Evidence
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Little to choose between open and keyhole surgery as options for repairing shoulder rotator cuff tears

This NIHR-funded trial in people over 50 years looked at whether open surgery compared with keyhole surgery for a common shoulder tear injury and improved shoulder function more. It found that there was little to choose between the two approaches in terms of benefits or costs. The muscles and tendons around the shoulder form the ...

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Spironolactone is effective for treating resistant hypertension

This trial investigated which drug is best added to high blood pressure (hypertension) treatment if blood pressure has not come down to normal levels after taking three blood pressure lowering drugs. Such “resistant hypertension” accounts for around 10% of all people who have hypertension. The study found that adding spironolactone to the existing three-drug regimen was ...

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Less stringent target oxygen levels for acute bronchiolitis are safe and effective

This NIHR-funded trial found that acute bronchiolitis in children can be safely managed to a slightly lower target level of oxygen saturation than currently used. Setting the level at which children might be taken off oxygen or allowed home at 90% or more led to resolution of cough in 15 days. Time to resolution of ...

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Handwashing advice reduces the number of colds and their severity

This large trial looked at the impact of online advice to the public about effective handwashing. It found that using soap and water or hand gel reduced the number of cases of colds and flu, the severity of symptoms, the length of time people were ill and the spread of infection within households. Colds and ...

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Birthplace in England follow-up analysis reveals some variation between units delivering maternity care

This study is a follow-on analysis of data from the Birthplace in England study. It consists of five sub-studies that further analyse the original Birthplace in England study data. The NIHR funded this study to provide evidence to inform the development of maternity services. It found that, irrespective of the woman’s ethnic background, age or ...

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Medication impregnated dressings for central venous catheters reduce the number of bloodstream infections, but the quality of the research is low

This review found that securing central venous catheters with dressings impregnated with medication reduced the number of bloodstream infections compared to other dressings. The frequency of infection was particularly reduced with chlorhexidine antiseptic dressings. Based on the study population it is anticipated that rates might fall from about 2.8 infections per 100 people using usual ...

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A supervised toothbrushing programme in nurseries reduced dental treatment costs

This cost analysis showed that a Scotland-wide programme of supervised toothbrushing in nurseries is linked to large savings in dental treatment costs because of the reduced levels of tooth decay in five year-old children. In the eighth year, the programme saved more than two and a half times the programme’s cost of implementation. The greatest ...

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A simple test can help point to serious illness in children

This review found that the capillary refill test was useful in diagnosing serious illness or dehydration in children. The quick test, done by pressing on the nail bed, is used to monitor blood flow. The review of studies testing its accuracy showed it can be used as a “red-flag” to identify (i.e.rule in) potential serious ...

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New evidence available on corticosteroids added to antibiotics in severe pneumonia

For adults admitted to hospital with severe pneumonia, this review found that adding corticosteroids to the usual antibiotic treatment may be beneficial. The evidence was less supportive of using corticosteroids in people with less severe pneumonia. Results showed modest benefits in allowing patients to reach a clinically stable recovery and leave hospital an average of ...

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Rapid tests for diagnosing drug resistant tuberculosis are accurate and may be cost effective

This NIHR funded systematic review and economic evaluation found that three rapid tests for diagnosing drug resistant tuberculosis were highly accurate and likely to be cost effective in the UK. These tests produce results within one day of obtaining a sample. This is a significant reduction compared with the standard tests which can take about ...

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