NHS Library and Information Service North Staffordshire

Clinical Effectiveness Bulletin

for PCTs in North Staffordshire
Issue No: 39 – April 2010

About this Bulletin:

It aims to draw attention to some of the key documents and reviews on clinical
effectiveness that have been published in the previous month.

Where possible, links to the full text documents are included. If the article is in a
journal, you can contact the Health Library for a copy.
Link to request form: http://www.keele.ac.uk/depts/li/hl/illjournal.htm
[Please note - a charge of £2 per request is payable for most copies]

If you need further assistance, please contact the Health Library or the NHS
Outreach Librarians, details below.

The bulletin can be e-mailed to colleagues who may also find it useful.

A list of websites that are checked in the production of this bulletin are listed on
the first page. Please suggest further useful sites.

Feedback is always welcomed to inform future issues of the bulletin.

Contents in this issue

Allied Health Contact information
Cancer
Cardiovascular Disease
Bulletin produced by NHS Outreach Librarians
Commissioning
Tel: 07834 115958 [please leave a message]
Guidance
E-mail: jayne.hickton@northstaffs.nhs.uk
Immunisation/Vaccination
Musculoskeletal
Respiratory Disease
Service Management North Staffs Health Library
Workforce Tel: 01782 556565
Fax: 01782 556582
E-mail: health.library@keele.ac.uk

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Sources for Clinical Effectiveness Bulletin

Please suggest further sites that should be monitored in the production of this bulletin

Websites
Bandolier http://www.medicine.ox.ac.uk/bandolier/
Clinical Knowledge Summaries [NLH] http://cks.library.nhs.uk/
Cochrane Library http://www.library.nhs.uk/
CRD Centre for Reviews and Dissemination http://www.crd.york.ac.uk/crdweb/
- DARE – (Database of Abstracts of Reviews of Effects)
- NHS Economic Evaluation Database
Department of Health http://www.dh.gov.uk/en/index.htm
Health Technology Assessment (HTA) Database http://www.ncchta.org/
NICE http://www.nice.org.uk/
NHS Evidence Specialist Collections http://www.library.nhs.uk/specialistcollections/
SIGN http://www.sign.ac.uk/new.html

Allied Health
Transforming community services: allied health professional referral to treatment guide
Department of Health
This guide sets out the definitions for clock starts and clock stops for NHS allied health
professional (AHP) services to enable consistent collection of NHS funded AHP referral to
treatment data. This will enable the measurement of waiting times for NHS AHP services and
support service improvement to reduce waiting times and improve patient access to NHS AHP
services.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D
H_114871

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Cancer
Colorectal Cancer Annual Evidence Update
NHS Evidence
http://www.library.nhs.uk/cancer/viewResource.aspx?resid=347330&code=172d4651c8f2b6c432
cc96c7a8d4a2b7

Cancer survival rates

Office for National Statistics
The figures show that survival for most of the 21 common cancers improved for both sexes over
the period 2003-2007 compared with the period 2001-2006. For the majority of cancers, women
had higher five-year survival than men. However, women diagnosed with bladder cancer had
lower survival compared to men (46.8 per cent compared to 56.9 per cent).
http://www.statistics.gov.uk/cci/nugget.asp?id=861

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Cardiovascular Disease
Cardiac Rehabilitation Annual Evidence Update
NHS Evidence

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http://www.library.nhs.uk/CARDIOVASCULAR/ViewResource.aspx?resID=346140

Cardiovascular health disparities: a systematic review of health care interventions

Davis AM, Vinci LM, Okwuosa TM, Chase AR, Huang ES
Database of Abstracts of Reviews of Effects (DARE)
CRD Summary: This review addressed hypertension, hyperlipidaemia, physical activity, tobacco
use, coronary artery disease and heart failure in "communities of color" in North America,
concluding that high-quality research on reducing cardiovascular racial and ethnic disparities was
virtually non-existent; data supporting the value of registries, multidisciplinary teams and
community outreach were found. The authors' conclusions were vague but appear reasonably
reliable.
http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?LinkFrom=OAI&ID=12008009418

Telehealth interventions for the secondary prevention of coronary heart disease: a

systematic review
Neubeck L, Redfern J, Fernandez R, Briffa T, Bauman A, Freedman SB
Database of Abstracts of Reviews of Effects (DARE)
CRD Summary: This review concluded that telemedicine interventions provided effective risk
factor reduction and secondary prevention in patients with coronary heart disease. This was
generally a well-conducted review and the authors’ conclusions are likely to be reliable.
http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?LinkFrom=OAI&ID=12009108577

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Commissioning
Where next for commissioning in the English NHS?
Nuffield Trust
This report uses research evidence as the basis for examining current commissioning
arrangements, analyses the nature of the ‘commissioning problem’, and sets out practical
suggestions for how commissioning might be strengthened to meet the challenges ahead.
http://www.nuffieldtrust.org.uk/publications/detail.aspx?id=145&PRid=694

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Guidance
NICE

During the general election campaign NICE will not be issuing guidance or tools.

Clinical Knowledge Summaries updated in April 2010

• Achilles tendinopathy (new)

• Parvovirus B19 infection (new)
• Tinnitus (new)
• Vertigo (new)

Health Technology Assessments

North of England and Scotland Study of Tonsillectomy and Adeno-tonsillectomy in

children (NESSTAC): a pragmatic randomised controlled trial with a parallel non-
randomised preference study (Lock)
Health Technol Assess 2010; 14.13

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Multicentre randomised controlled trial of the clinical and cost-effectiveness of a bypass-

surgery-first versus a balloon-angioplasty-first revascularisation strategy for severe limb
ischaemia due to infrainguinal disease. The Bypass versus Angioplasty in Severe
Ischaemia of the Leg (BASIL) trial (Bradbury)
Health Technol Assess 2010; 14.14

A randomised controlled multicentre trial of treatments for adolescent anorexia nervosa

including assessment of cost-effectiveness and patient acceptability - the TOuCAN trial
(Gowers)
Health Technol Assess 2010; 14.15

Randomised control trials for policy interventions: a review of reviews and meta-
regression (Oliver)
Health Technol Assess 2010; 14.16

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Immunisation/Vaccination
Cost-effectiveness of vaccination against cervical cancer: a multi-regional analysis
assessing the impact of vaccine characteristics and alternative vaccination scenarios
Suarez E, Smith JS, Bosch FX, Nieminen P, Chen CJ, Torvinen S, Demarteau N, Standaert B
NHS Economic Evaluation Database (NHS EED)
CRD Summary: The objective was to examine the cost-effectiveness of a cervical cancer
vaccination programme considering the impact of different vaccine-related factors and
vaccination scenarios in various countries. The authors concluded that vaccination was cost-
effective, particularly with broader and sustained vaccine protection, with vaccination at younger
ages, and with the inclusion of catch-up cohorts. The study was based on sound methodology
and, despite limited reporting of data sources, the authors' conclusions appear to be valid.
http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?LinkFrom=OAI&ID=22008101930

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Musculoskeletal
Rheumatoid Arthritis Annual Evidence Update
NHS Evidence
This AEU has concentrated on highlighting new guidelines, systematic reviews, treatment
uncertainties and forthcoming evidence.
http://www.library.nhs.uk/MUSCULOSKELETAL/ViewResource.aspx?resID=371970

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Respiratory Disease
Associations between statins and COPD: a systematic review
Dobler CC, Wong KK, Marks GB
Database of Abstracts of Reviews of Effects (DARE)
This review concluded that available evidence suggested statins may reduce morbidity and
mortality in patients with chronic obstructive pulmonary disease, but that further research was
needed to confirm these findings. Given the limitations of the evidence reported in the review, the
recommendation for further research appears appropriate.
http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=12009108246

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Service Management
Health Profile of England 2009
Department of Health
The Health Profile of England (HPoE) provides national and regional data, which local areas can
compare against their own Health Profiles. There is a section of international comparisons.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_114561

Where next for integrated care organisations in the English NHS?

Nuffield Trust
Since the 1950s, the NHS has been looking at ways of improving care coordination. Lord Darzi’s
NHS Next Stage Review introduced a new concept, that of the integrated care organisation.
Since then, the Government has begun piloting schemes that offer different models of integrated
care. This report, published jointly by The Nuffield Trust and The King’s Fund, examines some of
these new models. It focuses in particular on organisations that combine commissioner and
provider roles. These, the authors suggest, offer the most promise for aligning incentives to
produce efficient care across primary, community and acute services.
http://www.nuffieldtrust.org.uk/publications/detail.aspx?id=145&PRid=693

The NHS Performance Framework: implementation guidance 2010/11

Department of Health
This guidance aims to support the application of the NHS Performance Framework; to inform
Strategic Health Authorities (SHAs) as the regional system managers and Primary Care Trusts
(PCTs) as the local commissioners of NHS services of when they should intervene to address
poor performance and to inform NHS organisations of the criteria against which their performance
will be assessed.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D
H_115035

A high-performing NHS? A review of progress 1997-2010

King’s Fund
The Labour government was elected in 1997 with a promise to ‘save the NHS’. So is the NHS in
England a better health care system in 2010 than it was in 1997? This review examines the
progress made by the NHS in the past 13 years.
http://www.kingsfund.org.uk/publications/a_highperforming_nh.html

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Workforce
NHS Workforce Census 1999 – 2009
NHS Information Centre
Workforce information for a wide range of staff groups in the NHS is available from the NHS
Information Centre at the link below.
http://www.ic.nhs.uk/statistics-and-data-collections/workforce/nhs-staff-numbers

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