Evidence
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Weight-loss surgery dramatically reduces risk of diabetes

This NIHR-funded study found that very obese adults who had weight-loss surgery were 80% less likely to develop type 2 diabetes within 7 years than similar obese adults who did not have weight-loss surgery. The study data came from a large UK-wide database of general practices which was representative of the UK population. The treatment ...

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Pulmonary rehabilitation improves quality of life and exercise capacity

This Cochrane systematic review found that pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD) improved quality of life and exercise capacity compared to usual care. It also relieved shortness of breath and fatigue. This updated review provides stronger evidence to support NICE's recommendation that pulmonary rehabilitation should be available to everyone who is ...

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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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Restricting blood transfusion may not be effective after cardiac surgery

This large NIHR-funded randomised trial found that using a lower haemoglobin threshold was no better or cheaper than using a higher one when deciding to transfuse blood after non-emergency cardiac surgery. People with milder anaemia, receiving blood transfusion at a haemoglobin level less than 90g/L (the liberal transfusion group) had similar health outcomes and health ...

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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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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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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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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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