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May 19, 2006, Issue No. 200
A Special Message from AHRQ Director Carolyn M. Clancy, M.D., on the 200th issue of the Agency's Electronic Newsletter
Today, we are proud to bring you the 200th issue of the AHRQ Electronic Newsletter. Since its inception in February 2000, the newsletter has chronicled a number of changes throughout the Agency. For example, in 2000, our budget was $206 million; today it is nearly $319 million. In 1999, Congress enacted the Healthcare Research and Quality Act of 1999, which reauthorized the Agency for Health Care Policy and Research and changed our name to what it is today: the Agency for Healthcare Research and Quality. Since that time, Congress has directed the Agency to undertake a broad program of activities to improve the quality, safety, effectiveness, and efficiency of the health care services that all Americans receive, including national reports issued each year on quality and disparities in care.
We hope that our expanding readership—which has grown from an initial list of 800 to approximately 20,000—reflects the fact that many people continue to find this newsletter a valuable source of information about research and tools that can be used to make patients' lives better. As always, we welcome your feedback, and thank you!
AHRQ News and Numbers
Although only 12 percent of the U.S. population was 65 and older in 2003, these seniors accounted for one-third of all patients admitted to the Nation's community hospitals in that year—more than 13 million hospital stays. People in this age group also accounted for 44 percent of all hospital charges—nearly $329 billion. [Source: Agency for Healthcare Research and Quality, HCUP Statistical Brief No. 6: Hospitalizations in the Elderly Population, 2003.]
- AHRQ Director Testifies at Hearing on Information for Health Care Consumers
- Four in 10 Women Face Partner Abuse and Health Problems
- AHRQ-Funded Study Finds Much Off-Label Prescribing
- Latest Issue of AHRQ WebM&M Available Online
- Task Force Issues New Recommendations on Screening and Iron Supplementation for Iron Deficiency Anemia
- AHRQ Calls for Nominations for Quality Indicators Workgroup on Risk Adjustment
- AHRQ Women's Health Program Features Information for Consumers and Clinicians
- Special Journal Issue Features Articles on Translation Issues in Prevention and Treatment Research
- Eighth Annual Child Health Services Research Meeting Set for June 24
- HCUP Seminars Set for June 26 and 27
- AHRQ in the Professional Literature
1. AHRQ Director Testifies at Hearing on Information for Health Care Consumers
AHRQ Director Carolyn M. Clancy, M.D., testified at a hearing on May 10 before the House/Senate Joint Economic Committee on "Arming Health Care Consumers with Better Information and Incentives." Dr. Clancy discussed AHRQ's and HHS' initiatives to ensure that Americans can easily obtain understandable information about the quality and price of health care. She focused on consumer information intended to help consumers make market and treatment decisions. Select to read her testimony.
2. Four in 10 Women Face Partner Abuse and Health Problems
Forty-four percent of women ages 18 to 64 who enrolled in a large Seattle-based health maintenance organization (HMO) reported experiencing physical, sexual, or psychological violence by current or former spouses, live-in partners, or dating partners during their adult lifetime. This study and an accompanying study on the same sample of 3,400 women were conducted by researchers with Group Health Cooperative and the University of Washington School of Medicine.
In the first study, Robert S. Thompson, M.D., and colleagues found that 44 percent of women reported intimate partner violence of any type in their lifetime, with 67 percent of those women indicating they experienced more than one type of violence. Between 11 percent and 21 percent of the women suffered abuse from more than one partner. The persistence of abuse varied, with up to 13 percent of the women saying it persisted for more than 20 years. Select to access the abstract in PubMed®.
In the second study, Amy E. Bonomi, Ph.D., and colleagues found that the health of women who had been abused in the previous 5 years was poorer than that of women who had never been abused. Women who experienced recent physical and/or sexual abuse were four times more likely to report severe depressive symptoms and three times more likely to report fair or poor health; they also reported lower social functioning and more physical symptoms, such as nausea and back pain. The effects of physical abuse (slapping, hitting, kicking, or forced sex) were stronger than those of nonphysical abuse (threats, chronic disparaging remarks, or controlling behavior) alone; but nonphysical abuse also eroded these women's health.
The studies were published in the June issue of the American Journal of Preventive Medicine. Select to access the abstract in PubMed®.
3. AHRQ-Funded Study Finds Much Off-Label Prescribing
A new AHRQ-funded study shows that one of every five medications prescribed by doctors to treat a health condition has not been approved by the FDA for that use. The study also found a lack of strong scientific support for three-quarters of the off-label use of drugs. Physicians can legally prescribe approved medications for any diagnosis, even when the diagnosis is not specified on the drug's label or in the application for FDA approval.
Off-label prescribing allows physicians the freedom to innovate but also raises questions about patient safety and costs, since off-label uses do not receive the same level of scientific scrutiny as approved uses. The drugs most likely to be prescribed off-label were cardiac medications, anticonvulsants and drugs to treat asthma. The off-label use of psychiatric drugs had the least scientific support. The study, "Off-label Prescribing Among Office-Based Physicians," appeared in the May 8 issue of the Archives of Internal Medicine. Select to access the abstract in PubMed®.
4. Latest Issue of AHRQ WebM&M Available Online
The May 2006 issue of AHRQ WebM&M is now available online. This month, the Perspectives on Safety section discusses outpatient safety and features a piece by Rainu Kaushal, M.D., on patient safety for office-based anesthesia; Nancy Elder M.D., provides an overview of safety issues in ambulatory practice.
In the Spotlight Case, a woman with a fractured right foot receives spinal anesthesia and nearly has surgery for trimalleolar fracture and dislocation of the left ankle: only immediately prior to surgery does the team realize that the X-ray was not hers. In the second case, a pharmacist mistakenly dispenses Polycitra instead of Bicitra, and a patient winds up with severe hyperkalemia and hyperglycemia. In the third case, a nursing student administers the wrong 'cup' of medications to an elderly man, and another student discovers the error.
Commentary authors are Robert Weber, M.S., R.Ph., of the University of Pittsburgh; Mary Blegen, Ph.D., R.N., of the University of California, San Francisco; and Ginette Pepper, Ph.D., R.N., of the University of Utah. A Spotlight slide presentation is available for download as always, and you can receive CME, CEU, or trainee certification by taking the Spotlight Quiz. Please submit cases to AHRQ WebM&M via the "Submit Case" button. All previously published commentaries are available under "Case Archive."
5. Task Force Issues New Recommendations on Screening and Iron Supplementation for Iron Deficiency Anemia
The U.S. Preventive Services Task Force issued new recommendations on routine screening for iron deficiency anemia and iron supplementation in pregnant women and children. The Task Force concluded that evidence is insufficient to recommend for or against routine screening for iron deficiency anemia in asymptomatic children ages 6 months to 12 months (I recommendation).
The Task Force further recommended routine screening for iron deficiency anemia in asymptomatic pregnant women (B recommendation). The Task Force also recommended routine iron supplementation for asymptomatic children ages 6 to 12 months who are at increased risk for iron deficiency anemia (B recommendation).
The Task Force concluded that evidence is insufficient to recommend for or against routine iron supplementation for asymptomatic children ages 6 to 12 months who are at average risk for iron deficiency anemia (I recommendation). The Task Force also concluded that evidence is insufficient to recommend for or against routine iron supplementation for non-anemic pregnant women (I recommendation). Select to access the recommendations.
6. AHRQ Calls for Nominations for Quality Indicators Workgroup on Risk Adjustment
AHRQ is seeking nominations for members of a workgroup on risk adjustment specifically focused on the AHRQ Quality Indicators (QIs). This workgroup is being formed to evaluate risk adjustment and the appropriateness of hierarchical modeling methodology for the AHRQ QIs at the area and/or provider levels. The workgroup will evaluate appropriate technical and methodological approaches now available and will discuss and suggest strategies for risk adjustment approaches to best fit AHRQ QI user needs. Nominations are due June 15. Select to access the May 16 Federal Register notice.
7. AHRQ Women's Health Program Features Information for Consumers and Clinicians
May 14-20 is National Women's Health Week, which encourages women to take simple steps for a longer, healthier, and happier life. AHRQ's Women's Health Web page has consumer materials, clinical information by topic, and stories on women's health published in AHRQ's monthly newsletter, Research Activities. Select to access AHRQ's Women's Health Pathfinder.
8. Special Journal Issue Features Articles on Translation Issues in Prevention and Treatment Research
The March issue of Evaluation & Health Professions features five articles in a series of three special issues by AHRQ Translating Research Into Practice (TRIP) grantees entitled, "Translation Issues in Prevention and Treatment Research." The first series, "Translation Research: Introduction to the Special Issue," by R. Barker Bausell is as follows:
- Translation in the Health Professions: Converting Science Into Action, by Sussman S, Valente TW, Rohrbach LA, Skara S, and Pentz MA. Select to access the abstract in PubMed®.
- Translational Research in Child and Adolescent Transportation Safety, by Simons-Morton BG, and Winston FK. Select to access the abstract in PubMed®.
- The Logic Behind a Multimethod Intervention to Improve Adherence to Clinical Practice Guidelines in a Nationwide Network of Primary Care Practices, by Feifer C, Ornstein SM, Jenkins RG, Wessell A, Corley ST, Nemeth LS, Roylance L, Nietert PJ, and Liszka H. Select to access the abstract in PubMed®.
- Translation as a Function of Modality: The Potential of Brief Interventions, by Werch C, Grenard GL, Burnett JP, Watkins JA, Ames S, and Jobli E. Select to access the abstract in PubMed®.
- Evaluating the Relevance, Generalization, and Applicability of Research: Issues in External Validation and Translation Methodology, by Green LW and Glasgow RE. Select to access the abstract in PubMed®.
9. Eighth Annual Child Health Services Research Meeting Set for June 24
The Eighth Annual Child Health Services Research meeting will be held on June 24 in Seattle, WA. This 1-day meeting is offered in conjunction with the AcademyHealth Annual Research Meeting. It will feature a keynote speech by quality expert Beth McGlynn and presentations of the latest child health services research; debates on critical health policy issues for children; skill-building workshops on quality indicators and data resources; and a joint poster session with National Research Service Award trainees, featuring more than 150 posters. Select to register and for more information.
10. HCUP Seminars Set for June 26 and 27
AHRQ will hold two seminars about its Healthcare Cost and Utilization Project (HCUP) as part of the AcademyHealth Annual Research Meeting to be held in Seattle, WA. A 90-minute introduction to HCUP data on June 26 will familiarize participants with several HCUP software tools. A full-day, interactive, hands-on seminar will be held on June 27, during which researchers will learn how to best use HCUP tools and databases to support their individual analyses in real time.
11. 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.
Feudtner C, Silveira MJ, Shabbout M, Hoskins RE. Distance from home when death occurs: a population-based study of Washington State, 1989-2002. Pediatrics 2006 May;117(5):e932-9. Select to access the abstract in PubMed®.
Westfall JM, Van Vorst RF, McGloin J, Selker HP. Triage and diagnosis of chest pain in rural hospitals: implementation of the ACI-TIPI in the high plains research network. Ann Fam Med 2006 Mar-Apr;4(2):153-8. Select to access the abstract in PubMed®.
Gordon HS, Street, RL, Sharf BF, et al. Racial differences in trust and lung cancer patients' perceptions of physician communication. J Clin Oncol 2006 Feb 20;24(6):904-9. Select to access the abstract in PubMed®.
Seow H, Phillips CO, Rich MW, et al. Isolation of health services research from practice and policy: the example of chronic heart failure management. J Am Geriatr Soc 2006 Mar;54(3):535-40. Select to access the abstract in PubMed®.
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Current as of May 2006