What are the benefits and risks of different ways of accessing the hip joint during partial hip replacement surgery? Key messages The evidence is still developing, and future studies may change our conclusions. We are not confident that one surgical approach (way of accessing the hip joint) compared to another leads to a different outcome for performing daily tasks, health-related quality of life, mobility or functional status, mortality, or pain, within the first four months after surgery. What is hip hemiarthroplasty? Hip hemiarthroplasty, or partial hip replacement, is surgery that...

Do programs with multiple behavioral components improve the regular usage of eye pressure-lowering medications in people with glaucoma? Key messages Multifaceted behavioral programs that are intended to improve regular usage of eye pressure-lowering eye drops in people with high eye pressure or diagnosed with glaucoma can include a combination of reminders, multimedia education, in-person education, dosing aids, mindfulness-based stress reduction, monetary incentives, simplification of drop regimen, and doctor education. How well these programs work is unclear; some data show favorable...

Does using multiple tests in combination ('parallel testing') result in better accuracy for detecting TB in the lungs (pulmonary tuberculosis) in children than using a single test? Key messages - Using both respiratory samples and stool for low-complexity automated testing (LC-aNAATs) increased the number of pulmonary tuberculosis cases detected in children (with and without HIV). - Adding the lateral flow urine lipoarabinomannan test (LF-LAM) identified additional pulmonary tuberculosis cases in children with HIV. - Parallel testing may lead to more misdiagnoses of children who do...

Do dietary and activity strategies help prevent obesity in children aged 2 to 4 years? Key messages Combining strategies for changing diet and physical activity levels in children aged 2 to 4 years to help prevent overweight and obesity may reduce body mass index (BMI) slightly in the long term (after 15 months). There was very little information about whether the strategies resulted in serious adverse events (e.g. injuries), but none of the strategies appeared to result in any serious harm to the children. Future research should carry out obesity prevention strategies in community settings,...

In adults and adolescents with HIV, is using two different rapid tests together ('parallel testing') to diagnose tuberculosis (TB) disease more accurate than using only one? This review looked at adults and adolescents with HIV who have signs and symptoms of tuberculosis (TB) disease. Diagnosis can be done using respiratory samples (fluids or mucus collected by coughing or using tubes to remove fluid from the throat, lungs, or stomach) or urine. We wanted to know whether using two rapid tests together - an automated test on a respiratory sample (LC-aNAAT) and a urine strip test...

Does removing more or fewer lymph nodes improve outcomes in women who have endometrial cancer? Key messages Not removing pelvic lymph nodes (which are part of the immune system and in the lower tummy) probably does affect survival compared with removing all pelvic lymph nodes in women without obvious disease spread and may reduce the risk of disease coming back. Not removing pelvic lymph nodes, or removing only the first draining lymph nodes (called sentinels), probably greatly reduces the risk of developing swelling in the legs after surgery compared with removing all pelvic nodes, or...

Gonadotropin-releasing hormone (GnRH) analogues for treating premenstrual syndrome (PMS) Review question What are the benefits and risks of using medication known as gonadotropin-releasing hormone (GnRH) agonists and antagonists in the management of premenstrual syndrome (PMS)? Key messages • We found reliable evidence that GnRH agonists without add-back improve PMS symptoms compared to placebo, but also that menopausal side effects are common, and women taking GnRH agonists without add-back are more likely to stop their treatment than women taking placebo. • We are moderately confident that...

Does using hormonal contraception increase a woman's risk of gettingHIV? Does using hormonal contraception increase a woman's risk of getting HIV? Key messages DMPA (depot medroxyprogesterone acetate) injections likely result in little to no difference in the risk of getting HIV compared to the copper intrauterine device (IUD). The levonorgestrel implant (LNG) likely results in little to no difference in the risk of getting HIV compared to the copper IUD. DMPA injections likely slightly increase the risk of getting HIV compared to LNG implants. We are not certain about the effect of...

Does community care navigation (where a clinician helps guide patients through healthcare systems) reduce unplanned hospitalisations for ‘at-risk’ individuals? Key messages • People who receive community care navigation assistance are probably slightly less likely to be admitted to hospital for unplanned reasons in the first year after care navigation than those who do not receive this type of assistance. • We need more studies, with better reporting, to identify the types of people, settings and ways of delivering community care navigation that are likely to deliver the most benefit and to...

Are there differences in benefits and harms among regional pain management techniques in women undergoing breast cancer surgery? Key messages Overall, we found that different pain blocks were similar for managing pain after breast cancer surgery. Complication rates were low among all pain block techniques. What is regional analgesia, and how does it work? Regional analgesia is a pain block technique used in breast cancer surgery. It involves injecting pain-numbing medicine near specific nerves in the breast area to block pain signals during and after surgery. Unlike opioids, which affect the...

Immunomodulators and immunosuppressants for myasthenia gravis: a network meta‐analysis This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary To assess the comparative benefits and harms of immunomodulators and immunosuppressants for people with generalised myasthenia gravis through a network meta-analysis. Secondary To estimate the relative ranking of immunomodulators and immunosuppressants according to their effects. This is a protocol....

Is the use of telemedicine services for medical abortion better than in-clinic care? What is medical abortion care? A medical abortion is an abortion where a person ends a pregnancy using a combination of two types of medication, mifepristone and misoprostol, or by using misoprostol alone. Medical abortion care comprises three different phases: pre-abortion, abortion, and post-abortion. These phases include different care components. The pre-abortion phase includes pre-abortion information, counselling, if desired, and eligibility assessment. The abortion phase includes instructions for,...

Which combinations of ways to diagnose and treat excessive bleeding after childbirth (postpartum haemorrhage) are most effective? Key messages We found the combination of using a diagnosis with 1) birth-attendant clinical concern, or 2) 300 mL to 500 mL of drape-measured blood loss (blood is collected in a plastic drape with markings indicating the volume) with observations (e.g. heart rate, blood pressure, the tone of the womb, and flow of blood), or 3) 500 mL or more of drape-measured blood loss to diagnose postpartum haemorrhage (PPH), plus a treatment bundle, was more effective than...

Exercise interventions for the treatment of lower limb lymphoedema after treatment for gynaecological cancers This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of load exercise therapy with complex decongestive therapy compared with complex decongestive therapy alone for lower limb lymphoedema after gynaecological cancer treatment. This is a protocol....

Community-based interventions for the prevention or management of dental caries in children This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To undertake network meta-analysis (NMA) and component network meta-analysis (CNMA) to explore the comparative effectiveness of different community-based interventions, and the components within the interventions used singly or in combination, for the prevention or management of dental caries in children. This is a protocol....

What is the best treatment for complex abdominal aortic aneurysms? Key messages • There are currently no studies with information available to guide patients' and doctors' choices regarding treatments for complex abdominal aortic aneurysms (AAAs). • It is difficult to conduct research in this area because relatively few people have this condition and the types of aneurysm they have vary. • Future research should explore how organisations that fund and oversee healthcare services could require or promote the inclusion of people with AAAs in studies testing different treatments. What is an...

What are the most accurate tests for diagnosing low vitamin A? Key messages • The two most common tests (serum or plasma retinol and retinol-binding protein) cannot reliably identify at-risk individuals with or without vitamin A deficiency in the community or clinics. • This may mean that using these tests could lead to over- or underestimated levels of low vitamin A at the population level and incorrect diagnosis of individuals. • Estimates of test accuracy should improve as more studies become available. Why is it important to improve screening for vitamin A? Vitamin A, also called...

Do epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) after lung cancer surgery help people live longer and prevent cancer from returning? Key messages • Taking EGFR TKIs after lung cancer surgery may help people stay cancer-free for longer than chemotherapy or no further treatment. • EGFR TKIs probably help people live longer compared to no treatment, but may make little to no difference in survival compared to chemotherapy. • EGFR TKIs have fewer serious side effects than chemotherapy, but they may cause more mild-to-moderate side effects. • More research is needed...

Does yoga relieve cancer-related fatigue in people with cancer? Key messages - Compared to no yoga, yoga after anticancer therapy probably reduces cancer-related fatigue slightly in the short term (up to 12 weeks after doing yoga). - We do not know if yoga during anticancer therapy relieves short-, medium-, or long-term cancer-related fatigue compared to no yoga. - More research is needed to understand (1) if the effects of starting yoga after anticancer therapy persist beyond 12 weeks, and (2) what are the effects of doing yoga before starting and during cancer treatment. What is...

Is post-incident debriefing after coercive measures for people with schizophrenia effective? Key messages • Due to a lack of evidence, the benefits of post-incident debriefing after coercive measures (seclusion: locking someone in a separate room, or restraint: preventing them from moving) for people with schizophrenia or schizophrenia-type psychosis are unclear. • Future research is needed into the effects of post-incident debriefing after coercive measures to find out whether it has benefits for people with schizophrenia and whether it has unwanted effects and costs. What is schizophrenia,...