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 11/06/12 to 24/06/12, 40 new records were added to the DARE database.

Abstracts of the week - a selection

Effect of pharmacological therapies for stroke prevention on major gastrointestinal bleeding in patients with atrial fibrillation. This well-conducted review found that adjusted-dose vitamin K antagonists increased the risk of major gastrointestinal bleeding compared with placebo or aspirin when used for stroke prevention in atrial fibrillation patients; combining vitamin K antagonists with aspirin also increased this risk. The authors' findings are generally reliable but limited by the small number of trials and rarity of events.
Behavioural interventions for weight management in pregnancy: a systematic review of quantitative and qualitative data. The authors of this review concluded that interventions to prevent excessive weight gain during pregnancy showed no clear evidence of effect or lack of effect. Further research to explore the types of interventions that might be effective was needed. This is a well conducted review and the conclusion and recommendations for research should be considered reliable and appropriate.
Dexamethasone versus prednisone for induction therapy in childhood acute lymphoblastic leukemia: a systematic review and meta-analysis. This review compared dexamethasone with prednisone during induction chemotherapy in children with acute lymphoblastic leukaemia and found that dexamethasone was more efficacious than prednisone but was also associated with more toxicity. Therefore, it was unclear whether this short-term superiority would translate to superior overall survival with longer follow-up. These conclusions are likely to be reliable.
Efficacy and safety of tigecycline: a systematic review and meta-analysis. The authors concluded that clinicians should avoid tigecycline monotherapy as treatment for severe infections and reserve it as a last resort. More trials investigating combination regimens including tigecycline were required. Limited patient information made it difficult to ascertain the wider applicability of the findings. Based on the findings presented, the authors' conclusions appear to be reliable.
Insufficient evidence of benefit: a systematic review of home telemonitoring for COPD. This generally well-conducted review concluded that the benefits of home telemonitoring for patients with chronic obstructive pulmonary disease were not yet proven. The authors' conclusions reflect the limitations of the evidence presented and seem reliable
Sentinel node mapping in the prostate cancer: meta-analysis. This well conducted review concluded that sentinel node mapping was an accurate method of pelvic lymph node staging in patients with prostate cancer and had a high detection rate and low false-negative rate. This conclusion is supported by the data presented and is likely to be reliable.
Systematic review of erosion after laparoscopic adjustable gastric banding. The review concluded that re-banding after erosion (and there was a low incidence of erosion) in laparoscopic adjustable gastric banding patients resulted in low re-erosion rates and maintenance of weight loss. However, the evidence was generally considered to be poor and limited conclusions could be drawn. The authors’ conclusions reflect the evidence presented and seem reasonable.
Prophylaxis with itraconazole is more effective than prophylaxis with fluconazole in neutropenic patients with hematological malignancies: a meta-analysis of randomized-controlled trials. The review concluded that itraconazole resulted in significantly fewer episodes of fungal infections and invasive fungal infections than fluconazole, but also had a significantly higher risk of adverse effects in neutropenic patients with haematological malignancies. The authors' conclusions reflect the evidence presented and appear likely to be reliable.
Is intranasal zinc effective and safe for the common cold? A systematic review and meta-analysis. This well-conducted review concluded that there may be some benefit from zinc for symptoms of a common cold in adults, but the results for symptom relief at day three were not significant; there may be a risk of loss of the sense of smell. The authors overall conclusions reflect the evidence presented and are likely to be reliable.