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Objective 3.2: Develop and facilitate the use of new tools, talent, products, and implementation methodologies stemming from research portfolio.
1st Indicator: Produce evidence summaries for use in Federal direct care
providers' efforts to create guidelines.
Results: Nine evidence summaries that were produced in FY 01 were used by Federal direct care providers to create guidelines including:
- Impact of Cancer-related Decision Aids
- Defining/Management of Chronic Fatigue Syndrome
- Diagnosis/Management of Parkinson's Disease
- Management of Post-Term Pregnancy
- Evaluation/Management of Stroke, Effectiveness and Cost Effectiveness of Echocardiography and Carotid Ultrasound
- Making Health Care Safer: A Critical Analysis of Patient Safety Practices
- Management of Chronic Asthma
- Otitis Media with Effusion
- Management of Neurogenic Pain
The findings from AHRQ sponsored and conducted research has been used by public and private partners to inform the development of guidelines or other quality improvement tools. The following four examples illustrate how public and private partners have used evidence developed by AHRQ to improve the quality of care received:
- Treatment of Pulmonary Disease Following Spinal Chord Injury—The VA Spinal Chord Injury Quality Enhancement Research initiative (SCI QUERI) is considering this evidence report as it develops quality improvement strategies for translating evidence into practice for patients with spinal chord injury treated within the VA healthcare system.
- Making Health Care Safer: A Critical Analysis of Patient Safety Practices—This evidence report has been disseminated to members of the National Forum for Health Care Quality Measurement and Reporting (NQF), which includes a variety of stakeholders, including Federal direct care providers such as the Veteran's Administration and the Department of Defense. This report should be useful to these providers as well as private and public purchasers, employers, consumers, and accrediting bodies, in developing effective strategies for reducing medical errors and improving patient safety.
- Evaluation and Treatment of New Onset Atrial Fibrillation in the Elderly—The North Carolina Peer Review/Quality Improvement Organization (PRO), as part of its efforts under the National Stroke Project sponsored by the Centers for Medicare and Medicaid Services, has widely disseminated copies of the AHRQ-sponsored evidence report on Atrial Fibrillation to physicians and hospitals that treat atrial fibrillation patients across the state. In addition, a physician opinion leader presented the findings of the report to an audience of 246 health care professionals during a teleconference on preventing strokes in patients with atrial fibrillation. Participants had the opportunity to discuss the finding with an expert panel. Rates of warfarin prescription prior to discharge of patients with atrial fibrillation have been measured for the state and will serve as a baseline for assessing improvements in practice over time. The PRO is also providing a data abstraction tool to hospitals in the state that will enable them to assess their performance on this measure and assist in targeting quality improvement efforts.
- US Preventive Services Task Force (USPSTF)—The Centers for Medicare and Medicaid Services (CMS) is using USPSTF recommendations based on AHRQ-sponsored systematic evidence reviews to develop messages (based on focus group testing) for consumers and clinicians regarding Medicare-covered services for osteoporosis, cervical cancer, prostate cancer and breast cancer.
2nd Indicator: EPCs will produce a minimum of 12 evidence reports and
technology assessments that can serve as the basis for interventions to enhance health outcomes and quality by improving practice.
Results: In FY 01, AHRQ-supported EPC's produced the following 18 Evidence Reports and 3 Technology Assessments that can serve as the basis for interventions to enhance health outcomes and quality by improving practice.
- Impact of Cancer-related Decision Aids (McMaster U. EPC)
- Chronic Fatigue Syndrome (San Antonio EPC)
- Diagnosis/Management of Parkinson's Disease (MetaWorks EPC)
- Management of Post-Term Pregnancy (Duke EPC)
- Methods to Rate Strength of Scientific Evidence (RTI/UNC EPC)
- Evaluation/Management of Stroke, Effectiveness and Cost Effectiveness of Echocardiography and Carotid Ultrasound (OHSU EPC)
- Utilization of Physician Services (RAND EPC)
- Refinement of HCUP Quality Indicators (UCSF/Stanford EPC)
- Making Health Care Safer: A Critical Analysis of Patient Safety Practices (UCSF/Stanford EPC)
- Management of Chronic Asthma (BC/BS EPC)
- Otitis Media With Effusion (RAND EPC)
- Management of Neurogenic Pain (McMaster U. EPC)
- Ayruvedic Interventions for Diabetes Mellitus (RAND EPC)
- Feasibility Study: Use of Hyperbaric Oxygen Therapy for Stroke and Brain Injury (OHSU EPC)
- Management of Allergic Rhinitis (NEMC)
- Diagnosis and Treatment of Repetitive Motion Disorders (ECRI)
- Bioterrorism, Training for Rare Public Health Events (JHU)
- Actinic Keratosis (OHSU EPC)
- PET for Breast Cancer (BC/BS EPC)
- Pneumatic Compression for Venous Insufficiency (intramural)
Note: Summaries of Evidence Reports, Final Reports and Technical Supplements can be found at www.ahrq.gov/clinic/epcix.htm
3rd Indicator: Support a minimum of 165 pre- and post-doctoral trainees.
Results: AHRQ provided support for approximately 176 pre and postdoctoral students through a variety of mechanisms including individual pre-doctoral fellowships
(4 students), individual postdoctoral fellowships (7 students), dissertation grants
(15 students) and institutional training program grants (75 pre-doctoral students and 75 postdoctoral students).
4th Indicator: Support up to 3 Minority Research Infrastructure Support Program
(M-RISP) grants in order to develop the health services research capabilities of traditionally minority-serving institutions.
Results: Three M-RISP projects will be supported, reflecting a multidisciplinary blend of clinical and nonclinical perspectives and partnerships. Support will be provided for the development of health services research infrastructure in these institutions. Awardees include the University of Hawaii, Tennessee State/Meharry Universities, and the University of Texas at Galveston, which respectively serve large numbers of Asian/Pacific Islanders, African Americans, and Hispanic students. Research foci of funded centers will include preventative medicine, health disparities, quality of care, and medical effectiveness.
5th Indicator: Support up to 6 Building Research Infrastructure and Capacity
(BRIC) two-year planning grants in EPSCOR states and states which historically have received little or no research support from AHRQ.
Results: AHRQ will provide support for planning associated with the development of research infrastructures in four institutions located in states that historically have not received significant health services research funding. Recipients will include institutions located in states such as Kentucky, Louisiana, Utah, and a consortium of the intermountain states of Nevada, Montana, Idaho and Wyoming. These projects emphasize a variety of health services research interests that draw upon multidisciplinary perspectives to address critical issues pertaining to child health, primary care, health care quality, and rural and frontier health care.
6th Indicator: Fund at least 10 projects in tool development.
Results: AHRQ, through intramural and extramural research, has funded more than 10 projects in the development of new tools and facilitated their use in diverse health care delivery systems. The following are selected examples:
- Development of a series of Web-based, user-friendly quality indicators for improving the quality of inpatient and ambulatory health care to include: (1) AHRQ's prevention/access indicators, and (2) Mortality/utilization indicators. These indicators resulted from a refinement and expansion of the original HCUP Quality Indicators.
- Development of clinical classifications software (ICD-10). This tool includes categories that can be employed in many types of projects analyzing data on diagnoses. For example, they can be used to identify populations for disease - or procedure - or specific duties, provide statistical information about relatively specific conditions, and define comorbidities.
- Publication of the HCUP Fact Book. This Fact Book was produced as a tool to provide statistics and information on procedures performed in U.S. hospitals. The book provides information on the most common procedures, characteristics of patients who receive procedures, procedures associated with the longest hospital stays, the most expensive hospitalizations, and the highest in-hospital mortality. Elixhauser A, Klemstine K, Steiner C, Bierman A. Procedures in U.S. Hospitals, 1997. Rockville (MD): Agency for Healthcare Research and Quality: 2001. HCUP Fact Book No.2; AHRQ Publication NO. 01-0016ISBN 1-58763-029-X.
- Kids' Inpatient Database (KID): Nation's First Database Devoted Solely to Children's Hospital Care. The KID is the only dataset on hospital use, outcomes, and charges for children age 28 and younger, including newborns, regardless of whether they were privately insured, received public assistance, or had no health insurance. The KID is the most recent tool in a family of databases, Web-based products, and user friendly software developed as part of HCUP.
- Release of the 1998 and 1999 State Inpatient Databases (SID - 15 states) and State Ambulatory Surgery Databases (SASD - 7 states) - powerful health care research and policy analysis tools. The SID contains information for every inpatient hospitalization in each participating state, while the SASD captures information on surgeries performed at hospital-affiliated ambulatory surgery sites. These research resources are part of a family of databases and software tools developed as part of HCUP.
GPRA Goal 3—FY 2002 Indicators
|Goal 3 Objectives
||FY 2002 Indicator
|Objective 3.1: Maximize dissemination of information, tools, and products developed from research results for use in practice settings.
Increase by 15% (relative to FY 2001 baseline) the number of state and local governments trained and/or receiving technical assistance through User Liaison Program (ULP).
Identify at least 5 new and important on-going partnerships with public and private-sector organizations to disseminate and implement AHRQ sponsored or conducted research findings.
Synthesis of at least 5 grant portfolio areas on quality of care across Agency's goals for persons with chronic care needs produced and disseminated with particular focus on outreach to managed care executives.
Patient safety research findings will be disseminated to 1000 providers through the Patient safety dissemination and education program.
Augment the family of CAHPS instruments to include a Group Practice Level Survey.
Increase by 15% (relative to the FY 2001 baseline) the number of publications of AHRQ funded and conducted research.
Establish a baseline of electronically available tools and publications that bring AHRQ research to our intended audiences—policymakers, clinicians, State and local officials, health care systems and researchers.
|Objective 3.2: Develop and facilitate the use of new tools, talent, products, and implementation methodologies stemming from research portfolio. (This is objective 3.3 in FY 99-00).
Fund or conduct at least 5 projects in tool and data development.
Fund or conduct at least 5 projects in tool and data use.
Provide technical assistance to 30 new users of CAHPS tools.
Obtain data for the National CAHPS Benchmarking Database from 10 new sponsors of CAHPS surveys.
HIV Research Network data will be used to produce 3 analyses on disparities or quality.
Establish at least 1 Patient Safety Investigator training programs.
Support at least 5 new career development or research infrastructure grants to help to ensure the existence of an adequate cadre of future health services researchers to address existing and emerging research priorities.
Evidence-based Practice Centers
Produce evidence summaries for use in Federal direct care providers' efforts to increase evidence-based care.
Produce a minimum of 18 evidence reports, systematic evidence reviews, and technology assessments that may serve as the basis for interventions by Federal and other direct care providers, professional associations, and other healthcare organizations to increase evidence-based practice and enhance health outcomes and quality.
For at least four evidence reports or technology assessments work with partners to measure how the reports or assessments were used and what impact they had on clinical decision making and patient care.
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GPRA Goal 4: Evaluate the effectiveness and impact of AHRQ research and associated activities. (HCQO)
(Note: All Agency evaluation activities, including MEPS-related studies, are included under Goal 4. This is because the MEPS budget line covers only costs associated with data design, data collection and analysis, and data products.)
Strategy: Cycle of Research Phase 4: Evaluation
As explained in other portions of this document, interim outcomes of research can be evaluated on a relatively short-term basis. However, the ultimate outcome of how the research affects people receiving health care or people interacting with the system requires large, expensive retrospective studies. AHRQ is implementing a growing portfolio of evaluations that will show, iteratively, the outcomes of the investments of Agency funds.
Types of indicators: Interim outcomes of research
Use of results by AHRQ:
AHRQ conducts evaluations of its major programs or products to achieve one or more of the following:
- Evaluate the current state of the program or product including impact in health care;
- Improve customer satisfaction with the program or product;
- Target or prioritize future activities to increase their usability or usefulness.
Many of the evaluations are conducted with the assistance of consultants who are highly skilled in evaluation research and/or the subject matter. Some are done through surveys for customer satisfaction that were cleared through OMB. The third category is evaluations conducted through consultations with experts and users to obtain direct feedback on a particular product. In order to ensure the integrity of the evaluations, the AHRQ staff assigned to these projects are not program staff responsible for the day-to-day administration of the program. Additionally, advice on the evaluation questions as well as on the interpretation and use of the results is often sought from experts on the AHRQ National Advisory Council.
GPRA Goal 4—FY 2001 Results
Objective 4.1: Evaluate the impact of AHRQ sponsored products in advancing methods to measure and improve health care.
1st Indicator: Use of evidence reports and technology assessments to create quality improvement tools in at least 10 organizations.
Results: Twenty-one examples are listed of Organizations and their uses of evidence reports to create tools for improving health care quality:
- Treatment of Attention Deficit and Hyperactivity Disorder (ADHD)—The American Academy of Pediatrics (AAP) is developing a clinical practice guideline based on the AHRQ-sponsored evidence report on this topic that is expected to be issued in October 2001.
- Venous Thromboembolism—The Eastern Association for Surgery of Trauma has developed a guideline submitted to the Journal of Trauma Surgery based on an AHRQ-sponsored evidence report on this topic.
- Anesthesia Management During Cataract Surgery and Treatment of Co-Existing Cataract and Glaucoma—The American Academy of Opthalmology (AAO) has considered this evidence report in developing a Preferred Practice Parameter for Cataract in the Adult Eye. The practice parameter will be issued in September 2001 and will be posted on the AAO's website and disseminated to new opthalmic residents.
- Treatment of Co-Existing Cataract and Glaucoma—The American Academy of Opthalmology (AAO) has considered this evidence report in developing a Preferred Practice Parameter for Cataract in the Adult Eye. The practice parameter will be issued in September 2001 and will be posted on the AAO's website and disseminated to new opthalmic residents.
- Use of Epoetin in Oncology—The American Society of Hematology/American Society of Clinical Oncology (ASH/ASCO) has developed a guideline based on an AHRQ-sponsored evidence report on this topic.
- Pharmacotherapy for Alcohol Dependence—The American Society of Adolescent Medicine (ASAM) has developed a guideline based on an AHRQ-sponsored evidence report on this topic that will be published in late 2001.
- Evaluation and Treatment of New Onset Atrial Fibrillation in the Elderly—The ACP-ASIM, with representation from AAFP, has developed a guideline based on the AHRQ-sponsored evidence report on this topic. The American College of Cardiology (ACC), in conjunction with the European Society of Cardiology, is also planning to develop a guideline based on this report.
- Management of Neurogenic/Neuropathic Pain Following Spinal Cord Injury—In response to the findings of this evidence report revealing insufficient information on which to base an evidence-based guideline, the Paralyzed Veterans of America Steering Committee has approved a proposal to use the evidence report to plan a strategy for stimulating collaborative research to fill the evidence gaps in this field.
- Otitis Media with Effusion—The American Academy of Pediatrics (AAP) has convened a panel to develop guidelines based on an AHRQ-sponsored evidence report on this topic.
- Acute Bacterial Sinusitis in Children—The American Academy of Pediatrics (AAP) developed a practice guideline based on the AHRQ-sponsored evidence report that will appear in Pediatrics in September. There will be a session to promote the guideline at the next AAP annual meeting and a CME program on the guideline is being developed. This evidence report was also considered in the development of guidelines by the American College of Physicians (ACP) and the CDC, as well as the Sinus and Allergy Health Partnership (a partnership composed of the American Academy of Otolaryngic Allergy, the American Academy of Otolaryngology-Head and Neck Surgery and the American Rhinologic Society).
- Criteria for Referral of Patients with Epilepsy—The American Academy of Neurology (AAN) and the American Epilepsy Society (AES) sponsored an Epilepsy Guideline Topic Forum at the most recent AES meeting (December 2000) and plan to develop a guideline on this topic, based on the AHRQ-sponsored evidence report, beginning in September 2001.
- Management of Acne—AHRQ partners, the American Academy of Pediatrics (AAP) and the American Academy of Dermatology (AAD), are currently using the evidence report in the development of guidelines for the treatment of acne. The completed guidelines is expected by the end of 2002. These guidelines will be disseminated through each professional society, including publication in the Journal of AAD and in Pediatrics.
- Acute Otitis Media—The American Academy of Pediatrics (AAP) and the American Association of Family Practitioners has convened an expert panel that is in the final stages of developing a clinical practice guideline based on this evidence report.
- Management of Post-operative Atrial Fibrillation—When this evidence report is completed it will be used by the American College of Chest Physicians to develop a clinical practice guideline.
- Stable Angina—The American College of Cardiology/American Heart Association has developed a guideline based on this evidence report.
- Use of Epoetin in Oncology—The American Society of Hematology/American Society of Clinical Oncology Guideline Development Committee is using this evidence report as the basis for development of a clinical practice guideline.
- Cervical Cytology—The methodology used for this evidence report has been adapted for use by an expert-working group (Consensus Panel on Cervical Cancer Screening) advising the American Cancer Society on development of new guidelines for cervical cancer screening.
- Management of Cancer Pain—The American Pain Society will use the evidence report to update their guideline on management of cancer pain. The evidence report was cited by a recently published IOM report titled Improving Palliative Care for Cancer.
- Management of Acute Exacerbations of Chronic Obstructive Pulmonary Disorder (COPD)—This evidence report was used by the American College of Chest Physicians and the American College of Physicians-American Society of Internal Medicine Joint Expert Panel on Chronic Obstructive Pulmonary Disease to develop a clinical practice guideline for management of acute exacerbations of chronic obstructive pulmonary disease.
- Pulmonary Complications after Spinal Cord Injury—The Spinal Cord Injury Consortium (funded by Paralyzed Veterans of America) is in the process of convening an expert panel to develop a clinical practice guideline based on evidence summarized in the report.
- US Preventive Services Task Force (USPSTF)—The American Association of Family Practitioners (AAFP) is using new USPSTF recommendations based on four AHRQ-sponsored systematic evidence reviews in updating AAFP recommendations for preventive care. AAFP has also adapted the new USPSTF evidence rating system, released in the April 2001 issue of the American Journal of Preventive Medicine for developing prevention recommendations and policies for its members.
2nd Indicator: For at least four evidence reports or technology assessments per
year, work with partners to measure how the reports or assessments were used and what impact they had on clinical.
Results: The following six examples show how AHRQ worked with various partners to measure the impact of evidence reports on clinical practice:
- Diagnosis and Treatment of Attention Deficit/Hyperactivity Disorder (ADHD)—AHRQ's partner, the American Academy of Pediatrics (AAP) is launching a three-pronged campaign to promote implementation of its guidelines on diagnosis and treatment of ADHD. The guidelines are based on the two AHRQ-sponsored evidence reports on these topics. The campaign will address providers, parents, and payers/purchasers. Tool kits will be developed for providers, containing resources such as reminder cards and flow sheets, to facilitate adoption of guideline recommendations within pediatric practices. In addition, a module on ADHD will be added to the AAP's Educational Quality Improvement Program (EQuIP), a web-based interactive training tool and database that will offer educational case studies and enable practitioners to compare practice patterns related to the guidelines with those of other practitioners. A companion parent education pamphlet will also be developed and disseminated via AAP members and a more detailed informational book, written for a lay audience, will be distributed. Outreach to payers and purchasers will be accomplished through a series of regional meetings. AAP hopes to evaluate the effectiveness of the program, particularly the provider tool kits, in a second phase using the PROS (Pediatric Research in Office Settings).
- Acute Otitis Media—AHRQ has awarded a task order, under the ISDRN contract, to the Lovelace Clinic Foundation to facilitate implementation and evaluation of guidelines based on the AHRQ-sponsored evidence report on Acute Otitis Media. The project involves:1) development of a clinical practice guideline based on the evidence report; 2) implementation of the guideline within the Lovelace Health Systems, a large integrated managed care delivery system in Albuquerque, New Mexico, based on an Episode of Care (EOC) model; measurement of the impact and evaluation of the effectiveness of the implementation strategies; and assessment of the difference in outcomes by ethnicity and socioeconomic status. The goal of the project is to enhance understanding of the most effective methods of changing physician and patient behavior to promote adherence to evidence-based guidelines.
- Venous Thromboembolism—Based on the research gaps identified in the AHRQ-sponsored evidence report on this topic, a multi-centered trial (US and Canada) has been launched to obtain more definitive evidence regarding best treatment practices for venous thromboembolism.
- Evaluation and Treatment of New Onset Atrial Fibrillation—The North Carolina Peer Review/Quality Improvement Organization (PRO), as part of its efforts under the CMS-sponsored National Stroke Project, has widely disseminated copies of the AHRQ-sponsored evidence report on Atrial Fibrillation to physicians and hospitals that treat atrial fibrillation patients across the state. In addition, a physician opinion leader presented the findings of the report to an audience of 246 health care professionals during a teleconference on preventing strokes in patients with atrial fibrillation. Participants had the opportunity to discuss the finding with an expert panel. Rates of warfarin prescription prior to discharge of patients with atrial fibrillation have been measured for the state and will serve as a baseline for assessing improvements in practice over time. The PRO is also providing a data abstraction tool to hospitals in the state that will enable them to assess their performance on this measure and assist in targeting quality improvement efforts.
- Diagnosis and Treatment of Dysphagia/Swallowing Problems in the Elderly—Based on the results of this evidence report, AHRQ is working with relevant healthcare and research organizations to develop a research agenda that would facilitate filling in the gaps in the evidence in order to improve clinical practice surrounding treatment of swallowing problems in the elderly.
- Use of Ethropoeitin in Hematology and Oncology—AHRQ provided grant funding for an investigator from Northwestern University to conduct a baseline survey of EPO use patterns among clinician members of the American Society for Clinical Oncology (ASCO) and the American Society of Hematology (ASH). Results of this survey will serve as a benchmark that will be useful in measuring and evaluating how the introduction of the ASH/ASCO clinical practice guideline, based on the AHRQ-sponsored evidence report, are affecting clinical practice.
3rd Indicator: Findings from at least 3 evidence reports or technology assessments will affect State or Federal health policy decisions.
Results: The following twelve examples are listed of the effects of evidence reports and technology assessments on the health policy decisions of State and Federal agencies:
- Efficacy of Interventions to Modify Dietary Behavior Related to Cancer Risk—The National Cancer Institute served as partner and funder of the AHRQ-sponsored evidence report on this topic. The evidence report was incorporated into a Review for the National Cancer Policy Board (a joint NCI/IOM collaboration) on behavioral interventions in cancer prevention and early detection. In June, 2001 the Research subcommittee of the 5 A Day Steering Committee noted the evidence report in developing a strategic plan for new research priorities. The NCI has broadly disseminated the report. They have posted a link to the report on their website and have highlighted it at a variety of investigator meetings, including the NCI Nutrition Behavior Change investigators meeting and the American Institute for Cancer Research Conference.
- Technology Assessment on Actinic Keratosis—This technology assessment was used by the Centers for Medicare and Medicaid Services (CMS) as a basis for a coverage decision. On July 19, 2001 CMS announced that the Coverage Issues Manual will be revised to indicate that Medicare will cover the destruction of actinic keratosis, without restrictions based on lesion or patient characteristics, using surgical or medical treatment methods, including but not limited to: cryosurgery with liquid nitrogen; curettage; excision; and photodynamic therapy.
- Diagnosis and Prevention of Dental Caries—This evidence report was used as the basis for a NIH Consensus Development Conference (CDC). This was the first Federal CDC to base its findings on an evidence-based systematic review. Subsequent to the success of this effort, the NIH Office of Medical Applications of Research Consensus Development Conference program and AHRQ developed a clearly defined coordination process to provide systematic reviews on an ongoing basis for NIH CDCs. Prior to every Consensus Development Conference, an AHRQ Evidence-based Practice Center (EPC) develops an evidence report based on a rigorous systematic review and analysis of the scientific literature on the Conference topic. The EPC clinical experts and methodologists present their report findings and conclusions to the Consensus Conference panel and at the Consensus Conference. The Conference panel then can incorporate the findings of the EPC into their final Conference report. This insures that they have an impartial review of the best evidence when they are making their recommendations.
- Oral Health and HIV—This evidence report was the basis of a State of the Science conference sponsored by NIH and NIDCR in December 2000.
- Telemedicine for the Medicare Population—CMS is using this evidence report to develop a research agenda.
- Criteria to Determine Disability in Patients with Chronic Renal Failure—Based on this evidence report the SSA concluded there is insufficient evidence to change their policy regarding disability determination for End Stage Renal Disease (ESRD) patients.
- Management of Hepatitis C—This project will generate a report that will be used by an NIH-sponsored Consensus Development Conference on Management of Hepatitis C.
- US Preventive Services Task Force (USPSTF)—Consistent with recommendations in a recent Institute of Medicine (IOM) report, Sen. Bob Graham has introduced legislation in Congress that would establish a fast-track approval process for decisions on coverage of clinical preventive services recommended by the USPSTF, based on AHRQ-sponsored systematic evidence reviews.
- Diagnosis and Monitoring of Osteoporosis in Postmenopausal Women—An AHRQ-sponsored evidence report on this topic was used by the panel of the National Institutes of Health Consensus Development Conference on Osteoporosis Prevention, Diagnosis and Therapy, held March 27-29, 2000.
- Cervical Cytology—Findings from this evidence report have been considered by the National Breast and Cervical Cancer Detection Program and the Expert Panel on HPV Infection and Sequelae at the CDC, as well as the Advisory Panel on Microbiological Devices of the FDA. They were also used by the US Preventive Services Task Force in developing recommendations for cervical cancer screening.
- Management of Cancer Pain—This evidence report will be updated and used in the upcoming National Institutes of Health State-of-the-Science Conference on Symptoms Management in Cancer.
- Management of Uterine Fibroids—The Steering Committee of the Cooperative Multicenter Reproductive Medicine Network of the National Institute of Child Health and Human Development (NICHD) is using this evidence report to help develop research projects for the Network. The results of the report were also presented to the Annual Meeting of Directors of Programs in Reproductive Medicine who receive grants funded by NICHD. The results were also presented to the Advisory Council of the National Institute of Environmental Health Sciences, for assistance in strategic planning of the research agenda for the Institute. This report is also being used by the Obstetrics and Gynecology Devices Branch of the Food and Drug Administration to evaluate issues in the regulatory evaluation of medical devices used in the treatment of women with fibroids.
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