October 17, 2007, Issue No. 241
AHRQ News and Numbers
Sharp declines in the hospital death rates of patients from heart attack and five other leading conditions meant that an estimated 136,000 who would have died had they been hospitalized a decade earlier survived their stays in 2004. AHRQ compared the death rates for 1994 and 2004 for patients who were hospitalized for heart attack, congestive heart failure, stroke, pneumonia, gastrointestinal hemorrhage, or hip fracture. (Source: Agency for Healthcare Research and Quality [AHRQ], HCUP Statistical Brief #38: Trends in Hospital Risk-Adjusted Mortality for Select Diagnoses and Procedures, 1994-2004.)
Today's Headlines
1. New report finds surgery more likely than angioplasty to relieve pain for patients with coronary artery disease
2. AHRQ announces next phase of its evidence-based practice center program
3. AHRQ expands therapeutics education and research centers and adds new topics
4. AHRQ awards four contracts to help improve hospital quality measurement
5. AHRQ audio podcast discusses knee osteoarthritis, advice for doctors, and kids with cancer
6. Radiocast features researcher discussing data on people who have never had their cholesterol checked
7. AHRQ in the professional literature
1. New Report Finds Surgery More Likely Than Angioplasty to Relieve Pain for Patients with Coronary Artery Disease
Patients with mid-range coronary artery disease are more likely to get relief from painful angina and less likely to have repeat procedures if they get bypass surgery rather than balloon angioplasty with or without a stent, according to a new AHRQ report. As defined by the report, mid-range disease may occur in three ways: a single blockage of the vital left anterior descending artery, blockage of two arteries or some forms of less-severe blockage of three arteries. The report also shows that for mid-range coronary artery disease, bypass surgery and angioplasty patients had about the same survival rates and similar numbers of heart attacks, but that bypass surgery presents a slightly higher risk of stroke within 30 days of the procedure.
A summary of the report, completed by AHRQ's Stanford-University of California at San Francisco (UCSF) Evidence-based Practice Center, compared the outcomes and risks of the procedures in patients with mid-range coronary disease, where either procedure might be chosen. The new report, Comparative Effectiveness of Percutaneous Coronary Interventions and Coronary Artery Bypass Grafting for Coronary Artery Disease, is published in the online version of Annals of Internal Medicine. Select to read our press release and select to read the report.
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2. AHRQ Announces Next Phase of Its Evidence-Based Practice Center Program
AHRQ announced the 14 institutions that will comprise the third iteration of its Evidence-Based Practice Centers (EPC) program. AHRQ's EPCs conduct research syntheses and analyses of the scientific literature on clinical and other health care delivery issues and produce reports and technology assessments on the evidence. Of the 14 5-year contracts awarded, the University of Connecticut and Vanderbilt are new to the EPC program. Select to read our press release.
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3. AHRQ Expands Therapeutics Education and Research Centers and Adds New Topics
AHRQ announced the award of $41.6 million over the next 4 years for a new coordinating center and 10 research centers as part of its Centers for Education and Research on Therapeutics (CERTs) program. Four new centers are also added to the CERTs program. The new AHRQ-funded CERTs Coordinating Center is Kaiser Permanente's Center for Health Research in Portland, OR. In addition to assuming infrastructure and leadership support for the CERTs National Steering Committee and research centers, the Center for Health Research will expand the program's ability to translate research findings through collaborations with other research networks, including the National Institutes of Health Roadmap's Clinical Trials Initiative, the NIH Clinical and Translational Science Awards, and AHRQ's Effective Healthcare Program. In addition to the new coordinating center, there are now 14 CERTs program centers. The four new centers receiving first-time funding are Brigham and Women's Hospital in Boston, which will focus on how health information technology can improve the safe use of medications; the University of Illinois at Chicago, which will focus on how reinvigorating formularies promote best medication uses; Cincinnati's Children's Hospital Medical Center which will focus on improving pediatric patient care through projects, such as how children's metabolism may affect drug effectiveness and safety; and the University of Chicago, which will focus on hospital use of medications and other therapeutics and their clinical and economic implications. Select to read our press release.
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4. AHRQ Awards Four Contracts to Help Improve Hospital Quality Measurement
AHRQ has awarded contracts totaling $1 million to four Statewide data organizations for pilot projects that are designed to help make it easier for hospitals to link administrative data with electronic clinical data, such as lab results and information about co-existing illnesses at the time of admission. The 2-year contracts are part of AHRQ's new "Joining Forces" initiative, which will enable experts to more accurately measure the quality of hospital care. More detailed clinical information on patients at the time of admission is important because it helps researchers control for severity of illness when assessing in-hospital mortality and provides better information to clinicians and others who are working to improve the quality of care in hospitals. Three pilot project contracts were awarded to the Florida Agency for Health Care Administration's Center for Health Information and Policy Analysis, the Minnesota Hospital Association, and Virginia Health Information. In addition, AHRQ awarded a planning contract to the Washington State Department of Health's Center for Health Statistics. Visit AHRQ's Healthcare Cost and Utilization Project for more information.
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5. AHRQ Audio Podcast Discusses Knee Osteoarthritis, Advice for Doctors, and Kids with Cancer
In this week's Healthcare 411 audio podcast, David Samson, M.S., Associate Director of AHRQ's Blue Cross Blue Shield Evidence-based Practice Center, discusses the EPC review of osteoarthritis of the knee. He explains the findings about glucosamine and chondroitin, arthroscopy, and hyaluronic acid injections. In another interview, AHRQ Director Carolyn M. Clancy, M.D., provides advice to doctors about how to handle patients who bring stacks of Internet printouts and want to discuss it all. And a third story provides Medical Expenditure Panel Survey (MEPS) statistics about hospitalizations of children with cancer. Select to hear the program and select to read the transcript. To access any of AHRQ's podcasts, visit our Healthcare 411 series main page.
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6. Radiocast Features Researcher Discussing Data on People Who have Never Had Their Cholesterol Checked
In a recent Healthcare 411 radiocast, Anita Soni, Ph.D., discusses her statistical brief about people who have never had their cholesterol checked. She also provides some statistics on cholesterol drugs from another MEPS statistical brief. Select to listen to the 2-minute radio program or select to read the transcript.
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7. 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.
O'Shea TM, Nageswaran S, Hiatt DC, et al. Follow-up care for infants with chronic lung disease: a randomized comparison of community- and center-based models. Pediatrics 2007 Apr; 119(4):e947-57. Select to access the abstract in PubMed®.
McInnes DK, Landon BE, Wilson IB, et al. The impact of a quality improvement program on systems, processes, and structures in medical clinics. Med Care 2007 May; 45(5):463-71. Select to access the abstract in PubMed®.
Curtis JR, Patkar N, Xie A, et al. Risk of serious bacterial infections among rheumatoid arthritis patients exposed to tumor necrosis factor a antagonists. Arthritis Rheum 2007 Apr; 56(4):1125-33. Select to access the abstract in PubMed®.
Boord JB, Sharifi M, Greevy RA, et al. Computer-based insulin infusion protocol improves glycemia control over manual protocol. J Am Med Inform Assoc 2007 May-Jun; 14(3):278-87. Select to access the abstract in PubMed®.
Tracy JI, Dechant V, Sperling MR, et al. The association of mood with quality of life ratings in epilepsy. Neurology 2007 Apr 3; 68(14):1101-7. Select to access the abstract in PubMed®.
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Contact Information
Please address comments and questions to Nancy Comfort at Nancy.Comfort@ahrq.hhs.gov or (301) 427-1866.
Current as of October 2007
Internet Citation:
AHRQ Electronic Newsletter. October 17, 2007, Issue No. 241. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews241.htm
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