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Matchar, D.B., Samsa, G.P., Cohen, S.J., and Oddone, E.Z. (2000). "Community impact of anticoagulation services: Rationale and design of the Managing Anticoagulation Services Trial (MAST)." (AHRQ contract 290-91-0028). Journal of Thrombosis and Thrombolysis 9, S7-S11.

Atrial fibrillation (AF) is a common cardiac rhythm disturbance, especially among older people, that increases the risk of stroke 5- to 6-fold, compared with people who have normal heart rhythms. This article describes the design of a practice improvement trial testing whether anticoagulation services are a preferred way to manage anticoagulation to prevent stroke among patients with AF. Practice improvement trials such as the Managing Anticoagulation Services Trial (MAST) are effectiveness trials that examine the management of clinical problems in the context in which care is usually given. Noteworthy features of the MAST include defining the interventions in functional terms, which can empower site investigators to invent locally suitable systems, and collaboration with managed care organizations.

Nabors, L.A., Weist, M.D., and Reynolds, M.W. (2000, May). "Overcoming challenges in outcome evaluations of school mental health programs." (AHRQ grant HS09847). Journal of School Health 70(5), pp. 206-209.

School mental health programs have grown and improved substantially in the last 20 years. However, evaluations of outcomes for children receiving these services are needed to provide accountability data and ensure the sustainability of these programs. Most outcome evaluations of school mental health programs are in their infancy and focus on examining the short-term impact of services on individuals. This focus probably should be expanded to explore both short-term and long-term effects of these programs in different schools and in various communities. Such studies eventually can determine exactly which treatments are related to positive changes for children with specific problems, such as phobias or depression. When designing these studies, evaluators must overcome several challenges that may threaten the validity of their conclusions. In this paper, the authors review these threats and suggest ways to overcome them.

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Current as of October 2000
AHRQ Publication No. 01-0008

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