Apixaban for the prevention of venous thromboembolism in people ...

Non-RCT Evidence (Apixaban)
Adequate searches were carried out on all NICE required databases. ERG noted the same limitations
in the facets for hip/knee replacement as in earlier searches (see Clinical Effectiveness)
Cost effectiveness
Further limitations
There were some missed opportunities to use truncation. Examples:
i. Line #78 Medline strategy “(surgery or replac*) rather than replacement to pick up
replace, replaced, replacing, replacement and replacements.
ii. Line #49 Medline strategy raise$ would be better as rais$, suspend$ would be better
as suspen$
There are cases where broader MeSH terms make the use of narrower ones redundant:
i. Line #24 Medline exp Heparin, Low-Molecular-Weight/” makes line #27, “exp
Nedroparin/” redundant.
There were a variety of synonyms and variants that were not used for hip/knee replacement.
Those missed include prosthe$ or surgical or implant$ (see Appendix 1A).
Although start dates and search dates were reported there was no Issue given for the Cochrane
search.
The ERG queried why a Medline cost filter (lines #76-97) was applied to the Embase search, the
use of Medline mesh such as “exp cost/” in Embase will also pick up unwanted terms such as
Energy cost/. The Manufacturer addressed this in their response by adding additional terms. The
ERG reran the manufacturer’s search with all corrections (n=348) but noted some remaining
weaknesses so conducted an additional search (n=485) (See Appendix 1A)
Measurement and valuation of health effects
Limitations
There were some missed opportunities to use truncation. Examples within the Cochrane search:
Line #77 use replac* rather than replacement to pick up replace, replaced, replacing, replacement
and replacements
There are cases where broader terms make the use of narrower ones redundant:
i. Line #25 Medline is redundant due to line #24 exp Heparin, Low-Molecular-Weight/
There were a variety of synonyms and variants that were not used for hip/knee replacement.
Those missed include prosthe$ or surgical or implant$ (see Appendix 1A).
Resource identification, measurement and valuation
See cost effectiveness
88
Copyright 2011 Queen’s Printer and Controller of HMSO. All rights reserved.