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 06/12/12 to 02/01/13, 47 new records were added to the DARE database.

Abstracts of the week - a selection

An evaluation of the feasibility, cost and value of information of a multicentre randomised controlled trial of intravenous immunoglobulin for sepsis (severe sepsis and septic shock): incorporating a systematic review, meta-analysis and value of information analysis. The authors concluded that there was borderline significant evidence that intravenous immunoglobulin reduced all-cause mortality for patients with severe sepsis or septic shock. There was variation in the treatment effect across trials and the results should be interpreted with caution. This was a well-conducted review and the cautious conclusions reflect the evidence and are likely to be reliable.
Comparison of interdental brush to dental floss for reduction of clinical parameters of periodontal disease: a systematic review. Interdental brushes were an effective alternative to dental floss for reducing bleeding and plaque between four and 12 weeks. Overall, this review was well conducted and benefited from a thorough search, robust review methods and reliable analyses. The findings of this review are likely to be reliable.
Conservative management of end-stage renal disease without dialysis: a systematic review. Despite limitations to the review process the authors' conclusion that conservative management should be discussed when counselling patients, with end-stage renal disease, about dialysis seems reasonable.
Effect of reducing total fat intake on body weight: systematic review and meta-analysis of randomised controlled trials and cohort studies. Authors concluded that lower fat intake was associated with a small but clinically meaningful reduction in body weight in adults; similar findings were also identified in children and young people. This was mainly a well-conducted review and the conclusions appear reliable.
Operative and nonoperative treatment of clavicle fractures in adults. The authors concluded that patients treated operatively had slightly better function and less disability than those treated non-operatively at short-term follow-up, but this effectiveness diminished and was weak at six months. The authors’ conclusions reflect the evidence presented and appear likely to be reliable.
Postoperative adjuvant chemotherapy for stage II colorectal cancer: a systematic review of 12 randomized controlled trials. This review compared the effects of surgery combined with postoperative adjuvant chemotherapy versus surgery alone in patients with stage II colorectal cancer. The authors concluded cautiously that the combined intervention might be associated with improved five-year overall survival and five-year disease-free survival, and reduction in risk of recurrence. This tentative conclusion seems reliable
What strategies are effective for exercise adherence in heart failure? A systematic review of controlled studies. This review concluded that motivational strategies, such as goal setting, feedback and problem solving, might increase exercise adherence in patients with heart failure, in the short-term, but strategies to maintain this physical activity remain unclear. The conclusions of this review should be reliable.
Second-line therapy in patients with type 2 diabetes inadequately controlled with metformin monotherapy: a systematic review and mixed-treatment comparison meta-analysis. This review concluded that all classes of second-line anti-hyperglycaemic drugs, when added to metformin, achieved clinically meaningful reductions in glycated haemoglobin in patients with type 2 diabetes inadequately controlled with metformin monotherapy. The authors' conclusions reflect the evidence presented and appear likely to be reliable.