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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: CRD42024603377
KQ1: What are the characteristics of studies that have evaluated antimicrobial stewardship programs or strategies focused on improving antimicrobial prescribing?
KQ2: For prioritized studies (based on settings and/or type of programs or strategies), what are the reported outcomes associated with implementation of antimicrobial stewardship programs or strategies?
PROSPERO registration number: CRD42024611898
KQ1a: What is the comparative effectiveness of high-intensity focused ultrasound therapy versus other surgical treatments (eg, deep brain stimulation, stereotactic radiosurgery and other ablative treatments) applied to specific anatomic targets for the treatment of:
KQ21b: Do benefits and harms vary by patient characteristics (including treatment history) and anatomic targets?
KQ2a: What are the benefits and harms of high-intensity focused ultrasound therapy applied to specific anatomic targets for the treatment of:
KQ2b: Do benefits and harms vary by patient characteristics (including treatment history) and anatomic targets?
The scope of this report is an update of a previous map conducted in 2016 that will include the following: an evidence map that provides a visual overview of the distribution of evidence for massage for non-pain conditions, and an accompanying narrative that helps stakeholders interpret the state of the evidence to inform policy and clinical decision-making. This update will include more conditions of interest to VA stakeholders.
Participants/population: Adults
Intervention(s)/exposure(s): Not self-delivered massage therapy, acupressure, and myofascial therapy, which could include but is not limited to sports massage, manual lymph drainage, etc. Reviews of osteopathic manipulative medicine and needling are excluded. Reviews of cupping and myofascial rolling as single approaches are excluded.
Comparator(s): Comparators include sham, placebo, usual care, other active therapies.
Context: Any health care setting
Outcome(s): Non-pain related health outcomes and adverse events. Additional outcomes might include use of medications, health care services utilization.
KQ: What AI-assisted techniques have been investigated for prostate, breast, lung, and colorectal cancer screening and diagnosis?
Population: Adults undergoing screening or diagnostic tests for prostate, breast, lung, or colorectal cancer (including for staging purposes)
Intervention: AI-assisted techniques for cancer screening or diagnosis
Comparator: Non-AI-assisted techniques for cancer screening or diagnosis
Outcomes:
Diagnostic accuracy (area under the curve [AUC], sensitivity/specificity, etc)
Implementation outcomes (provider training and uptake, efficiency, healthcare staff satisfaction, patient experience, etc)
Harms or unintended consequences (overdiagnosis, provider skill loss, etc)
Study Design: Comparative studies (multiple-group or before-after designs) published 2020–present
KQ1: What are the benefits and harms of virtual reality (VR) interventions for treating mental health disorders?
KQ2: What are the benefits and harms of VR interventions for suicide prevention?
Participants/population:
KQ1: Adults with:
Posttraumatic stress disorder
Generalized anxiety disorder
Panic disorder
Agoraphobia
Specific phobia
Social anxiety disorder (Social phobia)
Major depressive disorder
Persistent depressive disorder (Dysthymia)
Premenstrual dysphoric disorder
Bipolar disorder
Schizophrenia
Schizoaffective disorder
Other schizophrenia spectrum and psychotic disorders
Dissociative disorders
Obsessive compulsive disorder
Substance use disorders (any; e.g. alcohol use disorder, opioid use disorder)
KQ2: Adults
Intervention(s)/exposure(s): Fully immersive (all-encompassing three-dimensional space that is visually sealed off from the physical environment) VR interventions to treat mental health disorders (KQ1) or prevent suicide (KQ2)
Comparator(s): Any intervention
Context: Any
Outcome(s): Symptom severity, treatment response, recovery, quality of life, treatment engagement (e.g. initiation of treatment, retention in treatment), suicidal ideation and/or behaviors, adverse events
KQ: To identify and compare and contrast published studies that make conclusions about the quality of medical care delivered by hospitalists in VA hospital general medical wards compared with care provided in other inpatient settings.
Participants/population: Patients receiving care from VA or non-VA providers, in the following hierarchy: Veterans receiving care in VA and Veterans receiving care in the community as part of the CHOICE or MISSION Act; Veterans receiving care in VA and Veterans receiving care in the community not as part of CHOICE or MISSION; Veterans receiving care in VA and general population patients receiving care in the community
Intervention(s)/exposure(s): Care received from VA
Comparator(s): Community care
Context: Veteran and non-VA US health care providers
Outcome(s): Quality in any of the IOM domains: clinical quality, safety, efficiency, access, patient experience, equity
PROSPERO registration number: CRD420251014455
KQ1a: Quantitative associations of nurse work environment characteristics on nurse-rated health care quality and safety
What is the impact of nurse work environment characteristics on nurse-rated health care quality and safety?
KQ1b: Qualitative views about nurse work environment on nurse-perceived health care quality and safety
How do nurses perceive that their work environment impacts health care quality and safety?
KQ2: Mapping of nurse work environment interventions on nurse-rated health care quality and safety
What nurse work environment interventions or strategies are available to improve on nurse-rated health care quality and safety?
KQ1: What are the harms of ketamine use for pain control, sedation, or rapid sequence intubation in the prehospital setting?
KQ1a: What are the benefits of ketamine use for pain control, sedation, or rapid sequence intubation in the prehospital setting?
Participants/population: Adult patients receiving prehospital emergency care
Intervention(s)/exposure(s): Ketamine (any administration method) for pain control, sedation, or rapid sequence intubation
Comparator(s): Any other intervention for pain control, sedation, or rapid sequence intubation or no comparatora
Outcome(s): Harms (eg, mortality, nausea, vomiting, respiratory changes), benefitsb (eg, pain relief, sedation)
Study Design: Any, but may prioritize studies to fit timeline based on a best-evidence approach
Notes: aStudies without a comparator will be included for assessment of harms/adverse events only. bBenefits of prehospital ketamine use will be summarized from the available literature, but the focus of the synthesis will be on harms.
KQ1: What is the efficacy of wearable remote patient monitoring (RPM) devices for improving health care delivery and patient outcomes among adult patients transitioning from inpatient to outpatient care?
KQ2: What evidence is available on feasibility, acceptability, and other implementation outcomes for wearable RPM devices for adult patients transitioning from inpatient to outpatient care?
Participants/population: Adults transitioning from inpatient care to an outpatient care setting.
Intervention(s)/exposure(s): Use of platform-agnostic wearable RPM devices for continuous monitoring of vital signs and/or activity for real-time clinical analytics and feedback after discharge from inpatient care. We will exclude studies where the wearable device is one of several components and the effects of the wearable device cannot be isolated.
Comparator(s): KQ1: No use of a wearable medical device after discharge (comparative studies); KQ2: Any or none.
Outcome(s): KQ1: Health care delivery outcomes (eg, continuity of care, access to care, patient-provider communication, etc) and patient outcomes (eg, clinical outcomes, patient satisfaction, quality of life); KQ2: Feasibility, acceptability, and other implementation outcomes (eg, costs, sustainability, etc).
Study Design: Any, but may prioritize studies to fit timeline based on a best-evidence approach.
KQ1: What is the efficacy of faith-based digital applications for improving mental health and wellbeing among adults?
Participants/population: Adults with or without mental health symptoms or diagnoses.
Intervention(s)/exposure(s): Faith-based digital applications (mobile apps that facilitate religious or spiritual practices, including prayer, spiritual meditation, etc) for improving mental health and/or wellbeing. Facilitation of religious or spiritual practices must be a primary component of the intervention.
Comparator(s): Any or none
Outcome(s): Mental health symptoms, stress, and/or wellbeing outcomes assessed with a standardized or formal assessment tool.
Study Design: Any, but may prioritize studies to fit timeline based on a best-evidence approach.
Key Questions
KQ1: Among adults with lumbar spinal stenosis, what is the effectiveness, comparative effectiveness and adverse events of percutaneous image-guided lumbar decompression?
KQ1a: Does the effectiveness, comparative effectiveness and adverse events of percutaneous image-guided lumbar decompression vary based on patient characteristics?
KQ1b: Does the effectiveness, comparative effectiveness and adverse events of percutaneous image-guided lumbar decompression vary based on whether it is an initial or subsequent procedure at the same lumbar vertebral level?
Participants/population: Adults with lumbar spinal stenosis
Intervention(s)/exposure(s): Percutaneous image-guided lumbar decompression (ie, minimally invasive lumbar decompression [MILD])
Comparator(s):
KQ1: Any
KQ1a: Different patient characteristics (eg, age, sex, race, BMI, diabetes, comorbidities, treatment history [eg, epidural steroids], symptoms related to stenosis, degree of neurological/functional impairment [gait/walking distance], pain, stenosis location, medication use)
KQ1b: Initial versus subsequent procedures at the same level
Context: Adults with lumbar spinal stenosis
Outcome(s):
KQ1a: Among at risk adults, what is the efficacy and safety of remote monitoring devices for prevention of foot ulcers?
KQ1b: Does the efficacy and safety of remote monitoring devices for prevention of foot ulcers vary based on patient demographics, the presence of chronic kidney disease, patient device adherence, or physical activity level?
KQ1c: Does the efficacy and safety of remote monitoring devices for prevention of foot ulcers vary based on the type of monitoring device, frequency of monitoring, or methods of monitoring feedback to patient?
Participants/population: Ambulatory adults who are at risk for foot ulcer based on:
Intervention(s)/exposure(s): Remote pressure, temperature, and/or visual monitoring technology that measure physiological changes indicative of impending ulcer development and which can be reversed with changes to patient behavior such as off-loading pressure
Eligible interventions:
Comparator(s):
Context:
Outcome(s):
KQ1: Among adults with metastatic tumors in the lungs, what is the safety of percutaneous ablation compared to stereotactic body radiation therapy?
KQ2: Among adults with metastatic tumors in the lungs, what is the effectiveness of percutaneous ablation compared to stereotactic body radiation therapy?
Participants/population: Adults with metastatic tumors in the lungs from other organs.
We will exclude nonhuman studies, studies exclusive to primary lung cancer, pleura, lymphadenopathy and studies on pediatric populations.
Intervention(s)/exposure(s): For KQ1, interventions will include Percutaneous image guided thermal ablation (IGTA), regardless of the type of energy used (eg, radiofrequency, microwave, or cryotherapy energies), or stereotactic body radiation therapy (ie, stereotactic ablative radiation therapy).
For KQ2, image-guided percutaneous thermal ablation, regardless of the type of energy used (eg, radiofrequency, microwave, or cryotherapy energies).
Exclusions will include patients receiving re-radiation, brachytherapy, large particle radiation therapy, peptide receptor radionuclide therapy, pulsed electric field, endobronchial ablation, transbronchial ablation, irreversible electroporation, studies where patients are not being treated in the lungs.
Comparator(s): For KQ1, comparators will include any or no comparators.
For KQ2, comparators will include stereotactic body radiation therapy (ie, stereotactic ablative radiation therapy).
Exclusions will include patients receiving re-radiation, brachytherapy, large particle radiation therapy, peptide receptor radionuclide therapy, irreversible electroporation, and studies where patients are not being treated in the lungs.
Context: Any
Outcome(s): For KQ1, outcomes will include adverse events, complications, safety, side effects (including whether studies report on adverse events).
For KQ2, outcomes will include effectiveness, cost, function, and quality of life.
