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April 21, 2006, Issue No. 197
AHRQ News and Numbers
The number of hospital patients with pressure sores, also called decubitus ulcers or bed sores, rose from 280,000 cases in 1993 to 455,000 cases in 2003—a 63 percent increase. Hospital charges for stays principally for treatment of pressure ulcers averaged $37,800. [Source: Agency for Healthcare Research and Quality, HCUP, HCUP Statistical Brief #3: Hospitalizations Related to Pressure Sores. (PDF File, 319 KB; PDF Help).]
- AHRQ study finds wrong-site surgery rare and preventable
- AHRQ expands therapeutic education and research network to focus on critical issues facing the health care system
- New report finds no effective medications for anorexia nervosa, but behavioral therapy may have a limited benefit
- Call for nominations for AHRQ Quality Indicators Workgroup on Inpatient and Patient Safety Composite Measures
- Latest AHRQ audio newscasts feature stories on inappropriate antibiotic prescribing, C-sections, asthma treatment, and more
- AHRQ releases evidence report on B vitamins and berries and age-related neurodegenerative disorders
- Webcast on pay for performance will feature latest evidence, practical tools
- 2006 Pharmacoeconomic Conference set for June 12
- AHRQ in the professional literature
1. AHRQ Study Finds Wrong-site Surgery Rare and Preventable
Wrong-site surgery is extremely rare and major injury from it even rarer, according to an AHRQ-funded study published in the April 2006 Archives of Surgery. The term "wrong-site surgery" includes surgery on the wrong organ or limb, at the wrong site on the spine, or on the wrong person. Researchers led by Mary R. Kwaan, M.D., M.P.H., of Brigham and Women's Hospital and Harvard School of Public Health in Boston, estimate that a wrong-site surgery serious enough to result in a report to insurance risk managers or in a lawsuit would occur approximately once every 5 to 10 years at a single large hospital.
The study assessed all wrong-site surgeries reported to a large medical malpractice insurer between 1985 and 2004 and found that the number of wrong-site surgeries conducted on limbs or organs other than the spine occurred once in every 112,994 operations. Forty cases of wrong-site surgery were identified among 1,153 malpractice claims and 259 instances of insurance loss related to surgical care were reported. Twenty-five of the cases were non-spine wrong-site surgeries, with the remainder involving surgery of the spine. Select to read our press release and select to read the abstract in PubMed®.
2. AHRQ Expands Therapeutic Education and Research Network to Focus on Critical Issues Facing the Health Care System
AHRQ announced the award of $16 million over the next 5 years to establish four new Centers for Education and Research on Therapeutics (CERTs) to increase awareness of the benefits and risks of therapeutic products, including prescription medicines, biological products and medical devices, and to translate research findings into improved health care. The four new AHRQ-funded CERTs are located at Rutgers, the State University of New Jersey in New Brunswick; the University of Iowa in Iowa City; Baylor College of Medicine in Houston; and Weill Medical College of Cornell University in New York City.
The cooperative agreement grants expand the existing CERTs network from 7 to 11 AHRQ-funded centers and one coordinating center. Each center will work collaboratively with AHRQ and the FDA to conduct research and provide education that advances the optimal use of medications, medical devices, and biologic products. Select to read our press release and select for more information on the CERTs activities.
3. New Report Finds No Effective Medications for Anorexia Nervosa, but Behavioral Therapy May Have a Limited Benefit
No medications are available that effectively treat patients suffering from anorexia nervosa, but a few behavioral therapies may help prevent a relapse and offer other limited benefits, according to a new review of currently available research on eating disorders. The review also found evidence that several medications and behavioral therapies can help patients suffering from bulimia nervosa and binge eating disorder.
Cognitive behavioral therapy (CBT) helped prevent relapse in adult anorexic patients once their weight had been restored to a normal level. Both medications and behavioral therapies were found helpful in treating bulimia nervosa; however, there was no clear information about how to combine medications with behavioral treatments. The selective serotonin reuptake inhibitor (SSRI) fluoxetine, commonly known as Prozac, was found helpful in treating bulimia in a short-term clinical trial. CBT, offered either individually or in a group, and interpersonal psychotherapy were also helpful in reducing the core symptoms of bulimia nervosa, binge eating and purging, and in alleviating the psychological symptoms of this disorder.
The review was conducted by AHRQ's Evidence-based Practice Center at RTI International and the University of North Carolina at Chapel Hill. Select to access our press release and to access the report. A print copy of the report, The Management of Eating Disorders, is available by sending an E-mail to firstname.lastname@example.org.
4. Call for Nominations for AHRQ Quality Indicators Workgroup on Inpatient and Patient Safety Composite Measures
AHRQ is seeking nominations for members of the AHRQ Quality Indicators Workgroup on Composite Measures for the Inpatient Quality Indicators and the Patient Safety Indicators. Nominations should be submitted to: AHRQ Quality Indicators Initiative, Center for Delivery, Organization and Markets, 540 Gaither Road, Room 5121, Rockville, MD 20850 or by E-mail to email@example.com. Select to access the April 4 Federal Register notice for more information. Nominations are due May 4.
5. Latest AHRQ Audio Newscasts Feature Stories on Inappropriate Antibiotic Prescribing, C-sections, Asthma Treatment, and More
Statistics about dental checkups for children age 2 to 17, stories about AHRQ evidence reports on abnormal adnexal masses and cesarean section, and an item about a pilot project to combine public and private information to measure physician quality are featured in AHRQ's 8-minute April 12 newscast, the latest in our Healthcare 411 series.
Statistics about headaches, an item on an AHRQ evidence report on inappropriate antibiotic prescribing, and an interview with a top researcher on asthma medication use by inner-city patients are featured in the 15-minute March 29 newscast.
If your computer has a sound card and speakers and can play MP3 audio files, you will be able to listen to the Newscasts on your computer at your convenience—according to your schedule, whenever you have 10 or 15 minutes to listen. Please visit the main page of our Healthcare 411 series to access these Newscasts, hear any of AHRQ's Newscasts and Special Reports, or to subscribe to the series and receive all AHRQ podcasts automatically. The subscription is free.
6. AHRQ Releases Evidence Report on B Vitamins and Berries and Age-related Neurodegenerative Disorders
A new report released by AHRQ finds no conclusive evidence that taking B vitamin supplements can prevent Alzheimer's disease and Parkinson's disease or make their effects less severe. Similarly, the evidence is inconclusive about whether the presence or severity of these disorders depends on whether an individual has a B vitamin deficiency. The only study of berry consumption in humans found no connection with Parkinson's disease. The report indicates that good quality studies would be needed to pinpoint the way B vitamins act to prevent specific brain disorders, particularly Parkinson's disease, and to identify the specific components of berries that might be beneficial.
The report, B Vitamins and Berries and Age-Related Neurodegenerative Disorders, was prepared by AHRQ's Evidence-based Practice Center at the Tufts-New England Medical Center in Boston. Select to access the report. A print copy is available by sending an E-mail to firstname.lastname@example.org.
7. Webcast on Pay for Performance Will Feature Latest Evidence, Practical Tools
AHRQ is sponsoring a free Web conference for health care purchasers, health plans, and providers on May 16 from 2:00 p.m. to 3:30 p.m. EST. The Web conference will feature a panel of health services researchers and purchasers who will share the latest evidence and practical experiences on a range of issues related to the design and implementation of pay-for-performance initiatives. The discussion will offer lessons learned and practical tools of interest to public and private purchasers, health plans, and providers-whether they are contemplating, implementing, or evaluating pay-for-performance activities.
The Web conference will feature the AHRQ-supported tool, Pay for Performance: A Decision Guide for Purchasers, and the latest findings on quality-based purchasing from a recent special supplement of the Medical Care Research and Review. The Web conference will include introductory comments from AHRQ Director Carolyn Clancy, M.D.
8. 2006 Pharmacoeconomic Conference Set for June 12
AHRQ is co-sponsoring, with the University of Illinois at Chicago Center for Pharmacoeconomic Research and the University of Chicago Program for Pharmaceutical Policy, the 2006 Pharmacoeconomic Conference, "Prescription Drug Expenditures: Too Much or Not Enough?" to be held in Chicago on June 12.
The conference will bring together researchers and other interested stakeholders to collectively discuss the forces that drive the rising expenditures for drugs in the United States, to debate the benefits that are derived from pharmaceuticals, and to create a better understanding of these issues and identify future research needs. Select to register and for more information about the conference.
9. 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.
Vidyarthi AR, Katz PP, Wall SK, et al. Impact of reduced duty hours on residents' educational satisfaction at the University of California, San Francisco. Acad Med 2006 Jan;81(1):76-81. Select to access the abstract in PubMed®.
Galbraith AA, Wong ST, Kim SE, et al. Out-of-pocket financial burden for low-income families with children: socioeconomic disparities ad effects of insurance. Health Serv Res 2005 Dec;40(6 PT 1):1722-36. Select to access the abstract in PubMed®.
Bhandari VK, Kushel M, Price L, et al. Racial disparities in outcomes of inpatient stroke rehabilitation. Arch Phys Med Rehabil 2005 Nov;86(11):2081-6. Select to access the abstract in PubMed®.
Cimiotti JP, Quinlan PM, Larson EL, et al. The magnet process and the perceived work environment of nurses. Nurs Res 2005 Nov-Dec;54(6):384-90. Select to access the abstract in PubMed®.
Barkin SL, Scheindlin B, Brown C, et al. Anticipatory guidance topics: are more better? Ambul Pediatr 2005 Nov-Dec;5(6):372-6. Select to access the abstract in PubMed®.
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Current as of April 2006