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March 7, 2008, Issue No. 252

AHRQ News and Numbers

Chest pain that does not appear to be a heart attack when examined in hospital emergency departments, accounted for 1.6 million visits in 23 selected states in 2005. About one-fifth of the cases—345,000 people—were admitted to hospitals for observation or treatment. [Source: Agency for Healthcare Research and Quality, HCUP Statistical Brief #47: Emergency Department Visits for Adults in Community Hospitals from Selected States, 2005.]

Today's Headlines

  1. Modest health care quality gains outpaced by spending
  2. AHRQ announces new members to U.S. Preventive Services Task Force
  3. New clinical preventive health topics to be considered for review by the Task Force
  4. Task Force recommends against screening for chronic obstructive pulmonary disease using spirometry
  5. National Conference on Reducing Diagnostic Error in Medicine set for May 31-June 1
  6. 2008 AHRQ annual conference set for September 7-10
  7. New evidence report on Hydroxyurea Treatment of Sickle Cell Disease is available
  8. AHRQ in the professional literature

1. Modest Health Care Quality Gains Outpaced by Spending

The quality of health care improved by an average 2.3 percent a year between 1994 and 2005, a rate that reflects some important advances but points to an overall slowing in quality gains, according to AHRQ's 2007 National Healthcare Quality Report and National Healthcare Disparities Report. The improvement rate is lower than the 3.1 percent overall average annual improvement rate reported in the 2006 reports. Those reports measured trends between 1994 and 2004. Quality improvement rates are lower than widely documented increases in health care spending. The Centers for Medicare & Medicaid Services estimate health care expenditures rose by a 6.7 percent average annual rate between 1994 and 2005. While the 2007 reports show some notable gains, such as improvements in the care of heart disease patients, the Dispartities Report shows that many major disparities remain. This year's National Healthcare Quality Report synthesizes more than 200 "quality measures," which range from how many pregnant women received prenatal care to what portion of nursing home residents were controlled by physical restraints. The National Healthcare Disparities Report, meanwhile, summarizes which racial, ethnic or income groups are benefiting from improvements in care.

Select to read our press release and select to access the Quality and Disparities Reports. A print copy of the reports is available by sending an E-mail to

2. AHRQ Announces New Members to U.S. Preventive Services Task Force

AHRQ Director Carolyn M. Clancy, M.D., announced new members of the U.S. Preventive Services Task Force. David Grossman, M.D., of Seattle; J. Sanford (Sandy) Schwartz, M.D., of Philadelphia; and Timothy Wilt, M.D., M.P.H., of Minneapolis join the Task Force this month. Another new member, Bernadette Melnyk, Ph.D., of Phoenix, joined the Task Force in November 2007. The Task Force consists of 16 health care experts in the specialties of family medicine, pediatrics, internal medicine, obstetrics and gynecology, geriatrics, preventive medicine, public health, behavioral medicine, and nursing. Select to read our press release.

3. New Clinical Preventive Health Topics to be Considered for Review by the Task Force

AHRQ invites individuals and organizations to nominate primary and secondary prevention topics pertaining to clinical preventive services that they would like the U.S. Preventive Services Task Force to consider for review. All topics previously reviewed by the Task Force are available on AHRQ's Web site.

Nominations must be no more than 500 words in length and must include the name of the topic and rationale for consideration by the Task Force, describing:

  • Characterization as primary or secondary prevention topic (screening, counseling or preventive medication)
  • Primary care relevance (applicable clinical preventive service must be provided by a primary care provider or initiated in the primary care setting which can be defined as family practice, internal medicine, pediatrics or obstetrics/gynecology).
  • Public health importance (burden of disease/suffering, potential of preventive service to reduce burden, including effective interventions). Citations and supporting documents are recommended.
  • Potential impact of Task Force's review of the topic, i.e., change in clinical practice, research focus, etc.

AHRQ will not reply to submissions in response to the request for nominations but will consider all topic nominations during the selection process. If a topic is selected for review by the Task Force, the nominator will be notified by AHRQ.

Nominations should be submitted by March 21 to Gloria Washington, ATTN: USPSTF Topic Nominations, Center for Primary Care, Prevention & Clinical Partnerships, AHRQ, 540 Gaither Road, Rockville, MD 20850 or by fax to 301-427-1595 or by sending an E-mail to

Select to read the Federal Register notice. (PDF File, Plugin Software Help.)

4. Task Force Recommends Against Screening for Chronic Obstructive Pulmonary Disease Using Spirometry

The U.S. Preventive Services Task Force issued a new recommendation that adults without symptoms of chronic obstructive pulmonary disease (COPD) should not be screened for the disease using spirometry. The recommendation and the accompanying summary of evidence are posted online and will appear in the April 1 print edition of the Annals of Internal Medicine.

Select to read our press release and select to access the recommendation. A print copy is available by sending an E-mail to

5. National Conference on Reducing Diagnostic Error in Medicine Set for May 31-June 1

AHRQ and the American Medical Informatics Association are co-sponsoring the first national meeting dedicated to diagnostic errors in medicine May 31-June 1 in Phoenix. The goals of the meeting are to: summarize the current state of the field and approaches to reducing diagnostic errors; examine the role of clinical decision support systems in addressing diagnostic errors; identify and discuss ongoing research on diagnostic errors; stimulate creative thought directed at reducing harm from diagnostic errors; and establish a community of stakeholders interested in reducing diagnostic errors. In addition, experts plan to explore both system-related contributions to errors and cognitive origins. Select for conference details and further information.

6. 2008 AHRQ Annual Conference Set for September 7-10

Save the date! AHRQ's 2008 Annual Conference will be held September 7-10 in Bethesda, MD, at the Marriott Bethesda North Conference Center. The conference will feature exciting opportunities to learn about AHRQ's latest research aimed at improving quality, safety, efficiency, and effectiveness of care. Conference sessions will feature leading experts involved in AHRQ-sponsored research and implementation projects. Information regarding registration and hotel accommodations will be available soon.

7. New Evidence Report on Hydroxyurea Treatment of Sickle Cell Disease Is Available

A new AHRQ evidence report finds that clinicians should be encouraged by the proven effect of hydroxyurea in testing sickle cell anemia in children and adults. Although evidence existed to support the efficacy of hydroxyurea, more research is needed on the use of this drug. Study limitations include lack of long-term efficacy data, scant evidence on the benefits for patients with genotypes other than the hemoglobin S mutation, and insufficient long-term data about the potential toxicities of the drug. The report, Hydroxyurea Treatment of Sickle Cell Disease, was requested and funded by the NIH's Office of the Medical Applications of Research, for a State-of-the-Science Conference on the topic on February 25-27. AHRQ's Johns Hopkins University Evidence-based Practice Center conducted the systematic literature review and prepared the report.

Select to review the report. A print copy is available by sending an E-mail to

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.

Stitzenberg KB, Thomas NE, Dalton K, et al. Distance to diagnosing provider as a measure of access for patients with melanoma. Arch Dermatol 2007 Aug; 143(8):991-8. Select to access the abstract in PubMed®.

Darmody J, Pawlak R, Hook M, et al. Substitution of hospital staff in concurrent utilization review. J Nurs Care Qual 2007 Jul-Sep; 22(3):239-46. Select to access the abstract in PubMed®.

Fiscella K, Medldrum S, Franks P. Post partum discharge against medical advice: who leaves and does it matter? Matern Child Health J 2007 Sep; 11(5):431-6. Select to access the abstract in PubMed®.

Muller KE, Edwards LJ, Sipson SL, et al. Statistical tests with accurate size and power for balanced linear mixed models. Stat Med 2007 Aug 30; 26(19):3639-60. Select to access the abstract in PubMed®.

Hennessy S, Bilker WB, Leonard CE, et al. Observed association between antidepressant use and pneumonia risk was confounded by comorbidity measures. J Clin Epidemiol 2007 Sep; 60(9):911-8. Select to access the abstract in PubMed®.

Contact Information

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Current as of March 2008


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