Health Problem: Choroidal hemangioma is a relatively uncommon benign vascular tumor that presents either as a circumscribed mass, generally without systemic associations, or as a diffuse mass that is often associated with Sturge-Weber syndrome. Choroidal hemangiomas can produce visual acuity loss from macular fluid or even lead to serous retinal detachment and elevated risk fo…
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.
Acupuncture for Treatment of Fibromyalgia
Health Problem: Fibromyalgia is a chronic condition characterized by widespread pain, fatigue, mood changes, and sleep disturbances. Estimates suggest that nearly 3.7 million people in the United States have fibromyalgia.
Technology Description: The technique of acupuncture involves percutaneous insertion of very fine needles to a depth of approximately…
Acupuncture for the Treatment of Shoulder Pain or Chronic Neck Pain: A Review of Reviews
Health Problem: Both neck and shoulder pain are health impairments that become more frequent as individuals age. Neck pain affects up to 66% of people in developed countries during their lifetime and can become chronic in approximately 10% of individuals. Shoulder pain is also quite common, with prevalence estimates ranging from 4% to 36%.
Technology Description…
Partial Knee Arthroplasty with the Mako Robotic-Arm Assisted Surgery (Stryker) for Treatment of Osteoarthritis
Health Problem: Osteoarthritis (OA) is a degenerative disorder affecting more than 30 million adults in the United States and is the leading cause of disability in older adults. OA is characterized by the breakdown of joint cartilage with involvement of the subchondral bone and synovium. Symptoms of OA of the knee include joint pain, stiffness, and swelling, which ultimately i…
Percutaneous Mechanical Thrombectomy and Ultrasound-Assisted Thrombolysis for Deep Vein Thrombosis
Health Problem: Venous thromboembolism (VTE) occurs when a blood clot blocks blood circulation. Deep vein thrombosis (DVT) is a blood clot that forms in a deep vein, usually the leg or pelvis, although sometimes in the arm. DVT causes serious morbidity and mortality, with a 1-month mortality rate of 6%.
Technology Description: Percutaneous mechanical th…
Comparative Effectiveness Review of Bupivacaine Liposome Injectable Suspension for Relief of Postoperative Pain Following Total Knee Arthroplasty: A Review of Reviews
Health Problem: More than 70 million surgical procedures are performed annually in the United States. Fewer than half of patients who undergo surgery report adequate postoperative pain relief. Controlling postoperative pain increases patient mobility, permits earlier return to activities of daily living, and reduces the risk for postoperative complications. According to 2010 s…
Sex Reassignment Surgery for the Treatment of Gender Dysphoria
Health Problem: In people with gender identity disorder (GID), formerly called transsexualism, there is severe incongruity between anatomical sex and gender identity. Individuals with GID have persistent discomfort with his or her anatomical sex, usually beginning in childhood. The discomfort or stress caused by this incongruity is gender dysphoria (GD).
Technol…
Comparative Effectiveness Review of Acupuncture for the Treatment of Knee Osteoarthritis: Review of Reviews
Health Problem: Osteoarthritis (OA) of the knee is a common, debilitating, painful condition with few treatment options. 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, eventually leading to OA. Be…
Fetal Surgery for Myelomeningocele
Health Problem: Myelomeningocele (MMC) is the most severe form of spina bifida, in which the neural tube does not completely close and a sac of fluid, including cerebrospinal fluid, meninges, and possibly damaged parts of the spinal cord and nerves, protrudes through an opening in the baby’s back. Moderate-to-severe disabilities accompany MMC, including impaired cognition, uri…
Fetal Surgery for Congenital Diaphragmatic Hernia
Health Problem: Congenital diaphragmatic hernia (CDH) is an abnormal development of the diaphragm that allows for organs such as the stomach, liver, and bowel to protrude into the chest cavity. Pulmonary hypoplasia (lung underdevelopment) and impaired function result, leading to respiratory insufficiency and possibly causing potentially fatal persistent pulmonary hypertension….