Evidence
Alert

Continuous positive airway pressure led to less daytime sleepiness in older adults with sleep apnoea

This NIHR trial found that continuous positive airway pressure for obstructive sleep apnoea in people aged 65 and over led to less daytime sleepiness and was reasonable value for money. Obstructive sleep apnoea causes the airway to close intermittently overnight leading to daytime sleepiness. It is most common in older people, but previous studies have ...

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Surgery is no more effective than a sling for misaligned shoulder fractures

This NIHR funded trial showed that conservative treatment involving a sling was as effective as surgery for treating people with displaced fractures of the upper arm. A linked economic analysis showed that surgery was not cost-effective. These kinds of shoulder fractures are common and disabling, and mainly affect people over 65. Slings are already used ...

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Paracetamol may be ineffective in treating lower back pain

This systematic review found that paracetamol as a first-line treatment did not reduce pain, disability, or improve quality of life in the short-term (up to 8 weeks) for people with low back pain. There was a very small effect in reducing pain and disability in the short-term for people with osteoarthritis of the hip or ...

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Whooping cough infection common in school aged children with stubborn coughs

This NIHR-funded study found that almost a fifth of children aged five to 15 years who visited their GP with persistent cough showed signs of recent whooping cough infection, despite having a booster vaccination before school age. These data, from 22 GP practices in Thames Valley UK, describe the duration of vaccine-induced immunity and the ...

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Continuity in primary care may be linked to reduced unscheduled hospital care

One positive finding from this review of a broad range of observational studies was that being able to see the same doctor in primary care was associated with fewer emergency department visits and emergency hospital admissions. Other factors associated with less unscheduled secondary care were younger age, higher socioeconomic status, not having a chronic disease ...

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Interventions that help and harm patients in the critical care unit

This systematic review and expert consensus process found 15 non-surgical interventions affecting adult mortality in critical care. Seven interventions, such as the use of tranexamic acid after severe blood loss, reduced deaths. Eight interventions, such as improving oxygen supply by using a drug, dobutamine, increased them. 2015 UK guidelines only partly reflect these findings. They ...

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Financial incentives change health-related behaviour in the short term, but effects may not be sustained

This comprehensive review found that financial incentives were effective in changing individual health behaviours in the short term but not, in the few studies to look at longer term effects, beyond 18 months. Improvements stopped soon after the incentive was removed, though lasted a little longer for smoking cessation. Of the 34 studies included in ...

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Very early mobilisation following a stroke is no better than usual care

The AVERT trial found very early mobilisation - such as out-of-bed sitting, standing and walking - within 24 hours of stroke onset and at increased intensity, led to 4% fewer people with good recovery than usual care. No differences were found in death rates, overall disability scores, or in the time to be able to ...

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Laser treatment is the preferred treatment for troublesome varicose veins

Initial results from this trial (CLASS) found that the three main treatments for varicose veins all improved symptoms and quality of life six months after treatment. On a balance of scores, laser treatment was more effective than foam treatment or surgery. Laser involved fewest complications six weeks after the procedure and may be the most ...

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Two common drugs do not help more people pass kidney stones

This large, high quality trial found that people with a single kidney stone taking tamsulosin or nifedipine drugs for up to four weeks were no more likely to pass the stone spontaneously than those taking a placebo. This suggests that these drugs should not be offered to people with renal colic who are managed with ...

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