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Compared to younger age groups, older people spend more time in their locality and rely more heavily on its pedestrian and public transport infrastructure. Qualitative studies provide unique insight into people's experiences. We conducted a qualitative evidence synthesis of United Kingdom-based studies of older people's experiences of travelling in the urban environment. We searched health, social science, age-related and transport-related databases from 1998 to 2017. Fourteen papers (from 12 studies) were included in a thematic synthesis, a three-staged process that moves iteratively between codes, descriptive themes and cross-cutting analytical themes. Emerging themes were discussed with policy advisers. Four overarching themes were identified. The first and second theme pointed to the importance of ‘getting out’ and of being independent travellers. The third and fourth themes highlighted how local environments and travel systems enabled (or prevented) older people from realising these valued dimensions of travel. The loss of local amenities and micro-environmental features, such as pavement quality, personal safety and aesthetic appearance, were recurrent concerns. Free modes of travel like walking and bus travel were highly valued, including the social engagement they facilitated. Our review suggests that, while its extrinsic value (reaching destinations) matters, the intrinsic value of travel matters too. The process of travel is experienced and enjoyed for its own sake, with older people describing its contribution to their wellbeing.

Background: The most effective sources to search to identify adverse effects data for medical devices are currently unknown.Methods: The included studies from a systematic review of the safety of recombinant human bone morphogenetic protein-2 (rhBMP-2) for spinal fusion were used for analysis. For each source searched, a record was made for each relevant publication of whether it was retrieved by the search strategy used and whether it was available in the database but not retrieved. To account for multiple publications of the same study, a record was made of the relevant studies identified. The sensitivity, precision, and number needed to read were calculated as well as the minimum combination of sources to identify all the publications or studies.Results: There were eighty-two publications (forty-nine studies) included in the systematic review. Only one article was available in a database searched but not retrieved by our search strategy. Science Citation Index (SCI) and EMBASE both achieved the highest sensitivity (62 percent), followed closely by MEDLINE/PubMED (56 percent). With the search strategies used, the minimum combination of sources needed to identify all the publications was SCI, EMBASE, CENTRAL, and either MEDLINE or PubMED, in addition to reference checking, contacting authors and an automated current awareness service. In relation to identifying all the relevant studies, the minimum combination of studies was similar with the exclusion of CENTRAL.Conclusions: To identify all the relevant publications or studies included in this case study systematic review, several different sources needed to be searched.

INTRODUCTION:Hyperhidrosis is characterized by uncontrollable excessive sweating, which occurs at rest, regardless of temperature, and can significantly affect quality of life. There is substantial variation in the availability of treatments in secondary care and uncertainty regarding optimal patient management. A systematic review was undertaken to assess the clinical effectiveness of treatments prescribed by dermatologists (iontophoresis, anticholinergic medications, botulinum toxin injections) and minor surgical treatments (curettage and newer energy based technologies) for primary hyperhidrosis and identify areas for further research.METHODS:Fifteen databases and trial registers were searched to July 2016. Pairwise meta-analyses were conducted for comparisons between botulinum toxin injections and placebo for axillary hyperhidrosis. For other treatments data were synthesised narratively due to limited and heterogeneous data.RESULTS:Fifty studies were included in the review; thirty-two randomized controlled trials (RCTs), seventeen non-RCTs and one case series. There was substantial variation between the studies in terms of country of origin (indicating climate and population differences), interventions and methods of outcome assessment. Most studies were small, at high risk of bias and poorly reported. There was moderate quality evidence of a large statistically significant effect of botulinum toxin injections on axillary hyperhidrosis symptoms in the short to medium term (up to 16 weeks), compared with placebo. There was weak but consistent evidence for iontophoresis for palmar hyperhidrosis. Evidence for other interventions was low or very low quality. Combining the evidence and patient advisor input, we established that further research on the clinical and cost-effectiveness of botulinum toxin injections (with anesthesia) versus iontophoresis for palmar hyperhidrosis would be useful.CONCLUSIONS:The evidence for the effectiveness and safety of treatments for primary hyperhidrosis is limited overall and few firm conclusions can be drawn. However, there is moderate quality evidence to support the use of botulinum toxin injections for axillary hyperhidrosis. A trial comparing botulinum toxin injections with iontophoresis for palmar hyperhidrosis is warranted.

INTRODUCTION:Primary hyperhidrosis has no discernible cause and is characterised by uncontrollable excessive and unpredictable sweating, which occurs at rest, regardless of temperature. The symptoms of hyperhidrosis can significantly affect quality of life, and can lead to social embarrassment, loneliness, anxiety and depression.The aim of this literature review was to identify the tools used to measure quality of life in studies of hyperhidrosis. Patient advisors provided insight and their perspective.METHODS:Studies were identified through searches undertaken in January 2016. The search strategies combined topic terms for hyperhidrosis with a recognised search filter for “quality of life”. All studies that reported measuring quality of life or described a quality of life measure/tool in the context of primary hyperhidrosis were included. The information on the tools and their use in hyperhidrosis was summarized in a narrative synthesis. Patient advisors contributed to the interpretation of the findings.RESULTS:The review included 184 studies and many studies used multiple tools. Twenty-two individual tools were identified. The review identified disease specific, dermatology specific, and general health/utility tools. The most commonly identified tools were the Dermatology Life Quality Index (DLQI), the Hyperhidrosis Disease Severity Scale (HDSS), and the Hyperhidrosis Quality of Life Questionnaire (HQLQ). The Hyperhidrosis Quality of Life index (HidroQoL©) is recently designed and validated, and therefore was used only in its validation study.When asked about these four quality of life tools patient advisors agreed that the HidroQoL© tool covered disease-specific quality of life dimensions relevant to them most comprehensively and was easy to complete. The DLQI was considered to be too general and too focussed on the skin. The HDSS was considered to be too basic and not sufficiently discriminating.CONCLUSIONS:Future studies of the effectiveness of interventions for hyperhidrosis on health-related quality of life may benefit from including the HidroQoL© tool.

INTRODUCTION:Increasing numbers of research papers about information retrieval for Health Technology Assessments (HTA), systematic reviews and other evidence syntheses are being published. It is time-consuming for information specialists to keep up-to-date with the latest developments in the field. To help searchers with this challenge, the Interest Group on Information Retrieval (IRG) of Health Technology Assessment International (HTAi) has compiled the best available research evidence on information retrieval aspects into an open-access web resource: Summarized Research in Information Retrieval for HTA (SuRe Info). The resource can be accessed at http://www.sure-info.orgMETHODS:The Sure Info team run topic-specific search strategies in selected relevant databases to identify information retrieval methods publications that fulfil the SuRe Info inclusion criteria. Eligible publications receive a structured abstract containing a brief critical appraisal. Key messages for search practice based on the appraisals and accepted best practice are summarized into topic-specific chapters.RESULTS:SuRe Info currently offers fourteen chapters, with more in development. SuRe Info chapters fall into two categories: (i) chapters about general search methods that are used across all types of research, such as how to develop search strategies and the availability and use of search filters, and (ii) chapters summarizing the methods to use when searching for specific aspects of HTA (as defined in the European Network for HTA (EUnetHTA) HTA Core Model®), including searching for evidence on clinical effectiveness and safety, and identifying economic evaluations. References at the end of each chapter are linked to appraisals of publications that have been used to develop each chapter. Links to the full-text of the publications are provided when freely available. The SuRe Info chapters are reviewed every six months and updated if new evidence is identified or if resources change.CONCLUSIONS:SuRe Info is a unique resource, identifying and summarizing current best research evidence on information retrieval aspects for HTA. It supports the timely uptake of potential efficiencies arising from new evidence that may be incorporated into the evidence identification processes of HTA organizations.

Background: The Centre for Reviews and Dissemination (CRD) funded through the United Kingdom National Institute for Health Research undertakes systematic reviews evaluating the research evidence on health and public health questions of national and international importance. CRD is involved in methods research and produces internationally accepted guidelines for undertaking systematic reviews. A core product of the Centre are the CRD databases; a key resource for health professionals, policy makers, and researchers around the world. Research evidence evaluating the effects and cost-effectiveness of healthcare interventions is growing year on year, and can be difficult and time consuming to identify and appraise. The databases assist decision makers by systematically identifying and critically describing systematic reviews and economic evaluations, appraising their quality and highlighting their relative strengths and weaknesses; and providing a comprehensive listing of ongoing and published health technology assessments.Methods and Results: This article briefly outlines the processes behind each of the three databases, gives details of the records, the information they contain and the value added by CRD. An overview of the new public interface for the CRD databases to be launched later this year is given. Improvements and innovations to supplement existing functions are listed, including enhanced and new search options, the addition of quick links to relevant material from within individual records, an integrated PubMed search and the ability to select personal preferences.Conclusions: CRD's databases provide free access to an important knowledge base and are used widely to underpin evidence informed healthcare decisions in the United Kingdom and internationally.

INTRODUCTION:Information specialists and others searching for Health Technology Assessments (HTAs) can use the ISSG Search Filter resource (SFR) to identify filters to incorporate into search strategies. This can save time and effort when designing searches and create more efficient searches that retrieve fewer and possibly more relevant database records (link available here: https://sites.google.com/a/york.ac.uk/issg-search-filters-resource/home).What are search filters? Search filters are collections of search terms designed to retrieve selections of records from bibliographic databases. Some filters are designed to retrieve records of specific study designs such as randomized controlled trials (RCTs) or systematic reviews; others aim to retrieve records relating to other features or topics such as the age or gender of study participants.Search filters may be designed to be sensitive, precise or balanced between sensitivity and precision.METHODS:When would you use a search filter in HTA? Search filters can be added to search strategies to limit to specific study types, for example, RCTs, mixed methods studies, systematic reviews. They can also be used when searching for other aspects of HTA such as patient views or specific age groups.The ISSG SFR includes sections listing search filters to help identify adverse effects, aetiology, economic evaluations, health state utility values, public views, and quality of life.RESULTS:How are filters used? A search filter is often used in combination with a topic search to restrict the search results to a specific type of record, for example, records reporting health state utility values or records of randomized controlled trials.CONCLUSIONS:Further guidance on the use of search filters can be found in the SuRe Info Search Filters chapter.

INTRODUCTION:Hyperhidrosis is characterized by uncontrollable excessive sweating, which occurs at rest, regardless of temperature. Symptoms can significantly affect quality of life. There is substantial variation in the secondary care treatment of hyperhidrosis and uncertainty regarding optimal patient management. The objective of the Health Technology Assessment (HTA) was to review the evidence and establish the expected value of undertaking additional research into effective interventions for the management of primary hyperhidrosis in secondary care. Capturing the perspectives of patients and clinicians treating hyperhidrosis was an important part of the research.METHODS:The assessment included a systematic review and economic model, including value of information analysis. Patients, dermatologists, a vascular surgeon and a specialist nurse (who set up the UK Hyperhidrosis Support Group) provided advice at various stages, including at an end-of-project workshop, to help interpret results and prioritize research recommendations.RESULTS:Patient and clinician advisors were unsurprised by the finding that there is evidence of a large effect of botulinum toxin injections on axillary hyperhidrosis symptoms in the short to medium term; there was consensus amongst patients and clinicians that botulinum toxin injections were very effective. The advisors agreed that a trial of botulinum toxin injections (plus anesthetic) versus iontophoresis for palmar hyperhidrosis would be useful. Patients and clinicians were happy with the sequence of treatments identified as being cost effective for axillary hyperhidrosis: iontophoresis, botulinum toxin injections, anticholinergic medication, curettage, endoscopic thoracic sympathectomy. All patients agreed that the Hyperhidrosis Quality of Life index (HidroQoL©) tool was superior to other commonly used tools for assessing quality of life in hyperhidrosis.CONCLUSIONS:Patients and clinicians considered the key findings of the systematic review and economic analyses to be appropriate. Advisors advocated a trial of botulinum toxin injections (plus anaesthetic) versus iontophoresis for palmar hyperhidrosis. Patients preferred the HydroQoL® tool over other commonly used quality of life tools in hyperhidrosis research.