Recently Published Projects

Published on June 27, 2021
The Use of Chloroquine and Hydroxychloroquine for Prophylaxis and Treatment of COVID-19
24 Studies • 1 Key Questions • 24 Extraction Forms
Project created on June 27, 2021
Last updated on June 27, 2021
Objectives: The purpose of this review is to determine if hydroxychloroquine or chloroquine is effective and safe when used alone or when combined with azithromycin for the prophylaxis and treatment of COVID-19.
Published on June 27, 2021
Nonopioid Pharmacologic Treatments for Chronic Pain
180 Studies • 2 Key Questions • 180 Extraction Forms
Project created on June 27, 2021
Last updated on June 27, 2021
Objectives: To evaluate the effectiveness and comparative effectiveness of nonopioid pharmacologic agents in patients with specific types of chronic pain, considering the effects of on pain, function, quality of life, and adverse events.
Published on June 27, 2021
Skin Substitutes for Treating Chronic Wounds
22 Studies • 1 Key Questions • 22 Extraction Forms
Project created on June 27, 2021
Last updated on June 27, 2021
Objectives: Systematic review to describe skin substitute products commercially available in the United States used to treat chronic wounds, examine systems used to classify skin substitutes, identify and assess randomized controlled trials (RCTs), and suggest best practices for future studies.
Published on June 27, 2021
Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update. Comparative Effectiveness Review No. 227. [Entered Retrospectively]
250 Studies • 10 Key Questions • 250 Extraction Forms
Project created on June 27, 2021
Last updated on June 27, 2021
Objectives: Structured Abstract Objectives. We updated the evidence from our 2018 report assessing persistent improvement in outcomes following completion of therapy for noninvasive nonpharmacological treatment for selected chronic pain conditions. Data sources. Electronic databases (Ovid MEDLINE®, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews), through November 2017 (for priorAHRQreport) and from September 2017 through September 2019 (for this update report), reference lists, ClinicalTrials.gov, and our previous report. Review methods. Using predefined criteria, we selected randomized controlled trials (RCTs) of noninvasive nonpharmacological treatments for five common chronic pain conditions (chronic low back pain; chronic neck pain; osteoarthritis of the knee, hip, or hand; fibromyalgia; and tension headache) that reported results for a at least 1 month postintervention. We analyzed effects and assessed strength of evidence (SOE) at short term (1 to <6 months following treatment completion), intermediate term (≥6 to <12 months), and long term (≥12 months).Results. We included 233 RCTs (31 new to this update). Many were small (N<70), and evidence beyond 12 months after treatment completion was sparse. The most common comparison was with usual care. Evidence on harms was limited, with no evidence suggesting increased risk for serious treatment-related harms for any intervention. Effect sizes were generally small for function and pain. Chronic low back pain: Psychological therapies were associated with small improvements compared with usual care or an attention control for both function and pain at short-term, intermediate-term, and long-term followup (SOE: moderate). Function improved over short and/or intermediate term for exercise, low-level laser therapy, spinal manipulation, massage, yoga, acupuncture, and multidisciplinary rehabilitation (SOE moderate at short term for exercise, massage, and yoga; low for all others). Improvements in pain at short term were seen for massage, mindfulness-based stress reduction, acupuncture,and multidisciplinary rehabilitation (SOE: moderate), and exercise, low-level laser therapy, and yoga (SOE: low). At intermediate term, spinal manipulation, yoga, multidisciplinary rehabilitation (SOE: moderate) and exercise and mindfulness-based stress reduction (SOE: low) were associated with improved pain. Compared with exercise, multidisciplinary rehabilitation improved both function and pain at short and intermediate terms (small effects, SOE: moderate.) Chronic neck pain: In the short-term, low-level laser therapy (SOE: moderate) and massage (SOE: low) improved function and pain. Exercise in general improved function long term, and combination exercise improved function and pain both short and long term compared with usual care (SOE: low). Acupuncture improved function short and intermediate term, but there was no pain improvement compared with sham acupuncture (SOE: low). Compared with acetaminophen, Pilates improved both function and pain (SOE: low). Osteoarthritis pain: Exercise resulted in small improvements in function and pain at short-term(SOE: moderate) and long-term, and moderate improvement at intermediate-term (SOE: low) followup for knee osteoarthritis versus nonactive comparators. Small improvements in function and pain with exercise were seen for hip osteoarthritis short term (SOE: low). Functional improvement persisted into intermediate term, but pain improvement did not (SOE: low). Fibromyalgia: Functional improvements were seen with exercise, mind-body practices, multidisciplinary rehabilitation (SOE: low) and acupuncture (SOE: moderate) short term compared with usual care, attention control, or sham treatment. At intermediate term, there was functional improvement with exercise and acupuncture (SOE: moderate), cognitive-behavioral therapy (CBT), mindfulness-basdedstress reduction, myofascial release,and multidisciplinary rehabilitation (SOE: low). LLong term, functional improvements persisted for multidisciplinary rehabilitation without improvement in pain (SOE: low). Compared with exercise, tai chiconferred improvement in function short and intermediate term (SOE: low). Pain was improved with exercise (short and intermediate term, SOE moderate), and for CBT (shortterm),mindfulness practices,and multidisciplinary rehabilitation (MDR) (intermediate term)(SOE lowfor these three). Chronic tension headache: Evidence was sparse and the majority of trials were of poor quality. Spinal manipulation resulted in moderate improvement in pain short term. Conclusions. Trials identified subsequent to the earlier report largely support previous findings, —namely that exercise, multidisciplinary rehabilitation, acupuncture, CBT, mindfulness practices, massage,and mind-body practices most consistently improve function and/or pain beyond the course of therapy for specific chronic pain conditions. Additional research, including comparisons with pharmacological and other active controls, on effects beyond the immediate post-treatment period is needed, particularly for conditions other than low back pain
Published on June 27, 2021
Opioid Treatments for Chronic Pain
175 Studies • 4 Key Questions • 175 Extraction Forms
Project created on June 27, 2021
Last updated on June 27, 2021
Objectives: To assess the effectiveness and harms of opioid therapy for chronic noncancer pain; alternative opioid dosing strategies; and risk mitigation strategies