Agency News and Notes

First phase of reviews are beginning under AHRQ's new research program on the effectiveness of health care interventions

The Agency for Healthcare Research and Quality has announced the first phase of research reviews that will be performed under the Agency's new Effective Health Care Program. The program will largely include work funded under Section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

The essential goals of the Section 1013 mandate are to develop evidence on the comparative effectiveness of different treatments and appropriate clinical approaches to difficult health problems. To achieve these goals, AHRQ will support projects to review, synthesize, and translate published and unpublished scientific evidence, as well as identify important issues for which existing scientific evidence is insufficient to inform decisions about health care. This evidence will be made readily available to all health care decisionmakers in a wide range of formats.

This initial set of 10 research reviews will provide science-based information on the effectiveness of health care interventions—including prescription drugs—to enhance decision making by Medicare policymakers, beneficiaries and providers. The reviews will address questions on the priority conditions of the Medicare program established by the Secretary of Health and Human Services in 2004. The priority conditions, which were selected by a steering committee made up of representatives from AHRQ, the Centers for Medicare & Medicaid Services, the Food and Drug Administration, and the HHS Office of the Secretary, are:

• Ischemic heart disease.
• Cancer.
• Chronic obstructive pulmonary disease/asthma.
• Stroke, including control of hypertension.
• Arthritis and non-traumatic joint disorders.
• Diabetes mellitus.
• Dementia, including Alzheimer's disease.
• Pneumonia.
• Peptic ulcer/dyspepsia.
• Depression and other mood disorders.

Future reviews will address issues that relate to Medicaid and the State Children's Health Insurance Program. The results will be made available to the three public programs as well as to health plans, prescription drug plans, other health care providers, and the public.

AHRQ's Evidence-based Practice Centers (EPCs) will conduct the reviews, and the Oregon EPC at Oregon Health & Science University and Kaiser Permanente Center for Health Research in Portland will serve as the Methodology Resource Center for AHRQ's Effective Health Care Program. The reviews will take 7 to 12 months to complete, and they are expected to be available beginning in October 2005. The set of initial topics will address:

• Management strategies for gastroesophageal reflux disease.
• Benefits and safety of analgesics for osteoarthritis.
• New diagnostic technologies for evaluation of abnormal breast cancer screening.
• Epoetin and darbepoetin for managing anemia in patients undergoing cancer treatment.
• Off-label use of atypical antipsychotic medications.
• Renal artery stenting compared with aggressive antihypertensive medical therapy for mild renal artery stenosis.
• Therapies for localized prostate cancer.
• Oral medications for diabetes management.
• Medications for depression management.
• Drug therapies and behavioral interventions (exercise, diet, and vitamin supplementation) for osteoporosis and osteopenia.

The EPCs will review and analyze all the scientific literature relating to key questions under each topic, and they will produce a set of high-quality reviews that concisely synthesize the evidence, clearly state conclusions about the evidence, and identify research gaps. The Resource Center will translate identified gaps into suggestions for priority studies to fill critical information needs.

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