MEDLINE Search Strategy Research Articles

Recommendations for newborn screening for galactokinase deficiency: A systematic review and evaluation of Dutch newborn screening data

IntroductionGalactokinase (GALK) deficiency causes cataract leading to severe developmental consequences unless treated early. Because of the easy prevention and rapid reversibility of cataract with treatment, the Dutch Health Council advised to include GALK deficiency in the Dutch newborn screening program. The aim of this study is to establish the optimal screening method and cut-off value (COV) for GALK deficiency screening by performing a systematic review of the literature of screening strategies and total galactose (TGAL) values and by evaluating TGAL values in the first week of life in a cohort of screened newborns in the Netherlands. MethodsSystematic literature search strategies in OVID MEDLINE and OVID EMBASE were developed and study selection, data collection and analyses were performed by two independent investigators. A range of TGAL values measured by the Quantase Neonatal Total Galactose screening assay in a cohort of Dutch newborns in 2007 was evaluated. ResultsEight publications were included in the systematic review. All four studies describing screening strategies used TGAL as the primary screening marker combined with galactose-1-phosphate uridyltransferase (GALT) measurement that is used for classical galactosemia screening. TGAL COVs of 2200 μmol/L, 1665 μmol/L and 1110 μmol/L blood resulted in positive predictive values (PPV) of 100%, 82% and 10% respectively. TGAL values measured in the newborn period were reported for 39 GALK deficiency patients with individual values ranging from 3963 to 8159 μmol/L blood and 2 group values with mean 8892 μmol/L blood (SD ± 5243) and 4856 μmol/L blood (SD ± 461). Dutch newborn screening data of 72,786 newborns from 2007 provided a median TGAL value of 110 μmol/L blood with a range of 30–2431 μmol/L blood. ConclusionBased on TGAL values measured in GALK deficiency patients reported in the literature and TGAL measurements in the Dutch cohort by newborn screening we suggest to perform the GALK screening with TGAL as a primary marker with a COV of 2500 μmol/L blood, combined with GALT enzyme activity measurement as used in the classical galactosemia screening, to ensure detection of GALK deficiency patients and minimize false positive referrals.

Outdoor pollen is a trigger of child and adolescent asthma emergency department presentations: A systematic review and meta-analysis.

In the context of increased asthma exacerbations associated with climatic changes such as thunderstorm asthma, interest in establishing the link between pollen exposure and asthma hospital admissions has intensified. Here, we systematically reviewed and performed a meta-analysis of studies on pollen and emergency department (ED) attendance. A search for studies with appropriate search strategy in MEDLINE, EMBASE, Web of Science and CINAHL was conducted. Each study was assessed for quality and risk of bias. The available evidence was summarized both qualitatively and meta-analysed using random-effects models when moderate heterogeneity was observed. Fourteen studies were included. The pollen taxa investigated differed between studies, allowing meta-analysis only of the effect of grass pollen. A statistically significant increase in the percentage change in the mean number of asthma ED presentations (MPC) (pooled results from 3 studies) was observed for an increase in 10 grass pollen grains per cubic metre of exposure 1.88% (95% CI=0.94%, 2.82%). Time series studies showed positive correlations between pollen concentrations and ED presentations. Age-stratified studies found strongest associations in children aged 5-17years old. Exposure to ambient grass pollen is an important trigger for childhood asthma exacerbations requiring ED attendance. As pollen exposure is increasingly a problem especially in relation to thunderstorm asthma, studies with uniform measures of pollen and similar analytical methods are necessary to fully understand its impact on human health.

Clinician, patient and general public beliefs about diagnostic imaging for low back pain: protocol for a qualitative evidence synthesis

IntroductionLittle is known about how to reduce unnecessary imaging for low back pain. Understanding clinician, patient and general public beliefs about imaging is critical to developing strategies to reduce overuse.ObjectiveTo...

Continuity of Care in Resident Outpatient Clinics: A Scoping Review of the Literature.

Continuity between patients and physicians is a core principle of primary care and an accreditation requirement. Resident continuity clinics face challenges in nurturing continuity for their patients and trainees. We undertook a scoping review of the literature to better understand published benchmarks for resident continuity; the effectiveness of interventions to improve continuity; and the impact of continuity on resident and patient satisfaction, patient outcomes, and resident career choice. We developed a MEDLINE search strategy to identify articles that defined continuity in residency programs in internal medicine, family medicine, and pediatrics published prior to December 31, 2015, and used a quality evaluation tool to assess included studies. The review includes 34 articles describing 12 different measures of continuity. The usual provider of care and continuity for physician formulas were most commonly utilized, and mean baseline continuity was 56 and 55, respectively (out of a total possible score of 100). Clinic and residency program redesign innovations (eg, advanced access scheduling, team-based care, and block scheduling) were studied and had mixed impact on continuity. Continuity in resident clinics is lower than published continuity rates for independently practicing physicians. Interventions to enhance continuity in resident clinics have mixed effects. More research is needed to understand how changes in continuity affect resident and patient satisfaction, patient outcomes, and resident career choice. A major challenge to research in this area is the lack of empanelment of residents' patients, creating difficulties in scheduling and measuring continuity visits.

Effectiveness of extended pelvic lymphadenectomy in the survival of prostate cancer: a systematic review and meta-analysis.

IntroductionTo determine the effectiveness and safety of extended pelvic lymphadenectomy compared with standard lymphadenectomy in the overall, cancer-specific survival and biochemical recurrence-free survival of patients with localized prostate cancer who underwent radical prostatectomy.Material and methodsClinical trials and cohort studies were included without language restrictions with the following participants: men older than 40 years of age diagnosed with localized prostate cancer who received radical prostatectomy plus pelvic lymphadenectomy. Standard vs. extended pelvic lymphadenectomy were compared. The primary outcomes were overall and cancer-specific survival. A search strategy in MEDLINE, EMBASE, CENTRAL, LILACS, and other databases was conducted to obtain published and unpublished literature. The risk of bias was evaluated with the Cochrane Collaboration tool. The statistical analysis was performed in STATA 14.ResultsSix studies were included, of which only one was experimental; the other studies were cohort studies. The surgical technique was robot-assisted in three studies. Two studies only had information concerning the adverse effects. It was not possible to include one clinical trial that met the criteria because an erratum was published in which falsification of the experimental data was proven. There was a biochemical recurrence-free survival hazard ratio (HR) = 0.62 and a 95% confidence interval (CI) (0.36 to 0.87).ConclusionsAccording to current literature, a mild difference was evident favoring the extended lymphadenectomy in biochemical recurrence-free survival. Additionally, there was no evidence to draw a conclusion regarding the overall survival since we did not find any studies concerning this outcome.

Major Clinical Considerations for Secondary Hypertension and Treatment Challenges: Systematic Review

Introduction: In this context, secondary arterial hypertension (SH) is defined as an increase in systemic arterial pressure (SAP) due to an identifiable cause. Only 5 to 10% of patients suffering from hypertension have a secondary form, while the vast majorities have essential hypertension. Objective: This study aimed to describe, through a systematic review, the main considerations on secondary hypertension, presenting its clinical data and main causes, as well as presenting the types of treatments according to the literary results. Methods: Following the criteria of literary search with the use of the Mesh Terms that were cited in the item below on Search strategies, the total of 76 papers that were submitted to the eligibility analysis were collated and, after that, 23 studies were selected, following the rules of systematic review-PRISMA. In general, as an example, the search strategy in MEDLINE / Pubmed, Web of Science, ScienceDirect Journals (Elsevier), Scopus (Elsevier), OneFile (Gale). Major findings: According to epidemiological data, secondary hypertension (SH) presents an incidence of 5.0 to 10.0% of the world population. In this context, since SH cases are difficult to screen and expensive, only patients with clinical suspicion should be examined. In recent years, some new aspects have gained importance in relation to this screening. Thus, increasing evidence suggests that 24-hour ambulatory blood pressure monitoring plays a central role. The prevalence of SH is related to age and clinical characteristics. In addition, some residual hypertension remains after the pathogenic cause of secondary hypertension has been identified and removed because of the existence of essential hypertension. Conclusion:It was concluded with the present study that secondary hypertension effects on average 7.5% of hypertensive patients. Screening in the diagnosis of secondary hypertension is expensive and laborious and should be performed only in patients with high clinical suspicion.

PROTOCOL: Strategies for scaling up the implementation of interventions in social welfare: protocol for a systematic review.

PROTOCOL: Strategies for scaling up the implementation of interventions in social welfare: protocol for a systematic review.

WHICH DATABASES SHOULD BE USED TO IDENTIFY STUDIES FOR SYSTEMATIC REVIEWS OF ECONOMIC EVALUATIONS?

This study investigated which databases and which combinations of databases should be used to identify economic evaluations (EEs) to inform systematic reviews. It also investigated the characteristics of studies not identified in database searches and evaluated the success of MEDLINE search strategies used within typical reviews in retrieving EEs in MEDLINE. A quasi-gold standard (QGS) set of EEs was collected from reviews of EEs. The number of QGS records found in nine databases was calculated and the most efficient combination of databases was determined. The number and characteristics of QGS records not retrieved from the databases were collected. Reproducible MEDLINE strategies from the reviews were rerun to calculate the sensitivity and precision for each strategy in finding QGS records. The QGS comprised 351 records. Across all databases, 337/351 (96 percent) QGS records were identified. Embase yielded the most records (314; 89 percent). Four databases were needed to retrieve all 337 references: Embase + Health Technology Assessment database + (MEDLINE or PubMed) + Scopus. Four percent (14/351) of records could not be found in any database. Twenty-nine of forty-one (71 percent) reviews reported a reproducible MEDLINE strategy. Ten of twenty-nine (34.5 percent) of the strategies missed at least one QGS record in MEDLINE. Across all twenty-nine MEDLINE searches, 25/143 records were missed (17.5 percent). Mean sensitivity was 89 percent and mean precision was 1.6 percent. Searching beyond key databases for published EEs may be inefficient, providing the search strategies in those key databases are adequately sensitive. Additional search approaches should be used to identify unpublished evidence (grey literature).

Clinical outcomes to exercise training in type 1 diabetes: A systematic review and meta-analysis

AimsTo establish the relationship between exercise training and clinical outcomes in people with type I diabetes. MethodsStudies were identified through a MEDLINE search strategy, Cochrane Controlled Trials Registry, CINAHL, SPORTDiscus and Science Citation Index. The search strategy included a mix of key concepts related to trials of exercise training in people with type 1 diabetes; glycaemic control. Searches were limited to prospective randomized or controlled trials of exercise training in humans with type 1 diabetes lasting 12 weeks or more. ResultsIn exercised adults there were significant improvements in body mass Mean Difference (MD): −2.20 kg, 95% Confidence Interval (CI) −3.79–0.61, p = .007; body mass index (BMI) MD: −0.39 kg/m2, 95% CI −0.75–0.02, p = .04; Peak VO2 MD: 4.08 ml/kg/min, 95% CI −2.18–5.98, p < .0001; and, low-density lipoprotein cholesterol (LDL) MD: −0.21 mmol/L, 95% CI −0.33–0.08, p = .002. In exercised children there were significant improvements in insulin dose MD: −0.23 IU/kg, 95% CI −0.37–0.09, p = .002; waist circumference MD: −5.40 cm, 95% CI −8.45 to −2.35, p = .0005; LDL MD: −0.31 mmol/L, 95% CI −0.55 to −0.06, p = .02; and, triglycerides MD: −0.21 mmol/L, 95% CI −0.42 to −0.01, p = .04. There were no significant changes in glycosylated haemoglobin (HbA1C%), fasting blood glucose, resting heart rate, resting systolic blood pressure or high density lipoproteins in either group. ConclusionsExercise training improves some markers of type 1 diabetes severity; particularly body mass, BMI, Peak VO2 and LDL in adults and insulin dose, waist circumference, LDL and triglycerides in children.

Trial registration in pediatric surgery trials

BackgroundProspective clinical trial registration serves to increase transparency and to mitigate selective reporting bias. An assessment of adult surgical trials revealed poor trial registration practice with incomplete provision of information in registries and inconsistent information in the corresponding publication. The extent and completeness of pediatric surgical trial registration are unknown. We aimed to determine the proportion and adequacy of clinical trial registration in pediatric surgery trials published in 2014. MethodsUsing sensitive search strategies in MEDLINE, abstracts and full-texts of prospective pediatric intervention studies published in 2014 were screened in duplicate. Pediatric surgical trials were included. Clinical trial registration numbers obtained from publications were searched in trial registries. Data were extracted based on WHO 20-item minimum data set to determine the completeness of registration data. The proportion of registered trials was recorded and registration data were compared to reported data in the corresponding publication. ResultsOur search and abstract screening identified 3375 articles for full text review. Following coding, a total of 54 pediatric surgical trials were included and analyzed; 28% (15/54) of which published a registration number. In trials which reported a registration number, 40% (6/15) were retrospectively registered and 40% (6/15) had made changes to their registered primary and/or secondary outcome measures. One included published trial reported an incorrect registration number. ConclusionsAnalysis of pediatric surgery trials published in 2014 revealed a poor prospective trial registration rate and incomplete registration data. Our study supports future initiatives for improved registration behaviors in pediatric surgery trials to ensure high-quality, transparent, reproducible evidence is generated. Study typeTherapeutic (clinical trials), level II.

Can coenzyme Q10 supplementation effectively reduce human tumour necrosis factor-α and interleukin-6 levels in chronic diseases? Protocol for a systematic review and meta-analysis of randomised controlled trials

IntroductionInflammation, as a critical factor, can cause numerous chronic diseases by creating various proinflammatory cytokines. Coenzyme Q10 (CoQ10) can potentially exert an anti-inflammatory agent; in turn, this agent can reduce...

Which Information Sources Should Be Used To Identify Studies for Systematic Reviews of Economic Evaluations In Healthcare?

The key economic evaluation (EE) databases, NHS EED and HEED, have closed. Which databases do we now need to search to identify economic evaluations for models and systematic reviews (SRs)? We assess which databases are now the best sources of EEs and whether typical search strategies are effective. A quasi-gold standard (QGS) set of economic evaluations was formed from studies included in SRs of EEs undertaken to inform HTA. 9 databases were searched for each QGS reference. Yield for each database, and combination of databases, was calculated. MEDLINE search strategies reported in source SRs were re-run to assess their performance in finding EEs. We built a QGS of 351 records from 46 reviews. Embase had the highest yield (0.89), followed by Scopus (0.84) and MEDLINE and PubMed (both 0.81). The HTA database identified the highest number of unique records (13/351), despite a low overall yield (0.1). All 9 databases combined retrieved 337/351 records. The most efficient combination of databases which could be searched to find records for all 337 references was Embase, Scopus, HTA Database and (MEDLINE or PubMed). 10/29 (34.5%) of re-run strategies missed at least 1 of the included records available in MEDLINE (25 records missed in total). Only 1 of the missed records was due to failings of search terms used for the economics concept. For most SRs Embase, HTA Database and either PubMed or MEDLINE are likely to be sufficient to identify EEs included in bibliographic databases. Additionally searching a multidisciplinary database may be useful, particularly in non-clinical topics. Beyond this, supplementary search techniques may be more efficient than extensive database searching. Weaknesses in reported MEDLINE search strategies were identified which impacted retrieval; these weaknesses appear to be associated with population and intervention concepts, rather than the economics concept.

Managing Complications in Abdominoplasty: A Literature Review.

BackgroundAbdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them.MethodsA systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles.ResultsAccording to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death.ConclusionsThe complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.

The effect of exercise training on clinical outcomes in patients with the metabolic syndrome: a systematic review and meta-analysis

BackgroundPurpose: to establish if exercise training improves clinical outcomes in people with metabolic syndrome (MetS). Registered with PROSPERO international prospective register of systematic reviews (https://www.crd.york.ac.uk/PROSPERO/Identifier:CRD42017055491). Data sources: studies were identified through a MEDLINE search strategy (1985 to Jan 12, 2017), Cochrane controlled trials registry, CINAHL and SPORTDiscus. Study selection: prospective randomized or controlled trials of exercise training in humans with metabolic syndrome, lasting 12 weeks or more.ResultsWe included 16 studies with 23 intervention groups; 77,000 patient-hours of exercise training. In analyses of aerobic exercise studies versus control: body mass index was significantly reduced, mean difference (MD) −0.29 (kg m−2) (95% CI −0.44, −0.15, p < 0.0001); body mass was significantly reduced, MD −1.16 kg (95% CI −1.83, −0.48, p = 0.0008); waist circumference was significantly reduced MD −1.37 cm (95% CI −2.02, −0.71, p < 0.0001), peak VO2 was significantly improved MD 3.00 mL kg−1 min−1 (95% CI 1.92, 4.08, p < 0.000001); systolic blood pressure and diastolic blood pressure were significantly reduced, MD −2.54 mmHg (95% CI −4.34, −0.75, p = 0.006), and, MD −2.27 mmHg (95% CI −3.47, −1.06, p = 0.0002) respectively; fasting blood glucose was significantly reduced MD −0.16 mmol L−1 (95% CI −0.32, −0.01, p = 0.04); triglycerides were significantly reduced MD −0.21 mmol L−1 (95% CI −0.29, −0.13, p < 0.00001); and low density lipoprotein was significantly reduced MD −0.03 mmol L−1 (95% CI −0.05, −0.00, p = 0.02). In analyses of combined exercise versus control: waist circumference, MD −3.80 cm (95% CI −5.65, −1.95, p < 0.0001); peak VO2 MD 4.64 mL kg−1 min−1 (95% CI 2.42, 6.87, p < 0.0001); systolic blood pressure MD −3.79 mmHg (95% CI −6.18, −1.40, p = 0.002); and high density lipoprotein (HDL) MD 0.14 (95% CI 0.04, 0.25, p = 0.009) were all significantly improved. We found no significant differences between outcome measures between the two exercise interventions.ConclusionsExercise training improves body composition, cardiovascular, and, metabolic outcomes in people with metabolic syndrome. For some outcome measures, isolated aerobic exercise appears optimal.

Cost of Waiting on an Orthopaedic Waiting List: a scoping review

Background: Approximately 30% Australians suffer from arthritis and other musculoskeletal disorders. From 2003-2033 there is a predicted 223% increase in expenditure on health management of musculoskeletal disorders. There is evidence of increasing prevalence of orthopaedic complaints, in longer waiting lists for specialist consultations in public hospital outpatient clinics. Little is known about the costs and ramifications of waiting for orthopaedic consultations.&#x0D; Aim: Establish what is known about the direct and indirect costs of being placed on a waiting list for an orthopaedic consultation.&#x0D; Method: Patient and Outcome search strategy of Medline, Embase, Pubmed, NHS Economic evaluation database (NHS-EED) from each database inception date. Handsearching of reference lists of included papers alsooccurred. A realist synthesis framework underpinned the review, using a ubiquitous patient journey to map available literature on the impact of waiting. Hierarchy of evidence was reported using NHMRC criteria andarticles critically appraised using either the PEDRo or CASP criteria (relevant to the design). A purpose-built data extraction instrument was developed.&#x0D; Results: We identified 786 studies, of which 139 were relevant, including a systematic review (Hoogeboom et al) with 15 included articles which were added to the list of eligible papers (and the review itself deleted), leaving 153 included articles; 17 were relevant to the review. Fourteen papers reported on quality of life and four reported on costs, two of these papers reported on both and all were of low to moderate quality. The research was not based on a comprehensive understanding of the stages of waiting, and there were inconclusive outcomes for quality of life and cost.&#x0D; Conclusion: There is scant evidence of the impact on quality of life and costs of waiting for orthopaedic outpatient appointments. Future research should aim for improved methodological quality and use patientfocused quality of life measures, and validated measures of cost.&#x0D; Abbreviations: NHMRC – National Health and Medical Research Council; PROMS – Patient Related Outcome Measures; QoL – Quality of Life; WOMAC – Western Ontario and McMaster Universities Osteoarthritis Index; YLD – Years Lived With Disability

Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: a systematic review.

The aim of this systematic review was to assess a potential benefit of laser use in the treatment of recurrent aphthous stomatitis (RAS). The primary outcome variables were pain relief, duration of wound healing and reduction in episode frequency. A PICO approach was used as a search strategy in Medline, Embase and Cochrane databases. After scanning and excluding titles, abstracts and full texts, 11 studies (ten RCTs and one non-randomised controlled trial) were included. Study selection and data extraction was done by two observers. Study participants varied between 7-90 for the laser and 5-90 for the control groups. Laser treatment included Nd:YAG laser ablation, CO2 laser applied through a transparent gel (non-ablative) and diode laser in a low-level laser treatment (LLLT) mode. Control groups had placebo, no therapy or topical corticosteroid treatment. Significant pain relief immediately after treatment was found in five out of six studies. Pain relief in the days following treatment was recorded in seven studies. The duration of RAS wound healing was also reduced in five studies. However, criteria of evaluation differed between the studies. The episode frequency was not evaluated as only one study addressed this outcome parameter, but did not discriminate between the study (LLLT) and control (corticosteroid) groups. Jadad scores (ranging from 0 to 5) for quality assessment of the included studies range between 0 and 2 (mean = 1.0) for studies analysing pain relief and between 0 and 3 (mean = 1.1) for studies evaluating wound healing. The use of lasers (CO2 laser, Nd:YAG laser and diode laser) to relieve symptoms and promote healing of RAS is a therapeutic option. More studies for laser applications are necessary to demonstrate superiority over topical pharmaceutical treatment and to recommend a specific laser type, wavelength, power output and applied energy (ablative versus photobiomodulation).

Treatment Outcomes for Mandibular Mini-Implant-Retained Overdentures: A Systematic Review.

This systematic review evaluated treatment outcomes for mandibular mini-implant-retained overdentures (MMIOs) in terms of (1) implant survival rate, (2) peri-implant marginal bone loss, (3) prosthodontic maintenance and complication occurrence, and (4) patient satisfaction. Pertinent literature published in English before October 12, 2015 was identified using a MEDLINE and EMBASE search strategy and hand searching of relevant journals. Inclusion and exclusion criteria were applied to the titles and abstracts and subsequently to the full text of included studies. A total of 16 articles were included, from which qualitative and quantitative data were extracted for analysis. Of the 16 evaluated articles, 5 were randomized controlled trials, 8 were prospective studies, and 3 were retrospective studies. The follow-up time range from implant placement was 1 to 6 years, and only four studies included more than 3 years of follow-up. The mini-implant survival rate ranged from 86.9% to 100%. Mean marginal bone resorption was 0.28 to 1.2 mm after 1 year of loading. Of the 16 studies, 5 reported prosthodontic maintenance and complications, and all included studies showed significant improvement in patient satisfaction. Despite the limitations of this systematic review, particularly the short follow-up periods, the results suggest that MMIOs showed predictable results regarding implant survival rates, marginal bone resorption, and patient satisfaction.

Development and testing of a medline search filter for identifying patient and public involvement in health research.

BackgroundResearch involving the public as partners often proves difficult to locate due to the variations in terms used to describe public involvement, and inability of medical databases to index this concept effectively.ObjectiveTo design a search filter to identify literature where patient and public involvement (PPI) was used in health research.MethodsA reference standard of 172 PPI papers was formed. The references were divided into a development set and a test set. Search terms were identified from common words, phrases and synonyms in the development set. These terms were combined as a search strategy for medline via OvidSP, which was then tested for sensitivity against the test set. The resultant search filter was then assessed for sensitivity, specificity and precision using a previously published systematic review.ResultsThe search filter was found to be highly sensitive 98.5% in initial testing. When tested against results generated by a ‘real‐life’ systematic review, the filter had a specificity of 81%. However, sensitivity dropped to 58%. Adjustments to the population group of terms increased the sensitivity to 73%.ConclusionThe PPI filter designed for medline via OvidSP could aid information specialists and researchers trying to find literature specific to PPI.

PP037 Quality Criteria And Good Practices In The Health Technology Assessment Spanish Network

INTRODUCTION:The Spanish Network of Agencies for Health Technology Assessment (REDETS) is a group of eight agencies, units and services, depending on National and Regional Governments that coordinate their work within a common methodological framework, guided by the principles of mutual recognition and cooperation. In this work, guided by the necessity of implementing a Quality Management System, we present the process to achieve this objective.METHODS:As an initial step, a review was carried out based on a structured search strategy in the main electronic databases Medline and EMBASE, and a manual search in websites of national and international agencies (March 2016) in order to collate previous knowledge and experiences. Through the information included in this review, a proposal to create a quality, self-evaluating tool is necessary.RESULTS:In total, 800 references were found and finally 6 studies were included in the review (1-3). All had a similar structure. Some lists of good practices, classified in dimensions related to different quality aspects in Health Technology Assessment (HTA) organizations, were found. Also some information about questions for evaluating quality standards was indicated. Taking all this information, a proposal of sixty-six standard titles was put forward. These standards were then grouped into twelve quality criteria structured in four dimensions: I Responsibility, II Clients and Stakeholders, III Production Process and IV Resources.CONCLUSIONS:Based on the systematic review, we developed a proposal for a self-evaluating tool and this is the baseline for a common Quality Management System for the Spanish Network of HTA Agencies. The quality management process will require the development of a handbook by each member of REDETS that will be based on agreed quality standards.

Abstract 12054: Electro-anatomic Mapping Guided Endomyocardial Biopsy: A Systematic Review

Introduction: Electro-anatomic mapping (EAM) has been studied as a modality to improve the sensitivity and reduce false negative rates with endomyocardial biopsy (EMB). We systematically reviewed the literature describing EAM guided EMB. Methods: An experienced librarian developed search strategies for Ovid MEDLINE, Ovid Embase, Ovid CDR, Cochrane Central, Scopus and Web of Science. There were no restrictions on language or publication date. Animal studies were excluded. Search strategy included MESH headings and keywords including endomyocardial biopsy and electroanatomic mapping. Results: Out of 139 studies initially identified, 16 (9 case series, 7 case reports) were included in this systematic review. EAM guided EMB was performed in 152 patients and results of 241 biopsies were available for analysis. The most common indications for EAM guided EMB were suspected arrhythmogenic right ventricular cardiomyopathy (ARVC), myocarditis and cardiac sarcoidosis (CS). While fluoroscopic visualization of the bioptome close to mapping catheter was the most commonly utilized biopsy technique (n=7 studies), direct visualization of bioptome on CARTO (n=4) and on NavX (n=2) were used as well. Low voltage areas had abnormal myocardial histology more commonly (range 60-100%) than normal voltage areas (range 11-52%). Sensitivity of low voltage areas for abnormal myocardium ranged from 60% to 82%. EAM guided EMB appears safe and adverse events were noted in only one study (remote hemopericardium). Conclusions: EAM guided EMB is a safe and efficacious method to improve the sensitivity and reduce the false negative rate of conventional fluoroscopy guided biopsy.