Health Problem: Knee osteoarthritis (KOA) develops via progressive destruction of the cartilage lining the knee joints, subchondral bone surfaces, and synovium. KOA causes pain, immobility, muscle weakness, decreased function, and impaired ability to complete activities of daily living. Symptomatic KOA has a prevalence rate of 12% in adults aged 60 years or greater. KOA negati…
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.
Comparative Effectiveness Review of Human Acellular Dermal Matrix for Breast Reconstruction
Health Problem: In women without adequate local tissue and muscle envelopes following mastectomy, human acellular dermal matrix (HADM) provides an alternative to autologous tissue donation or more extensive dissection and may enable 1-stage breast reconstruction (BR).
Technology Description: Biologic meshes are extracellular collagen matrices derived fr…
Comparative Effectiveness Review of Bariatric Surgeries for Treatment of Obesity in Adolescents
Health Problem: Child and adolescent obesity is a body mass index (BMI) at or above the sex-specific 95th percentile on BMI-for-age growth charts. Consequences of obesity in children and adolescents include type 2 diabetes mellitus, obstructive sleep apnea, hypertension, nonalcoholic fatty liver disease, hyperlipidemia, musculoskeletal disorders, endocrine conditions, psycholo…
Ultrasound-Guided Percutaneous Carpal Tunnel Release for Treatment of Carpal Tunnel Syndrome
Health Problem: Carpal tunnel syndrome (CTS) is a compression neuropathy of the median nerve at the wrist. It is characterized by increased pressure within the carpal tunnel and decreased function of the nerve. The estimated prevalence of CTS is 3.1% to 7.8% among adult workers, with higher prevalence among female and older-age workers.
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CardioMEMS Implantable Hemodynamic Monitor (Abbott) for Managing Patients with Heart Failure
Health Problem: Heart failure (HF) is a chronic condition that develops over time due to circumstances that overwork and damage the heart. The primary causes include coronary heart disease, high blood pressure, and diabetes. HF is characterized by the inability of the heart to pump blood efficiently. HF is estimated to affect approximately 5.7 million people in the United Stat…
Conventional Corneal Collagen Cross-Linking for Treatment of LASIK-Related Ectasia
Health Problem: Laser in situ keratomileusis (LASIK) is a refractive surgery procedure that reshapes the surface of the cornea with an excimer laser to focus visual images directly onto the retina and improve visual acuity. LASIK may disrupt the cornea. Post-LASIK corneal ectasia (also called keratectasia or keratoectasia) is a serious side effect that involves keratoconus-lik…
Spinal Cord Stimulation for Relief of Neuropathic Pain
Health Problem: Neuropathic pain is defined as pain that is caused by a lesion or disease of the somatosensory system and is distinct from other pain conditions. The transmission of sensory information in the peripheral and central nervous systems can be profoundly impacted by these deleterious factors and result in perception of painful sensations generated by the nervous sys…
iFuse Implant System (SI-Bone Inc.) for Sacroiliac Joint Fusion for Treatment of Sacroiliac Joint Dysfunction
Health Problem: Low back pain is the most common cause of chronic pain, with an estimated worldwide prevalence in adults ranging from 4% to 25%. The sacroiliac joint (SIJ) has been implicated as the primary source of pain in up to 10% to 30% of patients with chronic low back pain, although no widely accepted reference standard exists for the diagnosis of pain originating from …
Comparative Effectiveness Review of Antimicrobial Central Line Dressings for the Prevention of Central Line-Associated Bloodstream Infections
Health Problem: Intravenous catheters provide essential venous access when treating patients who are acutely or chronically ill, but their use also increases the risk of complications such as central line-associated bloodstream infections (CLABSIs). CLABSIs occur when microorganisms gain access to the bloodstream via 1 of several different routes: catheter hub contamination, c…
Hemospray for Endoscopic Hemostasis for Treatment of Upper Gastrointestinal Bleeding in Adults
Health Problem: Gastrointestinal (GI) bleeding is a serious, often life-threatening, condition. There are many potential sources of GI bleeding, including an underlying condition with ulcerative and nonulcerative lesions, malignancy, or as a result of medical interventions. Vascular malformations may underlie GI bleeding as well. Estimates of acute upper GI bleeding range from…