a well-conducted review with appropriate conclusions and recommendations.
• Exercise for rotator cuff tendinopathy: a systematic review.  This generally well-conducted review concluded that the available literature was supportive of the use of exercise for rotator cuff tendinopathy (a type of shoulder pain), but that the paucity of research and associated limitations warranted further study. The authors’ conclusions reflect the limitations of the evidence presented and seem appropriate.
• Interventions to prevent substance use and risky sexual behaviour in young people: a systematic review.  The authors concluded that there was limited evidence that programmes to reduce multiple risk behaviours in school children can be effective. The most promising programmes were those that addressed multiple domains of influence on risk behaviour. Given some potential limitations in the included studies and in the review process, this conclusion is suitably cautious and is likely to be reliable.
• Meta-analysis on the comparison between two topical calcineurin inhibitors in atopic dermatitis.  The review concluded that tacrolimus ointment had higher efficacy and better tolerance than pimecrolimus cream in the treatment of atopic dermatitis over six weeks. The review had some methodological problems but the authors’ conclusions reflect the results and seem reasonable.
• Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: a meta-analysis of randomized trials.  This review found that the use of morphine added to intrathecally-administered bupivacaine local anaesthetic was associated with analgesic (pain relief) benefits for minor surgery but increased adverse events. The review was generally well conducted and the authors' conclusions are likely to be reliable.
• Selective serotonin reuptake inhibitor treatment and risk of fractures: a meta-analysis of cohort and case-control studies.  The review findings indicated that treatment with selective serotonin reuptake inhibitors was associated with an increased risk of bone fracture. A large number of patients were included in the review and, although there were some omissions in reporting, the authors' conclusions are likely to be reliable.
• The role of a rapid assessment zone/pod on reducing overcrowding in emergency departments: a systematic review.  The review concluded that although the results appeared to suggest a positive effect of rapid assessment zone/pod in mitigating emerge department overcrowding, the available evidence to support its implementation was limited and weak. The review was generally well conducted. The authors’ conclusions appropriately acknowledge the limitations of the evidence base and seem reliable.
• Efficacy of behavioral interventions to increase condom use and reduce sexually transmitted infections: a meta-analysis, 1991 to 2010.  This review found that behavioural interventions could increase condom use and reduce the incidence of sexually transmitted disease, including HIV. There was wide variation in the results, but the results and authors conclusions about components of successful interventions are likely to be reliable.
• Malignancies associated with tumour necrosis factor inhibitors in registries and prospective observational studies: a systematic review and meta-analysis.  This review reported that tumour necrosis factor inhibitors did not increase the risk of malignancy but they appeared to increase the risk of skin cancer, including melanoma. These findings were based on observational data so the authors urged caution in considering these results. The authors' cautious conclusions appear likely to be reliable.
• Relationship between FEV1 change and patient-reported outcomes in randomised trials of inhaled bronchodilators for stable COPD: a systematic review.  This review concluded that improvements in mean trough forced expiratory volume in one second could be associated with proportional improvements in health status. This was a well-conducted review and the authors’ cautious conclusion appears to reflect the data and is likely to be reliable.
• Risk of infection in patients with lymphoma receiving rituximab: systematic review and meta-analysis.  The addition of rituximab to standard chemotherapy produced better overall response, in patients with CD20-positive malignant lymphomas, without increasing the risk of severe infections. Some of the review processes were not fully reported and overall response was not defined, but it seems likely that the results of this review are reliable and reflect the balance of the evidence available.
• Systematic review of intervention practices for depression in the workplace.  This review concluded that no one intervention could be recommended as effective for either the prevention or management of work disability/sickness absence (whether recurrent or not) or the improvement of work functioning among workers with mild to moderate depression. Given the limited amount and poor quality of available evidence this conclusion appears to be reliable.

Website: University of York Centre for Reviews and Dissemination