Health Problem: Lumbosacral radicular pain is generally characterized by pain radiating into 1 or more dermatomes and may be caused by nerve root irritation, inflammation, or compression. Lumbosacral radiculopathy typically refers to sensory or motor loss and can involve a continuum of radicular pain. Both radicular pain and radiculopathy often occur concurrently. Complete or …
Evidence Analysis
It is a challenge for health plans and clinicians to distill and analyze volumes of clinical evidence to determine likely clinical, financial, and risk impacts. This is what we do.Accessed through the Hayes Knowledge Center, the Evidence Analysis Solution addresses the following fundamental questions to help our clients determine coverage positions:
- Does the technology improve health outcomes?
- Are there other benefits associated with the technology?
- What harms might be associated with the technology?
- Have patient selection criteria been established for the technology?
- For which patients might the technology provide a benefit?
- Health Technology Assessments
- Evidence Analysis Research Briefs
- Evolving Evidence Review
- Clinical Research Responses
Comparative Effectiveness Review of Functional Electrical Stimulation (FES) for Upper Extremity Rehabilitation Post Stroke
Health Problem: In the United States, stroke afflicts 795,000 individuals each year, with 610,000 being a first stroke and 185,000 being recurrent stroke. Stroke causes 140,000 deaths annually. It is estimated that 29% to 75% of stroke survivors experience upper extremity impairments and stroke reduces mobility in more than 50% of survivors age 65 years and older.
Pulsed Radiofrequency Application to the Dorsal Root Ganglion for Treatment of Cervical Radicular Pain
Health Problem: Cervical radicular pain may be caused by cervical degenerative disc disease, herniated disc, spinal stenosis, and foraminal stenosis. Symptoms include pain with upper extremity radiation, paresthesias in the arm or hand in conjunction with diminished muscle tendon reflexes, sensory loss, or motor weakness. Symptoms most often follow the distribution pattern of …
Acoustic Radiation Force Impulse (ARFI) 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 …
Comparative Effectiveness Review of Laser Therapy for Psoriasis
Health Problem: Psoriasis is an immune-mediated disease of the skin that affects 7.5 million people in the United States and is characterized by the appearance of red, thickened, scaly patches on the skin.
Technology Description: Laser therapy typically involves passing a focused laser beam back and forth over the entire area of a psoriasis lesion. In s…
Percutaneous Tibial Nerve Stimulation for the Treatment of Symptomatic Neurogenic Lower Urinary Tract Dysfunction
Health Problem: Also known as neurogenic bladder, neurogenic lower urinary tract dysfunction (nLUTD) is a condition in which an individual lacks bladder control due to a brain, spinal cord, or peripheral nervous system disease or injury. Disturbances of storage may result in lower urinary tract symptoms such as urinary urgency, urge urinary incontinence, urinary frequency, and…
Magnetic Resonance–Guided Focused Ultrasound (MRgFUS) Unilateral Thalamotomy for Essential Tremor
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…
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…