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 21/02/13 to 27/02/13, 24 new records were added to the DARE database.

Abstracts of the week - a selection

• Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: a systematic review and meta-analysis.  After excluding seven trials by an investigator whose research was retracted due to scientific misconduct, this review concluded that, in critically ill patients who required acute volume resuscitation, hydroxyethyl starch was associated with significantly increased mortality and risk of acute kidney injury. The review was generally well conducted and the authors' conclusions are likely to be reliable.
• Optimal timing of coronary invasive strategy in non-ST-segment elevation acute coronary syndromes: a systematic review and meta-analysis.  This review concluded that there was insufficient evidence in favour of or against an early invasive approach in patients with NSTE-ACS. A more definitive RCT was warranted in order to guide clinical practice. The authors' conclusions and recommendations for a future RCT accurately reflect the inconclusive evidence base and are likely to be reliable.
• Carotid endarterectomy plus medical therapy or medical therapy alone for carotid artery stenosis in symptomatic or asymptomatic patients: a meta-analysis.  This review concluded that carotid endarterectomy was helpful in reducing the risk of stroke/death for patients with recent symptoms of carotid artery stenosis (50% or more), but had no benefit for asymptomatic patients. Despite the risks of bias identified in many included trials, the authors' conclusions reflected the evidence from a large number of patients and are probably reliable.
• Does upper extremity exercise improve dyspnea in patients with COPD? A meta-analysis.  This review found that upper extremity exercise may alleviate dyspnoea and arm fatigue during activities of daily living in patients with chronic obstructive pulmonary disease. The authors' conclusions appear likely to be reliable.
• Systematic review and meta-analysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes.  The review concluded that outcomes following aquatic exercise for adults with hip or knee arthritis appeared comparable to outcomes following land-based exercise. Aquatic programs provided an alternative for people who found it difficult or were unable to exercise on land. Despite not evaluating pain as an outcome, the authors' conclusions reflect the evidence presented and appear likely to be reliable.

Website: University of York Centre for Reviews and Dissemination