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AHRQ awards 15 new research projects on key topics

The Agency for Healthcare Research and Quality has announced the award of approximately $15.4 million in Total projected funding: over the next 5 years to fund 15 new research projects on key topics. Topics include pain management, children's health, elderly health, diabetes, and smoking cessation intervention. The newly funded projects are:

Point of care delivery of research evidence. Principal investigator: E. Andrew Balas, Ph.D., University of Missouri at Columbia. Total projected funding: $1,452,905. Project period: 9/01/00 - 8/31/03.

The researchers will develop a computerized decision support system for delivering research evidence and promoting behavioral change. They will investigate automated methods for selecting credible and substantial clinical evidence, matching patient data with clinical evidence, and directly delivering high-quality evidence to the point of clinical decisionmaking.

Economic impact of breastfeeding promotion intervention. Principal investigator: Karen A. Bonuck, Ph.D., Montefiore Medical Center, Bronx, NY. Total projected funding: $334,864. Project period: 9/01/00 - 11/30/03.

The researchers will examine the cultural issues that impact breastfeeding behavior among black, Asian, and Hispanic women and conduct a randomized controlled clinical trial at two community health centers. They will test the hypothesis that the economic benefits of promotions for breastfeeding outweigh the costs of providing the interventions.

Hospitalization of nursing facility residents. Principal investigator: Joan Buchanan, Ph.D., Harvard Medical School, Boston, MA. Total projected funding: $1,802,173. Project period: 9/30/00 - 9/29/03.

The researchers will analyze variations in hospitalization rates among nursing facilities. The two primary goals of this project are to understand the extent and determinants of variation in hospitalization rates and develop nursing home hospitalization profiles primarily by comparing predicted hospitalization rates to actual rates.

Developing and validating quality measures for children. Principal investigator: Mark R. Chassin, M.D., Mount Sinai School of Medicine, New York, NY. Total projected funding: $1,580,364. Project period: 9/30/00 - 8/31/04.

The researchers will assess the validity of quality measures on the appropriate use of tympanostomy tubes in children. They also will create evidence-based guidelines to identify children who are appropriate and inappropriate candidates for tympanostomy tube placement.

TennCare gaps for children: Asthma clinical outcomes. Principal investigator: William O. Cooper, M.D., Vanderbilt University Medical Center, Nashville, TN. Total projected funding: $241,318. Project period: 9/01/00 - 2/28/02.

The goal is to evaluate the effect of gaps in enrollment in Tennessee's Medicaid program, TennCare, for children with asthma using two markers for use of asthma care: emergency room visits and hospitalizations.

Health plan responses to Medicare HMO premium payments. Principal investigator: Randall P. Ellis, Ph.D., Boston University, Boston, MA. Total projected funding: $261,206. Project period: 9/01/00 - 8/31/02.

The researchers will examine Medicare policy in 1998 and 1999 that changed payments to Health Maintenance Organizations (HMOs) and assess the effects of such changes on HMO premiums, competition, benefit features, and enrollment.

Patient-centered care and health care costs. Principal investigator: Ronald M. Epstein, M.D., University of Rochester, Rochester, NY. Total projected funding: $1,401,442. Project period: 9/30/00 - 8/31/03.

The researchers will examine the relationship between measures of physicians' patient-centeredness and health care costs, health status, and patient satisfaction.

Observational studies vs. randomized controlled trials. Principal investigator: Arthur J. Hartz, M.D., Ph.D., University of Iowa, Iowa City. Total projected funding: $376,095. Project period: 9/30/00 - 8/31/02.

The researchers will compare the results of recent observational studies with those from randomized controlled trials that have investigated the same treatment and outcome. They will examine whether similar conclusions can be drawn from observational and randomized controlled studies and if differences can be explained.

Rural education as access point for teen smoking intervention. Principal investigator: Kimberly A. Horn, E.D.D., West Virginia University Research Corporation, Morgantown. Total projected funding: $1,437,199. Project period: 9/30/00 - 8/31/04.

The primary goal is to examine the feasibility and efficacy of a theory-based motivational tobacco intervention (MTI) for rural smokers ages 14 to 18 who present in the West Virginia University Hospital Emergency Department (ED) for treatment. Following demonstration of feasibility and efficacy, a secondary goal is to develop a transportable MTI package, including materials and practice recommendations for EDs, to guide future study and dissemination of MTIs.

Effect of Navajo interpreters on diabetes outcomes. Principal investigator: Melvina McCabe, M.D., University of New Mexico School of Medicine, Albuquerque. Total projected funding: $2,345,456. Project period: 9/30/00 - 9/29/05.

The goals are to evaluate the variable impact of language interpretation as a function of the training of Navajo interpreters and the effects they have on diabetes outcomes and the cost of ambulatory care of Navajo diabetic patients.

Efficacy/reliability of telemedicine in routine pediatric practice. Principal investigator: Kenneth M. McConnochie, M.D., University of Rochester, Rochester, NY. Total projected funding: $295,125. Project period: 9/30/00 - 9/29/01.

The primary goal of this project is to assess the reliability and efficacy of telemedicine for common, acute complaints of children presenting to the emergency department or primary care office setting.

Physician intervention to improve diabetes care. Principal investigator: Patrick J. O'Connor, M.P.H., HealthPartners Research Foundation, Minneapolis, MN. Total projected funding: $1,099,570. Project period: 9/30/00 - 8/31/03.

The goal of this randomized controlled trial is to compare two performance improvement interventions. One consists of a private session between a study physician and a reviewing physician ("influential physician"). The influential physician will provide case-based advice to the study physician on how to tailor treatment methods for their patients. The other intervention involves the use of a computerized automated medical record by a trained research associate to present each study physician with a series of clinical cases that will guide him or her through the appropriate treatments for their patients.

Computer-based guidelines to prevent sudden cardiac death. Principal investigator: Gillian D. Sanders, Ph.D., Stanford University, Stanford, CA. Total projected funding: $1,008,120. Project period: 9/30/00 - 8/31/03.

The three goals of this project are to:

  • Develop models for automated creation of guidelines from evidence-based decision models.
  • Create and evaluate a guideline based on the cardiac arrhythmia PORT.
  • Evaluate clinicians' use of and satisfaction with the Web-based ALCHEMIST—a computer-based system used to automatically create annotated guidelines from evidence-based decision models—as compared with traditional guidelines.

Consequences of drug cost sharing in the elderly. Principal investigator: Sebastian Schneeweiss, M.D., Brigham and Women's Hospital, Boston, MA. Total projected funding: $999,190. Project period: 9/30/00 - 2/28/03.

In this observational study, researchers will assess the impact of a Canadian policy to impose differential cost sharing for a class of medications in a health insurance program for the elderly and the needy population.

Resident assessment of pain management. Principal investigator: Joan M. Teno, M.D., Brown University, Providence, RI. Total projected funding: $728,284. Project period: 9/30/00 - 8/31/02.

The researchers will address the undertreatment of pain in nursing homes by developing and validating measurement tools for pain management for purposes of accountability and quality improvement.

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