Risks, Benefits of Emerging Heart Valve Replacement Technique Not Fully Understood
Electronic Newsletter, Issue 291
Treating back problems, one of the most bothersome medical problems, cost Americans more than $30 billion in 2007— up from $16 billion in 1997 (in 2007 dollars). In 2007 about 27 million people, or nearly 12 percent of adults age 18 and older, reported having back problems. Of those, more than 19 million sought medical treatment. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #289: Back Problems: Use and Expenditures for the U.S. Adult Population, 2007.] (PDF File, Plugin Software Help)
- Risks, benefits of emerging heart valve replacement technique not fully understood
- AHRQ's new Healthy Men Web site
- AHRQ seeks new topic nominations for U.S. Preventive Services Task Force
- AHRQ tool that measures patients' home health care experiences to be implemented by CMS
- Recent and upcoming releases of the AHRQ Quality Indicators software version 4.1
- New AHRQ effective health care guides on coronary heart disease are available
- 2008 Nationwide Inpatient Sample released
- New evidence report shows VBAC is a safe and reasonable choice for women
- New AHRQ guide to aid hospital quality reporting
- AHRQ in the professional literature
1. Risks, Benefits of Emerging Heart Valve Replacement Technique Not Fully Understood
A newer, less invasive method of heart valve replacement shows promise and may be appropriate for patients who cannot tolerate traditional open heart surgery, but research is needed to understand its potential risks and benefits, according to a new AHRQ-funded study. The report finds that percutaneous heart valve replacement, a procedure in which a replacement valve is implanted through a catheter rather than by open heart surgery, is a realistic option for some patients with heart valve disease, especially older or sicker patients. The report found that percutaneous heart valve replacement may be a safe and effective alternative to open heart surgery, especially in the short term, for those patients. However, information is lacking on the potential long-term benefits and risks of this procedure, particularly compared with open heart valve replacement surgery. The report did not conclude that any of the seven valves studied is safer or more effective than another. The report was produced by the Duke Evidence-based Practice Center for AHRQ, a leading federal agency conducting comparative effectiveness research. Results of the report were published online August 2 in Annals of Internal Medicine. Heart valve disease—a narrowing of the heart valve—is blamed for approximately 20,000 deaths a year. Select to read our press release and select to access the report.
2. AHRQ's New Healthy Men Web Site
AHRQ's new Healthy Men Web site is packed with key information for men on the importance of preventive health not only to them but also for the well-being of their families and loved ones. This information includes U.S. Preventive Services Task Force recommended tests, tips on talking with their doctors, a 10-question preventive health quiz for men, and a "Get Dad to the Doc" Web page for sending a health e-card to fathers or other men to remind them to get a preventive medical test. The Web site also includes 15- and 30-second videos developed from a new nationwide public service campaign by AHRQ and the Advertising Council. AHRQ data shows that men are 24 percent less likely than women to visit a doctor at least once a year and 30 percent more likely to be hospitalized for potentially preventable conditions such as congestive heart failure and complications from diabetes.
3. AHRQ Seeks New Topic Nominations for U.S. Preventive Services Task Force
AHRQ invites individuals and organizations to nominate primary and secondary prevention topics pertaining to clinical preventive services that they would like the United States Preventive Services Task Force (USPSTF) to consider for review. For complete information and directions please review the August 5 Federal Register (PDF File, Plugin Software Help).
4. AHRQ Tool that Measures Patients' Home Health Care Experiences to Be Implemented by CMS
AHRQ released a new tool designed to measure patients' experiences with Medicare-certified home health agencies, is being implemented by the Centers for Medicare and Medicaid Services (CMS) on a voluntary national basis beginning in October 2010. The Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Home Health Care Survey captures patients' perceptions on areas such as patient care, communication between providers and patients, specific care issues (e.g., medications, home safety, and pain), and overall rating of care. It is currently available in five languages: English, Spanish, Chinese, Russian, and Vietnamese. The survey is designed to meet the following goals:
- Create incentives for home health agencies to improve their quality of care through public reporting of survey results.
- Hold health care providers accountable by informing the public about the providers' quality of care.
- Produce standardized data on patients' perspectives of care that allow objective and meaningful comparisons between home health agencies on domains that are important to consumers.
Select to access the Home Health Care Survey.
5. Recent and Upcoming Releases of the AHRQ Quality Indicators Software Version 4.1
AHRQ is releasing the version 4.1 of the AHRQ Quality Indicators software in stages. Version 4.1a software for both SAS® and Windows® Quality Indicators was released on July 2 and can be found on the AHRQ Quality Indicators Web site. The subsequent version will result in a methodological refinement as well some revisions to further harmonize the SAS® and Windows® software. This release will be version 4.1b and AHRQ plans to release this version in late August.
6. New AHRQ Effective Health Care Guides on Coronary Heart Disease Are Available
AHRQ released a new consumer and clinician summary guides on coronary heart disease. The clinician guide, Adding ACEIs and/or ARBs to Standard Therapy for Stable Ischemic Heart Disease: Benefits and Harms offers clinical bottom line findings. The findings include level-of-confidence ratings for possible benefits and harms. The consumer guide, "ACE Inhibitors" and "ARBs" To Protect Your Heart?, provides plain-language information on coronary heart disease and helps patients work with clinicians to understand the benefits and risks of these treatments. Print copies are available by sending an E-mail to email@example.com.
7. 2008 Nationwide Inpatient Sample Released
AHRQ's Healthcare Cost and Utilization Project (HCUP) released 2008 data from the Nationwide Inpatient Sample (NIS). The 2008 NIS contains annually updated, nationally representative data from over 8 million hospital stays from more than 1,000 hospitals in 42 States. The NIS is the largest all-payer inpatient care database in the United States and includes data from 1988 to 2008, which allows analysis of trends over time. Select for more information about the NIS and other HCUP products on the HCUP-US Web site.
8. New Evidence Report Shows VBAC is a Safe and Reasonable Choice for Women
AHRQ released a new evidence report, Vaginal Birth After Cesarean: New Insights, that found that vaginal birth after cesarean delivery (VBAC) is a safe and reasonable choice for a majority of women. Researchers at AHRQ's Oregon Health and Science University Evidence-based Practice Center found evidence that, while rare, the rate of maternal mortality was significantly higher for elective repeat cesarean delivery compared with vaginal delivery. Meanwhile, the risk of uterine rupture and perinatal death remains rare but higher for vaginal deliveries. Information about other important outcomes, such as hemorrhage/transfusion, adhesions, surgical injury, and wound complications, remains uncertain due to lack of consistent definition and reporting. Moreover, investigators also found increasing evidence that women who have had multiple cesarean deliveries are at significant risk of life-threatening conditions. Led by Jeanne-Marie Guise, M.D., M.P.H., researchers noted that the amount of evidence-based research on factors that may influence patient-, provider-, and hospital-related decisions about method of delivery, such as medical liability, economics, and hospital staffing, is not sufficient. Select to access the report.
9. New AHRQ Guide to Aid Hospital Quality Reporting
AHRQ has available a new resource, Selecting Quality and Resource Use Measures: A Decision Guide for Community Quality Collaboratives to help local health leaders who need an evidence-based primer and decisionmaking framework to guide them in selecting measures for public reporting. Developed by the University of California's Patrick Romano, M.D. and Dominique Ritley, M.P.H., and the RAND Corporation's Peter Hussey, Ph.D., and based in part on input from Chartered Value Exchange leaders, the Decision Guide summarizes available empirical evidence and incorporates expert advice, best practices, and real-life case examples to illustrate the breadth of considerations and implementation options. The guide includes information on performance data; measures of quality; resource use/efficiency measures; guidance on selecting quality and resource use measures; and guidance on interpreting quality and resource use measures. Select to access the guide. A print copy is available by sending an E-mail to firstname.lastname@example.org.
10. 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.
Omachi TA, Katz PP, Yelin EH, et al. Depression and health-related quality of life in chronic obstructive pulmonary disease. Am J Med 2009 Aug; 122(8): 778.e9-778.e15. Select to access the abstract on PubMed. ®
Chen RC, Clark JA, Talcott JA. Individualizing quality-of-life outcomes reporting: how localized prostate cancer treatments affect patients with different levels of baseline urinary, bowel, and sexual function. J Clin Oncol 2009 Aug 20; 27(24):3916-22. Select to access the abstract on PubMed. ®
Kahn CA, Schultz CH, Miller KT, et al. Does START triage work? An outcomes assessment after a disaster. Ann Emerg Med 2009 Sep; 54(3):424-30, 430.e1. Select to access the abstract on PubMed. ®
Dossett LA, Redhage LA, Sawyer RG, et al. Revisiting the validity of APACHE II in the trauma ICU: improved risk stratification in critically injured adults. Injury 2009 Sep; 40(9):993-8. Select to access the abstract on PubMed. ®
Wren TA, Kalisvaart MM, Ghatan CE, et al. Effects of preoperative gait analysis on costs and amount of surgery. J Pediatr Orthop 2009 Sep; 29(6):558-63. Select to access the abstract on PubMed. ®
Maas MB, Lev MH, Ay H, et al. Collateral vessels on CT angiography predict outcome in acute ischemic stroke. Stroke 2009 Sep; 40(9):3001-5. Select to access the abstract on PubMed. ®
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