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January 7, 2008, Issue No. 247
AHRQ News and Numbers
Hospitalizations for treating disorders caused by gastroespohageal reflux disease (GERD) increased by 103 percent between 1998 and 2005. During the same period, hospitalizations of patients who had milder forms of GERD in addition to other ailments, rose by 216 percent. [Source: Agency for Healthcare Research and Quality, HCUP Statistical Brief #44: Gastroesophageal Reflue Disease (GERD) Hospitalizations in 1998 and 2005.]
- Blacks, Hispanics, and other groups less likely to get strong pain medications in hospital emergency departments
- Latest issue of WebM&M is available online
- Task Force recommends against screening for carotid artery stenosis in adults without symptoms
- AHRQ director helps consumers navigate the health care system in a new advice column on the Web
- AHRQ Innovations Exchange Web conference presentation is available
- Podcast features safety tips for patients and hospitals, health literacy, and dentistry
- Calling all AHRQ researchers! "Help us to help you."
- AHRQ in the professional literature
1. Blacks, Hispanics, and Other Groups Less Likely to Get Strong Pain Medications in Hospital Emergency Departments
Blacks and Hispanics who go to hospital emergency departments in pain are significantly less likely than whites to get pain-relieving opioid drugs, according to a new study funded by AHRQ and the National Institute on Drug Abuse, part of the National Institutes of Health. The study, which analyzed treatments for more than 150,000 pain-related visits to U.S. hospitals between 1993 and 2005, found 23 percent of blacks and 24 percent of Hispanics received opioids compared with 31 percent of whites. Twenty-eight percent of Asians and other groups received opioids. The study, Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in US Emergency Departments, was published in the January 2 issue of JAMA. Select to read our press release and select to read the abstract in PubMed®.
2. Latest Issue of WebM&M Is Available Online
The December 2007 issue of AHRQ WebM&M is now available online. In the Perspectives on Safety section, we speak with Eric Coleman, M.D., Director of the University of Colorado's Care Transitions Program, about improving transitions in care. The Care Transitions Program is an innovative program designed to improve the safety of patient handoffs. In the accompanying perspective piece, Sunil Kripalani, M.D., director of the hospitalist program at Vanderbilt University in Nashville, discusses initiatives aimed at systematically ensuring high quality discharges and transitions. The commentaries in this issue consider patients who leave the hospital before being discharged, safety indicators, and a care-associated burn.
This issue's Spotlight case, features a hospital patient missing from his room and found several hours later outside the emergency department. Despite having arrived at the emergency department (ED) in a hospital gown with a patient ID bracelet, the patient is treated in the ED and discharged. The author, Debra Gerardi, R.N., of Creighton University School of Law in Omaha, Nebraska, discusses strategies for both preventing and responding to patient elopement. As always, a Spotlight slide presentation is available for download. Physicians and nurses can receive free continuing medical education (CME), continuing education units (CEU), or trainee certification by taking the Spotlight Quiz.
In the second Spotlight case, an elderly woman undergoes surgery to repair a hip fracture. Even though formal preoperative assessment placed her at low risk, the patient suffers a pulseless electrical activity arrest during the operation and dies the next day. Kaveh Shojania, M.D., of the University of Ottawa, Canada, discusses whether unexpected deaths are useful patient safety signals.
In the third Spotlight case, after removing the IV line on an infant receiving IV fluid and antibiotics, a nurse places a warm compress on the wound site. Later, another nurse discovers that the compress has caused a burn. The commentary addresses the safe use of thermal therapy; authors are Heather Cleland, M.B.B.S., and Jason Wasiak, B.N., M.P.H., of The Alfred Hospital in Melbourne, Australia.
You can easily share AHRQ WebM&M cases by using our "Email a colleague" feature.
3. Task Force Recommends Against Screening for Carotid Artery Stenosis in Adults without Symptoms
Adults without symptoms of carotid artery stenosis should not be screened for the disease using ultrasound or other tests, according to a new recommendation from the U.S. Preventive Services Task Force. The recommendation is published in the December 18 issue of the Annals of Internal Medicine. Screening for carotid artery stenosis most often occurs using ultrasound, which has potential harms and can result in more false positive results than true positive results. False positive test results can lead to unnecessary surgeries or angiograms that may cause serious harms, including death, stroke, and heart attacks. For the general population, the Task Force could find only a small benefit that screening for carotid artery stenosis would reduce strokes or death from the disease, but they also found that the harms from screening outweighed any benefit. Symptoms of carotid artery stenosis include having a history of transient ischemic attacks, or mini-strokes. Individuals who have had a history of these attacks should be evaluated by their clinicians for further treatment. Select for the recommendations and material for clinicians.
4. AHRQ Director Helps Consumers Navigate the Health Care System in a New Advice Column on the Web
AHRQ Director Carolyn M. Clancy, M.D., offers advice to consumers in new, brief, easy-to-understand columns. The biweekly columns will help consumers better navigate the health care system. Select to read Dr. Clancy's advice columns.
5. AHRQ Innovations Exchange Web Conference Presentation Is Available
If you missed the AHRQ Innovations Exchange's "What's in it for Me?" Web conference, it is not too late. Select to access the Web conference , including slides. The Web conference explores the Health Care Innovations Exchange site, discusses what AHRQ considers to be a service innovation, and clarifies the kinds of innovative activities we are seeking to include on the site. We invite you to visit the presentation at your leisure and share this link with your colleagues. You can submit innovations by sending an E-mail to firstname.lastname@example.org. Select to visit the AHRQ Healthcare Innovations Exchange.
6. Podcast Features Safety Tips for Patients and Hospitals, Health Literacy, and Dentistry
This week's AHRQ Healthcare 411 audio podcast features AHRQ Director Carolyn M. Clancy, M.D., talking to consumers about AHRQ's 5 Steps to Safer Health Care and to clinicians about the 10 Patient Safety Tips for Hospitals. This podcast was distributed to members of our 221 partnership organizations, including the American Board of Medical Specialties and the Leapfrog Group. Shorter versions of these stories and more are airing on 125 radio stations nationwide. Select to listen to this podcast and select to read the transcript.
Dr. Clancy also is featured discussing the issues of health literacy including a new set of health literacy tools for pharmacists. AHRQ data on how many children visit the dentist annually also is featured. Select to listen to this audio podcast or select to read the transcript.
7. Calling All AHRQ Researchers! "Help Us to Help You."
As you may know, AHRQ can help you promote the findings of your research, but we can't do it without you. AHRQ has been successful in working with our grantees and contractors to promote findings to the media and to transfer knowledge based on the research to appropriate audiences in the health care community. However, we know that we can do better. We need you to notify us when you have an article accepted for publication. Please send a copy of the manuscript, anticipated publication date, and contact information for the journal and your institution's public relations office to your AHRQ project officer and to AHRQ Public Affairs at email@example.com. Your manuscript will be reviewed to determine what level of marketing we will pursue. Please be assured that AHRQ always honors the journal embargo. Thank you for your cooperation.
8. 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.
Glance LG, Osler TM, Mukamel DB, et al. Effect of complications on mortality after coronary artery bypass grafting surgery: evidence from New York State. J Thorac Cardiovasc Surg 20007 Jul; 134(1):53-58. Select to read the abstract in PubMed®.
McWilliams JM, Meara E, Zaslavsky AM, et al. Use of health services by previously uninsured Medicare beneficiaries. N Engl J Med 2007 Jul 12; 357(2):143-153. Select to read the abstract in PubMed®.
Nolt BR, Gonzales R, Maselli J. Vital-sign abnormalities as predictors of pneumonia in adults with acute cough illness. Am J Emerg Med 2007 Jul; 25(6):631-636. Select to read the abstract in PubMed®.
Taira DA, GelberRP, Davis J, et al. Antihypertensive adherence and drug class among Asian Pacific Americans. Ethn Health 2007 Jun; 12(3):265-281. Select to read the abstract in PubMed®.
Cohen LA, Harris SL, Bonito AJ, Manski RJ, et al. Coping with toothache pain: a qualitative study of low-income person and minorities. J Public Health Dent 2007 Winter; 67(1):28-35. Select to read the abstract in PubMed®.
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Current as of January 2008