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Effective Health Care

AHRQ's DEcIDE Network

The Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Network is a component of AHRQ's Effective Health Care Program. DEcIDE Centers are developing new knowledge on a wide variety of clinical and other health care-related topics. The Network comprises research-based health organizations with electronic access to health information databases and the capacity to conduct comparative effectiveness research. More than 25 research reports from the DEcIDE Network are available online. Go to http://effectivehealthcare.ahrq.gov/ for more information.

Adding the Patient Perspective to Comparative Effectiveness Research. A. Wu, C. Snyder, C. Clancy, et al., Health Affairs, October 2010; 29(10):1863-1871. Describes how questionnaires can be used systematically to capture patients' experiences with care directly from the patients. (AHRQ 11-R022)

Advancing Methods for Comparative Effectiveness Research. S. Smith, Medical Care, June 2010; 48(6 Suppl 1):S1-S2. Editorial discusses AHRQ's role in advancing new scientific approaches for conducting studies on comparative effectiveness and safety and introduces a journal supplement that presents the proceedings of a 2009 AHRQ-supported symposium focused on this topic. (AHRQ 10-R075)

The Agency for Healthcare Research and Quality (AHRQ) Effective Health Care (EHC) Program Methods Guide for Comparative Effectiveness Reviews: Keeping Up-to-Date in a Rapidly Evolving Field. S. Chang, Journal of Clinical Epidemiology, November 2011; 64(11):1166-1167. Introduces five articles in the journal that nearly complete the finalization of version 1.0 of AHRQ’s Methods Guide for conducting comparative effectiveness reviews. (AHRQ 12-R022)

AHRQ's Effective Health Care Program: Why Comparative Effectiveness Matters. J. Slutsky, C. Clancy, American Journal of Medical Quality, January/February 2009; 24(1):67-70. Defines comparative effectiveness research and discusses the use of these research findings in making comparisons of treatment alternatives. (AHRQ 09-R028)

Assessing Applicability When Comparing Medical Interventions: Agency for Healthcare Research and Quality and the Effective Health Care Program. D. Atkins, S. Chang, G. Gartlehner, et al., Journal of Clinical Epidemiology, April 2011; e-pub. Describes a systematic approach for identifying, reporting, and synthesizing information to allow consistent and transparent consideration of the applicability of the evidence in a systematic review. (AHRQ 11-R052)

CER: Tools—Not Rules, and Its Effects Can Be Transformational. C. Clancy, Medscape, August 2010; e-pub. Commentary discusses comparative effectiveness research and its role in helping clinicians deliver safe, effective health care. (AHRQ 11-R010)

Charting a Path from Comparative Effectiveness Funding to Improved Patient-Centered Health Care. P. Conway, C. Clancy, Journal of the American Medical Association, March 2010, 303(10):985-986. Editorial comments on a study that presents publication criteria for comparative effectiveness studies and discusses next steps for disseminating and translating comparative effectiveness research into practice. (AHRQ 10-R048)

Comparative Effectiveness Research and Genomic Medicine: An Evolving Partnership for 21st Century Medicine. J. Khoury, E. Rich, G. Randhawa, et al., Genetics in Medicine, October 2009; 11(10):707-711. Commentary argues the position that comparative effectiveness and genomic medicine can and should coexist and will increasingly benefit from each other to enhance knowledge-based medical practice. (AHRQ 10-R033)

Comparative Effectiveness Research—Implications of the Federal Coordinating Council's Report. P. Conway, C. Clancy, New England Journal of Medicine, July 2009; 361(4):328-330. Perspective discusses the Federal investment in effectiveness research and the implications of a recent report to Congress on funding priorities for the program. (AHRQ 09-R086)

Comparative Effectiveness Research Priorities at Federal Agencies: The View from the Department of Veterans Affairs, National Institute on Aging, and Agency for Healthcare Research and Quality. T. O'Leary, J. Slutsky, M. Bernard, Journal of the American Geriatrics Society, June 2010; 58(6):1187-1192. Briefly describes the research mission of AHRQ, NIA, and VA, discusses various definitions of comparative effectiveness research, and sets forth approaches in which the three agencies support comparative effectiveness research involving the aging population, as well as opportunities for future research in this area. (AHRQ 10-R078)

Comparative Effectiveness Research: Promising Area of Study for Pharmacists. C. Clancy, Journal of the American Pharmaceutical Association, March-April 2010; 50(2):131-133. Defines comparative effectiveness research and discusses AHRQ's research in this area, including several studies that are directly relevant to pharmacists. (AHRQ 10-R065)

Conducting Quantitative Synthesis When Comparing Medical Interventions: AHRQ and the Effective Health Care Program. R. Fu, G. Gartlehner, M. Grant, et al., Journal of Clinical Epidemiology, November 2011; 64(11):1187-1197. Establishes recommendations for conducting quantitative synthesis or meta-analysis, using study-level data in comparative effectiveness reviews. (AHRQ 12-R024)

Focusing the Research Enterprise on the Patient. C. Clancy, NCI Cancer Bulletin, April 2010; 7(8):e-pub. Commentary discusses the potential of comparative effectiveness research to enhance patient-centered care and contribute to the evidence base on diagnosing and treating cancer. (AHRQ 10-R066)

Guiding Comparative Effectiveness Research—A U.S. Perspective. H. Birnbaum, J. Slutsky, Pharmacoeconomics, October 2010; 28(10):839-842. Article in interview format focuses on the challenges and opportunities of implementing comparative effectiveness research from the perspective of the Federal Government’s efforts to promote and facilitate evidence-based clinical practices and health care decisionmaking. (AHRQ 11-R025)

Infrastructure to Monitor Utilization and Outcomes of Gene-Based Applications: An Assessment. Agency for Healthcare Research and Quality, May 2008; 90 pp. Presents the results of an assessment of existing databases in the U.S. health care system for monitoring the use and outcomes of gene-based applications, including tests and related interventions. Offers recommendations for establishing practical systems to assess use and outcomes of gene-based therapies. (AHRQ 08-EHC012)

Observational Studies in Systemic Reviews of Comparative Effectiveness: AHRQ and the Effective Health Care Program. S. Norris, D. Atkins, W. Bruening, et al., Journal of Clinical Epidemiology, November 2011; 64(11):1178-1186. Presents a framework for decisionmaking on the inclusion of observational studies to assess benefits and intended effects in comparative effectiveness reviews. (AHRQ 12-R023)

Patient-Centered Comparative Effectiveness Research: Essential for High-Quality Care. J. Slutsky, C. Clancy, Archives of Internal Medicine, March 2010, 170(5):403-404. Commentary reviews recent developments in comparative effectiveness research and their implications for clinicians and patients. (AHRQ 10-R049)

Patient-Centered Outcomes Research and Nurse Practitioners’ Role in Shared Decision Making. C. Clancy, Journal of the American Academy of Nurse Practitioners, January 2012; 24(1):59-61. Provides a brief overview of AHRQ’s Effective Health Care Program and the role it plays in patient-centered care and shared decisionmaking. (AHRQ 12-R034)

The Promise and Future of Comparative Effectiveness Research. C. Clancy, Journal of Nursing Care Quality, January-March 2010, 25(1):1-4. Commentary by AHRQ director discusses the impact of the American Recovery and Reinvestment Act of 2009 on the future and direction of comparative effectiveness research. (AHRQ 10-R040)

Registries for Evaluating Patient Outcomes: A User's Guide, Second Edition. Agency for Healthcare Research and Quality, September 2010, 275 pp. Provides a reference tool for establishing, maintaining, and evaluating the success of registries. Expands the 2007 edition with new chapters discussing emerging issues and 38 case examples. (AHRQ 10-EHC049)

Roundtable on Expanding Capacity for Comparative Effectiveness Research in the United States. S. Tunis, C. Clancy, W. Helms, et al., Health Services Research, April 2009; 44(2 Pt 1):327-342. Presents an edited transcript of a discussion of comparative effectiveness research that took place June 3, 2007 at the AcademyHealth Annual Research Meeting in Orlando, FL. (AHRQ 09-R053)

Starting the Conversation. W. Lawrence, Pharmacoepidemiology and Drug Safety, August 2011; 20(8):807-809. Introduces a report on a multidisciplinary panel that addressed the needs for training researchers and policymakers in the fundamentals of comparative effectiveness research for pharmaceuticals. (AHRQ 11-R072)

Welcome to the Effective Health Care Program. Agency for Healthcare Research and Quality, September 2010; 8 pp. Describes AHRQ's Effective Health Care (EHC) program and the EHC publications available in print and online for clinicians, patients, policymakers, and researchers. (AHRQ 10-EHC064)

Guides for Clinicians

ACEIs, ARBs, or DRI for Adults with Hypertension: Clinician Research Summary. Agency for Healthcare Research and Quality, October 2011, 2 pp. Summarizes the results of a systematic review of available evidence on the comparative effectiveness, benefits, and adverse effects of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and a direct renin inhibitor (DRI) for adults with hypertension. (AHRQ 11(12)-EHC063-3)

ACEIs or ARBs for Adults with Hypertension: Clinician Guide. Agency for Healthcare Research and Quality, October 2007, 2 pp. Summarizes evidence comparing the effectiveness and safety of angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists when used by adults with essential hypertension. (AHRQ 08-EHC003-3).

Adding ACEIs and/or ARBs to Standard Therapy for Stable Ischemic Heart Disease: Benefits and Harms, Clinician Guide. Agency for Healthcare Research and Quality, August 2010, 2 pp. Discusses whether standard medical therapy in patients with stable ischemic heart disease should be augmented with an angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker. (AHRQ 10-EHC002-3)

Analgesics for Osteoarthritis: Focus of Research for Clinicians. Agency for Healthcare Research and Quality, January 2012, 3 pp. Updates information from a 2006 report on the comparative effectiveness, benefits, and adverse effects of analgesics and the supplements gluocosamine and chondroitin used for the treatment of osteoarthritis. (AHRQ 11(12)-EHC076-3)

Choosing Antidepressants for Adults: Clinician Guide. Agency for Healthcare Research and Quality, August 2007, 4 pp. Summarizes clinical research comparing the effectiveness and safety of commonly used antidepressants for adults with major depression. (AHRQ 07-EHC007-3)

Choosing Medications for Adults with Rheumatoid Arthritis: Clinician Guide. Agency for Healthcare Research and Quality, April 2008; 4 pp. Summarizes evidence comparing the effectiveness and safety of disease-modifying antirheumatic drugs and corticosteroids used for rheumatoid arthritis. (AHRQ 08-EHC004-3)

Choosing Non-Opioid Analgesics for Osteoarthritis: Clinician Guide. Agency for Healthcare Research and Quality, revised March 2009, 4 pp. Summarizes clinical evidence on the effectiveness and safety of non-opioid analgesics for osteoarthritis based on a systematic review of 351 research publications. (AHRQ 06(07)-EHC009-3)

Clostridium difficile Infections: Diagnosis, Treatment, and Prevention: Clinician Research Summary. Agency for Healthcare Research and Quality, December 2011, 2 pp. Discusses findings from a review of available evidence on the comparative effectiveness of diagnostic tests, treatments, and prevention strategies for Clostridium difficile (C-diff) infections in adults.

Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer: Clinician Guide. Agency for Healthcare Research and Quality, October 2010, 2 pp. Examines the comparative effectiveness and safety of external beam radiation therapies for head and neck cancer. (AHRQ 10-(11)-EHC014-3)

Comparative Effectiveness of Diagnosis and Treatment of Obstructive Sleep Apnea in Adults: Clinician Research Summary. Agency for Healthcare Research and Quality, July 2011, 4 pp. Examines the comparative effectiveness of approaches for screening, diagnosing, and treating obstructive sleep apnea. (AHRQ 11-EHC052-3)

Comparative Effectiveness of Interventions for Rotator Cuff Tears in Adults: Clinician Guide. Agency for Healthcare Research and Quality, October 2010, 2 pp. Summarizes an analysis of the current evidence on nonoperative and operative approaches for treating degenerative or traumatic rotator cuff tears. (AHRQ 10-(11)-EHC050-3)

Comparative Effectiveness of Therapies for Children with Autism Spectrum Disorders: Clinician Guide. Agency for Healthcare Research and Quality, June 2011, 2 pp. Discusses the available evidence on the effectiveness, benefits, and harms of therapies used to address the core and associated symptoms seen among children aged 2-12 years with autism spectrum disorders. (AHRQ 11-EHC029-3)

Comparing Medications for Adults with Type 2 Diabetes: Clinician Guide. Agency for Healthcare Research and Quality, June 2011, 8 pp. Summarizes available evidence on the comparative effectiveness, benefits, and adverse effects of available monotherapy and two-drug combinations of medications for adults with type 2 diabetes. Updates a 2007 review with information on newer medications and two-drug combinations. (AHRQ 11-EHC038-3)

Core-Needle Biopsy for Breast Abnormalities: Clinician Guide. Agency for Healthcare Research and Quality, April 2010, 4 pp. Compares core-needle biopsy with open surgical biopsy for diagnosing breast lesions and summarizes the accuracy and possible harms of various core-needle biopsy methods. (AHRQ 10-EHC007-3)

Depression After Traumatic Brain Injury: Clinician Guide. Agency for Healthcare Research and Quality, March 2011, 2 pp. Discusses the relationship among traumatic brain injury (TBI), depression, and other psychological conditions and summarizes the evidence that can be used to guide screening and treatment for TBI-related depression and concomitant psychiatric conditions. (AHRQ 11-EHC017-3)

Effectiveness of Self-Measured Blood Pressure Monitoring in Adults with Hypertension: Clinician Research Summary. Agency for Healthcare Research and Quality, February 2012, 2 pp. Reviews the role of self-measured blood pressure monitoring with or without additional support (e.g., telemonitoring, counseling, home visits, etc.) in the management of hypertension. (AHRQ 12-EHC002-3)

Elective Induction of Labor: Safety and Harms: Clinician Guide. Agency for Healthcare Research and Quality, November 2009; 4 pp. Summarizes clinical evidence comparing the safety of elective induction of labor with expectant management of term pregnancy and provides information about maternal and fetal outcomes when elective induction of labor is used. (AHRQ 10-EHC004-3)

Fracture Prevention Treatments for Postmenopausal Women with Osteoporosis: Clinician Guide. Agency for Healthcare Research and Quality, June 2008; 4 pp. Summarizes the effectiveness and safety of various treatments for preventing fractures among postmenopausal women with osteoporosis, including bisphosphonates, selective estrogen receptor modulators (SERMs), hormonal medications, calcium, and vitamin D. (AHRQ 08-EHC008-3)

Gestational Diabetes: Caring for Women During and After Pregnancy: Clinician Guide. Agency for Healthcare Research and Quality, August 2009; 2 pp. Summarizes clinical evidence about prenatal care and delivery management for women with gestational diabetes. (AHRQ 09-EHC014-3)

Management of Atherosclerotic Renal Artery Stenosis: Clinician Guide. Agency for Healthcare Research and Quality, March 2007, 2-sided sheet. Summarizes clinical evidence from 56 studies on the effectiveness and safety of angioplasty and medical therapy for treating atherosclerotic renal artery stenosis. (AHRQ 07-EHC004-3)

Managing Chronic Gastroesophageal Reflux Disease: Clinician Research Summary. Agency for Healthcare Research and Quality, September 2011, 2 pp. Updates a 2005 report with more recent evidence on the comparative effectiveness, benefits, and adverse effects of treatments for gastroesophageal disease (GERD), including information on factors that may influence or predict treatment effectiveness. (AHRQ 11-EHC049-3)

Medications to Reduce the Risk of Primary Breast Cancer in Women: Clinician Guide. Agency for Healthcare Research and Quality, January 2010, 4 pp. Summarizes the effectiveness and safety of two medications—tamoxifen and raloxifene—used to reduce the risk of primary breast cancer. (AHRQ 09(10)-EHC028-3)

Off-Label Use of Atypical Antipsychotic Drugs: A Summary for Clinicians and Policymakers. Agency for Healthcare Research and Quality, July 2007, 4 pp. Describes atypical antipsychotic drugs and their use for off-label conditions, including information on dosing, risks, and side effects. (AHRQ 07-EHC003-2)

Pain Management Interventions for Elderly Patients with Hip Fracture: Clinician Guide. Agency for Healthcare Research and Quality, May 2011, 2 pp. Summarizes available evidence on pain management interventions used during the preoperative, intraoperative, and postoperative periods of treatment for patients aged 50 and older with hip fractures. (AHRQ 11-EHC022-3)

Premixed Insulin Analogues: Clinician Guide. Agency for Healthcare Research and Quality, March 2009; 4 pp. Summarizes clinical evidence comparing the effectiveness and safety of premixed analogues with other insulin preparations and oral diabetes drugs. (AHRQ 09-EHC017-3)

Radiofrequency Ablation for Atrial Fibrillation: Clinician Guide. Agency for Healthcare Research and Quality, November 2009; 3 pp. Summarizes the clinical evidence on the effectiveness and safety of catheter-based radiofrequency ablation compared with anti-arrhythmic drugs for treatment of atrial fibrillation. (AHRQ 09(10)-EHC015-3).

Three Treatments for Osteoarthritis of the Knee: Evidence Shows Lack of Benefit, Clinician Guide. Agency for Healthcare Research and Quality, April 2009; 4 pp. Summarizes evidence on the effectiveness and safety of three treatments for osteoarthritis of the knee: use of glucosamine, chondroitin, or a combination of the two; viscosupplementation; and arthroscopic lavage and debridement of the knee joint. (AHRQ 09-EHC001-3)

Treating Cholesterol with Combination Therapy: Clinician Guide. Agency for Healthcare Research and Quality, November 2009; 2 pp. Summarizes clinical evidence on using combinations of lipid-lowering medications for the treatment of high cholesterol. (AHRQ 09(10)-EHC024-3)

Treatments for Clinically Localized Prostate Cancer: Clinician Guide. Agency for Healthcare Research and Quality, July 2008, 4 pp. Summarizes clinical evidence comparing the effectiveness and safety of treatments for clinically localized prostate cancer, including expectant management and three active treatments (radical prostatectomy, radiation therapy, and hormonal therapy). (AHRQ 08-EHC010-3)

Use of Recombinant Human Growth Hormone for Pediatric Patients with Cystic Fibrosis: Clinician Guide. Agency for Healthcare Research and Quality, March 2011, 2 pp. Examines the benefits and harms of using recombinant human growth hormone (rhGH) to improve pulmonary and overall health outcomes for children and teens with cystic fibrosis. (AHRQ 11-EHC003-3)

Utilization and Clinical Data on In-Hospital Off-Label Uses of Recombinant Factor VIIa: Clinician Guide. Agency for Healthcare Research and Quality, October 2010, 2 pp. Summarizes available information on the off-label use of recombinant factor VII (rFVIIa) in the hospital setting. (AHRQ 10(11)-EHC030-3)

Guides for Patients

ACE Inhibitors and ARBs to Protect Your Heart? A Guide for Patients Being Treated for Stable Coronary Heart Disease. Agency for Healthcare Research and Quality, May 2010, 12 pp. Provides information on the efficacy and safety of using ACE inhibitors, ARBs, or their combination vs. standard medical therapy. (AHRQ 10(11)-EHC002-A) Spanish language booklet (AHRQ 10(11)-EHC002-B)

Antidepressant Medicines: A Guide for Adults with Depression. Agency for Healthcare Research and Quality, August 2007, 9 pp. Booklet provides information to help adult patients work with their doctors to choose medicines for depression. Describes the various medications used to treat adults with depression, possible side effects, and cost of the drugs. (AHRQ 07(08)-EHC007-2A) Spanish language booklet (AHRQ 07(09)-EHC007-B)

Choosing Medicines for High Blood Pressure: A Review of the Research on ACEIs, ARBs, and DRIs. Agency for Healthcare Research and Quality, October 2011, 14 pp. Describes research findings on three types of medicine for high blood pressure, including how well they work, how they compare to each other, and their side effects. (AHRQ 11(12)-EHC063-A) Spanish language booklet (11(12)-EHC063-B)

Choosing Pain Medicine for Osteoarthritis: A Guide for Consumers. Agency for Healthcare Research and Quality, January 2007, 9 pp. Booklet describes the different kinds of pain relievers that are available to treat osteoarthritis and presents information about the trade-offs between pain relief, potential side-effects, and medication cost. (AHRQ 06(07)-EHC009-2A) Spanish language booklet (AHRQ 06(08)-EHC009-2B)

Comparing Two Kinds of Blood Pressure Pills: ACEIs and ARBs: A Guide for Adults. Booklet describes two kinds of pills used to treat high blood pressure, ACE inhibitors (ACEIs) and ARBs and presents information to help patients talk about these drugs with their doctors. (AHRQ 08-EHC003-2A) Spanish language booklet (AHRQ 08(09)-EHC003-B)

Depression After Brain Injury: A Guide for Patients and Their Caregivers. Agency for Healthcare Research and Quality, April 2011, 10 pp. Describes the symptoms associated with depression following a traumatic brain injury and the use of counseling and antidepressants to treat the depression. (AHRQ 11-EHC017-A) Spanish language booklet (AHRQ 11-EHC017-B)

DMARDs for Juvenile Idiopathic Arthritis: A Review of the Research for Parents and Caregivers. Agency for Healthcare Research and Quality, September 2011, 10 pp. Describes the research about the effectiveness and safety of disease modifying anti-rheumatic drugs used to treat juvenile idiopathic arthritis, including information on side effects and cost. (AHRQ 11-0039-A)

Gastroesophageal Reflux Disease (GERD). Agency for Healthcare Research and Quality, December 2005, 1 p. Provides information for patients who have more severe GERD and are being treated by a doctor or other health care provider. (AHRQ 06-EHC003-A). Spanish language booklet (AHRQ 06-EHC003-B)

Gestational Diabetes: A Guide for Pregnant Women. Agency for Healthcare Research and Quality, August 2009; 13 pp. Provides information on gestational diabetes, including treatment and followup care, to help pregnant women who have the condition talk with their doctors or midwives about their care. (AHRQ 09-EHC104-A). Spanish language booklet (AHRQ 09(10)-EHC014-B)

Having a Breast Biopsy: A Guide for Women and Their Families. Agency for Healthcare Research and Quality, April 2010, 9 pp. Booklet provides information to help women talk with their doctors or nurses about breast biopsy, explains the different kinds of biopsies, and describes what a woman should expect if she has a breast biopsy. (AHRQ 10-EHC007-A). Spanish language booklet (AHRQ 10-EHC007-B)

Human Growth Hormone for Children with Cystic Fibrosis: A Review of the Research for Parents and Caregivers. Agency for Healthcare Research and Quality, March 2011, 5 pp. Describes the potential benefits and risks of using human growth hormone for children with cystic fibrosis. (AHRQ 11-EHC003-A) Spanish language booklet (AHRQ 11-EHC003-B)

Managing Osteoarthritis Pain with Medicines: A Review of the Research for Adults. Agency for Healthcare Research and Quality, January 2012, 9 pp. Describes how to manage osteoarthritis pain by using analgesics and discusses the research about different types of analgesics. (AHRQ 11(12)-EHC076-A)

Managing Pain from a Broken Hip: A Guide for Adults and Their Caregivers. Agency for Healthcare Research and Quality, May 2011, 10 pp. Summarizes the risks and benefits of various treatments—including medications, nerve blocks, traction, acupressure, and other therapies—used to manage pain associated with a broken hip in older adults. (AHRQ 11-EHC022-A) Spanish language booklet (AHRQ 11-EHC022-B)

Measuring Your Blood Pressure at Home: A Review of the Research for Adults. Agency for Healthcare Research and Quality, February 2012, 9 pp. Summary provides information for consumers on at-home blood pressure monitoring and describes research findings about blood pressure monitors. Includes suggested questions for patients to discuss with their clinicians. (AHRQ 12-EHC002-A)

Medicines for Type 2 Diabetes: A Review of the Research for Adults. Agency for Healthcare Research and Quality, June 2011, 14 pp. Reviews research on the benefits and possible side effects of medicines to lower or control blood sugar and provides suggestions for talking with health care providers about medication choices. (AHRQ 11-EHC038-A) Spanish language booklet (AHRQ 11(12)-EHC038-B)

Osteoarthritis of the Knee: A Guide for Adults. Agency for Healthcare Research and Quality, April 2009; 4 pp. Summarizes the various treatments to help reduce pain associated with osteoarthritis of the knee and discusses research on treatments that usually are not helpful for this condition. (AHRQ 09-EHC001-A). Spanish language booklet (AHRQ 09(10)-EHC001-B)

Osteoporosis Treatments that Help Prevent Broken Bones: A Guide for Women After Menopause. Agency for Healthcare Research and Quality, June 2008; 13 pp. Booklet presents information about different kinds of treatments for preventing broken bones due to osteoporosis, including how well the treatments work and the side effects and costs of medications. (AHRQ 08-EHC008-2A) Spanish language booklet (AHRQ 08(09)-EHC008-B)

Premixed Insulin for Type 2 Diabetes: A Guide for Adults. Agency for Healthcare Research and Quality, March 2009; 13 pp. Describes the different kinds of insulin used for type 2 diabetes and the various ways to take insulin, including premixed insulin, and suggests some questions to ask the doctor about which kind of insulin to use. (AHRQ 08(09)-EHC017-A) Spanish language booklet (AHRQ 08(10)-EHC017-B)

Radiofrequency Ablation for Atrial Fibrillation: A Guide for Adults. Agency for Healthcare Research and Quality, November 2009; 9 pp. Booklet describes a procedure called radiofrequency ablation that can restore normal heart rhythm in people with atrial fibrillation. (AHRQ 09(10)-EHC015-A). Spanish language booklet (AHRQ 09(10)-EHC015-B) Spanish language booklet (AHRQ 09(10)-EHC015-B)

Reducing the Risk of Breast Cancer with Medicine: A Guide for Women. Agency for Healthcare Research and Quality, January 2010, 12 pp. Booklet discusses two medicines—raloxifene and tamoxifen—used to reduce the risk of breast cancer for women who have never had breast cancer, including how they work, possible benefits, and potential problems. (AHRQ 10-EHC028-A). Spanish language booklet (AHRQ 09(10)-EHC028-B)

Renal Artery Stenosis Treatments: A Guide for Consumers. Agency for Healthcare Research and Quality, June 2007, 8 pp. Provides information to assist patients in talking with their clinicians about treatments for renal artery stenosis and discusses problems that may be caused by the condition. (AHRQ 07-EHC004-2A) Spanish language booklet (AHRQ 07(09)-EHC004-B)

Rheumatoid Arthritis Medicines: A Guide for Adults. Agency for Healthcare Research and Quality, April 2008; 9 pp. Booklet presents information to help patients work with their doctors or nurses to find a medicine for rheumatoid arthritis that is right for them. Explains the benefits, risks, and costs of RA drugs. (AHRQ 08-EHC004-2A) Spanish language booklet (AHRQ 08(09)-EHC004-B)

Therapies for Children with Autism Spectrum Disorders: A Review of the Research for Parents and Caregivers. Agency for Healthcare Research and Quality, June 2011, 14 pp. Describes research about the possible benefits and negative side effects of therapies for children aged 2 to 12 who have been diagnosed with an autism spectrum disorder. (AHRQ 11-EHC029-A) Spanish language booklet (AHRQ 11(12)-EHC029-B)

Thinking About Having Your Labor Induced? A Guide for Pregnant Women. Agency for Healthcare Research and Quality, December 2009; 9 pp. Booklet describes what's involved in elective induction of labor, including possible problems, and discusses what is not yet known about the procedure. (AHRQ 10-EHC004-A). Spanish language booklet (AHRQ 10-EHC004-B) Spanish language booklet (AHRQ 10-EHC004-B)

Treating and Preventing C-diff Infections: A Review of the Research for Adults and Their Caregivers. Agency for Healthcare Research and Quality, December 2011, 10 pp. Provides information on symptoms and treatment of infections involving Clostridium difficile (C-diff), which causes persistent gastrointestinal upset. (AHRQ 11(12)-EHC051-A) Spanish language booklet (11(12)-EHC051-B)

Treating High Cholesterol: A Guide for Adults. Agency for Healthcare Research and Quality, November 2009; 12 pp. Presents information to help patients talk with their doctor or nurse about medicines to treat high cholesterol, including the different types of cholesterol medicines, how they work, and their side effects. (AHRQ 09(10)-EHC024-A). Spanish language booklet (AHRQ 09(10)-EHC024-B)

Treating Prostate Cancer: A Guide for Men with Localized Prostate Cancer. Agency for Healthcare Research and Quality, July 2008; 6 pp. Presents information to help men with localized prostate cancer work with their doctors to choose among four common prostate cancer treatments-watchful waiting, prostate surgery, radiation, and hormone treatment-and provides information about the side effects associated with each treatment. (AHRQ 08-EHC010-2A). Spanish language booklet (AHRQ 08(09)-EHC010-B)

Treating Sleep Apnea: A Review of the Research for Adults. Agency for Healthcare Research and Quality, July 2011, 10 pp. Discusses diagnosis and treatment options for obstructive sleep apnea. (AHRQ 11-EHC052-A)

Treatment Options for GERD or Acid Reflux Disease: A Review of the Research for Adults. Agency for Healthcare Research and Quality, September 2011, 14 pp. Describes gastroesophageal reflux disease (GERD) and explains research findings about types of treatment, including the benefits and risks of each treatment. (AHRQ 11-EHC049-A) Spanish language booklet (AHRQ 11(12)-EHC049-B)

Treatment Options for Rotator Cuff Tears: A Guide for Adults. Agency for Healthcare Research and Quality, October 2010, 12 pp. Booklet presents information to help patients and their doctors choose among the available treatments for rotator cuff tears. (AHRQ 10(11)-EHC050-A) Spanish language booklet (AHRQ 10(11)-EHC050-B)

Understanding Radiotherapy for Head and Neck Cancer: A Guide for Adults and Their Caregivers. Agency for Healthcare Research and Quality, October 2010, 12 pp. Provides information on the different types of radiotherapy used to treat head and neck cancer. (AHRQ 10(11)-EHC014-A) Spanish language booklet (AHRQ 10(11)-EHC014-B)

Guides for Policymakers

Adding ACEIs and/or ARBs to Standard Therapy for Stable Ischemic Heart Disease: Benefits and Harms, Policymaker Summary. Agency for Healthcare Research and Quality, August 2010, 2 pp. Explores the benefits and harms of augmenting standard therapy with an angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker for patients with stable ischemic heart disease. (AHRQ 10-EHC002-2)

Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer: Policymaker Summary. Agency for Healthcare Research and Quality, September 2010, 2 pp. Discusses whether external beam radiation therapies for head and neck cancer justify wider availability and provision of infrastructure. (AHRQ 10-EHC014-2)

Depression Following a Traumatic Brain Injury: Policy Brief. Agency for Healthcare Research and Quality, November 2011, 1 p. Synthesizes evidence from 115 studies on what is known and not known about diagnosing and treating depression following a traumatic brain injury. (AHRQ 11(12)-EHC017-2)

Particle Beam Radiation Therapies for Cancer: A Summary for Policymakers. Agency for Healthcare Research and Quality, September 2009; 4 pp. Outlines the theoretical pros and cons of particle beam radiation therapy and provides a profile of the costs and current uses of this technology. (AHRQ 09-EHC019-2)

Surgical and Nonsurgical Treatment of Rotator Cuff Tears: Policymaker Summary. Agency for Healthcare Research and Quality, August 2010, 2 pp. Examines the effectiveness of surgical and nonsurgical treatment for rotator cuff tears. (AHRQ 10-EHC050-2)

Comparative Effectiveness Reviews


Comparative Effectiveness Reviews

These final reports are systematic appraisals of existing scientific evidence regarding treatments for high-priority health conditions. They identify gaps in existing scientific evidence and support new research. The full reports and summaries are available at http://www.effectivehealthcare.ahrq.gov/reports/final.cfm.

Brain and Nerve Conditions

Effectiveness and Safety of Antiepileptic Medications in Patients with Epilepsy. Executive Summary No. 40. December 2011; 22 pp. (AHRQ 11(12)-EHC082-1

Breathing Conditions

Diagnosis and Treatment of Obstructive Sleep Apnea in Adults. Executive Summary No. 32. July 2011; 23 pp. (AHRQ 11-EHC052-1)

Recombinant Human Growth Hormone (rhGH) in the Treatment of Patients with Cystic Fibrosis. Executive Summary No. 23. October 2010; 16 pp. (AHRQ 11-EHC003-1)

Cancer

Core-Needle and Open Surgical Biopsy for the Diagnosis of Breast Lesions. Executive Summary No. 19. December 2009; 19 pp. (AHRQ 10-EHC007-1)

Epoetin and Darbepoetin for Managing Anemia in Patients Undergoing Cancer Treatment. Executive Summary No. 3. May 2006; 6 pp. (AHRQ 06-EHC008-1)

Fecal DNA Testing in Screening for Colorectal Cancer in Average-Risk Adults. Executive Summary No. 52. February 2012; 16 pp. (AHRQ 12-EHC022-1)

Medications to Reduce Risk of Primary Breast Cancer in Women. Executive Summary No. 17. September 2009; 8 pp. (AHRQ 09-EHC028-1)

Noninvasive Diagnostic Tests for Breast Abnormalities: Update of a 2006 Review. Executive Summary No. 47. February 2012; 12 pp. (AHRQ 12-EHC014-1)

Noninvasive Tests for Breast Abnormalities. Executive Summary No. 2. February 2006; 4 pp. (AHRQ 06-EHC005-1)

Radiotherapy Treatments for Head and Neck Cancer. Executive Summary No. 20. May 2010; 8 pp. (AHRQ 10-EHC014-1)

Therapies for Clinically Localized Prostate Cancer. Executive Summary No. 13. February 2008; 20 pp. (AHRQ 08-EHC010-1)

Cardiovascular Disease

Adjunctive Devices for Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. Executive Summary No. 42. December 2011; 23 pp. (AHRQ 11(12)-EHC089-1)

Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease. Executive Summary No. 18. October 2009; 24 pp. (AHRQ 10-EHC002-1)

In-Hospital Use of Recombinant Factor VIIa for Off-Label Indications vs. Usual Care. Executive Summary No. 21. May 2010; 16 pp. (AHRQ 10-EHC030-1)

Lipid-Modifying Agents. Executive Summary No. 16. September 2009; 12 pp. (AHRQ 09-EHC024-1)

Management Strategies for Renal Artery Stenosis. Executive Summary No. 5. October 2006; 12 pp. (AHRQ 06-EHC004-1)

Management Strategies for Renal Artery Stenosis: 2007 Update. Executive Summary No. 5 Update. November 2007; 4 pp. (AHRQ 07(08)-EHC004-1U)

Percutaneous Coronary Interventions and Coronary Artery Bypass Grafting for Coronary Heart Disease. Executive Summary No. 9. October 2007; 16 pp. (AHRQ 08-EHC002-1)

Radiofrequency Catheter Ablation for Atrial Fibrillation. Executive Summary No. 15. July 2009; 8 pp. (AHRQ 09-EHC015-1)

Chronic Conditions

Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (ARBs) for Treating Essential Hypertension. Executive Summary No. 10. November 2007; 5 pp. (AHRQ 08-EHC003-1)

Angiotensin-Converting Enzyme Inhibitors (ACEIs), Angiotensin II Receptor Antagonists (ARBs), and Direct Renin Inhibitors for Treating Essential Hypertension: An Update. Executive Summary No. 34. June 2011; 8 pp. (AHRQ 11-EHC063-1)

Insulin Analogues in Premixed Formulations for Adults with Type 2 Diabetes. Executive Summary No. 14. September 2008; 13 pp. (AHRQ 08-EHC017-1)

Management Strategies for Gastroesophageal Reflux Disease. Executive Summary No. 1. December 2005; 6 pp. (AHRQ 06-EHC003-1)

Management Strategies for Gastroesophageal Reflux Disease: An Update. Executive Summary No. 29. September 2011; 18 pp. (AHRQ 11-EHC049-1)

Oral Diabetes Medications for Adults with Type 2 Diabetes. Executive Summary No. 8. July 2007; 16 pp. (AHRQ 07-EHC010-1)

Oral Diabetes Medications for Adults with Type 2 Diabetes: An Update. Executive Summary No. 27. March 2011; 16 pp. (AHRQ 11-EHC038-1)

Self-Measured Blood Pressure Monitoring: Comparative Effectiveness. Executive Summary No. 45. January 2012; 20 pp. (AHRQ 12-EHC002-1)

Developmental Delays

Attention Deficit Hyperactivity Disorder: Effectiveness of Treatment in At-Risk Preschoolers; Long-Term Effectiveness in All Ages; and Variability in Prevalence, Diagnosis, and Treatment. Executive Summary No. 44. October 2011; 23 pp. (AHRQ 12-EHC003-1)

Therapies for Children with Autism Spectrum Disorders. Executive Summary No. 26. April 2011; 20 pp. (AHRQ 11-EHC029-1)

Infectious Diseases

Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection. Executive Summary No. 31. December 2011; 18 pp. (AHRQ 11(12)-EHC051-1)

Endocrine and Metabolic Conditions

Screening and Treatment of Subclinical Hypothyroidism or Hyperthyroidism. Executive Summary No. 24. October 2011; 11 pp. (AHRQ 11(12)-EHC033-1)

Genitourinary Conditions

Chronic Kidney Disease Stages 1-3: Screening, Monitoring, and Treatment. Executive Summary No. 37. January 2012; 20 pp. (AHRQ 11(12)-EHC075-1

Gynecology

Noncyclic Chronic Pelvic Pain Therapies for Women: Comparative Effectiveness. Executive Summary No. 41. January 2012; 12 pp. (AHRQ 11(12)-EHC088-1)

Mental Health

First- and Second-Generation Antipsychotics for Children and Young Adults. Executive Summary No. 39. February 2012; 12 pp. (AHRQ 11(12)-EHC077-1)

Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults. Executive Summary No. 33. September 2011; 16 pp. (AHRQ 11-EHC056-1)

Off-Label Use of Atypical Antipsychotics. Executive Summary No. 6. January 2007; 8 pp. (AHRQ 07-EHC003-1)

Off-Label Use of Atypical Antipsychotics: An Update. Executive Summary No. 43. September 2011; 18 pp. (AHRQ 11-EHC087-1)

Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression. Executive Summary No. 7. January 2007; 16 pp. (AHRQ 07-EHC007-1)

Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression: An Update of the 2007 Comparative Effectiveness Review. Executive Summary No. 46. December 2011; 21 pp. (AHRQ 12-EHC012-1)

Traumatic Brain Injury and Depression. Executive Summary No. 25. April 2011; 13 pp. (AHRQ 11-EHC017-1)

Muscle, Bone, and Joint Conditions

Analgesics for Osteoarthritis. Executive Summary No. 4. September 2006; 12 pp. (AHRQ 06-EHC009-1)

Analgesics for Osteoarthritis: An Update of the 2006 Comparative Effectiveness Review. Executive Summary No. 38. October 2011; 19 pp. (AHRQ 11(12)-EHC076-1)

Disease-Modifying Antirheumatic Drugs (DMARDs) in Children with Juvenile Idiopathic Arthritis (JIA). Executive Summary No. 28. September 2011; 10 pp. (AHRQ 11-EHC039-1)

Drug Therapy for Rheumatoid Arthritis and Psoriatic Arthritis in Adults. Executive Summary No. 11. November 2007; 11 pp. (AHRQ 08-EHC004-1)

Nonoperative and Operative Treatments for Rotator Cuff Tears. Executive Summary No. 22. July 2010; 8 pp. (AHRQ 10-EHC050-1)

Pain Management Interventions for Hip Fracture. Executive Summary No. 30. May 2011; 16 pp. (AHRQ 11-EHC022-1)

Treatments to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis. Executive Summary No. 12. December 2007; 6 pp. (AHRQ 08-EHC008-1)

Pediatrics

Adjuvant Treatment for Phenylketonuria (PKU). Executive Summary No. 56. February 2012; 16 pp. (AHRQ 12-EHC035-1)

Hematopoietic Stem-Cell Transplantation in the Pediatric Population. Executive Summary No. 48. February 2012; 16 pp. (AHRQ 12-EHC018-1)

Pregnancy and Childbirth

Terbutaline Pump for the Prevention of Preterm Birth. Executive Summary No. 35. September 2011; 18 pp. (AHRQ 11-EHC068-1)

Technical Briefs

Neurothrombectomy Devices for Treatment of Acute Ischemic Stroke. Technical Brief No. 4. January 2011. (AHRQ 11-EHC020-1)

Particle Beam Radiation Therapies for Cancer. Technical Brief No. 1. September 2009. (AHRQ 09(10)-EHC019-1)

Technical Briefs summarize key issues related to emerging medical interventions or health care services for which published data are limited. Go to http://www.effectivehealthcare.ahrq.gov/reports/final.cfm for additional Technical Briefs that are available in electronic format only.

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