The German Institute for Quality and Efficiency in Health Care (IQWiG) receives commissions from the Federal Joint Committee of Self-Administration of the Health Care Services or from the Federal Ministry of Health to conduct evidence assessments. The Institute can also undertake research and other projects under its own initiative.
You can read more about the commissions completed and in progress at IQWiG at the IQWiG website.
Heart disease and diabetes: Which statins have been well-investigated?
All of the five different statins that are licensed for use in Germany can lower the cholesterol level in the blood. But the deciding factor for patients is how well the medicine can prevent heart attacks and other coronary artery problems. From this point of view, simvastatin (marketed under various brand names) is the best tested. It has been shown to lengthen life expectancy of people with diabetes and particular heart diseases.more
Minimum surgery volumes in hospitals: Are the outcomes better in hospitals that do more operations?
There may be advantages to having surgery for a total knee replacement, for example, in a hospital with a higher volume of this operation. However, setting specific minimum volumes for operations in German hospitals is not simple.more
Nursing workload in hospitals: Does it have an impact on the health of patients?
In German hospitals the number of patients each nurse needs to care for has noticeably increased. It is not yet possible to conclude whether or not this has had an effect on the quality of patient care in Germany.more
Asthma medication: How does montelukast compare?
Taken in combination with an inhaled corticosteroid, montelukast tablets are slightly less effective in relieving symptoms associated with mild to moderate chronic asthma than a combination of inhaled salmeterol and a corticosteroid. However, serious adverse effects are also slightly less common. It is still unclear whether people with exercise-induced asthma benefit from long-term treatment with montelukast.more
Short-acting insulin analogues: Are they better than regular insulin for people with type 2 diabetes?
There are not enough adequate long-term clinical trials on whether short-acting insulin analogues have health benefits compared to regular human insulin for people with type 2 diabetes. It is also currently not possible to reliably evaluate the long-term safety of insulin analogues.more
Inhaled insulin: How safe is it?
There is currently not enough evidence to reliably evaluate the long-term benefits and harms of inhaled insulin. In most people with diabetes, inhaled insulin cannot completely replace insulin injections. The manufacturer of the inhaled insulin Exubera has taken it off the market.more
Asthma medication: How do fixed combinations of inhaled steroids and long-acting beta-2-agonists compare to combinations of the same drugs taken separately?
Fixed combinations of inhaled steroids and long-acting beta-2-agonists have the same effect on chronic asthma symptoms as combinations of the same drugs taken separately.more
Chronic wounds: Do they heal better with vacuum therapy?
There is some evidence to suggest that vacuum-assisted wound closure systems could help chronic and large open wounds to heal better. More research is needed to find out whether vacuum therapy is generally better than conventional wound treatment.more
Localized prostate cancer: Is brachytherapy better than other options?
It is currently not possible to be sure whether brachytherapy has advantages over other types of therapy in the treatment of early-stage prostate cancer in men. Yet there is evidence that following brachytherapy there are different adverse effects than after other treatment options like surgery or conventional radiotherapy.more
Screening programs: What effects could hearing tests for newborns have?
If all newborn babies had screening tests for hearing impairment, hearing problems could be diagnosed and treated earlier. This could improve early speech development in children who are born with hearing impairments.more
Evaluation of international guidelines: Recommendations for people with coronary heart disease
German disease management programs for people with coronary heart disease are essentially in line with recommendations made in international medical guidelines. Information could be added about nutritional advice, physical activity and counseling on smoking cessation, for example.more
Hypertension: Does losing weight reduce high blood pressure?
Losing weight by dieting (with or without exercise) or by using the drug orlistat can lower high blood pressure in the short term. It is not clear whether weight loss alone can protect against long-term harm from hypertension.more
Type 2 diabetes: What are the advantages and disadvantages of exenatide injections?
In type 2 diabetes, using exenatide injections together with oral antidiabetics can achieve target blood sugar levels as effectively as using insulin. Exenatide can also help reduce weight a little. However, adverse effects are common.more
Benign prostatic hyperplasia: How do newer procedures compare with standard surgery?
Transurethral resection of the prostate (TURP), a standard surgical procedure for the treatment of benign enlarged prostates, has the best proven effect in relieving the associated symptoms. However, some other procedures might work just as well and cause fewer adverse effects.more
Preterm birth and very low birthweight: Do hospitals that treat more preterm babies provide them with better care?
Preterm babies seem to be more likely to survive if they are cared for in large neonatal units, but it is not clear why. more
Evaluation of international guidelines: Breast cancer
New developments in breast cancer treatment for women, including a special kind of antibody therapy, could play a role in the upcoming revision of the German disease management programme for breast cancer. more
Type 2 diabetes: What are the advantages and disadvantages of lowering blood sugar with glitazones?
Glitazones have not been shown to be better than other medications at preventing the complications of type 2 diabetes. The drug rosiglitazone was taken off the market because of its unfavourable risk-benefit ratio. There are also safety concerns about the drug pioglitazone, so drug agencies are advising against its use.more
Dementia in Alzheimer's disease: Can Ginkgo help?
Ginkgo biloba could help some people with Alzheimer’s disease to perform daily tasks again. Adverse effects are not very common, but interactions with other medications cannot be ruled out.more
Dementia in Alzheimer's disease: How well do cholinesterase inhibitors work?
Cholinesterase inhibitors can slightly delay the loss of brain function in people who have mild to moderate Alzheimer’s disease. This means that they may help people to remain independent in everyday life for longer. It is not clear whether cholinesterase inhibitors work better than other treatments do.more
Screening programs: Are there more advantages than disadvantages to having eye tests for all preschool children?
It is important to find out whether children have vision problems, but not enough research has been done to be able to determine the benefits and harms of routine eye tests in preschool children.more
Type 2 diabetes: Are long-acting insulin analogues better than regular long-acting human insulin?
Long-acting insulin analogues have not been shown to have advantages over human insulin in the treatment of people with type 2 diabetes. More research is needed on the long-term benefits and harms of long-acting insulin analogues.more
Type 2 diabetes: How do glinides compare to other medications?
There are no good-quality trials of whether glinides can prevent diabetes complications such as damage to the eyes or kidneys. It is not clear whether these blood-sugar-lowering medications have advantages for people with type 2 diabetes compared to other medications.more
Hypertension: Does reducing your salt intake help?
Reducing your salt intake can help lower blood pressure in the medium term: one spoon of salt less per day could make a difference. It is not clear how this affects the long-term risk of complications or the use of medication.more
Dementia in Alzheimer’s disease: Can non-drug interventions like education programs for family members help people who have Alzheimer’s?
After attending education programs, family members can possibly care for people who have Alzheimer’s at home for a longer time. Some therapies seem to help people who have Alzheimer’s maintain their mental abilities for a longer time.more
Depression: Can duloxetine and venlafaxine help, and how do they compare?
The drugs duloxetine and venlafaxine can relieve the symptoms of depression. They can also reduce the risk of depression coming back and help people to cope better in everyday life. Stopping treatment because of adverse effects is less common with venlafaxine than with duloxetine.more
Angina pectoris and heart attacks: What are the advantages and disadvantages of using ASA and clopidogrel together?
People who have unstable angina pectoris or have had a heart attack in the past can lower their risk of further heart problems if they take the drug clopidogrel as well as ASA. But this also increases the risk of bleeding.more
Type 2 diabetes: Does self-monitoring urine and blood glucose levels have benefits for people who do not inject insulin?
Regular self-monitoring of glucose levels has not been proven to have benefits for people with type 2 diabetes who do not inject insulin. It is not known whether self-monitoring can help prevent diabetes-related complications in this group of people.more
Hypertension: Which drugs are best at preventing complications?
People with hypertension have an increased risk of cardiovascular disease. Drugs designed to work against high blood pressure can lower this risk. Compared with the different drug classes, diuretics can usually be seen as the first line treatment. Which drug is then used in an individual case will also depend on other aspects, for example whether someone has other diseases.more
Cardiovascular diseases: How do ASA and clopidogrel compare?
In people who have blood circulation problems in their legs, clopidogrel can lower the risk of complications somewhat more effectively than ASA can.more
Depression: Can the antidepressants bupropion, mirtazapine and reboxetine help?
Bupropion and mirtazapine can relieve depression. Reboxetine has not been shown to work. Mirtazapine and reboxetine often cause adverse effects.more
Type 1 diabetes: Are long-acting insulin analogues better than regular long-acting human insulin?
There is no scientific proof that long-acting insulin analogues are better than long-acting human insulin. There is also a lack of long-term trials looking at the effects of using insulin analogues for many years.more
Measuring bone density: Who could benefit from this test?
After menopause women are more likely to have fragile bones. Drug treatments can strengthen the bones and lower the risk of fracture. Whether women benefit from the medications can be assessed by measuring their bone density.more
Hypertension: What effect does physical exercise have?
Getting more exercise can help to lower your blood pressure. Whether increased physical activity also effects the risk of developing complications of hypertension has yet to be studied in trials.more
Soft tissue sarcoma: Does high-dose chemotherapy in combination with autologous blood stem cell transplantation have a benefit?
How much benefit or harm results from high-dose chemotherapy in combination with autologous blood stem cell transplantation in cancerous soft tissue tumors (soft tissue sarcomas) has not been studied enough. For this reason researchers recommend its use only in clinical trials.more
Advanced breast cancer: Is high-dose chemotherapy plus autologous blood stem cell transplantation an option?
High-dose chemotherapy followed by autologous blood stem cell transplantation could have benefits for some women. Yet because this treatment can also have serious complications and it is unclear whether it has advantages over other treatments used today, it is not done routinely.more
Gestational diabetes: Does a routine examination help to avoid complications for mother and child?
A routine examination can help to identify women who have possibly developed gestational diabetes. Treating gestational diabetes could help lower the risk of some complications during birth.more
Hodgkin’s lymphoma in adults: What is the benefit of stem cell transplantation with an unrelated donor?
Blood stem cell transplantation can be a treatment option for people with Hodgkin’s lymphoma, if other therapies were unsuccessful. However, there are not enough studies on the chances and risks of stem cell transplantation with unrelated donors.more
Brain tumors: What benefit does a PET scan have in recurrence of high-grade gliomas?
Whether positron emission tomography (PET) for detecting recurrence improves the treatment of people who have high-grade glioma, has not been studied in suitable trials. It also remains unclear how accurately recurrence can be determined using PET.more
Alzheimer’s disease: Do medications containing memantine help?
Medications containing the drug memantine are supposed to help people who have Alzheimer’s disease remember things and better manage their daily tasks. Trials show that memantine can somewhat delay the deterioration of mental abilities. Other abilities important to daily life may also last longer.more
Head and neck tumors: Is a PET examination more exact than routine examinations, and does it lead to better treatment?
It is not yet clear whether cancer in the head and neck region can be diagnosed more precisely by using positron emission tomography (PET) or PET / computed tomography (PET/CT), and whether recurrences can be more reliably detected than is possible with standard examinations. It has also not been possible to estimate what kind of an influence it has on the success of treatment.more
After a stroke: Does treatment with dipyridamole and ASA have a benefit?
A combination therapy of dipyridamole and ASA has more adverse effects than clopidogrel or ASA alone. It is not proven that the combination drug has benefits over clopidogrel or ASA alone.more
After a heart attack: How do clopidogrel and prasugrel compare?
Treatment with prasugrel and acetylsalicylic acid (ASA) aims to lower the risk of complications for people after a heart attack and associated intervention. Prasugrel and ASA seem to lower especially the risk of having more non-fatal heart attacks better than clopidogrel and ASA. But prasugrel does more often lead to serious bleeding.more
Type 2 diabetes: Is it better to lower blood sugar levels to near-normal levels?
People with type 2 diabetes can prevent complications if they lower their high blood sugar levels permanently. Many doctors even recommend trying to get to near-normal blood sugar levels. But trials show that lowering blood sugar to near-normal levels can have both advantages and disadvantages compared with lowering blood sugar levels more moderately.more
Skin cancer: What benefit does positron emission tomography have for treating malignant melanoma?
It is not clear whether positron emission tomography (PET) or PET / computed tomography (PET/CT) improves the treatment of people who have malignant melanoma. It is also not known how exact these procedures are in determining the size, location and spread of a melanoma.more
High cholesterol levels: Can ezetimibe lower the risk of complications?
There is not enough research on whether people with high cholesterol levels have a benefit by taking ezetimibe in addition to a statin. There is not enough data on adverse effects of ezetimibe.more
Ovarian cancer: Can a PET scan improve treatment?
Positron emission tomography (PET) alone or PET in combination with computed tomography (PET/CT) can detect recurrence of ovarian cancer more reliably than conventional tests and examinations. It is unclear, however, whether PET and PET/CT do indeed lead to better treatment of women with ovarian cancer.more
Multiple myeloma: Does allogeneic stem cell transplantation help?
There is not enough research to say whether stem cell transplantation using donor stem cells can help in multiple myeloma. It is therefore recommended to use certain treatments only as part of clinical trials.more
High blood pressure: Does drinking less alcohol help?
There is little research on whether people who have high blood pressure can reduce their risk of associated complications by drinking less alcohol. But there are many reasons for drinking alcohol only in moderation, if at all.more
High blood pressure: Do stress management interventions help?
There is not enough research to be able to say whether stress management interventions can lower blood pressure, and thereby possibly lower the risk of complications caused by high blood pressure.more
High blood pressure: Do special diets make a difference?
People who have high blood pressure are sometimes advised to follow a particular diet: cut down on animal fats and eat plenty of fruits, vegetables, whole grain products, as well as fish and poultry. But there is hardly any research on whether diets like this can lower high blood pressure and the risk of associated complications.more
Cervical cancer: What are the benefits of screening for HPV infection?
Women could benefit from having an HPV test in addition to, or instead of, conventional Pap tests as part of cancer screening.more
Bowel cancer: Do PET scans improve treatment for recurrent tumors?
If there is good reason to suspect bowel cancer recurrence, positron emission tomography (PET) or a combination of PET and computed tomography (PET/CT) can detect new tumor growth better than conventional methods. Yet it remains unclear whether this improves treatment, giving those affected by bowel cancer noticeable benefits.more
High blood pressure in diabetes: Does lowering blood pressure to especially low levels have any advantages?
People who have diabetes are at greater risk of cardiovascular disease. The risk is even higher if they have high blood pressure too. For this reason, an especially large reduction in blood pressure is sometimes recommended for people who have both high blood pressure and diabetes. This could have advantages as well as disadvantages for people with both conditions, but overall this issue has not been well studied.more
Heart attack: Do antibody-coated stents have advantages?
Antibody-coated stents have so far only been studied in people who are at increased risk of blood vessels narrowing again. Research suggests that these new stents are not as good at preventing heart attacks as drug-coated stents.more
Does tiotropium help in chronic obstructive pulmonary disease (COPD)?
Tiotropium reduces the number of acute flare-ups and related hospital stays, improves quality of life and may relieve some symptoms. It also has some advantages over several other COPD medications.more