| July 22, 2013, Issue #389
A special supplement now available in the Journal of Clinical Epidemiology provides proceedings from the fourth AHRQ-sponsored symposium on research methods for comparative effectiveness and patient-centered outcomes research (PCOR). The supplement, developed by AHRQ's Effective Health Care Program through the DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) Network, looks at research methods for comparative effectiveness research and PCOR studies. It examines the methodological work that illuminates contributors to differences inefficacy and effectiveness results. Select to access each of the 18 manuscripts for free from AHRQ's Effective Health Care Program website. Clinicians followed antibiotic prescribing guidelines for common bacterial acute respiratory tract infections (ARTIs) in children more often when they received education and feedback, according to an AHRQ-funded study in the June 12 issue of the Journal of the American Medical Association (JAMA). The cluster randomized trial of an outpatient antimicrobial stewardship program involved 18 pediatric primary care practices during a 1-year period. The study showed that broad-spectrum prescribing decreased from 26.8 percent to 14.3 percent among those who received training and feedback. Off-guideline prescribing for pneumonia decreased from 15.7 percent to 4.2 percent and, for acute sinusitis, from 38.9 percent to 18.8 percent. Little change was noted in off-guideline prescribing for streptococcal pharyngitis and viral infections. The authors suggest that antimicrobial stewardship should be extended to the ambulatory setting because outpatients are the greatest users of antibiotics for ARTIs. Select to access the PubMed® abstract of the study, "Effect of an Outpatient Antimicrobial Stewardship Intervention on Broad-Spectrum Antibiotic Prescribing by Primary Care Pediatricians: A Randomized Trial." AHRQ is sponsoring a webinar on August 7 from 1:00 to 2:00 p.m. ET on how clinical-community relationships can enhance health care delivery. The webinar will provide an overview of recent efforts on these relationships and the need for measures to evaluate their effectiveness. The webinar will be led by Janice L. Genevro, Ph.D., of AHRQ's Center for Primary Care, Prevention, and Clinical Partnerships; and presenters will be Rebecca Etz, Ph.D., Assistant Professor of Family Medicine, Virginia Commonwealth University, and Co-Director, Ambulatory Care Outcomes Research Network; and Robert M. Pestronk, M.P.H., Executive Director, National Association of County and City Health Officials. The webinar will feature an in-depth look at two new AHRQ tools that are designed to support research and evaluation in the field: the Clinical-Community Relationship Measures Atlas and the Clinical-Community Relationships Evaluation Roadmap. Select to register for the webinar or to access the Atlas and Roadmap. The latest issue of AHRQ's Health Care Innovations Exchange features three programs that improved access to specialty care in federally qualified health centers (FQHCs). One of the featured profiles describes a telemedicine program that provided retinopathy screening to patients with diabetes served by FQHCs. Connecticut's Community Health Center, Inc. developed a comprehensive annual visit for patients with diabetes that includes retinal screening. Using specially designed retinal imaging equipment, trained medical assistants take digital images and send them electronically for evaluation by ophthalmologists at Yale Eye Center who are paid a flat fee for this service. The program has enhanced access to retinal screenings, reduced costs, and increased patient convenience and satisfaction. These successes have led the Connecticut legislature to authorize a demonstration project in which Medicaid will reimburse for remote interpretation of ophthalmic images. Select to access more innovation profiles and tools related to specialty care and safety net providers on the Innovations Exchange website, which contains more than 800 searchable innovations and 1,550 quality tools. Most errors in health care are defined as slips rather than mistakes, and checklists can help prevent them, according to a patient safety primer available on AHRQ's Patient Safety Network (PSNet). The primer explains how participants in a project in Michigan reduced central line–associated bloodstream infections by following checklists along with doing extensive preparatory work in safety culture and teamwork. However, while checklists can help reduce the risk of errors where standardizing behavior is the goal, the primer notes that they are not appropriate for every problem. Diagnostic errors, for example, require different approaches. Select to access the full patient safety primer, titled "Checklists." | AHRQ in the Professional Literature
Newman-Toker DE, Tehrani AS, Mantokoudis G, et al. Quantitative video-oculography to help diagnose stroke in acute vertigo and dizziness: toward an ECG for the eyes. Stroke 2013 Mar 5. Select to access the abstract on PubMed.® Zima BT, Murphy JM, Scholle SH, et al. National quality measures for child mental health care: background, progress, and next steps. Pediatrics 2013 Mar; 131(Suppl 1):S38-S49. Select to access the abstract on PubMed.® Wittenberg E, Ritter GA, Prosser LA. Evidence of spillover of illness among household members: EQ-5D scores from a US sample. Med Decis Making 2013 Feb; 33(2):235-43. Select to access the abstract on PubMed.® Campbell JD, Zerzan J, Garrison LP, Libby AM. Comparative-effectiveness research to aid population decision making by relating clinical outcomes and quality-adjusted life years. Clin Ther 2013 Mar 8. Select to access the abstract on PubMed.® Schlitz NK, Koroukian SM, Lhatoo SD, et al. Temporal trends in pre-surgical evaluations and epilepsy surgery in the U.S. from 1998 to 2009. Epilepsy Res 2013 Feb; 103(2-3):270-8. Select to access the abstract on PubMed.® Flanagan ME, Saleem JJ, Millitello LG, et al. Paper- and computer-based workarounds to electronic health record use at three benchmark institutions. J Am Med Inform Assoc 2013 Mar 14. Select to access the abstract on PubMed.® Cherlin EJ, Curry LA, Thompson JW, et al. Features of high quality discharge planning for patients following acute myocardial infarction. J Gen Intern Med 2013 Mar; 28(3):436-43. Select to access the abstract on PubMed.® Goulet JL, Brandt C, Crystal S, et al. Agreement between electronic medical record-based and self-administered pain numeric rating scale: clinical and research implications. Med Care 2013 Mar; 51(3):245-50. Select to access the abstract on PubMed.® Contact Information Please address comments and questions about the AHRQ Electronic Newsletter to Linwood Norman at: (301) 427-1248 or Linwood.Norman@ahrq.hhs.gov. |
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