AHRQ begins first phase of intervention reviews

Evidence to be made available to decision makers

The U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) in Rockville, MD, has begun the first phase of research reviews that will be performed under its new Effective Health Care Program. The program largely will 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.

The program also will identify important issues for which existing scientific evidence is insufficient to inform decisions about health care. The reviews, which will be available beginning in October 2005, cover the following set of initial topics:

  • 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 medication.
  • Renal artery stenting compared to 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 (i.e., exercise, diet).

AHRQ’s Evidence-based Practice Centers (EPCs) will review and analyze all the scientific literature relating to key questions under each topic, and will produce a set of high-quality reviews that concisely synthesize the evidence, clearly state conclusions about the evidence, and identify research gaps.

The Oregon Evidence-based Practice Center at Oregon Health & Science University and the Kaiser Permanente Center for Health Research, both in Portland, will serve as the Methodology Resource Center for the program and will translate identified gaps into suggestions for priority studies to fill critical information gaps.

"There are 13 EPCs based in North America," explains Jean Slutsky, PA, MSPH, director of AHRQ’s centers for outcomes and evidence. "The centers will examine the scientific evidence, primarily in the form of studies, and look at the quality of the evidence."

That often is quite dense reading, she continues. "So to make it useful to different audiences, a secondary translation will have to occur, where language is used so that everyday people can make more immediate use of the findings."

AHRQ also will work with different sectors, such as the IT vendor community, to make sure the results are translated into products more easily used in health care IT systems, Slutsky adds.

The Methodology Resource Center will, in effect, be creating a resource for all the EPCs, in terms of using a highly rigorous methodology for all reviews and a centralized resource of information, she says. "Oregon will also provide access to the public by the addition of web sites within our own site."

Slutsky contends having this type of information available will improve health care outcomes. "I think one of the most important things to remember about having information on what works and what doesn’t is that it informs how we deliver and provide and seek care," she asserts. "Clearly, information on effective interventions has a huge capacity to improve the quality of health outcomes."

How will quality managers know when new results are available? "We’ll be pretty loud and clear about that," Slutsky promises. "One of the key components of the program is having people use the information."

Need More Information?

For more information, contact:

  • Jean Slutsky, PA, MSPH, Director, Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850. Phone: (301) 427-1601. Fax: (301) 427-1639. E-mail: jslutsky@ahrq.gov.