Health Problem: Essential tremor (ET) is a neurological disorder of involuntary rhythmic tremors. Although ET is considered a benign disease, disabling tremors affect activities of daily living and workplace productivity and are a source of psychological distress and embarrassment. Medication-resistant ET occurs in 30% to 50% of patients with ET. While approximately 50% of pat…
Health Technology Assessments
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.
Comparative Effectiveness Review of Lumbar Total Disc Replacement for Degenerative Disc Disease
Health Problem: It is estimated that 60% to 80% of the adult population in the United States will experience clinically significant low back pain (LBP) at some point in time. The vast majority of LBP is mechanical in nature, i.e., arising from anatomic structures of the spine. Nonspecific chronic LBP may be attributed to normal degenerative changes in the intervertebral discs …
Comparative Effectiveness Review of Image-Based Computer-Aided Navigation for Total Knee Arthroplasty
Health Problem: Osteoarthritis of the knee is the primary indication for total knee arthroplasty (TKA) in the United States. Many TKA recipients are unsatisfied with the amount of pain relief and functional improvement they have long term. Malalignment of the implant has particularly been associated with poor clinical outcomes, early implant loosening, premature implant wear, …
Comparative Effectiveness Review of Cold Compression Therapy for Patients Undergoing Total Knee Arthroplasty
Health Problem: Acute postoperative pain and swelling is common following total knee arthroplasty (TKA). Inadequately controlled pain negatively affects quality of life and recovery of function and may result in an increase in morbidity, recovery time, opioid use, and risk of complications or persistent postsurgical pain. According to 2010 data, approximately 4.7 million peopl…
Ultrasound Transient 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 …
Minimally Invasive Lumbar Decompression (mild; Vertos Medical Inc.) Device Kit for Treatment of Lumbar Spinal Stenosis
Health Problem: Lumbar spinal stenosis (LSS) affects more than 200,000 adults in the United States and is a source of substantial pain and disability. Major contributors to LSS include degenerative intervertebral discs and bone structures, as well as hypertrophy of the ligamentum flavum.
Technology Description: The mild device kit (Vertos Medical Inc.) …
Rezūm System (NxThera Inc.) for Benign Prostatic Hyperplasia
Health Problem: Benign prostatic hyperplasia (BPH) is an enlargement or growth of the prostate that affects approximately 8 million men in the United States, including 30% of men older than 50 years of age and nearly 70% of men older than 70 years of age. The enlarged prostate restricts the urethra and applies pressure on the base of the bladder. This restriction of the urethr…
Cartiva Synthetic Cartilage Implant (Wright Medical Group) for Treatment of First Metatarsophalangeal Joint Arthritis
Health Problem: Osteoarthritis is the second most common disorder of the first metatarsophalangeal (MTP) joint. Osteoarthritis is characterized by the progressive loss of articular cartilage and development of osteophytes. Also referred to as hallux rigidus or hallux limitus depending upon the severity of joint dysfunction, the condition is characterized by pain …
Hematopoietic Stem Cell Transplantation for Treatment of Multiple Sclerosis
Health Problem: Multiple sclerosis (MS) is a potentially disabling autoimmune disease that impacts the central nervous system. MS is estimated to affect 400,000 to 1,000,000 people in the United States and 2,300,000 people worldwide.
Technology Description: During hematopoietic stem cell transplantation (HSCT), a patient undergoes a partially or fully my…
Comparative Effectiveness Review of Platelet-Rich Plasma for Treatment of Conditions of the Achilles Tendon and Plantar Fascia
Health Problem: Conditions of the Achilles tendon, such as Achilles tendon rupture (ATR) or Achilles tendinopathy (AT), as well as conditions of the plantar fascia (plantar fasciitis [PF]) can result from overuse or can be due to sports, age, and/or a combination of seve…