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'Read It Today and Use It Today' News for Doctors

A new electronic newsletter strives to make evidence-based health care a little more likely with real-time research straight from the federal government.

The federal Agency for Healthcare Research and Quality this month launched its inaugural issue of Comparative Effectiveness News, an online newsletter summarizing the agency's Effective Health Care Program research findings.

The EHC Program "is the federal government's groundbreaking initiative to make head-to-head comparisons of health care interventions," Director Jean R. Slutsky said, adding that it will bring practical and reliable research findings — published and unpublished — to doctors, nurses and other clinical decision makers, as well as policymakers.

Slutsky says the dissemination process of AHRQ's research output already includes more than 300,000 messages sent to clinicans' handheld devices or computers.

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the genesis of the agency's work, which, Slutsky said, "relies on evidence-based research") includes a "healthy dose of public input" and, Slutsky said, will advance knowledge and research in new project areas, including autism, obesity and substance abuse.

The newsletter presents three major arenas of research findings. "Comparative Effectiveness Review" provides a summary of current medical practices and outcomes for a specific therapy. For example, the latest findings on localized prostate cancer therapies are reported in this first issue. Besides giving clinicians and consumers a basis for decisions based on diverse scenarios of the disease, CERs provide evidence for policymakers in their evaluations.

In "Clinical Topic," the newsletter reports on "Off-Label Use of Atypical Antipsychotic Drugs." This issue's AHRQ-commissioned study that developed a comparative review of the antipsychotic drug class for non-FDA-approved uses, particularly in elderly people with dementia, already has influenced public policy. The FDA has issued a new alert warning of "increased mortality in older people treated for dementia-related psychosis from both conventional and atypical antipsychotic therapies."

"DEcIDE Research" (Developing Evidence to Informed Decisions and Effectiveness) is another EHC Program component that collaborates with a select group of research institutions. In its first issue, the newsletter reports the DEcIDE findings of the University of Pennsylvania School of Medicine program investigating skyrocketing rates of pneumonia hospitalization in elderly people, a target concern identified by Congress.

William Baine, M.D., senior medical advisor of the agency's Center for Outcomes and Effectiveness Research, says this research focused on the results of a previously published study where iatrogenic illness (a disease or problem caused by a therapy, an intervention or other) could be linked to aspirational pneumonia. The first study, Baine said, reported that elderly people who were hospitalized for depression "were three times as likely to be re-hospitalized for aspirational pneumonia in the 90-day period following their initial release." Concern arose that there was a link between taking antidepressants and developing aspirational pneumonia.

Baine theorized that people taking antidepressants, which were increasingly prescribed, might be less alert or drowsy and less able to swallow properly, which could foster pneumonia.

However, the newsletter reports that the DEcIDE results "failed to confirm the hypothesis." The newsletter says clinical decisions about using antidepressants in the elderly should therefore "not be affected by concern about pneumonia risk."

It is this type of practical "read it today and use it today" information that Slutsky said speaks "so directly to the mission of improving the effectiveness and safety of American health care."

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