Reducing fall hazards within the environment Key messages For older adults at a higher risk of having a fall, such as having had a fall in the past year and recently hospitalised or needing support with daily activities, removing environmental fall hazards in the home can reduce the number of falls by 38%. Examples of environmental fall hazards are a stairway without railings, a slippery pathway, or poor lighting. Why is it important to consider environmental hazards as part of a fall prevention programme? Falls are common and can be deadly, but they are preventable. Approximately one-third...

Coordination of care to improve outcomes of emergency medical services This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness of interventions aiming to improve coordination of emergency medical services on patient outcomes of emergency care systems. This is a protocol....

What are the benefits and risks of different medications used to treat persistent postural-perceptual dizziness (PPPD)? Key messages We did not identify any studies that assessed the use of medication to treat persistent postural-perceptual dizziness (PPPD). Further work is needed in this area to help establish whether there are any treatments that may be effective at treating this condition, and to check if they cause any unwanted or harmful effects. What is PPPD? PPPD stands for persistent postural-perceptual dizziness. People with this condition have symptoms of dizziness or unsteadiness,...

Mobile health (m-health) technological support for women during pregnancy or the first six weeks postpartum, or both This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess maternal and newborn clinical and psychological outcomes where mobile health (m-health) technological support was given during pregnancy or the first six weeks post birth, or both, compared with different methods of m-health or no health support (usual care). This is a protocol....

Combined pharmacological and psychosocial interventions for alcohol use disorder This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and safety of combined pharmacological and psychosocial interventions for the treatment of alcohol use disorder. This is a protocol....

Dose-escalated radiotherapy for curative treatment in men with clinically localized prostate cancer Review question How does a higher radiation dose compare to a lower dose when treating prostate cancer that is limited to the prostate gland? Background Treatment for prostate cancer includes surgery, radiation therapy, hormone therapy, and chemotherapy. Radiation therapy (RT) is a treatment that uses beams of intense energy to kill cancer cells. So-called dose-escalated RT has an increased radiation dose compared to usual or 'normal' (conventional) dose RT, in order to better kill cancer, but...

Lens extraction compared with laser peripheral iridotomy to treat acute primary angle closure What is acute primary angle closure? Acute primary angle closure is a rare condition caused by changes to structures at the front of the eye. The drainage angle becomes very narrow, which blocks fluid drainage and causes raised eye pressure (intraocular pressure). People with acute primary angle closure may experience severe eye pain, blurred vision, redness, and clouding of the cornea (the clear front window of the eye) very suddenly. If left untreated, the condition can lead to blindness due to...

Parathyroidectomy for adults with primary hyperparathyroidism What is primary hyperparathyroidism? Primary hyperparathyroidism (PHPT) is a disorder in which the parathyroid glands (four glands located near or on the thyroid in the neck) become enlarged and produce too much parathyroid hormone. The disease affects 1% of adults. Overproduction of parathyroid hormone disrupts calcium levels in the body, which can lead to various other health issues, such as osteoporosis (a health condition that weakens bones) and bone fractures, chronic kidney disease, cardiovascular disease, and cognitive...

Spinal cord stimulation for low back pain Background Low back pain is a leading cause of disability around the world. Spinal cord stimulation, a surgical treatment involving implantation of a device that applies electric impulses to the spinal cord, has been suggested to improve pain in people with long-term low back pain. This study aimed to review evidence regarding the benefits and harms of this procedure for people with low back pain. Study characteristics We searched online databases and registries for relevant studies on 10 June 2022. We found 13 trials with 699 participants. Of these,...

Do treatment effects in randomised trials differ when using active placebo compared to standard placebo? Key messages 1. We found no clear difference in effect between active and standard placebos, but we are very uncertain about the results. 2. We suggest that researchers carefully consider the type of placebo when investigating medicines with clear side effects. What are standard placebos and active placebos? Blinding (or masking) is an important part of randomised trials and ensures that participants and healthcare providers are not influenced by knowing whether the participant is...

Are opioids the best choice for managing pain in babies after surgery? Key messages • We did not find enough good-quality evidence about the benefits and risks of opioids (a group of pain-relieving medicines) to manage pain after surgery in babies. We found only four studies and they had not enrolled enough babies to give reliable results. • Larger, well-designed studies are needed to give better estimates of the benefits and potential harms of opioids, other medicines and non-medicine-based treatments. Why are opioids given to manage pain after surgery in babies? Babies (particularly in the...

Wolbachia-carrying Aedes mosquitoes for preventing dengue infection This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy of wMel-, wMelPop-, and wAlbB-carrying Aedes species deployments for preventing dengue virus infection. This is a protocol....

Trunk training for improving activities in people with stroke Background Stroke is a common condition that can lead to major disabilities and even death in adults. Stroke has an important impact on various aspects of human functioning, including limiting movement. One frequently observed deficit after stroke is the reduced functioning of the torso of the body. This impairment can, amongst other things, be characterised by reduced mobility, reduced sitting balance, late or reduced reactions to internal and external disturbances, reduced muscle strength and muscle activation patterns of the...

Intermittent phototherapy versus continuous phototherapy for neonatal jaundice Review question In jaundiced newborn infants, is intermittent phototherapy compared with continuous phototherapy effective in reducing bilirubin levels. Background Neonatal jaundice is a yellowish discolouration of the of the newborn infant's skin due to high bilirubin (a yellow compound that occurs naturally in the blood) levels. Phototherapy (light therapy) is widely accepted as an effective treatment for jaundiced newborn infants. Phototherapy is usually used continuously but intermittent phototherapy has some...

What are the benefits and risks of corticosteroids given directly to the ear in Ménière's disease? Key messages Due to a lack of robust evidence, it is not clear whether corticosteroids given into the ear (intratympanic corticosteroids) work to improve symptoms for people with Ménière's disease. It is also not clear whether there are any risks associated with treatment. Larger, well-conducted studies are needed in order to identify whether this treatment may be effective, and to assess whether there are any harmful effects. Further work also needs to be done to find out how best to...

Entecavir for children and adults with chronic hepatitis B This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of entecavir versus no treatment or placebo for chronic hepatitis B infection in children and adults with chronic hepatitis B infection, who are either HBeAg-positive or HBeAg-negative. This is a protocol....

Overall prognosis of acute and chronic musculoskeletal, widespread, and neuropathic pain in children and adolescents This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: We aim to describe the overall prognosis (focusing on the pain course) and the negative impact(s) of acute and chronic musculoskeletal, widespread, and neuropathic pain in children (aged six to 12 years) and adolescents (aged 13 to 18 years) by evaluating: incidence of pain recovery at three and 12 months after reporting acute or chronic pain; change in pain severity at three and 12 months...

Medicines for central sleep apnoea in adults Key messages Studies in this area are small and we were unable to conclude whether any of the medicines studied helped people with central sleep apnoea (CSA) compared with dummy treatment. What is central sleep apnoea and how is it treated? CSA is a disorder in which breathing repeatedly stops and starts during sleep because the brain does not send proper signals to the muscles that control breathing. CSA mainly affects men and people with heart disease. The condition is different from and less common than obstructive sleep apnoea, where breathing...

Plastic stents versus fully covered self-expandable metallic stents for biliary tract strictures in adults with non-cancerous bile duct lesions This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of fully covered self-expandable metallic stents for the treatment of biliary tract strictures in adults with non-cancerous bile duct lesions comparted to plastic stents. This is a protocol....

Progestin intrauterine devices versus copper intrauterine devices for emergency contraception Why is this review important? This review is important as there are few available choices for emergency contraception (EC). Copper intrauterine devices (Cu‐IUDs) are the most effective method for EC currently available, but their use and uptake is low. We examined the literature to see if the levonorgestrel IUD (LNG‐IUD) was as effective as other methods for EC. If it were found to be as effective, it would increase the range of options available to women seeking EC. How did we identify and evaluate...