Current Evidence of the Management of Undifferentiated Spondyloarthritis: A Systematic Literature Review

2011 ◽  
Vol 40 (5) ◽  
pp. 421-429.e3 ◽  
Author(s):  
Jose De La Mata ◽  
Jesús Maese ◽  
Juan A. Martinez ◽  
Piedad Rosario ◽  
Estibaliz Loza
2014 ◽  
Vol 22 (5/6) ◽  
pp. 220-229 ◽  
Author(s):  
Neil Perkins ◽  
David James Hunter

Purpose – The purpose of this paper is to consider the effectiveness of partnership working in public health and draws on a systematic review of public health partnerships and original research conducted by the authors. It then considers in the light of research evidence whether the recently established Health and Wellbeing Boards (HWBs) under the 2012 Health and Social Care Act will help agencies to work together more effectively to improve population health or will go the way of previous initiatives and fall short of their original promise. Design/methodology/approach – The paper is based on a systematic literature review conducted by the authors and empirical research focusing upon the ability of public health partnerships to reduce health inequalities and improve population health outcomes. It also draws on recent studies evaluating HWBs. Findings – The paper finds that, hitherto, public health partnerships have had limited impact on improving population health and reducing health inequalities and that there is a danger that HWBs will follow the same path-dependent manner of previous partnership initiatives with limited impact in improving population health outcomes and reducing health inequalities. Research limitations/implications – The research draws on a systematic literature review and further scoping review of public health partnerships, in addition to empirical research conducted by the authors. It also reviews the current evidence base on HWBs. It is recognised that HWBs are in their early stages and have not as yet had the time to fulfil their role in service collaboration and integration. Practical implications – The paper gives an overview of how and why public health partnerships in the past have not lived up to the expectations placed upon them. It then offers practical steps that HWBs need to take to take to ensure the mistakes of the past are not replicated in the future. Social implications – The research outlines how public health partnerships can operate in a more effective manner, to ensure a more seamless provision for service users. The paper then gives pointers as to how this can benefit HWBs and the wider community they serve. Originality/value – The paper draws on a comprehensive research study of the effectiveness of public health partnerships on improving health outcomes and a systematic literature review. In addition, it also draws upon the current evidence base evaluating HWBs, to inform the discussion on their future prospects, in regard to partnership working in public health and promoting service integration.


2010 ◽  
Vol 69 (6) ◽  
pp. 987-994 ◽  
Author(s):  
R Knevel ◽  
M Schoels ◽  
T W J Huizinga ◽  
D Aletaha ◽  
G R Burmester ◽  
...  

ObjectivesTo perform a systematic literature review of effective strategies for the treatment of rheumatoid arthritis (RA).MethodsAs part of a European League Against Rheumatism (EULAR) Task Force investigation, a literature search was carried out from January 1962 until February 2009 in PubMed/Ovid Embase/Cochrane and EULAR/American College of Rheumatism (ACR)) abstracts (2007/2008) for studies with a treatment strategy adjusted to target a predefined outcome. Articles were systematically reviewed and clinical outcome, physical function and structural damage were compared between intensive and less intensive strategies. The results were evaluated by an expert panel to consolidate evidence on treatment strategies in RA.ResultsThe search identified two different kinds of treatment strategies: strategies in which the reason for treatment adjustment differed between the study arms (‘steering strategies’, n=13) and strategies in which all trial arms used the same clinical outcome to adjust treatment with different pharmacological treatments (‘medication strategies’, n=7). Both intensive steering strategies and intensive medication strategies resulted in better outcome than less intensive strategies in patients with early active RA.ConclusionIntensive steering strategies and intensive medication strategies produce a better clinical outcome, improved physical function and less structural damage than conventional steering or treatment. Proof in favour of any steering method is lacking and the best medication sequence is still not known.


Pain Medicine ◽  
2020 ◽  
Vol 21 (7) ◽  
pp. 1415-1420
Author(s):  
Timothy R Deer ◽  
Steven Falowski ◽  
Jeff E Arle ◽  
Jan Vesper ◽  
Julie Pilitsis ◽  
...  

Abstract Objective To conduct a systematic literature review of brain neurostimulation for pain. Design Grade the evidence for deep brain neurostimulation (DBS). Methods An international, interdisciplinary work group conducted a literature search for brain stimulation. Abstracts were reviewed to select studies for grading. Randomized controlled trials (RCTs) meeting inclusion/exclusion criteria were graded by two independent reviewers. General inclusion criteria were prospective trials (RCTs and observational) that were not part of a larger or previously reported group. Excluded studies were retrospective or existed only as abstracts. Studies were graded using the modified Interventional Pain Management Techniques–Quality Appraisal of Reliability and Risk of Bias Assessment, the Cochrane Collaborations Risk of Bias assessment, and the United States Preventative Services Task Force level-of-evidence criteria. Results Two high-quality RCTs and three observational trials supported DBS, resulting in Level II (moderate) evidence. Conclusion Moderate evidence supports DBS to treat chronic pain. Additional Level I RCTs are needed to further the strength of the evidence in this important area of medicine, but the current evidence suggests that DBS should be considered as an option in treating complex pain cases.


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