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Media Advisory Date: September 30, 1996
Appropriate and effective use of right heart catheterization,
home care of infants with neonatal
chronic lung disease, medical and surgical superspecialization,
and the effect of the market
structure on HMOs are among the topics to be studied in a series
of new grants awarded by the
Agency for Health Care Policy and Research.
"The findings of this research will go a long way to improve the
quality of care provided to
millions of Americans," according to AHCPR Administrator Clifton
R. Gaus, Sc.D. "The variety
of these topics reflects the wide gaps in information that exist
within the health care system,"
added Dr. Gaus.
The following are descriptions of the 12 new grants, listing the
principal investigator, first-year
funding, and project period.
Right Heart Catheterization: Appropriate/Effective Use
Case Western Reserve University, Cleveland, Ohio; Alfred F.
Connors, Jr., M.D.; $372,595
This study explores: 1) variation in the use of right heart
catheterization (RHC) in seriously ill
patients; 2)effectiveness of RHC in terms of survival, quality of
life, and satisfaction with care;
3)cost of RHC; and 4) appropriateness of use of RHC.
Superspecialization of Medical and Surgical Subspecialists
University of Pennsylvania, Philadelphia, PA; Jose Escarce,
M.D.; $271,721 (1996); (6/1/96-5/31/98)
This study will examine the patterns and determinants of
superspecialization among medical and
Community-Based Pharmaceutical Care: A Controlled Trial
Indiana University, Indianapolis, IN; Morris Weinberger,
M.D.; $590,656; (1996); (6/1/96-5/31/00)
The Investigator will develop algorithms to facilitate
pharmaceutical care for the treatment of
asthma. A randomized, controlled trial, with 460 patients in a
pharmacy intervention group and
two control groups will be undertaken. The pharmacy intervention
group will be provided with
patient-specific clinical information, displayed on their
computer workstations, when filling
prescriptions. Outcomes to be studied include cost and quality of
Assessing Pediatric Quality of Life in a Clinical Trial
University of New Mexico, Albuquerque, NM; Robert D.
Annett, Ph.D.; $36,329 (1996);
This study examines the relationship between a disease-specific
pediatric quality of life measure
(the PQLQ) and 1) current asthma symptom severity as measured in
the Childhood Asthma
Management Program (CAMP), 2) sociodemographic variables as
measured in the CAMP study,
and 3) the general multidimensional measures of quality of life
utilized in the CAMP study.
Additionally, it will try to determine the best clinical and
psychosocial predictors of disease-specific quality of life
The project will address two issues not reported by the few
existing pediatric asthma measures:
severity and its impact on quality of life or the impact on the
family's socioeconomic status.
Facilitating Home Care of Neonatal Chronic Lung
Bowman Gray School of Medicine, Winston-Salem, NC; Thomas
Michael O'Shea, M.D.;
$266,967 (1996); (7/1/96-6/30/01)
This study will measure the outcomes and costs of two
interventions that facilitate home care of
infants with chronic lung disease. The interventions to be tested
are: 1) a multi-disciplinary
(neonatologist, nurse, and social worker) center-based care
consisting of home visits and visits
by the patients to the outpatient department; or 2) follow-up
care coordinated by a center-based
nurse, by way of telephone contact, and by community-based
providers of primary medical care.
Advancing therapies have improved the survival rate of low birth
weight babies, resulting in a
significant number of infants with complex care needs after
discharge from the hospital.
Adoption of Cancer Pain Guidelines in Managed Care
Education Development Center, Inc., Newton, MA; Mildred
Z. Solomon, Ed.D.; $581,087
Researchers will conduct a randomized controlled study of cancer
patients and their providers in
managed care clinics to determine the effectiveness of a
two-tiered (organizational and
individual) dissemination strategy of the AHCPR-sponsored
guideline on the Management of
Cardiac Procedure Use: A Prospective Cohort Study
Brigham and Women's Hospital, Boston, MA; Thomas H. Lee,
M.D., MSC; $654,677
The project will evaluate the reasons for the racial and gender
differences in the use of cardiac
tests and procedures. The cohort will be identified at the time
of emergency room admission with
chest pain, and will be followed for all procedures, both
invasive and noninvasive, for one year.
Effects of Health Care Market Structure on HMOs
Georgetown University, Washington, DC; Jack Hadley, M.D.;
The study will analyze the impact of the recent growth and
concentration of HMOs on
employers, health insurance coverage decisions, health care
premiums, and employees' health
Selective Cervical Spine Radiography In Blunt Trauma
University of California, Los Angeles, CA; William R. Mower,
M.D., M.E., M.S.; $621,570
To determine whether it is possible to reduce radiographic
cervical spine imaging by
demonstrating that clinical criteria can reliably exclude
cervical spine injury in "no risk" blunt
trauma victims without misidentifying any injured patient.
Understanding Health Values of HIV-Infected Patients
University of Cincinnati Medical Center, Cincinnati, OH; Joel
Tsevat, M.D., M.P.H.; $160,160
Researchers will strive to gain an understanding of the health
values of 100 HIV-infected
patients through focus groups and interviewing, and then will
develop and test a conceptual
model of their health values.
Impact of Prospective Drug Use Review on Health
Pennsylvania State University, University Park, PA; Frank M.
Ahern, Ph.D.; $183,154 (8/1/96-7/31/98)
This study seeks to compare two different models of outpatient
prospective drug utilization
review programs in the state of Pennsylvania, one of which allows
active participation of the
pharmacist in the process and the other which does not. The aims
of the research are to 1)
conduct a descriptive epidemiological analysis of psychotropic
drug use, prescribing patterns,
and yield of prospective drug utilization review (ProDUR)
interventions, and compute estimates
of drug-related outcome measures; and 2) evaluate the independent
effects of two different
ProDUR procedures on health outcomes.
AHCPR UI Guidelines: Application in Nursing Homes
University of Rochester, Rochester NY; Nancy M. Watson, Ph.D.;
The project will evaluate the impact of the Agency for Health
Care Policy and Research-sponsored Clinical Practice Guideline
for Urinary Incontinence in Adults in the nursing home
For additional information, contact AHCPR Public Affairs: Karen Migdail,
(301) 427-1855 or Salina Prasad, (301) 427-1864.