The Resource Comparative effectiveness of management strategies for gastroesophageal reflux disease : update, prepared for Agency for Healthcare Research and Quality ; prepared by Tufts Medical Center Evidence-based Practice Center ; investigators, Stanley Ip [and others], (electronic resource)

Comparative effectiveness of management strategies for gastroesophageal reflux disease : update, prepared for Agency for Healthcare Research and Quality ; prepared by Tufts Medical Center Evidence-based Practice Center ; investigators, Stanley Ip [and others], (electronic resource)

Label
Comparative effectiveness of management strategies for gastroesophageal reflux disease : update
Title
Comparative effectiveness of management strategies for gastroesophageal reflux disease
Title remainder
update
Statement of responsibility
prepared for Agency for Healthcare Research and Quality ; prepared by Tufts Medical Center Evidence-based Practice Center ; investigators, Stanley Ip [and others]
Contributor
Subject
Genre
Language
eng
Summary
BACKGROUND: Gastroesophageal reflux disease (GERD) is one of the most common health conditions affecting Americans. Despite the availability of medical, surgical, and endoscopic options, optimal management strategies remain unsettled. PURPOSE: The purpose was to systematically review and update our previous Comparative Effectiveness Review, which compared the effectiveness of different management options for adults with GERD. DATA SOURCES: We searched MEDLINE,(r) Cochrane Central Register of Controlled Trials, and other relevant databases, as well as other existing systematic reviews. STUDY SELECTION: Studies of various designs were sought, including comparative randomized controlled trials, nonrandomized and cohort studies, and systematic reviews. DATA EXTRACTION: A standardized protocol was used to extract details on study design, diagnoses, interventions, outcomes, and quality. DATA SYNTHESIS: In total, 166 studies met eligibility criteria. We found a moderate strength of evidence that laparoscopic fundoplication in patients whose GERD symptoms were already well controlled by medical treatments was at least as effective as continued medical treatment (and in some cases superior) in controlling GERD-related symptoms for the first 1 to 3 years following surgery. However, the rate of serious adverse events was generally higher in patients who underwent fundoplication compared with those who had medical treatment. We did not identify sufficient evidence to conclude whether medical or surgical treatment was more effective in preventing long-term complications of GERD, such as the development of Barrett's esophagus or esophageal adenocarcinoma. We found a moderate strength of evidence that proton pump inhibitors were superior to histamine-2 receptor antagonists in resolving GERD symptoms at 4 weeks and promoting healing of esophagitis at 8 weeks. Evidence regarding the effectiveness of endoscopic procedures was insufficient. Evidence regarding the effectiveness of treatment of GERD on asthma symptoms was inconclusive. LIMITATIONS: Studies directly comparing surgery to medical therapy generally had high dropout rates in long-term followup. There was a great deal of variability in the rigor with which the outcomes were evaluated across studies, particularly in subjective endpoints. CONCLUSIONS: Medical therapy and laparoscopic fundoplication were similarly effective in improving GERD symptoms in patients whose symptoms were already well controlled by medical therapy for at least the first 1 to 3 years following surgery. Serious adverse events were more common after surgery. The effectiveness of endoscopic procedures remains substantially uncertain
Member of
Cataloging source
NLM
Funding information
Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by: Tufts Medical Center Evidence-based Practice Center
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
WI 250
http://library.link/vocab/relatedWorkOrContributorName
  • Ip, Stanley
  • United States
  • Tufts Evidence-based Practice Center
  • Effective Health Care Program (U.S.)
Series statement
  • Comparative effectiveness reviews
  • AHRQ publication
Series volume
  • no. 29
  • no. 11-EHC049-EF
http://library.link/vocab/subjectName
Gastroesophageal Reflux
http://bibfra.me/vocab/relation/supportingbody
RzTDSdffmEM
Label
Comparative effectiveness of management strategies for gastroesophageal reflux disease : update, prepared for Agency for Healthcare Research and Quality ; prepared by Tufts Medical Center Evidence-based Practice Center ; investigators, Stanley Ip [and others], (electronic resource)
Instantiates
Publication
Note
  • "Contract No. HHSA 290-2007-10055-I."
  • "September 2011."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
773978658
Extent
1 online resource
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations
Specific material designation
remote
System control number
(OCoLC)773978658
Label
Comparative effectiveness of management strategies for gastroesophageal reflux disease : update, prepared for Agency for Healthcare Research and Quality ; prepared by Tufts Medical Center Evidence-based Practice Center ; investigators, Stanley Ip [and others], (electronic resource)
Publication
Note
  • "Contract No. HHSA 290-2007-10055-I."
  • "September 2011."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
773978658
Extent
1 online resource
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations
Specific material designation
remote
System control number
(OCoLC)773978658

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