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August 11, 2000, Issue No. 12
AHRQ News and Numbers
- Women over age 80 less likely to receive full range of treatments for breast cancer
- Elderly New Yorkers tend to use local hospitals even when severely ill
- AHRQ has new data about health insurance
- User Liaison Program workshop
- HRSA awards funds for medical faculty training in genetics
- Evidence report on management of acute otitis media
- New publication called Le han diagnosticado: ¿Qué es lo que sigue? released in Spanish
- National Guideline Clearinghouse™ has a new feature
- Guidelines added to NGC
- Highlights from the most recent edition of our monthly newsletter
- New AHRQ publication
- AHRQ in the news
1. Women Over Age 80 Less Likely to Receive Full Range of Treatments for Breast Cancer
Women over age 80 were less likely to be referred to a radiation oncologist, and after breast conserving therapy, they were more than three times more likely not to receive radiation therapy, according to a study AHRQ announced on July 31. The study was conducted by the Lombardi Cancer Center, Georgetown University Medical Center, and researchers at 29 hospitals across the country. Select to access the abstract for "Patterns of Breast Carcinoma Treatment in Older Women" by Jeanne S. Mandelblatt, M.D., M.P.H.; Jack Hadley, Ph.D., Jon F. Kerner, Ph.D., Kevin A. Schulman, M.D. and others published in the August 1 issue of Cancer.
2. Elderly New Yorkers Tend to Use Local Hospitals Even When Severely Ill
Elderly people living in New York are less likely to travel outside their home counties for hospital care even when they are severely ill, according to a study AHRQ announced on August 4. The study involved nearly 250,000 hospital discharges in 1994 for patients from 58 New York counties, excluding the Bronx, New York County (Manhattan), Queens County, and Kings County. The study, entitled Out-of-Area Travel from Rural and Urban Counties: A Study of Ambulatory Care-Sensitive Hospitalizations for New York State Residents, by AHRQ's Joy Basu, Ph.D., and former AHRQ researcher James Cooper, M.D., was published in the Spring 2000 issue of the Journal of Rural Health.
3. AHRQ Has New Data About Health Insurance
The Medical Expenditure Panel Survey (MEPS) has new data available on health insurance status in the United States. In 1998, almost one-third of all Hispanics and one-fifth of all blacks had no health insurance compared with 12.2 percent of whites. In addition, blacks were the most likely to be covered by public assistance, while whites were the most likely to have private coverage. The total number of Americans without health insurance was 42.3 million, or 15.8 percent of the population. Select for Health Insurance Status of the Civilian Noninstitutionalized Population: 1998 Research Findings 11. To order print copies, call the AHRQ Publications Clearinghouse at 1-800-358-9295.
4. User Liaison Program (ULP) Workshop
AHRQ's User Liaison Program (ULP) workshop on Prescription Drug Coverage was held in Atlanta on January 10-12, 2000, and the ULP audio teleconference series on medical errors was held in March and April.
5. HRSA Awards Funds for Medical Faculty Training in Genetics
The Health Resources and Services Administration (HRSA) is awarding $200,000 in grants to 20 faculty teams to create models for adapting genetics knowledge and technology to everyday clinical practice. HRSA's Maternal and Child Health Bureau and Bureau of Health Professions will take the lead on this project, in collaboration with the National Human Genome Research Institute, NIH, and AHRQ.
6. Evidence Report on Management of Acute Otitis Media
AHRQ announced the availability of a summary of an evidence report on Management of Acute Otitis Media on August 9. The AHRQ-funded Southern California/RAND Evidence-based Practice Center (EPC) found that almost two-thirds of children with uncomplicated Acute Otitis Media (AOM) recover from pain and fever within 24 hours of diagnosis without treatment with antibiotics, and over 80 percent recover within 1-7 days. When treated with antibiotics, up to 93 percent of children will recover during the first week. The EPC analyzed clinical studies conducted on children 4 weeks to 18 years of age from 1964 through 1998. In addition, the EPC found no evidence to conclude that children with AOM treated with amoxicillin fared any differently from those treated with more expensive antibiotics such as cefaclor, cefixime, azithromycin, or clarithromycin. Furthermore, amoxicillin caused fewer side effects. Select to access the summary. Print copies of the summary are available from the AHRQ Publications Clearinghouse, 1-800-358-9295. Copies of the full report will be available later this year.
7. New Publication Called Le han diagnosticado: ¿Qué es lo que sigue? Released in Spanish
Le han diagnosticado: ¿Qué es lo que sigue? is the Spanish-language version of the recently published Now You Have a Diagnosis: What's Next?, developed by AHRQ and the Kanter Family Foundation. This handy guide helps recently diagnosed patients or family members of diagnosed patients find reliable information on the diagnosis and treatment options. It also explains how to use the information to make treatment decisions in partnership with the doctor. The publication is intended for employers, health insurance companies, patients and health care providers. Select to access the Spanish version of the publication.
8. National Guideline Clearinghouse™ (NGC) Has a New Feature
The NGC has added a new feature that you may find useful. NGC users may now search annotated bibliographies on the site covering guideline development methodology, structure, evaluation, and implementation. The bibliographies include peer-reviewed journal articles, books and book chapters, and video recordings and tapes. Currently, there are 920 citations in the database. Select to access the annotated bibliographies.
9. Guidelines Added to NGC
During the month of July, 12 guidelines were added to the NGC. There are now 827 guidelines in the NGC. Select http://www.guideline.gov to access these guidelines and
- Evaluation and preparation of pediatric patients undergoing anesthesia.
- Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures.
- Alzheimer Disease and Related Dementias Part I; Recognition and Assessment.
- Alzheimer Disease and Related Dementias Part II; Management.
- Breast Cancer Screening.
- Colorectal Cancer Screening.
- Ovarian Cancer Screening.
- Pharyngitis/Sore Throat.
- Cauda equina.
- Criteria for MRI of the lumbar spine.
- Guidelines for psychiatric and psychological evaluation of injured or chronically disabled workers.
- Guidelines for outpatient prescription of controlled substances, schedules II-IV for workers on time-loss.
10. Highlights from the Most Recent Edition of Our Monthly Newsletter
The new issue of Research Activities is in the mail. The key articles are:
- One-third of heart attack patients delay seeking care because they don't have chest pain.
- Urinary incontinence is associated with the risk of depression among the elderly.
- Screening for cervical cancer every 3 to 5 years with the conventional Pap test remains effective.
- Researchers examine use of emergency medical services and hospitalization for children with special needs.
- Sexual assault is a major problem for homeless women, which often correlates with physical and mental health problems.
Select to access the July issue of Research Activities.
11. New AHRQ Publication
MEPS Methodology Report 10: Imputation of Employer Information for the 1996 Medical Expenditure Panel Survey Insurance Component The MEPS Insurance Component is a survey of employers, the self-employed with no employees, unions, and insurance companies. It is designed to collect employment-related health insurance information, such as premiums and types of plans offered. Print copies are available from the AHRQ Publications Clearinghouse, 1-800-358-9295.
12. AHRQ in the News
Hoffman JR, Mower WR, Wolfson AB, et al. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. N Engl J Med 2000 July 13;343(2):94-99
Zorn B, Bauer JJ, Moul JW. Benign prostatic hyperplasia: new concepts for the millennium. Am J Manag Care 2000 May;5(5):911-22
Brown JS, Vittinghoff E, Wyman JF, et al. Urinary incontinence: does it increase risk for falls and fractures?J Am Geriatr Soc 2000 July;48(7):721-25
Lee-Feldstein A, Feldstein PJ, Buchmueller T, et al. The relationship of HMOs, health insurance, and delivery systems to breast cancer outcomes. Med Care 2000 July;38(7):705-18
Among 15-17 year-olds, three out of ten hospitalizations are related to pregnancy or childbirth. [McCormick, M.C., et al. Annual Report on Access to and Utilization of Health Care for Children and Youth in the United States-1999. Pediatrics 2000;105(1, pt. 3): 219-30]
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Current as of August 2000