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February 28, 2001, Issue No. 23


AHRQ News and Numbers

Today's Headlines:

  1. IOM to release new patient safety report
  2. AHRQ to co-sponsor ISTAHC 2001
  3. AHRQ National Advisory Council meeting
  4. Third annual workshop on pharmaceutical outcomes research
  5. Clinical informatics and patient safety research RFA
  6. Building patient safety research infrastructure and capacity RFA
  7. Evidence report on the management of cancer pain
  8. Evidence report on uterine fibroids
  9. Evidence report on epilepsy
  10. AHRQ-funded study on health insurance and hospitalization of children
  11. Guidelines added to the National Guideline Clearinghouse™
  12. AHRQ in the professional literature
  13. Factoid

1.  IOM to Release New Patient Safety Report

The Institute of Medicine (IOM) expects to release on March 1 the long-awaited followup report to its 1999 report on medical errors. An IOM notice previewing the report, Crossing the Quality Chasm: A New System for the 21st Century, states: "Research on the quality of care reveals a picture of a system that frequently falls short in its ability to translate clinical knowledge and technology into practice. The health care system as it is currently structured cannot consistently deliver effective care in a safe, timely and efficient manner. The IOM proposes a bold overhaul of the U.S. health care system and a strategy to address serious shortcomings in the quality of health care available to Americans. Select to access the report.

2.  AHRQ to Co-Sponsor ISTAHC 2001

AHRQ is co-sponsoring the 2001 conference of the International Society of Technology Assessment in Health Care (ISTAHC), which will be held in Philadelphia, June 3-6. The conference is being hosted by ECRI, one of AHRQ's Evidence-based Practice Centers. ISTAHC 2001 features a variety of plenary and special theme sessions, over 280 oral and poster presentations, several pre-conference programs, and a post-conference workshop. Plenary speakers include Arthur Caplan, M.D., director of the Center for Bioethics at the University of Pennsylvania; John M. Eisenberg, M.D., M.B.A., director of AHRQ, and David W. Feigal, Jr., M.D., M.P.H., director of the FDA's Center for Devices and Radiological Health. The deadline for early registration is March 31, 2001.

3.  AHRQ National Advisory Council (NAC) Meeting

The AHRQ NAC is scheduled to meet on Friday, March 2, at 6010 Executive Boulevard, Rockville, MD. The Council will discuss these specific topics: shape of U.S. health care in the future, partnership development, long-term care research agenda, and low income/rural health care.

4.  Third Annual Workshop on Pharmaceutical Outcomes Research

AHRQ, in conjunction with the Drug Information Association (DIA), will hold the Third Annual Workshop on Pharmaceutical Outcomes on April 22-24, in Savannah, GA. The meeting combines submitted abstracts, plenary sessions, and a roundtable session to provide an opportunity for participants to hear about new and important findings in the varied fields of outcomes research applied to the use of drugs and biologics. New this year will be a tutorial on using Quality of Life measurements. This conference is attended by leaders in the research community informing the safe and effective use of pharmaceuticals.

5.  Clinical Informatics and Patient Safety Research RFA

AHRQ issued a press release on February 23 announcing a Request for Applications (RFA) for clinical informatics and patient safety research. AHRQ expects to award up to $3.5 million in FY 2001. Projects funded under this RFA will support development and testing of technology tools, such as hand-held electronic medication and specimen management systems, training simulators for medical education, computerized bar-coding, patient bracelets, smart cards, automated medication dispensing systems, and computerized physician order entry that can be used to reduce the risk of medical errors and improve quality of care. Select to access the AHRQ Press Release and the RFA.

6.  Building Patient Safety Research Infrastructure and Capacity RFA

AHRQ issued a press release on February 27 announcing a Request for Applications (RFA) for research grants intended to broaden geographic distribution of health services research funding by enhancing the competitiveness for research funding among institutions located in states where successful applications to AHRQ have been historically low. AHRQ expects to award up to $1 million in FY 2001 to support the total first-year costs of approximately three to six grants under this RFA. Select to access the AHRQ Press Release and the RFA.

7.  Evidence Report on the Management of Cancer Pain

AHRQ issued on February 28 a press release on the availability of a summary of a new evidence report by the New England Medical Center Evidence-based Practice Center (EPC) on Management of Cancer Pain. Although there is a huge body of scientific research on cancer biology, the quality and quantity of research on the management of cancer pain are minimal. The EPC found that the number of patients enrolled in methodologically sound studies of cancer pain relief is a tiny fraction of those receiving care, a much lower percentage than for nearly all other high-impact, costly conditions. In addition, the average number of patients enrolled per trial on cancer pain treatment often is too few to draw firm conclusions about the treatment under study. Overall, the EPC found that the solid evidence that exists on specific therapies such as anti-inflammatory drugs or opioids is overshadowed by inadequate guidance on more complex choices now expected of front-line clinicians. Select to access the AHRQ Press Release and 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.

8.  Evidence Report on Uterine Fibroids

AHRQ issued on February 27 a press release on the availability of a summary of a new evidence report by the Duke University Evidence-based Practice Center (EPC) on Management and Treatment of Uterine Fibroids. The EPC found that black women at any age who have uterine fibroids are more likely to have them surgically removed through a myomectomy, a procedure that preserves the uterus, than are white or Hispanic women with fibroids. While the EPC confirmed earlier studies that showed that black women have higher rates of hysterectomy than other racial groups, they found that these black women also have higher rates of myomectomy. Select to access the AHRQ Press Release and 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.

9.  Evidence Report on Epilepsy

AHRQ issued on February 22 a press release on the availability of a summary of a new evidence report by the MetaWorks, Inc., Evidence-based Practice Center (EPC) on Management of Newly Diagnosed Patients with Epilepsy. The EPC supports that the use of a complete history and physical examination, including neuropsychologic assessment and a standard EEG, to diagnose epilepsy, prevent delayed or missed diagnoses, and predict remission outcomes. The EPC also found that other diagnostic tests, such as CT scan or MRI, are more important in ruling out secondary causes of seizures or to resolve uncertain diagnoses. Select to access the AHRQ Press Release and 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.

10.  AHRQ-Funded Study on Health Insurance and Hospitalization of Children

An article from an AHRQ-funded study found a strong association between types of health insurance and availability of primary care, and episodes of hospitalization of children outside their areas of residence. Children covered by Medicaid, HMOs, or whose care was self paid were less likely to be hospitalized away from home areas. Ethnic and racial differences were significant factors influencing use of out-of-area hospitals. The article, "Health Insurance, Primary Care and Preventable Hospitalization of Children in a Large State," by Bernard Friedman and Joy Basu is published in the March issue of the American Journal of Managed Care. Reprints are available from the AHRQ Publications Clearinghouse, 1-800-358-9295.

11.  Guidelines Added to the National Guideline Clearinghouse™ (NGC)

During the month of February, 16 guidelines were added to the NGC. There are now 950 guideline summaries in the NGC. Select http://www.guideline.gov to access these guidelines and others.

  • Benefits and risks of controlling blood glucose levels in patients with type 2 diabetes mellitus.
  • ACR Appropriateness Criteria™ for the role of imaging in cancer of the cervix.
  • ACR Appropriateness Criteria™ for premature cervical dilatation.
  • ACR Appropriateness Criteria™ for endometrial cancer of the uterus.
  • Recommendations regarding selected conditions affecting women's health.
  • U.S. Public Health Service (PHS) Task Force recommendations for the use of antiretroviral drugs in pregnant HIV-1 infected women for maternal health and interventions to reduce perinatal HIV-1 transmission in the United States.
  • Measles, mumps, and rubella: vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps.
  • The initial management of menorrhagia.
  • The management of infertility in secondary care.
  • The initial investigation and management of the infertile couple.
  • The management of infertility in tertiary care.
  • The management of menorrhagia in secondary care.
  • Male and female sterilization.
  • Screening for depression.
  • Screening for thyroid disease.
  • Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents.

12.  AHRQ in the Professional Literature

Eisenberg JM, Foster NE, Meyer G, Holland H. Federal efforts to improve quality of care: the Quality Interagency Coordination Task Force (QuIC). Jt Comm J Qual Improv 2001 Feb; 27(2):93-100.

Murphy J, Chang J, Montgomery JE, et al. The quality of physician-patient relationships: patients' experiences 1996-1999. J Fam Pract 2001 Feb; 50(2):123-29.

Safran DG, Montgomery JE, Chang H, et al. Switching doctors: predictors of voluntary disenrollment from a primary physician's practice. J Fam Pract 2001 Feb; 50(2):130-36.

Tierney WM, Dexter PR, Gramelspacher GP, et al. The effect of discussions about advance directives on patients' satisfaction with primary care. J Gen Intern Med 2001 Jan; 16(1):32-40.

13.  Factoid

In the previous 12 months, 6% of Americans said they had personally suffered injury or harm that they thought had resulted from a medical error. [Source: Agency for Healthcare Research and Quality/Kaiser Family Foundation National Survey on Americans as Health Care Consumers: An Update on the Role of Quality Information, December 2000].

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Current as of February 2001

 

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