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Electronic Newsletter

February 20, 2004, Issue No. 124

AHRQ News and Numbers

The proportion of children aged 0 to 4 years who used at least one antibiotic during the year decreased from 47.9 percent in 1996 to 38.1 percent in 2000. The average number of antibiotic prescriptions decreased from 1.42 prescriptions per child in 1996 to 0.78 prescription per child in 2000. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #35: Trends in Antibiotic Use Among U.S. Children Aged 0 to 4 Years, 1996-2000 (PDF Help).]

Today's Headlines:

Treadmill testing, EKG, and CT scans not recommended for screening patients at low risk for heart disease
U.S. Preventive Services Task Force brief updates
AHRQ participates in February 20 briefing on progress report of hospital quality initiative
AHRQ-supported research on pediatric preventive screenings in British Medical Journal
First AHRQ Web-assisted audio conference on surge capacity and health system preparedness set for March 2
Patient Safety Conference postponed
Medical Expenditure Panel Survey Web seminar set for April 20
New detailed search feature at the National Quality Measures Clearinghouse™
AHRQ in the professional literature

1. Treadmill Testing, EKG, and CT Scans Not Recommended for Screening Patients at Low Risk for Heart Disease

The U.S. Preventive Services Task Force does not recommend using treadmill exercise testing, resting electrocardiograms, or electron beam computerized tomography to screen for heart disease in low-risk adults who don't have any symptoms of heart disease. For adults at increased risk for heart disease, the Task Force found insufficient evidence for or against using these three tests for screening. The recommendations were published in the February 17 issue of the Annals of Internal Medicine. Select to access our press release and the recommendations on the three screening tests.

2. U.S. Preventive Services Task Force Brief Updates

The U.S. Preventive Services Task Force has released five brief updates regarding topics for which there is little or no new evidence since their last review in 1996. The Task Force grades its recommendations according to one of five classifications (A, B, C, D, I) reflecting the strength of evidence and magnitude of net benefit (benefits minus harms). The topics are:

Low back pain: The Task Force concludes that the evidence is insufficient to recommend for or against the routine use of interventions to prevent low back pain in adults in primary care settings. Rating: I recommendation.

Asymptomatic bacteriuria: The Task Force strongly recommends that all pregnant women be screened for asymptomatic bacteriuria using urine culture at 12-16 weeks' gestation. Rating: A recommendation. The Task Force recommends against the routine screening of men and nonpregnant women for asymptomatic bacteriuria. Rating: D recommendation.

Hepatitis B: The Task Force strongly recommends screening for hepatitis B virus (HBV) infection in pregnant women at their first prenatal visit. Rating: A recommendation. The Task Force recommends against routinely screening the general asymptomatic population for chronic hepatitis B virus infection. Rating: D recommendation.

Oral cancer: The Task Force concludes that the evidence is insufficient to recommend for or against routinely screening adults for oral cancer. Rating: I recommendation.

Rh (D) incompatibility: The Task Force strongly recommends Rh (D) blood typing and antibody testing for all pregnant women during their first visit for pregnancy-related care. Rating: A recommendation. The Task Force recommends repeated Rh (D) antibody testing for all unsensitized Rh (D)-negative women at 24-28 weeks' gestation, unless the biological father is known to be Rh (D)-negative. Rating: B recommendation.

3. AHRQ Participates in February 20 Briefing on Progress Report of Hospital Quality Initiative

AHRQ joined CMS and hospital and purchaser groups at a February 20 briefing on the progress of the National Voluntary Hospital Reporting Initiative. The briefing provided an update on national voluntary efforts to gather and report hospital performance information on 10 clinical quality measures for three medical conditions including acute myocardial infarction, heart failure, and pneumonia. Select to access CMS' Web site for this new information and is it intended primarily for health care professionals. Approximately 3,008 hospitals have pledged to participate in the Quality Initiative, and to date, 1,407 hospitals are sharing at least one of the clinical quality measures, more than three times the number that shared the same data in October 2003.

February 17 FR Notice—AHRQ Offers an Opportunity to Test the HCAHPS™ Instrument Prior to National Implementation

AHRQ published a notice in the Federal Register on February 17, inviting hospitals, vendors, and other interested parties to voluntarily test the revised 32-item HCAHPS™ instrument before national implementation. The purpose of this effort is to provide another opportunity to the hospital industry to use the revised draft HCAHPS™ survey and a chance to add items to the instrument, if desired, before national implementation. It should be noted that, as a result of the additional testing, the HCAHPS™ instrument may undergo some further refinement before finalization. Select to access the Federal Register notice published on July 31, 2003. Interested parties must contact AHRQ for authorization to use the instrument through June 2004; data analyses should be submitted to AHRQ by August 2004. Select to access the CAHPS™ Survey User Network Web site for more information on the project or to download an application for participating in this general testing. The HCAHPS™ pre-national implementation testing Web site will be active through April 15.

4. AHRQ-Supported Research on Pediatric Preventive Screenings in British Medical Journal

New AHRQ-supported research shows that more children receive age-appropriate preventive services if pediatricians and their support staff are trained to measure their current performance and implement new approaches to health care delivery. Researchers led by Dr. Peter Margolis and Dr. Carole Lannon of the University of North Carolina, Schools of Medicine and Public Health, found that practice-based, continuing medical education programs combined with process-improvement methods are effective in achieving this goal. Within 1 year of implementation, the proportion of children who received appropriate screening increased for the four areas of preventive services that were studied-immunizations and screening for tuberculosis, anemia, and lead. For example, 68 percent of children in the intervention group had received screening for lead, while only 30 percent of the children in the control group were screened. For tuberculosis screening, 54 percent of children in the intervention group were screened, compared with 32 percent in the control group. Findings of the study were published in the February 14 issue of the British Medical Journal. Select to access the abstract on PubMed®.

5. First AHRQ Web-Assisted Audio Conference on Surge Capacity and Health System Preparedness Set for March 2

Mark your calendars! AHRQ announces the first event in its 2004 series of free Web-assisted bioterrorism audio conference calls on Surge Capacity and Health System Preparedness. Surge capacity is a health care system's ability to rapidly expand beyond normal services to meet the increased demand for qualified personnel, medical care, and public health in the event of bioterrorism or other large-scale public health emergencies or disasters. The first Web-assisted audio conference is scheduled for Tuesday, March 2, from 2:00 to 3:30 p.m., EST and will focus on "Education and Training for a Qualified Workforce." These 90-minute audio conferences are designed to share the latest health services research findings, promising practices, and other important information with State and local health officials and key health systems decisionmakers.

6. Patient Safety Conference Postponed

Please note that "Making the Health Care System Safer: Third Annual Patient Safety Conference" scheduled for March 8-9, at the Marriott Crystal Gateway in Arlington, VA has been postponed. As soon as we have a new date for the conference, we will post the information in this electronic newsletter.

7. Medical Expenditure Panel Survey Web Seminar Set for April 20

Register now for a free 2-hour Web-assisted audio conference on AHRQ's Medical Expenditure Panel Survey (MEPS) on Tuesday, April 20, from 1:00 p.m. to 3:00 p.m., EST. The seminar, "MEPS: The Fundamentals," is an introductory course providing a technical orientation to the MEPS. Learn how to access and use MEPS data and documentation, distinguish among different levels of files, identify variables of interest, and understand basic concepts needed for merging and pooling MEPS data files. Select to access the Web site for complete program and registration information.

8. New Detailed Search Feature at the National Quality Measures Clearinghouse™

A new detailed search feature is now available on AHRQ's National Quality Measures Clearinghouse™ (NQMC) Web site, a Web-based public repository for evidence-based quality measures and measure sets. This feature allows users to filter searches by measures included in the National Healthcare Quality Report and/or the National Healthcare Disparities Report. To see what new features and measures have been added to NQMCTM™ select What's New. You can receive updates to the site via E-mail by subscribing to the NQMCTM™ Weekly Update Service. For information on submitting quality measures or for general questions, please send an E-mail to info@qualitymeasures.ahrq.gov.

9. 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.

Ray WA. Evaluating medication effects outside of clinical trials: new-user designs. Am J Epidemiol 2003 Nov 1;158(9):915-20. Select to access the abstract on PubMed®.

Fine MJ, Stone RA, Lave JR, et al. Implementation of an evidence-based guideline to reduce duration of intravenous antibiotic therapy and length of stay for patients hospitalized with community-acquired pneumonia: a randomized controlled trial. Am J Med 2003 Oct 1;115(5):343-51. Select to access the abstract on PubMed®.

Vuckovic N, Harris EL, Valanis B, et al. Consumer knowledge and opinions of genetic testing for breast cancer risk. Am J Obstet Gynecol 2003 Oct;189(4 Suppl):S48-53. Select to access the abstract on PubMed®.

Goodney PP, O'Connor GT, Wennberg DE, et al. Do hospitals with low mortality rates in coronary artery bypass also perform well in valve replacement? Ann Thorac Surg 2003 Oct;76(4):1131-7. Select to access the abstract on PubMed®.

Kushel MB, Evans JL, Perry S, et al. No door to lock: victimization among homeless and marginally housed persons. Arch Intern Med 2003 Nov 10;163(10):2492-9. Select to access the abstract on PubMed®.

Lingard EA, Berven S, Katz JN, et al. Management and care of patients undergoing total knee arthroplasty: variations across different health care settings. Arthritis Care Res 2000 Jun;13(3):129-36. Select to access the abstract on PubMed®.

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Current as of February 2004

Internet Citation:

AHRQ Electronic Newsletter. February 20, 2004, Issue No. 124. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews124.htm