Purpose of Technology: Anticoagulation is recommended for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Two commonly employed options include heparin and bivalirudin. Heparin is an indirect thrombin inhibitor; it binds and activates antithrombin …
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.
Minimally Invasive Transforaminal Lumbar Interbody Fusion (MITLIF) Versus Open Transforaminal Lumbar Interbody Fusion (OTLIF) for Treatment of Lumbar Disc Disease: A Review of Reviews
Purpose of Technology: Minimally invasive transforaminal lumbar interbody fusion (MITLIF) employs laparoscopic surgical techniques along with muscle dilation procedures to insert bone grafts and/or medical devices between 2 or more adjacent spinal vertebrae in order to stabilize them and initiate a biological response that w…
Noninvasive Electrical Bone Growth Stimulators for Spinal Fusion or Foot and Ankle Indications
Purpose of Technology: Noninvasive electrical bone growth stimulators (EBGS) are external devices that deliver electrical energy to a fracture or bone fusion site. The goal is to induce osteogenesis, stimulate bone growth, and promote healing of fresh, delayed, or nonunion bone fractures and surg…
Ultrasound-Guided High-Intensity Focused Ultrasound for Primary Treatment of Localized 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 th…
Patient-Specific Instruments for Total Knee Arthroplasty: A Review of Reviews
Purpose of Technology: Patient-specific instruments (PSI) for total knee arthroplasty (TKA) are custom-made bone-cutting guides for use during TKA surgical implantation that are manufactured for each patient based on analysis of presurgical magnetic resonance imaging or computed tomography.
Controv…
Minimally Invasive Surgical (MIS) Procedures for Treatment of Atrial Fibrillation
Purpose of Technology: Atrial fibrillation (AF) is a supraventricular, accelerated heart rhythm characterized by uncoordinated atrial activation that leads to inefficient, irregular atrial contraction. Surgical techniques for the treatment of AF can be broadly categorized into open heart procedures and minimally invasive pro…
Indwelling Pleural Catheters for the Management of Malignant Pleural Effusions
Purpose of Technology: The purpose of indwelling pleural catheters (IPCs) is to allow for the intermittent drainage of accumulated fluid from the lungs that can occur as a complication of advanced malignancy, causing dyspnea, cough, and/or chest pain that lead to a decreased quality of life (QOL) and reduced functional ability.
Controversy: The main con…
Noninvasive Computed Fractional Flow Reserve from Computed Tomography (FFRCT) for Coronary Artery Disease
Noninvasive fractional flow reserve deduced from computed tomography (FFRCT) involves computer-assisted processing of coronary computed tomography angiography (CCTA) images to estimate changes in blood pressure inside coronary arteries that have partial blockages, with the goal of determining how severely the blo…
Electrical Bone Growth Stimulation, Invasive
Purpose of Technology: Invasive bone growth stimulators are fully implanted battery-operated devices that deliver electrical energy to bone sites to which cathodes are applied. They are intended to induce osteogenesis, stimulate bone growth, and promote healing in nonhealing…
Noninvasive Electrical Bone Growth Stimulators for Acute, Delayed Union, and Nonunion Fractures
Purpose of Technology: Noninvasive electrical bone growth stimulators (EBGS) are external devices that deliver electrical energy to a fracture or bone fusion site. The goal is to induce osteogenesis, stimulate bone growth, and promote healing of fresh, delayed, or nonunion bone fractures and surgical joint fusions.
Rationale: In 2010, there were 18.3 mi…