Health Problem: The esophageal and gastric disorders most frequently evaluated with the Endolumenal Functional Lumen Imaging Probe (EndoFLIP) are achalasia, eosinophilic esophagitis (EE), and gastroparesis, but these disorders are relatively rare, with prevalence ranging from approximately 11 to 52 cases per 100,000 persons in the general population. Disorders of esophage…
Health Technology Assessments
Health Technology Assessments (HTAs) are a comprehensive systematic review and critical analysis of available evidence for A SINGLE medical technology for which there are several published clinical trials and a substantial body of evidence. This report details an entire technology class for which there are one or more indications or patient populations in use.
Our analysts evaluate clinical trial data, along with information regarding safety issues, coverage policies from the private and public sectors, regulatory approvals, consensus statements, and an overall projection of the potential clinical efficacy and economic impact of the technology. Reports are reviewed annually up to 5 years post publication to determine if there is new literature or evidence that would impact a change in rating and warrant an updated report.
Platelet-Rich Plasma for Hip Osteoarthritis
Health Problem: Osteoarthritis (OA) is a painful condition that occurs when the cartilage between the bones degenerates, no longer providing a smooth, gliding surface for motion or adequate cushioning. Damaged articular cartilage does not tend to heal and may progressively worsen and cause focal lesions and eventually OA. Hip OA is common. The estimated lifetime risk for …
Comparative Effectiveness Review of Radioactive Yttrium-90 Microspheres for Treatment of Primary Unresectable Liver Cancer
Health Problem: Hepatocellular carcinoma (HCC) is the most common liver malignancy in the United States, accounting for approximately 90% of primary liver cancers. The definitive therapies for HCC are surgical resection, tumor ablation, and liver transplantation; however, most patients are not eligible for these therapies due to the overall burden or severity of their dis…
Comparative Effectiveness Review of Mini Gastric Bypass–One Anastomosis Gastric Bypass for the Treatment of Obesity: A Review of Reviews
Health Problem: Obesity is a common condition in the United States, where approximately 37.7% of adults aged 20 years and older are considered obese. Data from 2013 to 2014 show a rate of obesity of 17.2% among younger individuals aged 2 to 19 years. Morbid obesity is associated with substantively elevated morbidity and mortality due to comorbid conditions, including type…
Pulsed Radiofrequency Application to the Dorsal Root Ganglion for Treatment of Lumbosacral Radicular Pain
Health Problem: Lumbosacral radicular pain is generally characterized by pain radiating into 1 or more dermatomes and may be caused by nerve root irritation, inflammation, or compression. Lumbosacral radiculopathy typically refers to sensory or motor loss and can involve a continuum of radicular pain. Both radicular pain and radiculopathy often occur concurrently. Complete or …
Comparative Effectiveness Review of Functional Electrical Stimulation (FES) for Upper Extremity Rehabilitation Post Stroke
Health Problem: In the United States, stroke afflicts 795,000 individuals each year, with 610,000 being a first stroke and 185,000 being recurrent stroke. Stroke causes 140,000 deaths annually. It is estimated that 29% to 75% of stroke survivors experience upper extremity impairments and stroke reduces mobility in more than 50% of survivors age 65 years and older.
Pulsed Radiofrequency Application to the Dorsal Root Ganglion for Treatment of Cervical Radicular Pain
Health Problem: Cervical radicular pain may be caused by cervical degenerative disc disease, herniated disc, spinal stenosis, and foraminal stenosis. Symptoms include pain with upper extremity radiation, paresthesias in the arm or hand in conjunction with diminished muscle tendon reflexes, sensory loss, or motor weakness. Symptoms most often follow the distribution pattern of …
Acoustic Radiation Force Impulse (ARFI) Elastography for Detecting Hepatic Fibrosis in Patients with Hepatitis C
Health Problem: Approximately 3.2 million people in the United States have a chronic hepatitis C virus (HCV) infection, which puts them at risk for developing hepatic fibrosis or cirrhosis, a need for liver transplantation, and possible death due to liver failure or liver cancer. However, HCV infection is a treatable disease and effective antiviral treatments that can lead to …
Comparative Effectiveness Review of Laser Therapy for Psoriasis
Health Problem: Psoriasis is an immune-mediated disease of the skin that affects 7.5 million people in the United States and is characterized by the appearance of red, thickened, scaly patches on the skin.
Technology Description: Laser therapy typically involves passing a focused laser beam back and forth over the entire area of a psoriasis lesion. In s…
Percutaneous Tibial Nerve Stimulation for the Treatment of Symptomatic Neurogenic Lower Urinary Tract Dysfunction
Health Problem: Also known as neurogenic bladder, neurogenic lower urinary tract dysfunction (nLUTD) is a condition in which an individual lacks bladder control due to a brain, spinal cord, or peripheral nervous system disease or injury. Disturbances of storage may result in lower urinary tract symptoms such as urinary urgency, urge urinary incontinence, urinary frequency, and…