Background: The value of dental radiographs to oral health care decision making must be balanced with radiation safety to minimize patient exposure and occupational risk of oral health care providers. This review summarizes recommendations and regulatory guidance regarding dental radiography and cone-beam computed tomography. An expert panel presents recommendations on radiation safety, appropriate imaging practices, and reducing radiation exposure.
View Article and Find Full Text PDFBackground: The purpose of this systematic review was to examine whether dental intervention involving bone or soft-tissue manipulation preradiotherapy (pre-RT) is associated with lower rates of osteoradionecrosis of the jaw (ORNJ) in patients with head and neck cancer (HNC).
Types Of Studies Reviewed: The authors included relevant studies from MEDLINE, Embase, and Cochrane Library, including observational studies published from 2007 through 2021 and involving adults who underwent dental intervention pre-RT for HNC. Authors assessed evidence certainty by using the Grading of Recommendations Assessment, Development, and Evaluation approach.
Background: In 1967, concerns about the carcinogenic potential of psychedelics arose after a study reported chromosomal damage in human leukocytes following in vitro lysergic acid (LSD) exposure. Worries were further heightened by subsequent reports of leukemia and other cancers in LSD users. Additional investigations of psychedelics' effects on chromosomes were published over the next decade, with the majority suggesting these concerns were unfounded.
View Article and Find Full Text PDFBackground: Effective pain management is a priority in dental practice. Government and private agencies highlight the need to provide optimal pain relief, balancing potential benefits and harms of both opioid and nonopioid analgesic agents. The purpose of this study is to summarize the available evidence on the benefits and harms of analgesic agents, focusing on preexisting systematic reviews.
View Article and Find Full Text PDFEvid Rep Technol Assess (Full Rep)
November 2008
Objectives: Systematic review of trastuzumab outcomes among breast cancer patients who have negative, equivocal, or discordant HER2 assay results; use of HER2 assay results to predict outcomes of chemotherapy or hormonal therapy regimen for breast cancer; use of serum HER2 to monitor treatment response or disease progression in breast cancer patients; and use of HER2 testing to manage patients with lung, ovarian, prostate, or head and neck tumors. Also, narrative review of concordance of HER2 assays.
Data Sources: We abstracted data from: three articles plus one conference abstract on negative, equivocal, or discordant HER2 results; 26 studies on selection of chemotherapy or hormonal therapy; 15 studies on serum HER2; and 26 studies on ovarian, lung, prostate, or head and neck tumors.
Evid Rep Technol Assess (Full Rep)
September 2007
Objectives: Systematic review of outcomes of three treatments for osteoarthritis (OA) of the knee: intra-articular viscosupplementation; oral glucosamine, chondroitin or the combination; and arthroscopic lavage or debridement.
Data Sources: We abstracted data from: 42 randomized, controlled trials (RCTs) of viscosupplementation, all but one synthesized among six meta-analyses; 21 RCTs of glucosamine/chondroitin, 16 synthesized among 6 meta-analyses; and 23 articles on arthroscopy. The search included foreign-language studies and relevant conference proceedings.
Purposes: This systematic review addressed the following key questions on managing small cell lung cancer (SCLC): the sequence, timing, and dosing characteristics of primary thoracic radiotherapy (TRTx) for limited-stage disease; primary TRTx for extensive-stage disease; effect of prophylactic cranial irradiation (PCI); positron emission tomography (PET) for staging; treatment of mixed histology tumors; surgery; and second-line and subsequent-line treatment for relapsed/progressive disease.
Methods: The review methods were defined prospectively in a written protocol. We primarily sought randomized controlled trials that compared the interventions of interest.
Objectives: This is a systematic review of evidence on issues in managing small cell lung cancer (SCLC). Key questions addressed are: the sequence, timing, and dosing characteristics of primary thoracic radiotherapy (TRTx) for limited-stage disease; primary TRTx for extensive-stage disease; effect of prophylactic cranial irradiation (PCI); positron emission tomography (PET) for staging; treatment of mixed histology tumors; surgery; and second- and subsequent-line treatment for relapsed/progressive disease.
Data Sources: MEDLINE, EMBASE, and the Cochrane Register
Review Methods: The review methods were defined prospectively in a written protocol.
Full-field digital mammography (FFDM) is proposed as an alternative to screen-film mammography (SFM). The ability to separate and optimize the acquisition, storage, and display of images may allow greater visualization of breast cancers at equal or lower radiation doses, especially in younger women and those with denser breasts. This is a synopsis of a systematic review by the Blue Cross Blue Shield Association Technology Evaluation Center.
View Article and Find Full Text PDFWireless capsule endoscopy is proposed in the management of patients with obscure gastrointestinal (GI) bleeding, defined as persistent or recurrent GI bleeding without a cause identified on routine endoscopy. Obscure GI bleeding often originates from a small-intestinal abnormality, which presents diagnostic and therapeutic challenges because the small intestine is not easily visualized on conventional workup. This is a synopsis of a systematic review by the Blue Cross Blue Shield Association Technology Evaluation Center.
View Article and Find Full Text PDFImaging technologies (e.g., magnetic resonance imaging [MRI]) have been proposed as noninvasive alternatives to surgical biopsy techniques in the follow-up of women with suspicious primary breast lesions.
View Article and Find Full Text PDFEvidence-based technology assessment can help answer critical questions concerning the safety, effectiveness, and appropriate uses of medical technologies. This practice can be used to avoid the promotion of ineffective technologies and the premature diffusion of technologies that have not been demonstrated to improve patient-oriented health outcomes, both of which draw resources from effective and appropriate medical care. This article describes the process of such evaluation as undertaken by the Blue Cross Blue Shield Association Technology Evaluation Center.
View Article and Find Full Text PDFPurpose: This systematic review evaluates evidence comparing therapy guided by chemotherapy sensitivity and resistance assays with empiric chemotherapy, emphasizing survival outcomes.
Methods: Prospective studies were sought comparing patients treated contemporaneously by assay-guided chemotherapy and empiric therapy. An initial MEDLINE search and a search performed by a Working Group of the American Society of Clinical Oncology were reviewed with attention to prespecified study selection criteria.