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Electronic Newsletter

June 24, 2009

AHRQ News and Numbers

Injuries to mothers during childbirth decreased significantly between 2000 and 2006. The number of mothers who experienced injuries while giving birth vaginally without the use of forceps or other instruments dropped by 30 percent. For mothers giving birth vaginally with the use of instruments and by Cesarean section, injuries declined about 20 percent. [Source: Agency for Healthcare Research and Quality, HCUP Statistical Brief #74: Potentially Avoidable Injuries to Mothers and Newborns During Childbirth, 2006.]

Today's Headlines

  1. Value of genetic testing for preventing blood clots unproven
  2. AHRQ study concludes common antibiotics may be best initial treatment for children with likely MRSA-related infections
  3. AHRQ and VA develop new materials for primary care clinicians and their patients
  4. New AHRQ study assesses the role of cost sharing in Medicaid and the CHIP
  5. New CHIRI™ issue brief on examines mental health problems of low-income children with special health care needs
  6. Promoting a Healthy Workforce Web conference
  7. What's new at AHRQ's Health Care Innovations Exchange?
  8. Task Force recommendation on screening for hepatitis B virus infection in pregnancy
  9. Twitter updates about AHRQ
  10. AHRQ in the professional literature

1.  Value of Genetic Testing for Preventing Blood Clots Unproven

AHRQ released a new evidence report that found insufficient evidence to conclude that genetic testing for two gene mutations in adults with a history of blood clots helps to prevent a condition known as deep-vein thrombosis or to improve other clinical outcomes. The report, a summary of which will be published in the June 17 issue of JAMA, also failed to find any benefit from genetic testing of family members of patients who have at least one of the two mutations—known as Factor V Leiden (FVL) and prothrombin G20210A—as well as a history of deep-vein thrombosis. The evidence report was requested and supported by CDC's Office of Public Health Genomics (OPHG). The Evaluation of Genomic Applications in Practice and Prevention Working Group, established by OPHG in 2005, will use this evidence report and other evidence to make recommendations on the validity and utility of genetic tests for FVL and prothrombin G20210A. This report, titled Outcomes of Genetic Testing in Adults with a History of Venous Thromboembolism, was conducted by AHRQ's Johns Hopkins Evidence-based Practice Center in Baltimore. Select to access the report.

2. AHRQ Study Concludes Common Antibiotics May Be Best Initial Treatment for Children With Likely MRSA-Related Infections

Penicillin and other antibiotics in the beta-lactam family work as well as other antibiotics to treat MRSA (methicillin-resistant Staphylococcus aureus) infections in the skin and soft tissue of children and may help prevent further resistance to antibiotic treatment, according to a new AHRQ-funded study. The study, published in the June issue of Pediatrics, compared treatment outcomes for three different antibiotics—beta-lactums (which include penicillin, cephalosporins, carbapenems and monobactams), clindamycin, and trimethoprim-sulfamethoxazole (TMP -SMZ). The study concluded that children treated with clindamycin for skin and soft-tissue infections potentially caused by MRSA did not show greater improvement compared to those treated with beta-lactam therapy. Children treated with TMP-SMZ were less likely to show improvement. Select to access the abstract in PubMed.®

3. AHRQ and VA Develop New Materials for Primary Care Clinicians and Their Patients

AHRQ and the Veterans Health Administration (VA) National Center for Health Promotion and Disease Prevention have joined to develop a line of patient brochures and clinician fact sheets for primary care clinicians and their patients based on the cardiovascular disease recommendations from the U.S. Preventive Services Task Force. The Partnership for Health: Heart and Circulation series is designed to help both clinicians and patients talk about cardiovascular preventive services and make informed decisions about which services patients need and when. The patient brochures include: Screening for Abdominal Aortic Aneurysm; High Blood Pressure; High Cholesterol; Taking Aspirin to Prevent Heart Attacks (Men); and Taking Aspirin to Prevent Strokes (Women). The clinician fact sheets include: Screening for Abdominal Aortic Aneurysm; Screening for Coronary Heart Disease; Screening for Vascular Disease (including carotid artery stenosis and peripheral arterial disease); and Using Aspirin for the Primary Prevention of Cardiovascular Disease. Select to access the new materials.

4.  New AHRQ Study Assesses the Role of Cost Sharing in Medicaid and the CHIP

A new AHRQ-funded study finds adding even modest cost-sharing requirements for children insured through Medicaid and the Children's Health Insurance Program (CHIP) could greatly increase the health spending burden faced by families, particularly for poor families and families of children with special health care needs. Of critical importance is the extent to which cost-sharing is capped as a percentage of family income. Out-of-pocket medical spending for publicly insured children is currently capped in CHIP at 5 percent of family income, and enforcement of such a cap could greatly reduce the financial burden on families while leaving most of the budgetary savings intact. However, it may be difficult for States to effectively monitor out-of-pocket spending and eliminate cost-sharing once the cap is reached, especially in States that require copayments as well as premium contributions. Cost Sharing In Medicaid And CHIP: How Does It Affect Out-Of-Pocket Spending? was posted online June 2 in Health Affairs. Select to access the abstract in PubMed.®

5. New CHIRI™ Issue Brief on Examines Mental Health Problems of Low-Income Children With Special Health Care Needs Theme Issue

A new issue brief from the Child Health Insurance Research Initiative (CHIRI™), Mental Health Needs of Low-Income Children with Special Health Care Needs, compared the prevalence of mental health problems among children with special health care needs to family perceptions of mental health needs. Mental health issues were second only to asthma as the top health problems in children with special health care needs as reported by their families. Over one-third of children with special health care needs had a mental health problem, but only one-quarter of caregivers recognized the need for mental health services in their child. Select to review the issue brief. A print copy is available by sending an E-mail to ahrqpubs@ahrq.hhs.gov.

6. Promoting a Healthy Workforce Web Conference

A free Web conference, "Promoting a Healthy Workforce," originally broadcast on June 1, is available on the AHRQ Web site. This Web conference focused on tools to support effective workplace wellness programs and resources that employers and other purchasers can share with employees to help them manage their health. Employers, employer coalitions, other purchasers, and consumers are invited to listen to experts from AHRQ discuss how patient-focused guides, videos, and other tools such as recommendations from the U.S. Preventive Services Task Force and the Effective Health Care guides for consumers can support employees who want to be more active and involved in their health care.

7. What's New at AHRQ's Health Care Innovations Exchange?

Women's Health is the topic of the newest issue of the AHRQ Health Care Innovations Exchange Web site. The featured innovations describe programs that use community health workers and telephone consultations to advance women's health The featured QualityTools describe practical aids to women's health. The Innovations Exchange contains additional women's health innovations and QualityTools and more than 300 searchable innovations and 1,400 searchable QualityTools. The Spotlight features Expert Commentary: Women's Health Care: A Novel Use of the Community Health Worker. You can access past issues of "What's New" on topics such as Mental Health, Management of Asthma, Obese and Overweight Youth, and Culturally Competent Care.

8. Task Force Recommendation on Screening for Hepatitis B Virus Infection in Pregnancy

The U.S. Preventive Services Task Force has reaffirmed its 2004 recommendation that clinicians screen all pregnant women for hepatitis B virus (HBV) infection. (A recommendation) The USPSTF performed a brief literature update, including a search for new and substantial evidence on the benefits and harms of screening pregnant women for HBV infection. The recommendation reaffirmation was published in the June 16 issue of Annals of Internal Medicine and is available on the AHRQ Web site.

9. Twitter Updates About AHRQ

AHRQ news updates are now available on Twitter, a micro-blogging service that allows users to send updates to people in their social network. Select to follow AHRQ on Twitter. Exit Disclaimer If you do not already have a Twitter account, you will be prompted to create one. Twitter accounts are free.

10. Reports on the Use of Systematic Reviews in Nutritional Research Are Available

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Unfortunately, some of you may not be able to access the abstracts because of firewalls or specific settings on your individual computer systems. If you are having problems, you should ask your technical support staff for possible remedies.

Huang CX, Plantinga LC, Fink NE, et al. Phosphate levels and blood pressure in incident hemodialysis patients: a longitudinal study. Adv Chronic Kidney Dis 2008 Jul; 15(3):321-31. Select to access the abstract in PubMed.®

Bennett AV, Lozano P, Richardson LP, et al. Identifying high-risk asthma with utilization data: a revised HEDIS definition. Am J Manag Care 2008 Jul; 14(7):450-56. Select to access the abstract in PubMed.®

Nowalk MP, Zimmerman RK, Lin CJ, et al. Raising adult vaccination rates over 4 years among racially diverse patients at inner-city health centers. J Am Geriatr Soc 2008 Jul; 56(7):1177-82. Select to access the abstract in PubMed.®

Nutankalva L, Wutoh AK, McNeil J, et al. Malignancies in HIV; pre- and post-highly active antiretroviral therapy. J Natl Med Assoc 2008 Jul; 100(7):817-20. Select to access the abstract in PubMed.®

Wang Y, Beydoun MA, Liang L, et al. Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity 2008 Jul 24. Select to access the abstract in PubMed.®

Lee GM, Riffelmann M, Wirsing von Konig CH. Cost-effectiveness of adult pertussis vaccination in Germany. Vaccine 2008 Jul 4; 26(29-30):3673-9. Select to access the abstract in PubMed.®

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Current as of June 2009

Internet Citation:

AHRQ Electronic Newsletter, June 24, 2009, Issue #277. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/enews/enews277.htm

 
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