Abdominal nerve block to prevent pain following minimally invasive gynaecologic surgery Is a transversus abdominis plane (TAP) block more effective than local anaesthetics or no block to treat post-surgical pain in women undergoing minimally invasive gynaecologic surgery? Key messages Women undergoing minimally invasive (key-hole) gynaecologic surgery who receive a TAP block to reduce the amount of pain felt after surgery are unlikely to experience large differences in pain or strong pain medicine needed when compared to those who do not receive the TAP block. What is a TAP block? A TAP...

Motivational interviewing for improving functional and psychosocial outcomes among stroke survivors This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of motivational interviewing for functional and psychosocial outcomes in stroke survivors, compared to no intervention, waiting list, or attention controls. This is a protocol....

Dual combination therapy versus long-acting bronchodilators alone for chronic obstructive pulmonary disease (COPD): a systematic review and network meta-analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the comparative efficacy and safety of fixed-dose dual inhalers (i.e. LABA/LAMA versus ICS/LABA) and combination therapies versus LABA or LAMA monotherapy in individuals with moderate to very severe COPD, using network meta-analysis, and to rank these treatments based on their efficacy and safety. This is a protocol....

What are the benefits and risks of stem cell injections for knee osteoarthritis? Key messages • Compared with placebo injection, stem cell injection for people with knee osteoarthritis may slightly improve pain and function. • We are uncertain whether stem cell injection slows down the progression of the disease, improves quality of life or the chance of treatment success, or whether stem cell injections are safe. What is osteoarthritis? Osteoarthritis is a disease of the joints. The joint loses cartilage and other changes to the structure of the joint may occur. This can lead to pain and...

What are the effects of stopping blood pressure medications in older people? Key messages • Due to a lack of strong evidence, the benefits and risks of stopping blood pressure medications in older people who are taking the medication for high blood pressure or primary prevention of heart disease are unclear. • Future research into the effects of stopping blood pressure medications should focus on older adults who are at the highest risk of side effects. This includes people taking multiple medications and those living with frailty. • Older adults should not stop any of their medications...

Mucolytics (drugs that break down mucus) for children with chronic suppurative lung disease Key messages - Due to a lack of robust evidence, it is unclear if mucolytics are helpful for children with chronic suppurative lung disease (CSLD). We found only one small study with design limitations. - Larger, well-designed studies are needed to assess the benefits and potential harms of mucolytic medications in children with CSLD. What is chronic suppurative lung disease (CSLD)? Chronic suppurative lung diseases are conditions associated with chronic infection and inflammation of the airways with...

What are the effects of ultrasound versus anatomic landmark guidance for percutaneous common femoral artery access? Key messages • Ultrasound guidance may lead to a higher first-attempt success rate and improved time to successful common femoral artery (CFA) access, while reducing the venipuncture rate (unintentionally accessing the vein instead of the targeted artery) and number of access attempts, compared to anatomic landmark guidance. • Further research is needed to increase our confidence in the evidence. What is the condition, and how is it treated? Percutaneous (through the skin)...

Do amphetamines increase blood pressure? Key messages • Amphetamines are substances that increase activity in the brain and central nervous system. Taking them every day by mouth for at least 8 weeks increases blood pressure and heart rate. • In studies that gave participants amphetamines or placebo medicine (an inactive substance), more people given amphetamines quit the studies due to unwanted or harmful effects than people given placebo. What are amphetamines, and what are they prescribed for? Amphetamines are medicines that have a stimulant effect on the brain. They can make you more...

What are the effects of oral decongestants on blood pressure? Key messages – We found no evidence that taking oral decongestants (medicine taken by mouth to relieve a stuffy nose) daily for a week or more changes blood pressure or heart rate or causes people to stop taking them due to unwanted effects. – There were only a few studies, and they were not well designed. More well-conducted studies are needed. – Given that oral decongestants are sometimes taken daily for weeks or months, and have the potential to increase blood pressure, people should consider this potential risk alongside the...

What are the likely benefits and harms of non-medicine and non-surgical treatments for non-specific low back pain? Key messages For acute low back pain (pain lasting less than 6 weeks) • Advice to stay active probably reduces pain and improves function compared to advice to rest in bed. For subacute low back pain (pain lasting from 6 to 12 weeks) • Multidisciplinary therapies probably reduce pain compared to usual care. • Spinal manipulation probably does not improve function compared to placebo (a 'sham' or 'dummy' treatment designed to resemble the actual treatment but lacking active...

Can antibiotics clear or suppress infection with non-tuberculous mycobacteria in the lungs of people with cystic fibrosis? Key messages There is a lack of evidence to inform guidelines about antibiotic treatment for non-tuberculous mycobacteria in people with cystic fibrosis. Larger and more standardised studies looking at both laboratory results and symptoms are needed before we can make meaningful comparisons between different antibiotic treatments. What is cystic fibrosis? Cystic fibrosis is a genetic condition (when both parents pass the cystic fibrosis gene to their children) and people...

Imaging-adapted therapy for individuals with Hodgkin lymphoma Key findings • The effect of treatment adaptation depends on the interim PET result and the stage of an individual with Hodgkin lymphoma (HL). • While the effect of treatment de-escalation based on a negative interim PET scan is uncertain in early-stage HL, it may have little effect on overall and progression-free survival in intermediate-stage HL. • In advanced-stage HL, reduction of chemotherapy or radiotherapy after a negative interim PET scan is probably beneficial for overall survival. • Treatment escalation with rituximab...

What are the benefits and risks of using a combination of treatments to manage cachexia (disease-related wasting)? Key messages: • We do not know if combinations of two or more treatments (of medication, diet, and exercise) benefit people who have or are at risk of developing cachexia (disease-related wasting). This is because there are currently not enough robust studies in this area. • We need future research to increase our confidence in the evidence by conducting better designed and larger studies. What is cachexia? Cachexia is a complex metabolic syndrome that occurs in people with...

Perceptions and experiences of the prevention, identification and management of pre-eclampsia and eclampsia: a qualitative evidence synthesis This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: The overall objective of this qualitative evidence synthesis is to describe and explore the perceptions and experiences of key stakeholders who have experience with pre-eclampsia/eclampsia or its prevention, identification, or management. The key stakeholders are women who have experienced pre-eclampsia/eclampsia, people in the community, lay health workers, and...

How accurate are GAD-7 and GAD-2 questionnaires for detecting anxiety disorders? Key messages • The GAD-7 and GAD-2 questionnaires alone cannot be used to diagnose or rule out an anxiety disorder. • However, they provide an indication of whether an anxiety disorder may be present. • The interpretation of a "negative" or "positive" questionnaire finding of an individual depends on the context. What are anxiety disorders? 'Anxiety disorder' is an umbrella term which refers to mental health conditions including (but not limited to): • generalised anxiety disorder: when someone experiences...

Audit and feedback: effects on professional practice Key messages - Audit and feedback in healthcare is when a health professional's performance is evaluated and compared to professional standards (audit). Then the health professionals are given the results of the comparison (feedback), with the hope that it might help them improve their performance. - Audit and feedback helps to improve health professional performance a little to a moderate amount. It works best when it shows health professionals how they compare to top performers, focuses on important areas for improvement, and includes...

How accurate are Truenat assays for detecting pulmonary tuberculosis and rifampicin resistance in adults and adolescents? Key messages – Truenat MTB Plus was more accurate than Truenat MTB for detecting pulmonary tuberculosis. Truenat MTB misidentified many people as having tuberculosis when they did not, which raises concern. – Xpert Ultra was more accurate than Truenat MTB. – Evidence on the accuracy of Truenat assay for detecting rifampicin was limited. What is pulmonary tuberculosis? Pulmonary tuberculosis is a lung disease caused by a bacterium (a germ) that spreads through the air via...

Does selecting targeted therapies based on genetic testing of an individual's cancer prolong their life or delay disease progression in people with advanced cancer? Key messages People with advanced cancers who received matched targeted therapies, either alone or in combination with standard treatments, experienced longer periods of disease control compared to those receiving standard treatments alone. However, the evidence on whether these therapies extend overall survival remains inconsistent. Further information is needed on the potential harms of matched targeted therapy and whether...

Perioperative glucocorticoid supplementation in pituitary surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects, including benefits and harms, of perioperative glucocorticoid supplementation in people undergoing surgery for pituitary neuroendocrine tumours (PitNETs) with a preoperatively intact hypothalamic-pituitary-adrenal axis. This is a protocol....

Mitral repair with annuloplasty for moderate ischemic mitral regurgitation in people undergoing coronary artery bypass surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of mitral repair with annuloplasty for moderate ischemic mitral regurgitation in people undergoing coronary artery bypass grafting. This is a protocol....