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April 19, 2000, Issue No. 6
AHRQ News and Numbers
- AHRQ-funded Study Released Today in NEJM Shows Disparities by Race and Sex in Emergency Department Care
- 1997 State Inpatient Databases (SID) Data Now Available
- Evidence Report on Testosterone Suppression Treatment for Prostatic Cancer
- New Study on Racial and Ethnic Differences
- Highlights from the Most Recent Edition of our Monthly Newsletter
- Medical Errors and PPIP in the Washington Post
- Did You Miss Your Guide to Choosing Quality Health Care?
- Three New AHRQ Publications
- AHRQ in the News
- Guidelines Added to National Guideline Clearinghouse™
- AHRQ Factoid
1. AHRQ-funded Study Released Today in NEJM Shows Disparities by Race and Sex in Emergency Department Care
Harry P. Selker, M.D., and researchers at the New England Medical Center published a study entitled: "Missed Diagnoses of Acute Cardiac Ischemia in the Emergency Department" in the April 20th issue of New England Journal of Medicine (NEJM). The study examined how often emergency department (ED) patients with acute cardiac ischemia (either heart attack or unstable angina pectoris, which can lead to heart attack) are mistakenly sent home. Researchers found that younger women, minorities, and patients without chest pain or diagnostic EKGs were more likely to be sent home from EDs with a heart attack or unstable angina pectoris. Researchers indicated that doctors must be careful not to over generalize about certain groups of patients, and they should learn to use properly the latest diagnostic technologies. Select to access the online study abstract.
2. 1997 SID Data Now Available
Data for 1997 from the State Inpatient Databases (SID) for 13 States (Arizona, California, Colorado, Florida, Iowa, Maryland, Massachusetts, New Jersey, New York, Oregon, South Carolina, Washington, Wisconsin) are now available for purchase from a central source.
The SID is a set of powerful hospital databases from 22 States that participate in AHRQ's Healthcare Cost and Utilization Project (HCUP). The SID contain a core set of more than 100 patient-level clinical and nonclinical variables included in a hospital discharge abstract for all patients, regardless of payer, including people covered by Medicare, Medicaid, and private insurance and the uninsured. To find out more, access detailed information about SID.
2a. Evidence Report on Testosterone Suppression Treatment for Prostatic Cancer
In an AHRQ-funded study in the April 4 issue of the Annals of Internal Medicine, "Single Therapy Androgen Suppression in Men with Advanced Prostate Cancer: A Systematic Review and Meta-Analysis," no differences were found in the effectiveness of the various types of LHRH agonist drugs used to suppress androgen in men with advanced prostate cancer. The study also found that survival after therapy with LHRH agonists is equivalent to that after orchiectomy (castration). The article reports the findings of an AHRQ evidence report, Relative Effectiveness and Cost-Effectiveness of Methods of Androgen Suppression in the Treatment of Advanced Prostatic Cancer, published January 1999. Select to read a summary of this report.
3. New Study on Racial and Ethnic Differences
AHRQ released a new study on racial and ethnic differences that describes the combined influence of a patient's race and sex on the use of reperfusion therapy (thrombolytic agents and other cardiac drug therapies) for acute myocardial infarction. After adjusting for differences in clinical and demographic characteristics, researchers found that there were minimal differences according to sex in the use of reperfusion therapy. However, blacks, regardless of sex, are significantly less likely than whites to receive this potentially life-saving therapy. The study "Relation of Race and Sex to the Use of Reperfusion Therapy in Medicare Beneficiaries with Acute Myocardial Infarction" was published in New England Journal of Medicine (NEJM).
For more information, read the April 13 issue of NEJM for the full study.
4. Highlights from the Most Recent Edition of our Monthly Newsletter
The new issue of Research Activities is in the mail. The key articles are:
- Health and economic benefits are substantial when pregnant women stop smoking.
- Routine medical testing before cataract surgery usually is not necessary.
- Less than 10 percent of medical decisions are made with participation of a fully informed patient.
- Primary care providers often fail to cover the most significant injury prevention issues during well-child visits.
- Worker preference may contribute to poorer health insurance coverage by small firms.
Select http://www.ahrq.gov/research/mar00/to access the entire March issue.
5. Medical Errors and PPIP in the Washington Post
Jay Siwek, M.D., who writes for the Washington Post in addition to being the editor of American Family Physician, wrote a series of columns on what patients can do to protect themselves from errors and about a new publication from our Putting Prevention into Practice (PPIP) program. These articles were based on the AHRQ fact sheet 20 Tips to Help Prevent Medical Errors and the guide Staying Healthy at 50+. Select for online information about PPIP and medical errors.
6. Did You Miss Your Guide to Choosing Quality?
Your Guide to Choosing Quality Health Care is based on research about the information people say they want and need to know when making decisions about health plans, doctors, treatments, hospitals, and long-term care. The guide describes consumer ratings, clinical performance measures, and accreditation—what they are, where to find them, and how to use them. Also included are checklists, questions, charts, and other tools to help you make the health care choices that are right for you.
7. Three New AHRQ Publications
- Making the Link: Strategies for Coordinating Publicly Funded Health Care Coverage for Children, AHRQ Publication No. 00-0014. This publication was prepared for a ULP workshop designed to inform State policymakers about SCHIP.
- A brochure on HCUPnet, AHRQ Publication No. 00-0051.
- A brochure on the Nationwide Impatient Sample, AHRQ Publication No. 00-0019.
If you are interested in these publications, call the AHRQ Publications Clearinghouse at 1-800-358-9295.
8. AHRQ in the News
Clemmitt M, editor. Field report on reducing medical errors: providers already showing it can be done. Medicine & Health Perspectives. In Medicine & Health 2000 April 3;54(14). (Includes statements on mandatory reporting and collaborative planning by AHRQ Director John Eisenberg.)
Daumit GL, Hermann JA, and Powe NR. Relation of gender and health insurance to cardiovascular procedure use in persons with progression of chronic renal disease. Med Care 2000 April;38(4):354-365. (Cites AHRQ's urinary incontinence guideline.)
Newacheck PW, McManus M, Fox HB, et al. Access to health care for children with special health care needs. Pediatrics April 2000;105(4):760-766. (Cites article by Weinick RM, et al., Health Affairs 1999.)
Orleans CT and Cummings KM. Population-based tobacco control: progress and prospects. Am J of Health Promotion 1999 November/December;14(2):92-97. (Cites AHRQ's smoking cessation guidelines.)
Samsa GP, Matchar DB, Goldstein LB, et al. Quality of anticoagulation management among patients with atrial fibrillation: results of a review of medical records from 2 communities. Arch Intern Med 2000 April 10;160:967-973. (Stroke Prevention PORT.)
Sanders GD, Nease RF, and Owens D. Design and pilot evaluation of a system to develop computer-based site-specific practice guidelines from decision models. Med Decis Making 2000 April-June;20(2):145-159. (Cites U. S. Prevention Services Task Force guidelines.)
9. Guidelines Added to National Guideline Clearinghouse™ (NGC)
During the week of April 17, 15 guidelines were added to the NGC (http://www.guideline.gov). These guidelines are from the Canadian Task Force on Preventive Health Care. This brings the total number of guidelines in the NGC to 777. Visit http://www.guideline.gov to access these guidelines and others.
Screening for prostate cancer
Screening for bladder cancer
Prevention of oral cancer
Prevention of skin cancer
Prevention of pancreatic cancer
Screening for ovarian cancer
Screening for cervical cancer
Screening for testicular cancer
Screening for cognitive impairment in the elderly
Prevention of household and recreational injuries in the elderly
Secondary prevention of elder abuse
Screening for visual impairment in the elderly
Hypertension in the elderly: case-finding and treatment to prevent vascular disease
Prevention of hearing impairment and disability in the elderly
Screening for asymptomatic bacteriuria in the elderly
10. AHRQ Factoid
Men are four times more likely than women to suffer a stroke due to large-vessel atherosclerosis. (Source: Petty et al., 1999)
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Current as of April 2000