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RESEARCH QUESTION: The objective of this investigation is to assess the benefit of treatment with single-session stereotactic radiosurgery (SRS) using linear accelerators or cobalt-60 gamma sources in comparison with microsurgical resection in patients with vestibular schwannoma requiring intervention (primary, recurrence, or residual tissue) with regard to patient-relevant outcomes. CONCLUSION: Results on patient-relevant outcomes which were usable for the report were found in a total of 3 non-randomized prospective comparative studies with a follow-up duration of about 2 years. For each of the outcomes of facial paresis and hearing ability, there is a hint of greater benefit of SRS in comparison with microsurgical resection. No data were available for the outcome of serious adverse events. With regard to the remaining outcomes, there is no hint of any greater benefit or harm of SRS in comparison with microsurgical resection. These outcomes include mortality, dizziness, headache, tinnitus, balance impairment, unfitness to work, adverse events as in complications of therapy and reinterventions as well as health-related quality of life. Based on the benefit-harm assessment across outcomes, this results in a hint of greater benefit of SRS in comparison with microsurgical resection in patients with vestibular schwannoma requiring intervention.

Radiotherapy.

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RESEARCH QUESTION: The aim of this investigation is to1. present and assess the correlation between the volume of services and the quality of treatment outcome in allogeneic stem cell transplantation (SCT) in adults (research question 1a),2. present and assess the correlation between the volume of services and the quality of treatment outcome in autologous SCT in adults (research question 1b), and3. present and assess studies which investigate the effects of a minimum number of cases of SCT introduced into the healthcare system on the quality of treatment outcomes (research question 2). CONCLUSION: For the investigation of a correlation between volume of services and quality of treatment outcome in haematopoietic SCT, a total of 4 registry studies were eligible for inclusion in the assessment. For 1 study, the informative value of results was rated as high. Among the outcomes relevant for the report, this study investigated only overall survival. As regards the outcome of overall survival, the results with high informative value show, for both transplantation types, a significant increase with rising volume of services on the level of the treating physician after up to 1 year. This positive correlation between the volume of services and quality of treatment outcome is also shown for a follow-up period of 8 years by studies with low informative value of results; these studies considered the volume of services at the transplantation centre level. For the other outcomes, only studies with low informative value of results were available. For the combined outcome of event-free survival after allogeneic SCT, a weak positive correlation between volume of services and event-free survival was derived only whenever the volume of services was defined disease-specifically for patients with chronic lymphatic leukaemia. A weak positive correlation between volume of services and non-relapse mortality after allogeneic SCT can also be derived for a follow-up period of 8 years. For shorter follow-up periods, the observed correlations are even weaker. In addition, a weak positive correlation between volume of services and relapse-free survival was found for allogeneic or autologous SCT as well as between volume of services and occurrence of relapse/progression for autologous SCT. In comparison, the observed correlation between the outcome of occurrence of relapse/progression after 5 or 6 years of follow-up, respectively, was weaker for allogeneic SCT. No correlation was derived between volume of services and non-relapse mortality in autologous SCT or occurrence of relapse/progression in allogeneic SCT at a follow-up period of 8 years. The included studies did not provide any usable data or did not report any data on other outcomes, such as acute or chronic graft-versus-host disease or quality of life. No studies were found for investigating the effects of specific minimum case numbers implemented in patient care for SCT on the quality of treatment outcomes.

Stem cells --- Outcome assessment (Medical care) --- Transplantation.

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Lungs --- Respiratory insufficiency. --- Diseases. --- Systematic review.

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Seasonal affective disorder. --- Phototherapy.

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Germ cells.