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Table 5 Comparison of predicted vs. actual priority for updating a

From: Assessment of a method to detect signals for updating systematic reviews

CER

2009 prediction

End date of update search

2013 assessment

Rationale

Comparative Effectiveness of Management Strategies for Gastroesophageal Reflux Disease[25]

High

August 2010

High

Some procedures specifically mentioned in the Executive Summary have been withdrawn from the market. New procedures have been introduced. There is a major change in the conclusion about surgery vs. medical therapy.

Effectiveness of Noninvasive Diagnostic Tests for Breast Abnormalities[26]

High

September 2010

Medium

The new data did not change the overall conclusions very much. The conclusion that MRI and ultrasound may be sufficient to evaluate lesions in women at low risk may be an important new conclusion.

Comparative Effectiveness of Epoetin and Darbepoetin for Managing Anemia in Patients Undergoing Cancer Treatment[27]

High

April 2012

High

Major safety concerns leading to substantial changes in black box warnings and practice guidelines

Comparative Effectiveness and Safety of Analgesics for Osteoarthritis[23]

High

January 2011

High

The updated Executive Summary specifically mentions a number of drugs that have been withdrawn because of safety concerns.

Efficacy and Comparative Effectiveness of Off-Label Use of Atypical Antipsychotics[28]

Medium

May 2011

Medium

There are many new off-label indications and data on effectiveness, but these do not indicate strong effects of these drugs.

Comparative Effectiveness of Drug Therapy for Rheumatoid Arthritis and Psoriatic Arthritis in Adults[29]

Medium

February 2011

High

New, expensive biologic DMARDs feature prominently in the Executive Summary of the updated report.

Comparative Effectiveness of Treatments to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis[30]

Medium

March 2011

Medium

There are two new drugs: zoledronic acid and denosumab. However, there is no evidence that they are any more effective than existing drugs. There are signals of serious but rare new side effects, in particular subtrochanteric fractures of the hip, but they are not sufficient to change the initial decision to recommend antiresorptive therapy for women with osteoporosis.

Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression[24]

Low

January 2011

Low

No substantive changes in conclusions

Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (ARBs) for Treating Essential Hypertension[31]

Low

December 2010

Low

No substantive changes in conclusions

  1. aDMARD, disease-modifying antirheumatic drug; MRI, magnetic resonance imaging.