Onychomycosis is a fungal infection of the nail. Onychomycosis can cause discomfort, pain, and disfigurement leading to serious physical and occupational limitations. Onychomycosis is a deep-seated, recalcitrant condition with a 40% to 70% recurrence rate, which includes either relapse or reinfection. Oral antifungals are the standard o…
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.
SurgiMend (Integra Life Sciences) for Postmastectomy Breast Reconstruction
Breast reconstruction (BR) may pose a challenge if the patient’s skin-pectoral muscle pocket cannot adequately support tissue expansion or hold the expander or implant in place. Various options exist for reinforcing coverage of this muscle, including autologous transplant of tissue from the latissimus dorsi and the blunt dissection and eleva…
Intravenous Lidocaine Infusion for Neuropathic Pain: A Review of Reviews
Purpose of Technology: Lidocaine hydrochloride is a local anesthetic with antiarrhythmic properties that may hold utility in the treatment of select patients with intractable neuropathic pain. Intravenous lidocaine helps to suppress spontaneous ectopic discharges of damaged nerves without blocking normal neuronal conduction, which in part underlies its analgesic effect.
Antibiotic-Impregnated Bone Cement for Total Hip Arthroplasty and Other Orthopedic Indications
Purpose of Technology: Antibiotic bone cement (ABC) is a type of curable polymethacrylate preparation created by adding various antibiotic medications to plain, nonmedicated bone cement. This material is used to fix the components of joint replacement devices or fractured bones. It may also be us…
Comparative Effectiveness Review of Dry Needling for Mechanical Neck and/or Trapezius Muscle Pain in Adults
Purpose of Technology: Dry needling (DN) is a skilled intervention by which thin filiform needles are used to penetrate the skin and stimulate underlying trigger points (TrPs), muscle, and connective tissues to manage neuromusculoskeletal pain and impaired movement.
Flow Diverter Devices for Intracranial Aneurysms: A Review of Reviews
Purpose of Technology: Flow diverters are stents tunneled through blood vessels to the site of an intracranial aneurysm to block the blood vessel opening to the aneurysm. The stent diverts blood flow past the aneurysm opening, prohibiting inflow to the aneurysm, with the intent of causing hemostasis within the aneurysm, endothelial growth at the opening to the aneurysm, and, e…
High-Intensity Focused Ultrasound for Salvage Therapy of Recurrent Prostate Cancer
Purpose of Technology: High-intensity focused ultrasound (HIFU) is a minimally invasive (transrectal) treatment that generates heat through sound energy to destroy tumor tissue. Sound waves produced by an ultrasonic transducer mounted on an endorectal probe penetrate the rectal wall and ablate either the entire prostate gland or focal areas containing tumor while avoiding dama…
Capsule Endoscopy for the Diagnosis of Small Bowel Crohn’s Disease
Purpose of Technology: Capsule endoscopy (CE), also called wireless capsule endoscopy or video capsule endoscopy, is a minimally invasive procedure in which the patient swallows a multivitamin-sized capsule containing a miniaturized video camera, light transmitter, and batteries. The camera takes a video recording of the mucosal lining of the esophagus, small bowel, and/or col…
Occupational Therapy for Attention-Deficit/Hyperactivity Disorder (ADHD)
Purpose of Technology: Occupational therapy (OT) for attention-deficit/hyperactivity disorder (ADHD) encompasses a wide array of interventions, with the aim of increasing function in all aspects of life and settings (school, home, etc.). Specific interventions vary and are determined by the occup…
Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures
Purpose of Technology: Percutaneous kyphoplasty (KP) is an interventional procedure used to treat painful vertebral compression fractures related to osteoporosis. The procedure involves guided insertion of an inflatable bone tamp into the partially collapsed vertebral body. Once in place, the bal…