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 31/01/13 to 06/02/13, 23 new records were added to the DARE database.

Abstracts of the week - a selection

Efficacy and safety of dual blockade of the renin-angiotensin system: meta-analysis of randomised trials. The authors concluded that compared with monotherapy, combination blockade of the renin-angiotensin system had some beneficial effects, but it did not reduce mortality and significantly compromised safety. Despite some limitations in the review, there were a lot of trials, and larger trials tended to find similar effects, which suggests that the authors' conclusions are likely to be reliable.
Dexamethasone for prevention of postoperative nausea and vomiting in patients undergoing thyroidectomy: meta-analysis of randomized controlled trials. This review found that prophylactic administration of dexamethasone was safe, significantly reduced the incidence of postoperative nausea and vomiting and may reduce pain in patients undergoing thyroidectomy surgery. In general the review was well conducted and the authors' conclusions are likely to be reliable.
Engaging patients in health care decisions in the emergency department through shared decision-making: a systematic review. The authors concluded that limited evidence showed no reason to suggest that shared decision making cannot be successful in the emergency department. This was a generally well-conducted review and the authors' conclusion seems reliable.
Intensive versus conventional glucose control in critically ill patients: a meta-analysis of randomized controlled trials. This review found that intensive glucose monitoring for critically ill patients, in the intensive care unit, did not reduce mortality and increased the risk of hypoglycaemia, compared with conventional therapy. The review was generally well conducted and these conclusions appear to be reliable.
Is routine second-look endoscopy effective after endoscopic hemostasis in acute peptic ulcer bleeding? A meta-analysis. The author concluded that without high-dose proton-pump inhibitor, routine second-look endoscopy appeared effective in patients with very high risk of peptic ulcer bleeding; the generalisability of these results to the patients with bleeding and high-risk stigmata was questionable without high-dose proton-pump inhibitor. The authors' conclusions reflect the evidence presented and seem reliable.
Meta-analysis of randomized trials of angioedema as an adverse event of renin-angiotensin system inhibitors. This review found that the risk of angio-oedema with angiotensin-receptor blockers was less than half that with angiotensin-converting enzyme inhibitors, and did not differ significantly from the risk with placebo. Both types of drug increased the risk of angio-oedema for patients with heart failure. Despite some reporting limitations in the review, these findings seem reliable.
The forgotten role of alcohol: a systematic review and meta-analysis of the clinical efficacy and perceived role of chlorhexidine in skin antisepsis. The authors concluded that chlorhexidine combined with alcohol was superior to aqueous povidone iodine in skin antisepsis for blood culture collection, vascular catheter insertion or surgical skin preparation. To guarantee patient safety, caregivers should be aware of this effect which was often wrongly attributed to chlorhexidine alone. Review methodology was sound and the authors' conclusions reflect the presented evidence.
Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures: meta-analysis of randomized trials. This review concluded that total hip arthroplasty, for patients with displaced femoral neck fractures, had lower reoperation rates and higher function scores than hemiarthroplasty, but with an increased risk of dislocations. The review was generally well conducted and, in spite of some limitations in the evidence, the authors' conclusions are likely to be reliable.