Technology
assessment reports
Reports are listed alphabetically
by title. Consult the index to identify
titles by subject. |
| TA
Num. |
Report
Name (year written or last reviewed) |
Format(s)
available: |
|
36 |
Acupuncture
for chronic osteoarthritis pain, headache and low back pain (2000) |
Update, abstract & report |
|
18 |
Acupuncture
for treatment of chemical dependency (1994) |
Committee summary |
|
43 |
Antiviral therapy
for chronic hepatitis C (2002) |
Abstract,
update & report |
|
38 |
Assisted
reproductive technologies (1998) |
Abstract & report |
|
46 |
Bilateral
prophylactic mastectomy for the prevention of breast cancer (1999) |
Abstract, brief & report |
|
53 |
Biochemical
markers for bone turnover in osteoporosis (2001) |
Abstract, brief & report |
|
59 |
Blood brain barrier
disruption chemotherapy (2001) |
Abstract,
brief & report |
|
26 |
Botulinum
toxin therapy (1996) |
Committee summary |
|
12 |
Cardiac
rehabilitation (2002) |
Abstract, update & report |
|
44 |
Case
management for chronic illness, the frail elderly, and acute
myocardial infarction (1998) |
Abstract, brief & report |
|
1 |
Cochlear
implants (1993) |
Abstract & report |
|
58 |
Computed
tomographic colonography for detection of colorectal polyps and
neoplasms (2001) |
Abstract, brief & report |
|
37 |
Computed
tomography for the diagnosis of pulmonary embolism (1998) |
Abstract & report |
|
52 |
Computed
tomography screening for lung cancer (2001) |
Abstract, brief & report |
|
55 |
Computerized
physician order entry (2001) |
Abstract, brief & report |
|
48 |
Deep
brain stimulation for essential tremor and Parkinson's disease
(2000) |
Abstract, brief & report |
|
31 |
Densitometry
as a diagnostic tool for the identification and treatment of
osteoporosis in women (2000) |
Abstract & report |
|
30 |
Dorsal
rhizotomy and intrathecal baclofen for lower extremity spasticity
associated with cerebral palsy (2000) |
Update, abstract & report |
|
35 |
Electrical
stimulation for non-union of a fracture (1997) |
Committee summary |
|
21 |
EEG
monitoring during carotid artery surgery (1999) |
Update, abstract & report |
|
34 |
Electron-beam
computed tomography for coronary artery disease (2000) |
Abstract, brief & report |
|
3 |
Excimer
laser use in ophthalmology (1993) |
Committee summary |
|
47 |
Fetal
fibronectin for the prediction of preterm labor (2000) |
Abstract, brief & report |
|
14 |
Gastric
restrictive surgery for morbid obesity (2000) |
Updates, abstract & report |
|
61 |
First
trimester prenatal testing for Down syndrome
using nuchal translucency (2002) |
Abstract, brief & report |
|
33 |
Genetic
screening for breast cancer (1997) |
Committee summary |
|
64 |
Genetic testing
for hereditary nonpolyposis colorectal cancer (HNPCC) (2002) |
Abstract
& report |
|
2 |
High-dose
chemotherapy with autologous stem cell support for the treatment
of breast cancer (2002) |
Abstract, updates & report |
|
25 |
High-dose
chemotherapy with hematopoietic stem cell transplantation for
treatment of multiple myeloma (1996) |
Committee summary |
|
5 |
High-frequency
chest compression devices for cystic fibrosis (1996) |
Update, abstract & report |
|
15 |
Home
uterine activity monitoring (HUAM) (2002) |
Abstract, updates & report |
|
57 |
Hospitalist
systems (2001) |
Abstract, brief & report |
|
56 |
HPV
DNA testing for cervical cancer (2001) |
Abstract, update & report |
|
17 |
Image directed biopsies of breast lesions (1999) |
Abstract & report |
|
11 |
Interferon
beta-1a, interferon beta-1b, glatiramer acetate, and mitoxantrone
for treatment of multiple sclerosis [formerly Interferon beta-1B
for multiple sclerosis] (2001) |
Abstract, brief & report |
|
63 |
Intracoronary
Brachytherapy to Treat Restenosis after Stent Placement (In-Stent
Restenosis) (2002) |
Abstract, brief & report |
|
62 |
Intradiscal
electrothermal therapy (IDET)
for low back pain (2002) |
Abstract, brief & report |
|
19 |
Intrathecal
baclofen infusion for controlling spasticity and spasms (1994) |
Committee summary |
|
6 |
Intravenous
immune gamma globulin (IVIG) for treatment of neurological conditions
(1998) |
Abstract & report |
|
51 |
Left
ventricular assist devices as permanent implants (2000) |
Abstract, update & report |
|
7 |
Lung transplants
(1993) |
Committee
summary |
|
23 |
Lung
volume reduction surgery for emphysema (1997) |
Abstract & report |
|
45 |
Lymphatic
mapping with sentinel lymph node biopsy (SLNB) for breast cancer
(2002) |
Abstract, update & report |
|
29 |
Magnetic
resonance angiography for venous sinus thrombosis, intracranial
atherosclerosis, intracranial aneurysms, carotid artery atherosclerosis,
and carotid or vertebral artery dissection (1996) |
Committee summary |
|
42 |
Microwave
thermotherapy for benign prostatic hypertrophy (1998) |
Abstract, brief & report |
|
41 |
Minimally
invasive direct vision coronary artery bypass grafting (MIDCABG)
(1998) |
Abstract & report |
|
13 |
Oral
devices for the treatment of sleep apnea syndrome (1994) |
Committee summary |
|
4 |
Pancreas
transplants (1993) |
Committee summary |
|
60 |
Pancreatic
islet transplantation for patients with type 1 diabetes mellitus
(2002) |
Abstract, brief & report |
|
10 |
PET
and SPECT scans for the evaluation of epileptic patients (1994) |
Committee summary |
|
54 |
PET
Scans for solitary pulmonary nodules, non-small cell lung cancer,
recurrent colorectal cancer, lymphoma, and recurrent melanoma
(2001) |
Abstract, brief & report |
|
39 |
Photodynamic
therapy for head and neck, tracheobronchial, and esophageal cancer
(1998) |
Abstract & report |
|
16 |
Prenatal
ultrasound as a screening test (2002) |
Abstract, update & report |
|
8 |
Prostate
specific antigen (PSA) as a screening test for prostate cancer
(1999) |
Update, abstract & report |
|
32 |
Pulmonary
rehabilitation for chronic obstructive pulmonary disease (1997) |
Abstract & report |
|
40 |
Screening
for the Factor V R506Q (Leiden) mutation prior to oral contraceptive
prescription (1998) |
Abstract & report |
|
9 |
Screening
tests (1993) |
Committee summary |
|
27 |
Small
bowel transplantation (1996) |
Committee summary |
|
24 |
Stereotactic
radiosurgery for brain lesions (1996) |
Committee summary |
| |
Stereotactically
directed fine-needle aspiration biopsy (FNAB) and core biopsy
of nonpalpable breast lesions (1994) |
See
Image directed biopsies of breast lesions |
|
28 |
Tissue-type
plasminogen activator for acute ischemic stroke (1996) |
Committee summary |
|
49 |
Tocolytic
Therapy for Preterm Labor (2000) |
Abstract, brief & report |
|
22 |
Transjugular
intrahepatic porto-systemic shunts (1995) |
Committee summary |
|
50 |
Transmyocardial
laser therapy for severe refractory angina (2000) |
Abstract, brief & report |
|
20 |
Tympanic
membrane thermometry (1995) |
Abstract & report |
| Committee summaries for
reports not available on ICSI's Web site |
|
Acupuncture for Treatment
of Chemical Dependency
First Issued: October,
1994
The ICSI Technology Assessment Committee finds auricular acupuncture
to be a safe adjuvant treatment modality for chemical dependency.
Acupuncture has not been proven effective for use in treating
chemical dependency.
Order
Form
|
|
Botulinum Toxin Therapy
First Issued: July, 1996
The ICSI Technology Assessment Committee finds botulinum toxin
to be safe and effective for treatment of strabismus, blepharospasm,
and hemifacial spasm when administered in appropriate doses by
physicians trained in its administration. The available evidence
also supports the effectiveness and safety of the toxin in the
treatment of cervical dystonia (spasmodic torticollis), jaw-closing
oromandibular dystonia (orofacial dyskinesia, Meige syndrome),
and adductor spasmodic dysphonia; but the Food and Drug Administration
(FDA) has not approved its use for these applications. Some evidence
also exists to support the effectiveness and safety of treatment
with the toxin for cerebral palsy; this evidence consists of
several case series reports and one randomized, controlled trial
published in abstract form. Again, its use for this indication
is not FDA-approved. Although some evidence suggests that botulinum
toxin is effective for treatment of selected patients with jaw-opening
oromandibular dystonia, focal and segmental limb dystonia, and
abductor spasmodic dysphonia, conclusions about long-term effectiveness
and safety cannot be made for these applications because the
available evidence is too limited. Available evidence includes
several class A and several class C studies.
Order
Form
|
|
Electrical Stimulation for Non-Union of a Fracture
First Issued: August,
1997
The ICSI Technology Assessment Committee finds that DC, CC, and
IC methods are safe and can be performed on an outpatient basis.
Each method has been shown to be effective although the exact
mechanism for stimulation of bone healing remains unknown and
is likely different for the three methods. The evidence, to date,
is mostly Grade C with the exception of 2 Grade A studies. Electrical
stimulation appears to be at least as effective as bone grafting
and standard fixation methods for the management of established
non-united fractures. There is no consensus on the indications.
Based on the available literature, the Committee concludes that
electrical stimulation should be limited to the indications listed
above.
Order
Form
|
|
Excimer Laser Use in Ophthalmology
First Issued: July, 1993
The Excimer laser appears to be a safe and effective treatment
for therapeutic ophthalmologic indications, such as treatment
of corneal scars and degenerations, and recurrent epithelial
erosion. While it seems to be helpful in treating refractive
errors as well, glasses and contact lenses are less risky and
superior for most refractive errors.
Order
Form
|
|
Genetic Screening For Breast Cancer
First Issued: July, 1997
The ICSI Technology Assessment Committee finds that genetic screening
for breast and ovarian cancer risk, and molecular diagnostic
testing for mutations in cancer susceptibility genes represent
technologies which are in evolution. These technologies offer
the potential to identify people who are high risk for breast
and ovarian cancer. These people, and their family members, can
be offered education, genetic counseling, programs of increased
surveillance, prophylactic surgery, and other measures to reduce
their risk of cancer. Patients who are at increased risk should
be referred to a program for risk assessment and genetic counseling
prior to the consideration for molecular diagnostic testing.
Molecular diagnostic testing should be offered only after expert
counseling, provided that the patient willingly consents to testing,
confidentiality can be maintained, laboratory standards are regulated,
and clinicians are adequately prepared to address the complex
social, ethical and legal issues associated with genetic testing.
Laboratories used for screening purposes should be participating
in clinical research trials to define the appropriate use of
screening studies.
Order
Form
|
|
High-Dose Chemotherapy with Hematopoietic Stem
Cell Transplantation for Treatment of Multiple Myeloma
First Issued: April, 1996
The ICSI Technology Assessment Committee finds that high-dose
chemotherapy with allogeneic hematopoietic stem cell transplantation
for multiple myeloma is a high-risk procedure, the efficacy of
which has yet to be proved in randomized, controlled trials.
Autologous transplantation is associated with limited toxicity
but future research is needed to establish whether it has the
ability to prolong survival. All patients considered for allogeneic
or autologous transplantation should be enrolled in randomized
local or national clinical trials.
Order
Form
|
|
Intrathecal Baclofen Infusion for Controlling Spasticity
and Spasms
First Issued: October,
1994
The ICSI Technology Assessment Committee finds intrathecal baclofen
safe and effective for selected patients with intractable spasticity
and spasms.
Order
Form
|
|
Lung Transplants
First Issued: September,
1993
The ICSI Technology Assessment Committee finds that lung transplantation,
although considered investigational, may be beneficial for carefully
selected patients with end-stage pulmonary disease.
Order
Form
|
|
Magnetic Resonance Angiography for Venous Sinus
Thrombosis, Intracranial Atherosclerosis, Intracranial Aneurysms,
Carotid Artery Atherosclerosis, and Carotid or Vertebral Artery
Dissection
First Issued: December,
1996
The ICSI Technology Assessment Committee finds that MRA is a
safe technique that continues to evolve and is gaining wider
acceptance for a variety of indications. At this point, MRA has
been proven to be efficacious for the diagnosis of venous sinus
thrombosis, for the diagnosis of carotid artery atherosclerosis
(when preceded by ultrasound), and for the diagnosis and follow-up
of carotid artery dissection. There is a need for continued research,
especially prospective, randomized clinical trials. To date,
the evidence is primarily Grade C.
Order
Form
|
|
Oral Devices for the Treatment of Sleep Apnea Syndrome
First Issued: April, 1994
The ICSI Technology Assessment Committee finds that tongue retaining
devices and mandibular repositioning devices have not been proven
effective for treatment of obstructive sleep apnea syndrome (OSAS).
The continuous positive airway pressure (CPAP) device is the
standard treatment for patients with OSAS. Some oral devices
may be an option for selected patients with mild to moderate
OSAS who have not responded to or cannot tolerate treatment with
the CPAP device.
Order
Form
|
|
Pancreas Transplants
First Issued: July, 1993
The ICSI Technology Assessment Committee finds pancreatic transplantation
to be an investigational treatment. Simultaneous pancreas-kidney
transplantation may be beneficial for carefully selected patients,
as an alternative to kidney transplantation alone. Any benefits
from insulin independence, however, must be weighed against the
side effects of immunosuppression and the risk of acute and chronic
rejection. Pancreas transplant alone is not recommended. Difficulties
in detecting rejection of the pancreas graft make pancreas transplantation
subsequent to kidney transplantation a less attractive option
than simultaneous pancreas-kidney transplant.
Order
Form
|
|
PET and SPECT Scans for the Evaluation of Epileptic
Patients
First Issued: January,
1994
The ICSI Technology Assessment Committee finds that interictal
PET and ictal or immediately post-ictal 3-headed SPECT scans
are safe and effective as supplementary tools to established
methodologies for locating epileptic foci in patients with intractable
epilepsy. While they are not effective as stand-alone diagnostic
mechanisms, they may be helpful when other non-invasive tests
cannot accurately localize the epileptiform focus or electrographic
seizure onset.
Order
Form
|
|
Screening Tests
First Issued: October,
1993
Requiring randomized trials before implementing screening procedures
may seem excessively rigorous to some. It takes time and money
to complete the trials. In the meantime people may lose their
chance for early diagnosis.
However, before exposing people
to the risks of tests and therapy, positive outcomes should be
established. The widespread implementation of untested screening
tests renders their subsequent rigorous evaluation much more
difficult and less decisive. It may become impossible to correct
the original error after a test has enjoyed wide popularity.
Research into alternative strategies is discouraged in the interim.
Clinical trials of screening
mechanisms are underway, and will resolve many of the questions
about the effectiveness of controversial tests. Established criteria,
should guide the decision making process.
Order
Form
|
|
Small Bowel Transplantation
First Issued: July, 1996
The ICSI Technology Assessment Committee finds small bowel transplant
(SBT) and combined liver-small bowel transplant to be clinically
effective for selected patients with short bowel syndrome with
and without end-stage liver disease. Clinical experience suggests
that small bowel transplant and combined liver-small bowel transplant
are clinical options that should be reserved for patients whose
intestinal failure is irreversible and when life threatening
complications of total parenteral nutrition (TPN) become unmanageable.
All evidence to date is Class C.
Order
Form
|
|
Stereotactic Radioneurosurgery for Brain Lesions
First Issued: March, 1996
The ICSI Technology Assessment Committee finds that radiosurgery
is a viable option for patients with brain lesions usually no
larger than 3-4 cm in maximum dimension who are at high risk
for or who decline conventional surgery. It is also a viable
option as an adjunct therapy. The procedure is effective and
relatively safe in comparison to open surgery although long-term
follow-up is needed.
Order
Form
|
|
Tissue-Type Plasminogen Activator for Acute Ischemic
Stroke
First Issued: August,
1996
The ICSI Technology Assessment Committee finds that intravenous
rt-PA (0.9 mg/kg to a maximum of 90 mg) is an efficacious although
potentially risky treatment for acute ischemic stroke if administered
within 3 hours of definite onset of symptoms with the strict
inclusion and exclusion criteria proposed in this report. The
treatment should only be administered in a setting of medical
care with expertise in treating acute stroke so that all criteria
proposed in the NINDS trial can be emulated.
Order
Form
|
|
Transjugular Intrahepatic Porto-Systemic Shunts
First Issued: September,
1995
The ICSI Technology Assessment Committee finds the long-term
safety and efficacy of TIPS cannot yet be made due to the lack
of randomized, controlled trials which are currently underway.
The case series published to date have indicated that TIPS appears
to be a safe and effective means of decompressing the portal
venous system and controlling acute variceal bleeding in the
short term. The only reference evidence to date is class c.
Order
Form
|
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last updated:
11/21/2002
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