Accessed through the Hayes Knowledge Center, the Evidence Analysis Solution addresses the following fundamental questions to help our clients determine coverage positions:
Patients with opioid use disorder may benefit from medication-assisted treatments that include a combination of medication and behavioral therapy.
Technology Description: Probuphine is an implantable system containing buprenorphine hydrochloride, which is an opioid partial agonist drug intended to ease symptoms of withdrawal and opioid cravings. The implantable system a…
Rationale: Ingestible capsules enable visualization or direct measurement of conditions in the gastrointestinal (GI) tract with no need to sedate or anesthetize the patient, no radiation exposure, and with little supervision or effort needed by the nurse or physician who monitors the procedure. Testing with wireless capsule systems offers an alternative to standard tests of GI…
Rationale: Combined positron emission tomography-computed tomography (PET-CT) has emerged as a tool for detecting and delineating lesions, staging and restaging disease, and predicting and monitoring response to treatment. The rationale for this imaging strategy is that accuracy may be improved by combining 2 types of data.
Technology Description: PET-C…
Patients with osteoarthritis (OA) of the knee may experience chronic pain that is refractory to conservative treatments.
Technology Description: Peripheral nerve ablation (PNA) involves the delivery of heat to the genicular nerve, causing thermocoagulation and localized neuronal tissue destruction, with the overall goal of reducing pain and improving function.
Rationale: Medical therapy can ameliorate symptoms associated with aortic or mitral prosthetic paravalvular leaks (PVLs). However, repeat cardiac surgery is associated with increased morbidity and mortality, with added risk secondary to paravalvular tissue friability and heavy calcification. Thus, percutaneous closure of prosthetic PVLs is under inv…
Rationale: Discography evaluates the suspected culprit discs with abnormal morphology and, as a control, normal discs. In theory, the combination of imaging that demonstrates disc degeneration or internal disc disruption and provoking the patient’s usual pain confirms a tested disc as a source of pain.
Technology Description: Discography involves image-…
Purpose of Technology: The goal of endovenous laser ablation (EVLA) is to use laser energy to seal off the damaged portions of varicose veins, prevent further varicose vein formation, eliminate associated discomfort, and improve cosmetic appearance. This therapy is intended primarily for the treatment of varicose veins that result from great saphenous vein (GSV), small sapheno…
Purpose of Technology: Robotically assisted hysterectomy (RAH) is intended for the minimally invasive removal of the uterus as a treatment for various medical conditions, including benign conditions such as endometriosis, uterine fibroids, and uterine prolapse. It is also used to treat and stage malignant conditions such as cervical and endometrial cancers.
Rati…
Cardiogenic shock (CS) is an acute life-threatening condition resulting from inadequate blood circulation due to the inability of the heart (most often the left ventricle) to adequately meet systemic tissue demands for oxygen and nutrients.
Technology Description:
Purpose of Technology: The most common skin preparation agents currently used in the United States for antisepsis prior to catheter insertion are products that contain iodophors or chlorhexidine gluconate (CHG).
Rationale: Skin preparation products are used prior to insertion of catheters to quickly eliminate a wide range of microbes and provide a conti…