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February 4, 2005, Issue No. 159
AHRQ News and Numbers
Approximately 95 percent of families had some health care expenses in 2002, and the total expenses for these families averaged $6,928. The average amount of expenses paid out-of-pocket per family was $1,321. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #64: Family Health Care Expenses, by Income Level, 2002 (PDF File, 356 KB; PDF Help).]
- Task Force recommends that male smokers between the ages of 65 and 75 be screened for abdominal aortic aneurysm
- Evidence-based medicine spotlighted in Health Affairs
- Special journal issue on women and medication safety is available online
- New evidence report on sexuality and reproductive health following spinal cord injury available
- New evidence report on wound healing techniques available
- AHRQ in the professional literature
1. Task Force Recommends that Male Smokers Between the Ages of 65 and 75 Be Screened for Abdominal Aortic Aneurysm
The U.S. Preventive Services Task Force recommends that men between the ages of 65 and 75 who are or have been smokers have a one-time ultrasound to screen for abdominal aortic aneurysm. Nearly 70 percent of men in this age group have smoked and would benefit from routine screening to check for aneurysms. Men ages 65 and older who currently are or have been regular smokers are at the highest risk for abdominal aortic aneurysm. Few studies have been conducted in women, and the published research indicates that women are at low risk for aneurysms. Death from an aneurysm is a rare event in women, and most of these deaths occur in women older than 80. The Task Force found no evidence of benefit from routine screening for abdominal aortic aneurysm in women and concluded that potential harms of screening, including mortality and complications of surgery for aneurysms, outweigh potential benefits. Select to access our press release and to read the recommendation, which was published in the February 1 issue of the Annals of Internal Medicine.
2. Evidence-Based Medicine Spotlighted in Health Affairs
A series of papers devoted to evidence-based medicine, some authored by AHRQ staff, appear in the January/February 2005 issue of Health Affairs. Select to access the full article, "Evidence-Based Decision Making: Global Evidence, Local Decisions," by AHRQ Director Carolyn M. Clancy, M.D., and Kelly Cronin, M.P.H. Select to access the abstracts for "Making Policy When The Evidence Is In Dispute," by David Atkins, M.D., M.P.H., Joanna Siegel, Sc.D., R.N., and Jean Slutsky, P.A., M.S.P.H.; "Evidence-Based Medicine: A Unified Approach," by David M. Eddy, M.D., Ph.D.; "Evidence Based? Caveat Emptor!" by Earl P. Steinberg, M.D., M.P.P., and Bryan R. Luce, Ph.D., M.B.A.; and "Evidence-Based Quality Improvement: The State Of The Science," by Kaveh G. Shojania, M.D., and Jeremy M. Grimshaw, M.B.Ch.B., Ph.D. Limited single copies of the January/February 2005 issue of Health Affairs are available by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
3. Special Journal Issue on Women and Medication Safety Is Available Online
The Journal of Women's Health has published a special issue on improving the use and safety of medications in women, which was edited by Rosaly Correa-de-Araujo, M.D., M.Sc., Ph.D., AHRQ's Senior Advisor for Women's Health. The articles in this issue were based on discussions at an expert meeting called by Dr. Correa-de-Araujo to highlight gender differences in medication use. Topics of the articles include evidence for gender and racial differences in drug response, the role of biological rhythms in medication safety for women, geriatric pharmacotherapy, and strategies for reducing the risk of medication errors in women. The entire free issue is available online.
4. New Evidence Report on Sexuality and Reproductive Health Following Spinal Cord Injury Available
For people with spinal cord injury, sexuality and reproductive health are high priorities for improving their quality of life, according to a new evidence report prepared by AHRQ's University of Ottawa Evidence-based Practice Center. Advanced fertility techniques for men with spinal cord injury can increase pregnancy rates to above 50 percent per couple, according to the report, which focuses on issues related to fertility, pregnancy rates, and live births in people with spinal cord injury and on issues related to male impotence following spinal cord injury. The report also found that intracavernous injections have a significantly higher efficacy than Viagra® (90 percent versus 79 percent). The report was requested by the Consortium for Spinal Cord Medicine (sponsored by the Paralyzed Veterans of America). Select to access the summary and full report. Print copies of the summary and report are available by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
5. New Evidence Report on Wound Healing Techniques Available
AHRQ released a new evidence report on wound healing techniques that reviews the use of low-level lasers and vacuum-assisted closure for wound care. This report was prepared by AHRQ's Blue Cross Blue Shield Association Technology Evaluation Center Evidence-based Practice Center in Chicago. The report found that the overall evidence was of poor quality for low-level laser, and the available data suggest that the addition of laser therapy does not improve wound healing. The body of evidence was also insufficient to support conclusions about the effectiveness of vacuum-assisted closure, but in most cases the data tended to favor the vacuum-assisted closure group. Additional randomized trials testing vacuum-assisted closure are ongoing. There are approximately 5 million to 7 million incidences of chronic wounds per year in the United States, with annual costs for wound care management of more than $20 billion. This report was requested by America's Health Insurance Plans. Select to access the summary and full report, "Wound Healing Technologies: Low-Level Laser and Vacuum Assisted Closure." Print copies of the summary and report are available by sending an E-mail to AHRQPubs@ahrq.hhs.gov.
6. AHRQ in the Professional Literature
We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.
Sheth HS, Verrico MM, Skledar SJ, Towers, AL. Promethazine adverse events after implementation of a medication shortage interchange. Ann Pharmacother 2005;39:255-61. Select to access the abstract on PubMed®.
Plunkett BA, Grobman WA. Elective cesarean delivery to prevent perinatal transmission of hepatitis C virus: a cost-effectiveness analysis. Am J Obstet Gynecol 2004 Sep;191(3):998-1003. Select to access the abstract on PubMed®.
Zizza C, Herring AH, Stevens J, et al. Length of hospital stays among obese individuals. Am J Public Health 2004 Sep;94(9):1587-91. Select to access the abstract on PubMed®.
Lappe JM, Muhlestein JB, Lappe DL, et al. Improvements in 1-year cardiovascular clinical outcomes associated with a hospital-based discharge medication program. Ann Intern Med 2004 Sep 21;141(6):446-53. Select to access the abstract on PubMed®.
Lozano P, Finkelstein JA, Carey VJ, et al. A multisite trial of the effects of physician education and organizational change in chronic-asthma care: health outcomes of the Pediatric Asthma Care Patient Outcomes Research Team II Study. Arch Pediatr Adolesc Med 2004 Sep;158(9):875-3. Select to access the abstract on PubMed®.
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Current as of February 2005