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HOW TO UNDERTAKE A CLINICALLY RELEVANT SYSTEMATIC REVIEW IN A RAPIDLY EVOLVING FIELD

Magnetic Resonance Angiography

Published online by Cambridge University Press:  20 May 2002

Marie E. Westwood
Affiliation:
University of Leeds
Steven Kelly
Affiliation:
University of Leeds
Elizabeth Berry
Affiliation:
University of Leeds
John M. Bamford
Affiliation:
United Leeds Teaching Hospitals NHS Trust
Michael J. Gough
Affiliation:
United Leeds Teaching Hospitals NHS Trust
C. Mark Airey
Affiliation:
University of Leeds
Linda M. Davies
Affiliation:
University of York
James F. M. Meaney
Affiliation:
United Leeds Teaching Hospitals NHS Trust
Jane Cullingworth
Affiliation:
United Leeds Teaching Hospitals NHS Trust
Michael A. Smith
Affiliation:
University of Leeds

Abstract

Objectives: The aim was to determine which generations of the evolving technology of magnetic resonance angiography (MRA) are currently of clinical relevance in two clinical applications. Our purpose was to plan a systematic review that would be valuable both to purchasers driven by cost-effectiveness and to practicing clinicians.

Methods: Information was gathered from a search of major bibliographic databases, from a short questionnaire sent to 500 U.K. vascular radiologists and vascular surgeons, and from local clinical experts. We asked which of the MRA techniques were currently used and, assuming availability, what would be their technique of choice.

Results: There were 206 published articles that satisfied preliminary inclusion criteria: 69 discussed 2D time of flight (TOF); 47, 3D TOF; and 38, contrast-enhanced techniques. There were 162 questionnaires returned (60 radiologists, 102 surgeons). Of the total respondents, 77/162 (48%) used MRA in the assessment of carotid artery stenosis; 47/77 (61%) used 2D TOF; 32/77 (42%), 3D TOF; and 26/77 (34%), contrast-enhanced techniques. Thirty-five of 162 (22%) respondents used MRA in the assessment of peripheral vascular disease (PVD); 15/35 (43%) used 2D TOF, 4/35 (11%) used 3D TOF, and 22/35 (63%) used contrast-enhanced techniques. For those wishing to use MRA, contrast-enhanced techniques were the method of choice.

Conclusions: The TOF methods that represent earlier generations of the technology remain clinically relevant, and will therefore be included in our systematic review. To ensure complete and relevant coverage in reviews of other evolving technologies, it would be advisable to obtain data for guidance in a similar way.

Type
Research Article
Copyright
© 2002 Cambridge University Press

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HOW TO UNDERTAKE A CLINICALLY RELEVANT SYSTEMATIC REVIEW IN A RAPIDLY EVOLVING FIELD
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