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Diagnose en behandeling van spataders in de benen / Felicity Allen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2011)
Diagnose en behandeling van spataders in de benen [printed text] / Felicity Allen, Author ; Michel Kroes, Author ; Stephen Mitchell, Author ; Françoise Mambourg , Author ; Dominique Paulus , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2011 . - IX, 111 p. : ill. ; A4. - (KCE Reports A. Good Clinical Practice (GCP); 164A) .
ISSN : D/2011/10.273/50 : € 0,00
Languages : English (eng) Dutch (nla)
Descriptors: Indexation
2010-01 ; Diagnosis ; R164 ; Therapeutics ; Varicose Veins
Classification
WG 620 Varicose veinsAbstract: Spataders in de benen kunnen worden verwijderd door een klassieke operatie, de zogenaamde ‘stripping’. Er bestaan vandaag ook nieuwere, mindere invasieve methoden. De ader wordt daarbij via een katheter met laser of radiofrequentie van binnenuit dichtgeschroeid, of verschrompelt na de inspuiting van een vloeistof of schuim (sclerotherapie). Het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) bekeek de doeltreffendheid en de veiligheid van deze technieken. Ze blijken niet minder doeltreffend te zijn dan de klassieke ingreep en beter te zijn voor de levenskwaliteit van de patiënt. Over de neveneffecten bestaan er wel nog weinig wetenschappelijke studies, vooral dan voor de inspuitingen met schuim. Er zijn ook nog twijfels over de resultaten op lange termijn. Het KCE raadt daarom aan deze ingrepen terug te betalen met een registratie van de patiënten om zo de lange termijn effecten van deze nieuwe behandelingen op te kunnen volgen. Over het nut van steunkousen bestaan weinig gegevens. Geneesmiddelen worden niet aanbevolen voor de behandeling van spataders. Contents note: Table of contents -- ABBREVIATIONS 4 -- 1 INTRODUCTION 5 -- 1.1 BACKGROUND OF THE STUDY 5 -- 1.1.1 Necessary update of billing codes 5 -- 1.1.2 Use of obsolete diagnostic techniques 5 -- 1.2 CLINICAL BACKGROUND: VARICOSE VEINS 6 -- 1.2.1 Definition 6 -- 1.2.2 Prevalence 6 -- 1.2.3 Aetiology and risk factors 6 -- 1.2.4 Disease severity: CEAP Classification 6 -- 1.3 RESEARCH QUESTIONS 7 -- 1.3.1 First research question: diagnostic procedures 7 -- 1.3.2 Second research question: effectiveness and safety of treatments 8 -- 1.3.3 Third research question: type of anaesthetic for each intervention 8 -- 1.4 DIAGNOSIS OF VARICOSE VEINS 8 -- 1.5 TREATMENT OPTIONS FOR VARICOSE VEINS 9 -- 1.5.1 Traditional surgical procedures 9 -- 1.5.2 Endovenous Laser Therapy 10 -- 1.5.3 Radiofrequency Ablation 10 -- 1.5.4 Sclerotherapy 10 -- 1.5.5 Mixed treatments 10 -- 2 METHODS 11 -- 2.1 SEARCH STRATEGIES 11 -- 2.1.1 Diagnostic techniques for varicose veins 11 -- 2.1.2 Treatment of varicose veins 11 -- 2.2 ASSESSING METHODOLOGICAL QUALITY AND RISK OF BIAS 12 -- 2.2.1 Diagnostic studies 12 -- 2.2.2 Systematic reviews 12 -- 2.2.3 Randomised controlled trials 12 -- 2.3 DATA EXTRACTION 12 -- 2.3.1 Diagnostic studies 12 -- 2.3.2 Systematic reviews 13 -- 2.3.3 Randomised controlled trials 13 -- 3 RESULTS: DIAGNOSTIC PROCEDURES FOR VARICOSE VEINS 14 -- 3.1 IDENTIFIED STUDIES AND QUALITY APPRAISAL 14 -- 3.1.1 Selection of two diagnostic studies 14 -- 3.1.2 Quality appraisal of diagnostic studies 16 -- 3.2 OVERVIEW OF INCLUDED DIAGNOSTIC STUDIES 16 -- 3.3 PRE-OPERATIVE DUPLEX ULTRASOUND COMPARED WITH NO SCAN 16 -- 3.4 COMPUTED TOMOGRAPHY VERSUS DUPLEX 17 -- 4 RESULTS: INTERVENTIONS FOR THE TREATMENT OF VARICOSE VEINS .. 18 -- 4.1 IDENTIFIED STUDIES AND QUALITY APPRAISAL 18 -- 4.1.1 Systematic reviews 18 -- 4.1.2 Randomised controlled trials 20 -- 4.2 OVERVIEW OF INCLUDED SYSTEMATIC REVIEWS 22 -- 4.2.1 Systematic reviews on multiple treatments 22 -- 4.2.2 Endovenous laser therapy 23 -- 4.2.3 Radiofrequency ablation 23 -- 4.2.4 Sclerotherapy 23 -- 4.2.5 Surgery 23 -- 4.2.6 Compression hosiery 23 -- 4.2.7 Drugs 23 -- 4.3 OVERVIEW OF INCLUDED RCTS 23 -- 5 RESULTS BY INTERVENTION 25 -- 5.1 ENDOVENOUS LASER THERAPY 25 -- 5.1.1 Results from systematic reviews 25 -- 5.1.2 Results from randomised controlled trials 25 -- 5.1.3 Summary: Endovenous Laser Therapy 27 -- 5.2 RADIOFREQUENCY ABLATION 27 -- 5.2.1 Results from systematic reviews 27 -- 5.2.2 Results from randomised controlled trials 27 -- 5.2.3 Summary: Radiofrequency ablation 29 -- 5.3 SCLEROTHERAPY 29 -- 5.3.1 Results from systematic reviews 29 -- 5.3.2 Results from randomised controlled trials 29 -- 5.3.3 Summary: Sclerotherapy 30 -- 5.4 SURGERY 31 -- 5.5 COMPRESSION HOSIERY 31 -- 5.6 DRUGS 32 -- 5.6.1 One Cochrane review on the effect of phlebotonics for chronic venous insufficiency .. 32 -- 5.6.2 Lack of evidence in one RCT 32 -- 5.7 OTHER CONSERVATIVE TREATMENTS 32 -- 6 SAFETY CONSIDERATIONS 33 -- 6.1 ENDOVENOUS LASER THERAPY 33 -- 6.2 RADIOFREQUENCY ABLATION 33 -- 6.3 SCLEROTHERAPY 34 -- 6.4 SURGERY 34 -- 6.5 SUMMARY: SAFETY 35 -- 7 ANAESTHESIA 36 -- 7.1 DESCRIPTION OF ANAESTHESIA IN THE INCLUDED RCTS 36 -- 7.2 ANAESTHESIA SUMMARY 36 -- 8 SUMMARY OF FINDINGS AND DISCUSSION 38 -- 8.1 SUMMARY OF FINDINGS 38 -- 8.1.1 Diagnostic: duplex ultrasound is the standard procedure 38 -- 8.1.2 Treatment options: comparable efficacy and complications 38 -- 8.1.3 Heterogenous anaesthetic procedures 38 -- 8.1.4 Coherence of the results with other recent publications 39 -- 8.2 TRANSFERABILITY OF RESULTS TO THE BELGIAN HEALTH CARE SETTING ? 39 -- 8.3 STRENGTHS AND LIMITATIONS OF THIS SYSTEMATIC REVIEW 39 -- 8.3.1 Strengths of this review 39 -- 8.3.2 Methodological limitations of the included studies 39 -- 8.4 SUGGESTIONS FOR FURTHER RESEARCH 40 -- 8.5 KEY POINTS OF THE REPORT 41 -- 9 APPENDICES 42 -- 9.1 ADDITIONAL HANDSEARCHING 42 -- 9.2 DIAGNOSTIC STUDIES: QUALITY APPRAISAL AND DETAILED RESULTS ABOUT THE -- USE OF HAND-HELD DOPPLER 44 -- 9.2.1 Quality items derived from QUADAS tool 44 -- 9.2.2 Quality appraisal of varicose vein diagnostic studies 45 -- 9.2.3 Data extraction table for Diagnostic studies (including hand-held Doppler) 46 -- 9.2.4 Overview of included diagnostic studies for hand-held Doppler 57 -- 9.2.5 Clinical Consequences of the findings: hand-held Doppler versus Colour duplex -- ultrasound 60 -- 9.3 QUALITY APPRAISAL FOR INCLUDED SYSTEMATIC REVIEWS 62 -- 9.4 DATA EXTRACTION TABLE FOR INCLUDED SYSTEMATIC REVIEWS 66 -- 9.4.1 Reviews evaluating multiple treatments 66 -- 9.4.2 Reviews evaluating EVLT 69 -- 9.4.3 EVLT RCTs from the review of Rees et al., 2009 29 70 -- 9.4.4 Reviews evaluating RFA 71 -- 9.4.5 RFA RCTs from Rees et al., 2009 29 72 -- 9.4.6 Reviews evaluating sclerotherapy 73 -- 9.4.7 Sclerotherapy RCTs from Rees et al., 2009 29 75 -- 9.4.8 Reviews focused on surgery evaluation, 77 -- 9.4.9 Reviews evaluating hosiery 77 -- 9.4.10 Reviews evaluating drugs 77 -- 9.5 QUALITY APPRAISAL FOR INCLUDED PRIMARY STUDIES 78 -- 9.5.1 Quality appraisal tool 78 -- 9.5.2 Quality appraisal of treatment RCTs: results 79 -- 9.6 DATA EXTRACTION TABLES OF INCLUDED RCTS 88 -- 9.6.1 Included RCTs evaluating EVLT 88 -- 9.6.2 Included RCTs evaluating RFA 91 -- 9.6.3 Included RCTs evaluating sclerotherapy 95 -- 9.6.4 Included RCT evaluating compression hosiery 98 -- 9.6.5 Included RCT evaluating drugs 99 -- 9.7 STUDIES EVALUATING THE SAFETY OF VARICOSE VEIN TREATMENTS 100 -- 10 REFERENCES 104 Link for e-copy: https://doi.org/10.57598/R164A Format of e-copy: PDF [Open Access] (906 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2768 Copies(0)
Status No copy Diagnosis and treatment of varicose veins in the legs / Felicity Allen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2011)
Diagnosis and treatment of varicose veins in the legs [printed text] / Felicity Allen, Author ; Michel Kroes, Author ; Stephen Mitchell, Author ; Françoise Mambourg , Author ; Dominique Paulus , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2011 . - IX, 111 p. : ill. ; A4. - (KCE Reports. Good Clinical Practice (GCP); 164C) .
ISSN : D/2011/10.273/52 : € 0,00
Languages : English (eng)
Descriptors: Indexation
2010-01 ; Diagnosis ; R164 ; Therapeutics ; Varicose Veins
Classification
WG 620 Varicose veinsContents note: 1 INTRODUCTION 5 -- 1.1 BACKGROUND OF THE STUDY 5 -- 1.1.1 Necessary update of billing codes 5 -- 1.1.2 Use of obsolete diagnostic techniques 5 -- 1.2 CLINICAL BACKGROUND: VARICOSE VEINS 6 -- 1.2.1 Definition 6 -- 1.2.2 Prevalence 6 -- 1.2.3 Aetiology and risk factors 6 -- 1.2.4 Disease severity: CEAP Classification 6 -- 1.3 RESEARCH QUESTIONS 7 -- 1.3.1 First research question: diagnostic procedures 7 -- 1.3.2 Second research question: effectiveness and safety of treatments 8 -- 1.3.3 Third research question: type of anaesthetic for each intervention 8 -- 1.4 DIAGNOSIS OF VARICOSE VEINS 8 -- 1.5 TREATMENT OPTIONS FOR VARICOSE VEINS 9 -- 1.5.1 Traditional surgical procedures 9 -- 1.5.2 Endovenous Laser Therapy 10 -- 1.5.3 Radiofrequency Ablation 10 -- 1.5.4 Sclerotherapy 10 -- 1.5.5 Mixed treatments 10 -- 2 METHODS 11 -- 2.1 SEARCH STRATEGIES 11 -- 2.1.1 Diagnostic techniques for varicose veins 11 -- 2.1.2 Treatment of varicose veins 11 -- 2.2 ASSESSING METHODOLOGICAL QUALITY AND RISK OF BIAS 12 -- 2.2.1 Diagnostic studies 12 -- 2.2.2 Systematic reviews 12 -- 2.2.3 Randomised controlled trials 12 -- 2.3 DATA EXTRACTION 12 -- 2.3.1 Diagnostic studies 12 -- 2.3.2 Systematic reviews 13 -- 2.3.3 Randomised controlled trials 13 -- 3 RESULTS: DIAGNOSTIC PROCEDURES FOR VARICOSE VEINS 14 -- 3.1 IDENTIFIED STUDIES AND QUALITY APPRAISAL 14 -- 3.1.1 Selection of two diagnostic studies 14 -- 3.1.2 Quality appraisal of diagnostic studies 16 -- 3.2 OVERVIEW OF INCLUDED DIAGNOSTIC STUDIES 16 -- 3.3 PRE-OPERATIVE DUPLEX ULTRASOUND COMPARED WITH NO SCAN 16 -- 3.4 COMPUTED TOMOGRAPHY VERSUS DUPLEX 17 -- 4 RESULTS: INTERVENTIONS FOR THE TREATMENT OF VARICOSE VEINS .. 18 -- 4.1 IDENTIFIED STUDIES AND QUALITY APPRAISAL 18 -- 4.1.1 Systematic reviews 18 -- 4.1.2 Randomised controlled trials 20 -- 4.2 OVERVIEW OF INCLUDED SYSTEMATIC REVIEWS 22 -- 4.2.1 Systematic reviews on multiple treatments 22 -- 4.2.2 Endovenous laser therapy 23 -- 4.2.3 Radiofrequency ablation 23 -- 4.2.4 Sclerotherapy 23 -- 4.2.5 Surgery 23 -- 4.2.6 Compression hosiery 23 -- 4.3 OVERVIEW OF INCLUDED RCTS 23 -- 5 RESULTS BY INTERVENTION 25 -- 5.1 ENDOVENOUS LASER THERAPY 25 -- 5.1.1 Results from systematic reviews 25 -- 5.1.2 Results from randomised controlled trials 25 -- 5.1.3 Summary: Endovenous Laser Therapy 27 -- 5.2 RADIOFREQUENCY ABLATION 27 -- 5.2.1 Results from systematic reviews 27 -- 5.2.2 Results from randomised controlled trials 27 -- 5.2.3 Summary: Radiofrequency ablation 29 -- 5.3 SCLEROTHERAPY 29 -- 5.3.1 Results from systematic reviews 29 -- 5.3.2 Results from randomised controlled trials 29 -- 5.3.3 Summary: Sclerotherapy 30 -- 5.4 SURGERY 31 -- 5.5 COMPRESSION HOSIERY 31 -- 5.6 DRUGS 32 -- 5.6.1 One Cochrane review on the effect of phlebotonics for chronic venous insufficiency .. 32 -- 5.6.2 Lack of evidence in one RCT 32 -- 5.7 OTHER CONSERVATIVE TREATMENTS 32 -- 6 SAFETY CONSIDERATIONS 33 -- 6.1 ENDOVENOUS LASER THERAPY 33 -- 6.2 RADIOFREQUENCY ABLATION 33 -- 6.3 SCLEROTHERAPY 34 -- 6.4 SURGERY 34 -- 6.5 SUMMARY: SAFETY 35 -- 7 ANAESTHESIA 36 -- 7.1 DESCRIPTION OF ANAESTHESIA IN THE INCLUDED RCTS 36 -- 7.2 ANAESTHESIA SUMMARY 36 -- 8 SUMMARY OF FINDINGS AND DISCUSSION 38 -- 8.1 SUMMARY OF FINDINGS 38 -- 8.1.1 Diagnostic: duplex ultrasound is the standard procedure 38 -- 8.1.2 Treatment options: comparable efficacy and complications 38 -- 8.1.3 Heterogenous anaesthetic procedures 38 -- 8.1.4 Coherence of the results with other recent publications 39 -- 8.2 TRANSFERABILITY OF RESULTS TO THE BELGIAN HEALTH CARE SETTING ? 39 -- 8.3 STRENGTHS AND LIMITATIONS OF THIS SYSTEMATIC REVIEW 39 -- 8.3.1 Strengths of this review 39 -- 8.3.2 Methodological limitations of the included studies 39 -- 8.4 SUGGESTIONS FOR FURTHER RESEARCH 40 -- 8.5 KEY POINTS OF THE REPORT 41 -- 9 APPENDICES 42 -- 9.1 ADDITIONAL HANDSEARCHING 42 -- 9.2 DIAGNOSTIC STUDIES: QUALITY APPRAISAL AND DETAILED RESULTS ABOUT THE -- USE OF HAND-HELD DOPPLER 44 -- 9.2.1 Quality items derived from QUADAS tool 44 -- 9.2.2 Quality appraisal of varicose vein diagnostic studies 45 -- 9.2.3 Data extraction table for Diagnostic studies (including hand-held Doppler) 46 -- 9.2.4 Overview of included diagnostic studies for hand-held Doppler 57 -- 9.2.5 Clinical Consequences of the findings: hand-held Doppler versus Colour duplex -- ultrasound 60 -- 9.3 QUALITY APPRAISAL FOR INCLUDED SYSTEMATIC REVIEWS 62 -- 9.4 DATA EXTRACTION TABLE FOR INCLUDED SYSTEMATIC REVIEWS 66 -- 9.4.1 Reviews evaluating multiple treatments 66 -- 9.4.2 Reviews evaluating EVLT 69 -- 9.4.3 EVLT RCTs from the review of Rees et al., 2009 29 70 -- 9.4.4 Reviews evaluating RFA 71 -- 9.4.5 RFA RCTs from Rees et al., 2009 29 72 -- 9.4.6 Reviews evaluating sclerotherapy 73 -- 9.4.7 Sclerotherapy RCTs from Rees et al., 2009 29 75 -- 9.4.8 Reviews focused on surgery evaluation, 77 -- 9.4.9 Reviews evaluating hosiery 77 -- 9.4.10 Reviews evaluating drugs 77 -- 9.5 QUALITY APPRAISAL FOR INCLUDED PRIMARY STUDIES 78 -- 9.5.1 Quality appraisal tool 78 -- 9.5.2 Quality appraisal of treatment RCTs: results 79 -- 9.6 DATA EXTRACTION TABLES OF INCLUDED RCTS 88 -- 9.6.1 Included RCTs evaluating EVLT 88 -- 9.6.2 Included RCTs evaluating RFA 91 -- 9.6.3 Included RCTs evaluating sclerotherapy 95 -- 9.6.4 Included RCT evaluating compression hosiery 98 -- 9.6.5 Included RCT evaluating drugs 99 -- 9.7 STUDIES EVALUATING THE SAFETY OF VARICOSE VEIN TREATMENTS 100 -- 10 REFERENCES 104 -- Link for e-copy: https://doi.org/10.57598/R164C Format of e-copy: PDF [Open Access] (9010 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2767 Copies(0)
Status No copy Diagnostic et traitement des varices des membres inférieurs / Felicity Allen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2011)
Diagnostic et traitement des varices des membres inférieurs [printed text] / Felicity Allen, Author ; Michel Kroes, Author ; Stephen Mitchell, Author ; Françoise Mambourg , Author ; Dominique Paulus , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2011 . - IX, 111 p. : ill. ; A4. - (KCE Reports B. Good Clinical Practice (GCP); 164B) .
ISSN : D/2011/10.273/51 : € 0,00
Languages : English (eng) French (fre)
Descriptors: Indexation
2010-01 ; Diagnosis ; R164 ; Therapeutics ; Varicose Veins
Classification
WG 620 Varicose veinsAbstract: L’opération classique des varices au niveau des jambes est appelée « stripping » mais aujourd’hui, de nouveaux traitements moins invasifs sont également proposés. Un cathéter introduit dans la veine détruit celle-ci par une température très élevée (laser, radiofréquence) ou par l’injection d’un produit chimique (sclérothérapie) sous forme de liquide ou de mousse.
Le Centre fédéral d’expertise des soins de santé (KCE) a examiné l’efficacité et la sécurité de ces techniques. Elles ne semblent pas moins efficaces que l’opération classique tout en offrant une meilleure qualité de vie au patient. Pour les effets secondaires, peu d’études scientifiques existent actuellement, surtout lors d’injection de mousse dans la veine. Des incertitudes subsistent également quant aux effets à long terme. Le KCE recommande dès lors le remboursement de ces interventions tout en procédant à un enregistrement des patients afin d’analyser les suites de ces nouveaux traitements. Enfin, peu de données existent quant à l’effet des bas élastiques. Les médicaments ne sont quant à eux pas recommandés pour le traitement des varices.Contents note: Table of contents -- ABBREVIATIONS 4 -- 1 INTRODUCTION 5 -- 1.1 BACKGROUND OF THE STUDY 5 -- 1.1.1 Necessary update of billing codes 5 -- 1.1.2 Use of obsolete diagnostic techniques 5 -- 1.2 CLINICAL BACKGROUND: VARICOSE VEINS 6 -- 1.2.1 Definition 6 -- 1.2.2 Prevalence 6 -- 1.2.3 Aetiology and risk factors 6 -- 1.2.4 Disease severity: CEAP Classification 6 -- 1.3 RESEARCH QUESTIONS 7 -- 1.3.1 First research question: diagnostic procedures 7 -- 1.3.2 Second research question: effectiveness and safety of treatments 8 -- 1.3.3 Third research question: type of anaesthetic for each intervention 8 -- 1.4 DIAGNOSIS OF VARICOSE VEINS 8 -- 1.5 TREATMENT OPTIONS FOR VARICOSE VEINS 9 -- 1.5.1 Traditional surgical procedures 9 -- 1.5.2 Endovenous Laser Therapy 10 -- 1.5.3 Radiofrequency Ablation 10 -- 1.5.4 Sclerotherapy 10 -- 1.5.5 Mixed treatments 10 -- 2 METHODS 11 -- 2.1 SEARCH STRATEGIES 11 -- 2.1.1 Diagnostic techniques for varicose veins 11 -- 2.1.2 Treatment of varicose veins 11 -- 2.2 ASSESSING METHODOLOGICAL QUALITY AND RISK OF BIAS 12 -- 2.2.1 Diagnostic studies 12 -- 2.2.2 Systematic reviews 12 -- 2.2.3 Randomised controlled trials 12 -- 2.3 DATA EXTRACTION 12 -- 2.3.1 Diagnostic studies 12 -- 2.3.2 Systematic reviews 13 -- 2.3.3 Randomised controlled trials 13 -- 3 RESULTS: DIAGNOSTIC PROCEDURES FOR VARICOSE VEINS 14 -- 3.1 IDENTIFIED STUDIES AND QUALITY APPRAISAL 14 -- 3.1.1 Selection of two diagnostic studies 14 -- 3.1.2 Quality appraisal of diagnostic studies 16 -- 3.2 OVERVIEW OF INCLUDED DIAGNOSTIC STUDIES 16 -- 3.3 PRE-OPERATIVE DUPLEX ULTRASOUND COMPARED WITH NO SCAN 16 -- 3.4 COMPUTED TOMOGRAPHY VERSUS DUPLEX 17 -- 4 RESULTS: INTERVENTIONS FOR THE TREATMENT OF VARICOSE VEINS .. 18 -- 4.1 IDENTIFIED STUDIES AND QUALITY APPRAISAL 18 -- 4.1.1 Systematic reviews 18 -- 4.1.2 Randomised controlled trials 20 -- 4.2 OVERVIEW OF INCLUDED SYSTEMATIC REVIEWS 22 -- 4.2.1 Systematic reviews on multiple treatments 22 -- 4.2.2 Endovenous laser therapy 23 -- 4.2.3 Radiofrequency ablation 23 -- 4.2.4 Sclerotherapy 23 -- 4.2.5 Surgery 23 -- 4.2.6 Compression hosiery 23 -- 4.2.7 Drugs 23 -- 4.3 OVERVIEW OF INCLUDED RCTS 23 -- 5 RESULTS BY INTERVENTION 25 -- 5.1 ENDOVENOUS LASER THERAPY 25 -- 5.1.1 Results from systematic reviews 25 -- 5.1.2 Results from randomised controlled trials 25 -- 5.1.3 Summary: Endovenous Laser Therapy 27 -- 5.2 RADIOFREQUENCY ABLATION 27 -- 5.2.1 Results from systematic reviews 27 -- 5.2.2 Results from randomised controlled trials 27 -- 5.2.3 Summary: Radiofrequency ablation 29 -- 5.3 SCLEROTHERAPY 29 -- 5.3.1 Results from systematic reviews 29 -- 5.3.2 Results from randomised controlled trials 29 -- 5.3.3 Summary: Sclerotherapy 30 -- 5.4 SURGERY 31 -- 5.5 COMPRESSION HOSIERY 31 -- 5.6 DRUGS 32 -- 5.6.1 One Cochrane review on the effect of phlebotonics for chronic venous insufficiency .. 32 -- 5.6.2 Lack of evidence in one RCT 32 -- 5.7 OTHER CONSERVATIVE TREATMENTS 32 -- 6 SAFETY CONSIDERATIONS 33 -- 6.1 ENDOVENOUS LASER THERAPY 33 -- 6.2 RADIOFREQUENCY ABLATION 33 -- 6.3 SCLEROTHERAPY 34 -- 6.4 SURGERY 34 -- 6.5 SUMMARY: SAFETY 35 -- 7 ANAESTHESIA 36 -- 7.1 DESCRIPTION OF ANAESTHESIA IN THE INCLUDED RCTS 36 -- 7.2 ANAESTHESIA SUMMARY 36 -- 8 SUMMARY OF FINDINGS AND DISCUSSION 38 -- 8.1 SUMMARY OF FINDINGS 38 -- 8.1.1 Diagnostic: duplex ultrasound is the standard procedure 38 -- 8.1.2 Treatment options: comparable efficacy and complications 38 -- 8.1.3 Heterogenous anaesthetic procedures 38 -- 8.1.4 Coherence of the results with other recent publications 39 -- 8.2 TRANSFERABILITY OF RESULTS TO THE BELGIAN HEALTH CARE SETTING ? 39 -- 8.3 STRENGTHS AND LIMITATIONS OF THIS SYSTEMATIC REVIEW 39 -- 8.3.1 Strengths of this review 39 -- 8.3.2 Methodological limitations of the included studies 39 -- 8.4 SUGGESTIONS FOR FURTHER RESEARCH 40 -- 8.5 KEY POINTS OF THE REPORT 41 -- 9 APPENDICES 42 -- 9.1 ADDITIONAL HANDSEARCHING 42 -- 9.2 DIAGNOSTIC STUDIES: QUALITY APPRAISAL AND DETAILED RESULTS ABOUT THE -- USE OF HAND-HELD DOPPLER 44 -- 9.2.1 Quality items derived from QUADAS tool 44 -- 9.2.2 Quality appraisal of varicose vein diagnostic studies 45 -- 9.2.3 Data extraction table for Diagnostic studies (including hand-held Doppler) 46 -- 9.2.4 Overview of included diagnostic studies for hand-held Doppler 57 -- 9.2.5 Clinical Consequences of the findings: hand-held Doppler versus Colour duplex -- ultrasound 60 -- 9.3 QUALITY APPRAISAL FOR INCLUDED SYSTEMATIC REVIEWS 62 -- 9.4 DATA EXTRACTION TABLE FOR INCLUDED SYSTEMATIC REVIEWS 66 -- 9.4.1 Reviews evaluating multiple treatments 66 -- 9.4.2 Reviews evaluating EVLT 69 -- 9.4.3 EVLT RCTs from the review of Rees et al., 2009 29 70 -- 9.4.4 Reviews evaluating RFA 71 -- 9.4.5 RFA RCTs from Rees et al., 2009 29 72 -- 9.4.6 Reviews evaluating sclerotherapy 73 -- 9.4.7 Sclerotherapy RCTs from Rees et al., 2009 29 75 -- 9.4.8 Reviews focused on surgery evaluation, 77 -- 9.4.9 Reviews evaluating hosiery 77 -- 9.4.10 Reviews evaluating drugs 77 -- 9.5 QUALITY APPRAISAL FOR INCLUDED PRIMARY STUDIES 78 -- 9.5.1 Quality appraisal tool 78 -- 9.5.2 Quality appraisal of treatment RCTs: results 79 -- 9.6 DATA EXTRACTION TABLES OF INCLUDED RCTS 88 -- 9.6.1 Included RCTs evaluating EVLT 88 -- 9.6.2 Included RCTs evaluating RFA 91 -- 9.6.3 Included RCTs evaluating sclerotherapy 95 -- 9.6.4 Included RCT evaluating compression hosiery 98 -- 9.6.5 Included RCT evaluating drugs 99 -- 9.7 STUDIES EVALUATING THE SAFETY OF VARICOSE VEIN TREATMENTS 100 -- 10 REFERENCES 104 Link for e-copy: https://doi.org/10.57598/R164B Format of e-copy: PDF [Open Access] (900 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2769 Copies(0)
Status No copy Systematic review of healthcare use and needs of prisoners / Michal Witkowski / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2017)
Systematic review of healthcare use and needs of prisoners : Health care in Belgian prisons - Chapter 3 [printed text] / Michal Witkowski, Author ; Pollyanna Hudson, Author ; Sarah Batson, Author ; Brigitte Moore, Author ; Stephen Mitchell, Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2017 . - 118 p. : ill., ; A4. - (KCE Reports. Health Services Research (HSR); 293C3) .
Health care in Belgian prisons / Patriek Mistiaen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2017)
ISSN : D/2017/10.273/68 : € 0,00
Languages : English (eng)
Descriptors: Indexation
2015-50 ; Criminals ; Health Services Research ; Healthcare Financing ; Insurance, Health ; Legislation as topic ; Prisoners ; Prisons ; R293
Classification
WA 300 Health issues of special population groupsContents note: SCIENTIFIC REPORT .8 -- 1 INTRODUCTION 8 -- 1.1 BACKGROUND INFORMATION 8 -- 1.2 OBJECTIVE 8 -- 2 METHODS .9 -- 2.1 PROTOCOL REGISTRATION 9 -- 2.2 ELIGIBILITY CRITERIA 9 -- 2.3 INFORMATION SOURCES 10 -- 2.3.1 Electronic database search .10 -- 2.3.2 Search strategies .10 -- 2.3.3 Supplementary data sources .10 -- 3 STUDY SELECTION .11 -- 3.1 BELGIUM-SPECIFIC SEARCH 11 -- 3.2 SYSTEMATIC REVIEW SEARCH .11 -- 4 RESULTS 13 -- 4.1 BACKGROUND 13 -- 4.2 GENERAL HEALTH AND HEALTHCARE-SEEKING BEHAVIOUR 15 -- 4.2.1 Belgian studies 15 -- 4.2.2 Systematic reviews .18 -- 4.3 TUBERCULOSIS .18 -- 4.3.1 Belgian studies 18 -- 4.3.2 Systematic reviews .19 -- 4.4 HIV, VIRAL HEPATITIS, AND BACTERIAL STI .19 -- 4.4.1 Belgian studies 19 -- 4.4.2 Systematic reviews .21 -- 4.5 MENTAL HEALTH 21 -- 4.5.1 Belgian studies 21 -- 4.5.2 Systematic reviews .26 -- 4.6 DRUGS AND DRUG ADDICTION IN PRISON 30 -- 4.6.1 Belgian studies 30 -- 4.6.2 Systematic reviews .32 -- 4.7 AGEING IN PRISON .34 -- 4.7.1 Belgian studies 34 -- 4.7.2 Systematic reviews .35 -- 4.8 EUTHANASIA (BELGIAN PUBLICATIONS) .35 -- 4.9 MEDICATION USE IN PRISON (BELGIAN PUBLICATIONS) 35 -- 4.10 ISSUES SPECIFIC TO FEMALE PRISONERS 36 -- 4.10.1 Belgian studies 36 -- 4.10.2 Systematic reviews .36 -- 5 LIMITATIONS 38 -- 6 DISCUSSION 38 -- APPENDICES 41 -- APPENDIX 1. SEARCH STRATEGIES 41 -- APPENDIX 2. CHARACTERISTIC OF INCLUDED STUDIES 49 -- APPENDIX 3. EXCLUDED STUDIES 86 -- REFERENCES . 108 Link for e-copy: https://doi.org/10.57598/R293C3 Format of e-copy: PDF (1,11 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=4223