Report in English with a French summary - KCE

KCE reports vol.39 Spine technology 17
3.3.1.2 Search terms
For the HTA database the following search-string was used:
((disk OR disc) AND balloon)/Title & Abstract OR (kyphoplast)/Title & Abstract OR
(vertebroplast)/Title & Abstract
The search algorithm used for Medline is provided in appendix.
For Embase the following search-string was used:
(('osteoporosis'/exp/dm_su/mj) OR ('spine fracture'/exp/dm_su/mj) OR ('compression
fracture'/exp/dm_su/mj) OR ('spinal cord compression'/exp/dm_su/mj) OR ('pathologic
fracture'/exp/dm_su/mj) OR ('kyphoplasty'/exp/mj) OR ((disc OR disk) AND
('balloon'/exp OR 'balloon')) OR ('percutaneous vertebroplasty'/exp/mj)) AND ([meta
analysis]/lim OR [systematic review]/lim OR [controlled clinical trial]/lim OR
[randomized controlled trial]/lim) AND [embase]/lim AND [2000-2006]/py
For the search in the Cochrane Library and Pre-Medline, we used the following search
string: kyphoplast$ or vertebroplast$.
Finally, for the Google search the following search terms were used in combination:
kyphoplasty, vertebroplasty, technology assessment, systematic review, randomized.
Overall, the search was limited to reports and articles published between 2000 and
2006. No language restriction was used.
The title and abstract of citations were reviewed for relevance by one reviewer (JV). In
case the abstract could not provide enough information, full-text of the article was
retrieved. The following in and exclusion criteria were used to select relevant papers:
Inclusion: HTA, systematic review, meta-analysis, RCT; balloon kyphoplasty or
vertebroplasty for the following conditions: osteoporotic compression fractures,
vertebral fractures caused by malignancy, hemangiomata; major outcomes of interest:
pain reduction, adverse events, mortality, health-related quality of life.
Exclusion: narrative reviews, letters, commentaries, case series, case studies; target
conditions other than mentioned above.
3.3.1.3 Quality assessment
The quality of the selected papers was assessed by one reviewer (JV) on the basis of the
full-text and quality controlled by a second internal reviewer and a group of external
experts. To assess the quality of HTA reports, the INAHTA checklist was used
(www.inahta.org) (see appendix). The quality of systematic reviews and RCTs was
assessed using the checklists of the Dutch Cochrane Centre (www.cochrane.nl) (see
appendix).
Quality assessment was summarized as good, average or poor quality (according to the
quality of evidence grading for interventional procedures of ASERNIP,
http://www.surgeons.org/Content/NavigationMenu/Research/ASERNIPS/ASERNIPsRevie
wProcess/Classifications_Syst.htm). HTA reports or systematic reviews received a poor
quality appraisal when the search of the literature was insufficient and no quality
assessment of included studies was reported. Since the subject of this report was a
surgical procedure, quality assessment of the RCTs did not comprise the blinding of the
surgeons (and even the patients). However, two major criteria were the randomization
process and the blinding of the assessors: an RCT received a poor quality appraisal
when at least one of these two criteria was negative.
Poor quality studies were excluded from further review.