The most common indication for lumbar fusion is degenerative disc disease (DDD) (discogenic pain). Spinal fusion may also be indicated for conditions related to DDD, including abnormal slippage of the vertebrae (spondylolisthesis or spondylolysis), a sideways curvature of the spine (scoliosis), facet joint degeneration, infection (e.g., disc…
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
Roux-en-Y Gastric Bypass for Treatment of Type II Diabetes: A Review of Reviews
Purpose of Technology: Roux-en-Y gastric bypass (RYGB) is surgery that reduces the capacity of the stomach and the length of the small intestine through which food travels. RYGB is widely accepted as very effective for weight loss in people with morbid obesity; however, recent research has explored the use of RYGB for the treatment of type II diabetes, including in less obese …
The Clinical Utility of Navigated Transcranial Magnetic Stimulation for Presurgical Planning for Brain Tumors
Approximately 26,070 primary malignant and 53,200 nonmalignant brain tumors will be diagnosed in the United States in 2017, with an estimated 16,947 deaths in the United States in 2017 attributable to primary malignant brain and central nervous system tumors. Surgery is typically the treatment of choice for most brain tumors, with a goa…
Surgical Treatment for Lymphedema: A Review of Reviews
Purpose of Technology: Lymphedema is the swelling of limbs caused by fluid accumulation, most commonly due to lymphatic injury caused by cancer treatment. Conservative management may confer insufficient control or be ineffective altogether, especially if lymphedema is advanced. Multiple surgical …
Arthroscopic Hip Surgery for Femoroacetabular Impingement
Purpose of Technology: Femoroacetabular impingement (FAI) occurs due to an altered or suboptimal shape of the femoral neck, leading repetitive contact and breakdown of the cartilage around the rim of the hip joint. Several different types of arthroscopic surgery have been developed to reshape bone and remove or repair damage…
Comparative Effectiveness Review of Mosaicplasty for Treatment of Articular Cartilage Injuries
Purpose of Technology: Mosaicplasty is a technique for repairing cartilage in weight-bearing joints that have been damaged by trauma or degenerative processes. It consists of removing small cylinders of cartilage or bone and cartilage from low- or non-weight-bearing sites in the affected joint or…
Neodymium-Doped Yttrium Aluminium Garnet Laser Treatment for Onychomycosis
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…
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…