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Research Activities

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December 1998, No. 222


Contents

About Research Activities

Feature Story

AHCPR's new guide helps Americans choose quality health care

Departments

Heart Disease
   Use of predictive instrument in the ER could save more than $700 million annually
   Consultation between generalists and cardiologists enhances care for heart attack patients

Outcomes/Effectiveness Research
   Amoxicillin works as well as newer, more costly, antibiotics for treating uncomplicated acute sinusitis
   Evaluation by a neurologist seems to be associated with better survival for many stroke patients
   Informal social support is linked to improved diabetes management among blacks

Clinical Decisionmaking
   Subcutaneous injections of epoetin work as well and cost less than IV epoetin for treating anemia in most dialysis patients
   Despite reported safety of the blood supply, many people prefer to store their own blood for transfusions
   Age affects recovery from traumatic brain injury

Hospitalization
   Patients undergoing major surgery in hospitals with limited nursing staffs suffer more complications
   Abnormal heart rhythm means longer hospital stays for many patients undergoing non-cardiac surgery
   Educational outreach programs can improve intensive care processes in rural hospitals
   Advance directives appear to have a limited role in guiding end-of-life care for seriously ill patients

Women and Families
   Women from diverse backgrounds generally agree on the quality of obstetric care they receive in the hospital
   Many low-income women are satisfied with Norplant contraception
   Treatment costs are nearly five times as high for infants weighing closer to 2 pounds than 3 pounds at birth
   Newborn screening for cystic fibrosis has little effect on future reproductive decisions of parents with a CF child
   Providing high school students with access to condoms does not increase teen sex

Long-term Care
   Nursing staff levels at U.S. nursing homes continue to be lower than recommended
   Nursing home characteristics have inconsistent effects on patient outcomes

HIV/AIDS Research
   Many HIV-infected Americans are not receiving medical care regularly

Special Populations
   Researchers identify the conditions that place homeless adults at the greatest risk of death

Managed Care/Primary Care
   Informal consultation among physicians may increase with growth in group practices and managed care
   Guidelines mailed to physicians on proper use of hypnotic sedatives can reduce inappropriate prescribing
   Quality improvement teams can address quality of care in primary care clinics, even in times of great turmoil

Law and Medicine
   Insurance contract language exerts the most influence over court decisions about treatment coverage
   States appear more willing than Federal authorities to approve mergers of health care providers

Research Issues
   Masking of author identity to improve fairness in review of medical journal articles remains difficult

AHCPR News and Notes
   AHCPR releases its first two evidence reports on sleep apnea and traumatic brain injury

Announcements
   AHCPR invites research proposals focusing on vulnerable populations
   AHCPR, SAMHSA, and NIMH award $2.1 million in grants to study mental health conditions in children
   Applications now being accepted for director of AHCPR's primary care research program
   AHCPR releases audiotapes from User Liaison Program workshops
   New products available from AHCPR and NTIS

Research Briefs
   Use of qualitative methods to evaluate diabetes education programs
   Reliability and validity of the adolescent health profile-types
   An empirical study of the effect of the control rate as a predictor of treatment efficacy in meta-analysis of clinical trials
   Physician retention in community and migrant health centers: Who stays and for low long?
   Analysis of life-long strategies to prevent Pneumocystic carinii pneumonia in patients with variable HIV progression rates

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