The following reports are currently under development. If you would like to provide comments about a particular topic, serve as a peer reviewer for the draft report, or know the timeline for completion, please contact the ESP Coordinating Center.
To review the most up-to-date protocols, please visit the PROSPERO website. Protocol registration numbers for an individual project can be found along with the brief abstract for the project, below.
PROSPERO registration number: RD42022347945
KQ1: What are the effects of automating the delivery of oral, enteral, or parenteral nutrition supplements to hospitalized patients on patient and process outcomes?
KQ2: How is automating the delivery of oral, enteral, or parenteral nutrition supplements to hospitalized patients experienced by the staff involved in implementing and delivering it?
Population(s): KQ1: Hospitalized patients - including long-term care, skilled nursing facility residents and end of life patients - at risk of malnutrition (ie, who have difficulty eating or absorbing nutrients through GI tract)
KQ2: Hospital staff involved in automating the delivery oral, enteral, or parenteral nutrition supplements to patients (eg, nurses and nursing assistants, pharmacists, food service, registered dietitians)
Interventions: Automated nutrition delivery of oral, enteral, or parenteral nutrition supplements (ie, medical food supplements) that includes automated notifications to the hospital care team (eg, nurses and nursing assistants, physicians pharmacists, food service, registered dietitians) that nutrition supplements have been ordered/ prescribed and requires responses that the care team has administered nutrition supplements and/or how much the patient actually received (eg, electronic health record alerts, barcode scanning)
Automation is defined as the "creation of a process or application of a technology to deliver hospital-based nutrition to patients minimizing human intervention” (ie, hospital staff provide the thinking on the ordering side (inputs) and the delivery side (outputs) is automated to minimize human touch points).
Automation should include one or both of the following aspects of implementation:
Comparator: KQ1: Any comparator (eg, usual care, active comparator, historical controls)
Outcome(s): KQ1:
Process outcomes:
Performance outcomes (eg, time required for supplement administration)
Patient outcomes:
Patient-level harms among patients exposed to automated delivery of nutrition (eg, all-cause mortality, pressure injury, falls, organ damage, aspiration, refeeding syndrome (ie, consuming calories too quickly after starvation), failure to thrive diagnosis, medication-nutrition interactions
KQ2:
Primary purpose of evaluation is to explore the experiences and attitudes of hospital staff (eg, nursing, pharmacy, food service, dietetics) who interact with some aspect of implementing and delivering the automated delivery of nutrition
We will conduct a primary search from inception to the current date of MEDLINE (via Ovid), Embase, and CINAHL from inception to January 16, 2022. We will use a combination of MeSH keywords and selected free-text terms to search titles and abstracts. To ensure completeness, search strategies will be developed in consultation with an expert medical librarian. We will hand-search previous systematic reviews conducted on this or a related topic for potential inclusion.
KQ1: Are transition to practice programs for newly graduated, entry-to-practice registered nurses (RNs) effective for improving organizational, nurse, and patient outcomes?
KQ2: What are the components and implementation characteristics of effective transition to practice programs for newly graduated, entry-to-practice RNs?
Population(s): Newly graduated, entry-to-practice RNs in the first 12 months of employment following graduation and/or licensure for entry to practice
Interventions: Transition to practice or nurse residency programs specifically designed for newly graduated, entry-to-practice RNs to provide support or preceptorship during the first 12 months of employment following graduation and/or licensure for entry to practice
Comparator: Any comparator (eg, usual care, active comparator, historical controls)
Outcome(s):
Key question 1:
Key question 2:
Setting: Any healthcare setting; programs implemented in countries listed on the 2022 Organization for Economic Co-operation and Development to approximate US healthcare delivery context.
We will conduct searches from 1/1/10 to the current date of PubMed/MEDLINE and CINAHL Plus. We will use a combination of MeSH keywords and selected free-text terms to search titles and abstracts (eg, “Education, Nursing, Graduate”, “graduate nurse transition”, “transition to practice”). To ensure completeness, search strategies will be developed in consultation with an expert medical librarian. We will hand search references from previous, relevant systematic reviews for potential inclusion.
PROSPERO registration number: CRD42023439903
This evidence review of extended reality (XR; including virtual reality [VR], mixed reality, and augmented reality) approaches for addressing chronic pain will be used to inform clinical guidance on use of XR to treat pain within the VA, as well as future research priorities targeted at evidence gaps in this area of work. Chronic pain is common in Veterans, and the prevalence of severe pain is higher in Veterans than in members of the general population. XR approaches may be promising non-pharmacological treatment options for chronic pain. VHA Extended Reality Network has launched several pilots of VR interventions to address pain, including one most recently to treat chronic low back pain. VA HSR&D and PMOP are collaborating with the Network on current and future efforts to implement XR treatments and address evidence gaps.
KQ1: For adults, what are the benefits and harms of extended reality (XR) interventions for treating chronic pain?
KQ2: For adults, what are the benefits and harms of XR interventions for preventing the development of chronic pain?
Population(s):
KQ1: Adults (≥18 years) with chronic pain:
condition that has chronic pain as a major symptom (eg, arthritis, fibromyalgia, phantom limb pain, diabetic neuropathy) AND/OR assessed pain of ≥ 90 days
KQ2: Adults (≥18 years) with pain
Interventions: Extended reality (ie, augmented, mixed or fully immersive virtual reality) treatments with a primary aim of treating or preventing chronic pain
Comparator: Any
Outcome(s):
Setting:
KQ1: Non-acute care settings (eg, outpatient clinic, home)
KQ2: Any
We will search MEDLINE, Embase, CINHAL, PsycINFO, and Scopus databases, from inception to current.
We will perform citation searching of relevant systematic reviews identified via the searches described above, as well as additional searches of AHRQ EPC and VA ESP reports. We also plan to perform searches of grey literature, including clinical trial registries.
What are the benefits and harms of low-dose radiation therapy for the treatment or prevention of benign hyperproliferative and degenerative skin/epithelial, and musculoskeletal disorders such as keloid scars, hidradenitis suppurativa, Dupuytren’s contracture, Ledderhose disease, Peyronie’s disease, plantar fasciitis, heterotopic ossification, pterygium, or osteoarthritis in adults?
Population(s): Adults ≥18 years of age with keloid scars, hidradenitis suppurativa, Dupuytren’s contracture, Ledderhose disease, Peyronie’s disease, plantar fasciitis, heterotopic ossification, pterygium or osteoarthritis (treatment, recurrence, or prevention).
Comparator: Sham radiation therapy, alternative treatments that do not include radiation, no treatment.
Outcome(s):
Setting: Any
We will conduct literature searches of the bibliographic databases including PubMed (Medline, EMBASE and clinicaltrials.gov (http://clinicaltrials.gov) by utilizing keywords and subject headings for each disease of interest (i.e., keloids, heterotopic ossifications) and radiation therapy.
There will be no restrictions to language of publication for searches.
We will review the list of references in identified systematic reviews.
PROSPERO registration number: CRD42023458540
KQ1:
1a. What cancer cachexia classification systems have been described/what criteria have been used?
1b. What are their performance characteristics?
KQ2: What are the short- and long-term outcomes for patients following cachexia classification with the tools identified in KQ1?
Population(s): This review will focus on adults with any type of cancer at risk for cachexia or with cachexia. We will exclude studies focusing on non-cancer populations, those conducted in pediatric populations, and those using non-human subjects.
Interventions/exposures: For KQ1, the exposures of interest will include cancer cachexia diagnostic strategies, screening, and classification/severity scoring tools (including modified tools, algorithms) (herein referred to as classification strategies).
For KQ2, the exposure of interest in cachexia stage. We will exclude studies that do not define the classification strategy used for cachexia.
Comparator(s): Comparators for KQ1 may include a reference standard for classification, an alternate classification strategy, or no comparator. Comparators for KQ2 may include other cachexia stages or those without cachexia.
Outcome(s):For KQ1, outcomes will include parameter for classification and data on performance measures of the identified classification strategies (eg, diagnostic accuracy, predicative ability, etc).
For KQ2, outcomes of interest include clinical and patient-important outcomes (eg, treatment response, overall survival, nutritional outcomes, functionality, quality of life):
Setting: We will not place any restrictions on the timing or setting of studies.
We will conduct literature searches of the bibliographic databases including PubMed (Medline), EMBASE, Cochrane and clinicaltrials.gov (http://clinicaltrials.gov) by utilizing keywords and subject headings relating to cancer cachexia, and severity assessment and diagnostic tools.
No restrictions will be placed on language or date of publication.
We will review the list of references in identified systematic reviews.
An evidence map on the association between toxic exposures during military service and mental, behavioral, and neuropsychiatric health issues (ie., psychiatric conditions or symptoms). The Sergeant First Class (SFC) Heath Robinson Honoring Our Promise to Address Comprehensive Toxics (PACT) Act expands and extends VA health care eligibility for Veterans with conditions presumed to be caused by toxic exposure that occurred during military service. An evidence map on this topic will be used to assist clinical teams in providing evidence-informed care to Veterans with psychiatric concerns that arise during toxic exposure screenings and to develop national guidance for approaches to screening, assessment, and treatment related to these concerns.
KQ1: For which military service-related environmental and chemical toxic exposures has the co-occurrence of psychiatric conditions or symptoms been evaluated?
KQ2: What is the prevalence, incidence, or association of co-occurring psychiatric conditions or symptoms among individuals with a history of military-service related environmental and/or chemical toxic exposures?
Population(s): Active-duty military personnel, national guard, reservists, or Veterans from the US or other countries.
For studies with mixed populations, 80% (and at least 100 individuals in total) of the analytic sample must be compromised of individuals meeting the above definition.
Intervention(s)/exposure(s): Exposure to environmental (eg, burn pits, radiation) and/or chemical (eg, asbestos, agent orange) toxins during military service inclusive of:
Comparator(s): No history of toxic exposure or no comparator
Outcome(s):Psychiatric symptoms and conditions, inclusive of related diagnoses (eg, MDD, GAD, PTSD, Mild or Major Neurocognitive Disorder, substance use disorder) and symptoms (eg, executive functioning, difficulty concentrating, memory, processing speed, suicidal behavior/ideation, sleep disturbance, aggression)
We will conduct a primary search from 1946 to July 27th 2023 of MEDLINE (via Ovid), Embase (via Elsevier), APA PsycINFO (via Ovid), and PTSDpubs (via ProQuest). We will use a combination of MeSH keywords and selected free-text terms to search titles and abstracts. To ensure completeness, search strategies will be developed in consultation with an expert medical librarian and peer-reviewed by another librarian. We will hand search selected systematic reviews conducted on this or related topics for potential inclusion.
PROSPERO registration number: CRD42023465675
An evidence review would inform efforts to standardize the way post-discharge follow-up calls are conducted across VHA facilities, including development of a standard operating procedure and a national documentation template.
KQ1a: Among adults with acute medical hospital admissions, what are the effects of post-discharge contacts on hospital readmission, emergency care use, and patient satisfaction?
KQ1b: Do the effects of post-discharge calls for acute medical hospital admissions vary by intervention characteristics (ie, mode of contact; clinical staff initiating the contact; timing of the contact; assessments used during contact; content of the contact)?
KQ2a: Among adults with acute psychiatric hospital admissions, what are the effects of post-discharge contacts on hospital readmission, emergency care use, and patient satisfaction?
KQ2b: Do the effects of post-discharge calls for acute psychiatric hospital admissions vary by intervention characteristics (ie, mode of contacted; clinical staff initiating the contact; timing of the contact; assessments used during contact)?
Population(s):
KQ1: Adults (≥18 years of age) with an acute medical hospital admission
KQ2: Adults (≥18 years of age) with acute psychiatric hospital admission
If populations are comprised of children and adults and does not include an adult-only subgroup, studies will be included if they have 80% or more adults in the included sample.
Intervention(s)/exposure(s): Post-discharge contact is defined as a bidirectional contact (eg, telephone, video, secure messaging system) from a non-specialist clinical service provider to an adult discharged from inpatient medical or psychiatric hospital that occurs up to 7 days from discharge from a hospitalization and prior to resumption of longitudinal primary care.
A post-discharge contact is intended to improve the post-acute transition from hospital to home and include at least one of the following components:
Comparator(s):
Outcome(s):
Setting: Initiated in the inpatient or outpatient setting, as long as the intent is to provide a post-discharge check-in prior to resumption of longitudinal primary care AND there is at least one contact made after the patient is discharged.
We will conduct a primary search from inception to the current date of MEDLINE (via Ovid), Embase, and CINAHL from inception to May 25th, 2023. We will use a combination of MeSH keywords and selected free-text terms to search titles and abstracts. To ensure completeness, search strategies will be developed in consultation with an expert medical librarian. We will hand search previous systematic reviews conducted on this or a related topic for potential inclusion.
PROSPERO registration number: CRD42023471333
KQ1: Are internet-based and mobile interventions with asynchronous therapist-guided or self-guided content and resources designed to improve PTSD symptom severity and/or self-management effective for improving PTSD symptoms and other mental health symptoms among adults with a diagnosis of PTSD?
KQ2: Are internet-based and mobile interventions with asynchronous therapist-guided or self-guided content and resources designed to enhance coping and symptom management skills for family members and caregivers of adults with PTSD effective for improving stress, mental health symptoms, and coping skills?
What is the scope and breadth of the literature on women Veteran’s health published since 2015?
Participants/population: Individuals who identify as women or who have female reproductive or sexual anatomy
AND, who have served in the armed forces including national guard and reserves
(Note: Women Veterans (WV) must comprise >75% of study population OR study must report results separately for WV as sub-group analysis or otherwise report results separately for women; total n must be at least 50 unless is a qualitative study or methods development)
OR, health care team members who provide care to women Veterans if focus of article is on provision of care to women Veteran population
Intervention(s)/exposure(s): Any or none
Comparator(s): Any or none
Outcome(s): Any
Context: Health care and health conditions relevant to women Veterans, including social determinants of health
PROSPERO registration number: CRD42024511257
KQ1: What communication strategies, tools, and/or approaches used for shared decision making (SDM) in lung cancer screening are reported in the literature?
KQ2: What is the effectiveness and comparative effectiveness of communication strategies, tools, and or approaches used to enhance SDM for lung cancer screening?
b. Does effectiveness vary by patient (i) or clinical setting (ii) characteristics:
i. ie, age, race/ethnicity, comorbidities, current smoking status, socioeconomic status (SES)/education, residency: geographic region, rural/urban
ii. Primary care, smoking cessation, prevention clinics, public forums
KQ3: What are the harms of the communication strategies, tools, and or approaches used to enhance SDM for lung cancer screening?
KQ4: What are the barriers and facilitators of implementing different communication strategies, tools, and/or approaches for lung cancer screening SDM?
KQ1: Among adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) and prescribed psychostimulant medications, what is the incidence of misuse of the prescribed medications, the incidence of diversion of the prescribed medications, and the incidence of substance use disorders (SUD) in this population?
KQ2: Among adults diagnosed with ADHD with a co-occurring substance use disorder (SUD), what are the benefits and harms of non-stimulant ADHD pharmacological and/or nonpharmacological treatment of ADHD compared to ADHD psychostimulant medications?
Participants/population:
KQ1: Adults and adolescents (age 12 and older at the time of study enrollment) diagnosed with ADHD using DSM-IV, IV-TR, V, V-TR or comparable criteria (eg, ICD codes, validated instruments) who have been prescribed psychostimulant medications for ADHD and are without a history or current diagnosis of ADHD medication misuse or diversion, or SUD.
KQ2: Adults 18+ diagnosed with ADHD using DSM-IV, IV-TR, V, V-TR or comparable criteria (eg, ICD codes, validated instruments) with a history or current diagnosis of a SUD.
Intervention(s)/exposure(s): Prescribed psychostimulant medications for ADHD, including short- and long-acting types
Comparator(s):
KQ1: None
KQ2: ADHD psychostimulant medication use alone will be compared to non-psychostimulant pharmacological ADHD medication, psychotherapeutic interventions intended to improve ADHD management skills and/or symptoms (eg, behavior management interventions like cognitive behavioral therapy, cognitive training interventions such as attention training or neurofeedback, or psychoeducation) and/or treatment as usual (including those that compare different doses of stimulants) or no treatment.
Exclude: Nonpharmacologic interventions which are not conducted by trained clinicians.
Context:
KQ1: Studies conducted in any community setting.
KQ2: Studies conducted in outpatient, residential, or community settings, and will exclude inpatient and incarcerated populations.
Outcome(s):
KQ1: ADHD medication misuse or diversion in adulthood (including poisoning/overdose) or development of substance use disorder/dependence/psychosis/abuse diagnosis in adulthood.
Exclude: Studies that do not assess any other substance beside tobacco/nicotine or caffeine and studies not examining outcomes in adulthood.
KQ2: Change in ADHD symptoms/severity or functional ability or impairment, SUD relapse/misuse/diversion, treatment adherence (SUD and ADHD), side effects, mortality, QOL and satisfaction, and other mental health diagnoses (including change in severity or symptoms)
KQ1: What are the characteristics of published research studies on moral injury in adults?
KQ2: How has published literature on moral injury changed over time?
KQ3: How many studies include moral injury as an outcome measure?
Population: KQ1&KQ2: Adults with or at risk for moral injury; KQ3: Any
Intervention: Any or none
Comparator: Any or none
Outcomes: KQ1&KQ2: Any; KQ3: Moral injury
Study Design: KQ1&KQ3: Research studies; KQ2: Any publication type