Evidence
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Stopping biological drugs for rheumatoid arthritis can lead to twice the relapse rate

It seems safer to reduce the dose of biological drugs, rather than to stop them if people with rheumatoid arthritis and their doctors want to avoid relapse. Stopping these powerful drugs caused the disease to recur in 58% of people compared with 29% who continued them. Reducing the dose also led to more relapses for ...

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New screening pathway could help to identify a rare, single-gene form of diabetes

A screening pathway using blood and urine tests followed by two genetic (DNA) tests identified all people with a rare subtype of diabetes called monogenic diabetes. The screening pathway performed better than current practice based on age at diagnosis and family history which misses 63%. It is, therefore, a useful approach for ruling out this ...

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A primary care intervention helps older people with depression

Enhanced case management (also called collaborative care) added to primary care reduced symptoms in people with clinical depression, compared with usual primary care. The benefit was similar to other depression treatments. However, the small benefit over usual care was not sustained to 12 months. This NIHR-funded UK trial was carried out among nearly 500 adults ...

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A surgical procedure for shoulder pain is less effective than previously thought

An increasingly common surgical procedure for shoulder pain, subacromial decompression, was only slightly more effective than no treatment. In the first trial of this sort, improvements in pain and function following decompression or arthroscopy (a placebo surgery) did not reach a threshold of clinical importance compared with people allocated to no treatment at all. This ...

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Biological therapies for psoriasis do not increase serious infection risk

People with psoriasis who take an immune-modulating treatment are no more likely to get serious infections than people taking standard therapies. There are fears that these biological therapies raise the risk of serious infections and this has discouraged their use. They are recommended by NICE for moderate to severe psoriasis. Previous studies have reached conflicting ...

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Staying on antidepressants may prevent a relapse of anxiety

People with anxiety disorders who continued taking antidepressants after successful treatment were less likely to experience a relapse, and relapsed later, than people who stopped taking antidepressants. About 16% of people had a relapse if they remained on antidepressants for on average 44 weeks compared with 36% who stopped after 20 weeks. Anxiety disorders are ...

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Single urine samples are just as good as 24-hour collections for diagnosing pre-eclampsia

The urine spot albumin-creatinine ratio (which is done on a single, on-the-spot sample) reliably identified 99% of pregnant women with high blood pressure who went on to develop severe pre-eclampsia. The spot protein-creatinine ratio, as currently recommended by NICE, was slightly less sensitive identifying over 90% of women. Both spot tests were good value for ...

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National tobacco control policies linked to improvements in children’s health

National smoke-free legislation in advanced economies is linked to reduced rates of preterm birth, asthma hospitalisations and serious throat and chest infections in children. Comprehensive smoke-free policies appear to be more effective than policies with only partial or selective introduction. Smoking increases health risks for the smoker and others through second-hand exposure. Although the number ...

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Two common operations to fix a broken tibia have similar outcomes

In people who had broken the lower part of their tibia (shin bone), fixation using a metal rod nailed to the inside of the bone was compared with a locking plate screwed onto the surface of the bone. There was no difference in the quality of life, disability or pain at 12 months for people who ...

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Starting antiretroviral therapy immediately after HIV diagnosis reduces transmission of the virus

Giving antiretroviral therapy to people newly diagnosed with HIV may be an effective and cost-effective way of reducing new infections. Increased HIV testing in at-risk populations may identify more people for treatment and also reduce infection rates. Using data from a number of sources including NIHR funded projects, researchers developed a computer simulation model. The ...

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