Treatments Show Promise in Reducing Autism-related Behaviors, But Some Have Significant Side Effects

Electronic Newsletter, Issue 311

Hospital stays for uninsured patients jumped 21 percent between 2003 and 2008, after holding fairly steady during the previous 5 years. By comparison, all hospital stays grew only 4 percent between 2003 and 2008, and 10 percent during the previous 5 years. The average cost of a 2008 uninsured hospital stay was $7,300. [Source: Agency for Healthcare Research and Quality, HCUP Statistical Brief #108: Uninsured Hospital Stays, 2008.]

Today's Headlines

  1. Treatments show promise in reducing autism-related behaviors, but some have significant side effects
  2. Guides for managing cystic fibrosis are available
  3. New technical brief on maternal-fetal surgical procedures
  4. New guide helps retirement community staff to implement an evidence-based exercise program for seniors
  5. AHRQ's Health Care Innovation Exchange features how public hospitals that use core measures can improve their performance
  6. Screening for testicular cancer: U.S. Preventive Services Task Force reaffirmation
  7. AHRQ's health IT funding opportunities available
  8. New AHRQ award-winning video series profiles innovators making a difference by providing patient-centered care
  9. AHRQ updates AHRQ PSNet and AHRQ WebM&M Web sites: improved navigation and search and browse functions
  10. AHRQ director helps consumers navigate the health care system in a new advice column on the Web
  11. AHRQ offers full-day HCUP Data Users' Workshop set for May 11—registration now open
  12. AHRQ in the professional literature

1. Treatments Show Promise in Reducing Autism-related Behaviors, But Some Have Significant Side Effects

Some medical and behavioral treatments show promise for reducing certain behaviors in children with autism spectrum disorders (ASDs), but more research is needed to assess the potential benefits and harms, according to a new AHRQ-funded report. The research results were published online in the journal Pediatrics. The comparative effectiveness report found that two commonly used medications—risperidone and aripiprazole—show benefit in reducing some behaviors, including emotional distress, aggression, hyperactivity and self-injury. However, these medicines are associated with significant side effects, such as rapid weight gain and drowsiness. The review found that no medications used for ASDs improved social behaviors or communication skills. The report, Comparative Effectiveness of Therapies for Children with Autism Spectrum Disorders, also found that several medications show promise and should be studied further, but that secretin, which has been studied extensively, has shown no effectiveness. Researchers at AHRQ's Vanderbilt Evidence-based Practice Center noted that further research is needed to identify which children are likely to benefit from particular interventions. The authors also were critical of the fact that current studies contain few comparisons of medical interventions with behavioral interventions as well as combinations of the two, despite the fact that most children undergo multiple treatments at the same time. Select to read our press release.

2. Guides for Managing Cystic Fibrosis Are Available

AHRQ has released a pair of plain-language guides to help families of children living with cystic fibrosis (CF) and their clinicians work together to make important decisions about how to treat and manage the condition. These free guides examine whether human growth hormone (HGH) can be used to successfully manage some symptoms of CF and what factors should be considered when making decisions about its use. The consumer guide, Human Growth Hormone for Children with Cystic Fibrosis, reviews the recent research on the use of HGH in children with CF and provides questions that a parent can ask their child's clinician about its benefits and risks. It highlights that children with CF who use HGH did show modest changes in weight and BMI; however, no significant changes in the measure of lung function associated with length or quality of life were observed. A modest decrease in hospitalization rate was associated with use of HGH; however, its long-term risks and impact on the disease remains unknown. The clinician guide, Use of Recombinant Human Growth Hormone for Pediatric Patients with Cystic Fibrosis, is intended to supplement existing resources available to clinicians to help them discuss treatment options with their patients.

3. New Technical Brief on Maternal-Fetal Surgical Procedures

AHRQ has released a new technical brief covering surgeries for seven fetal conditions, from heart defects to spina bifida. This report, Maternal-Fetal Surgical Procedures, authored by researchers at AHRQ's Vanderbilt Evidence-based Practice Center, indicates that although fetal surgery research is advancing quickly, it presently falls short of the level of rigor required to optimally inform care. Select to access this brief.

4. New Guide Helps Retirement Community Staff to Implement an Evidence-based Exercise Program for Seniors

AHRQ released a new Web-based step-by-step guide to help staff working in continuing care retirement communities implement an exercise program designed specifically for seniors. Staying Healthy Through Education and Prevention or STEP Implementation Guide provides tools such as handouts, curricula, and instructional videos to assist staff to implement an evidence-based program that incorporates basic strategies such as walking and strength training to help older adults increase active aging and decrease the risk of future disability. Wellness program professionals, activities coordinators, and other staff working directly with seniors also will find helpful instruction on the use of low-tech, inexpensive equipment such as ankle weights. Employing the techniques highlighted in the Staying Healthy Through Education and Prevention implementation guide also can help meet the U.S. Surgeon General's recommendations of 150 minutes of exercise a week for older adults. Select to access the STEP Guide.

5. AHRQ's Health Care Innovation Exchange Features How Public Hospitals That Use Core Measures Can Improve Their Performance

This week's issue from AHRQ's Health Care Innovations Exchange features three programs that describe innovative processes used to improve performance on four core measures heart attack, heart failure, pneumonia, and surgical care reported to the Centers for Medicare and Medicaid Services. In one example, Memorial Healthcare System in Hollywood, FL, implemented formal processes to ensure an organizational focus on each core measure. The system's hospitals identify and track all patients who meet the inclusion criteria, monitor gaps in their care and highlight them for providers, investigate care variances, and share data and best practices with hospital staff. Hospitals can use the featured QualityTools to measure and track their progress in implementing core measures. Select to read this issue and for more innovations and tools on core measures on AHRQ's Health Care Innovations Exchange Web site.

6. Screening for Testicular Cancer: U.S. Preventive Services Task Force Reaffirmation

The U.S. Preventive Services Task Force has reaffirmed its 2004 recommendation against screening for testicular cancer in adolescent and adult males without any symptoms. This is a grade D recommendation. The recommendation was published in the April 5 issue of Annals of Internal Medicine. Select to access the recommendation.

7. AHRQ's Health IT Funding Opportunities Available

AHRQ's health IT released two new funding opportunities announcements (FOAs). Understanding Clinical Information Needs and Health Care Decision Making Processes in the Context of Health Information Technology will fund research aimed at elucidating the nature of cognition, task distribution, and work in health care delivery settings. Research projects funded under this FOA will address current knowledge gaps regarding our understanding of health care providers' information needs and health care decision making processes. Ultimately, funded research projects will lead to the development and dissemination of evidence that will lead to appropriate design of health IT solutions that truly support clinical needs and lead to better outcomes. The total costs for a grant awarded under this FOA will not exceed $500,000 per year for a project period of up to 5 years. Understanding User Needs and Context to Inform Consumer Health Information Technology Design will fund projects that will help build a knowledge base about consumers' personal health information management needs and practices and related design principles. Successful applicants will be able to demonstrate how their proposed projects will lead to a better understanding of user needs and how their findings will impact consumer health IT design. Specifically, AHRQ is interested in funding research that leads to a robust understanding of user needs and context. The total costs for a grant awarded under this FOA will not exceed $500,000 per year for a project period of up to 5 years.

8. New AHRQ Award-Winning Video Series Profiles Innovators Making a Difference by Providing Patient-Centered Care

A new award-winning video series featuring stories about the value of implementing innovations to improve patient-centered care is now available from AHRQ's Health Care Innovations Exchange. The series titled, Frontline Innovators on Changing Care, Improving Health, profiles six very different who talk about the key elements of their innovations and their impact. The innovations include a program that reduces school absences and unnecessary emergency department for inner city children using telemedicine, and an initiative to train members of predominantly African American churches to provide health screenings and education to improve the lives and health status of their fellow congregants. The series recently received two national awards: the Aegis Award and the Telly for excellence in promoting health care information and education.

9. AHRQ Updates AHRQ PSNet and AHRQ WebM&M Web Sites: Improved Navigation and Search and Browse Functions

AHRQ has updated and enhanced the AHRQ PSNet and AHRQ WebM&M Web Sites. AHRQ Patient Safety Network (AHRQ PSNet) is a Web-based resource featuring the latest news and essential resources on patient safety. The site offers weekly updates of patient safety literature, news, tools, and meetings ("What's New"); Patient Safety Primers; and a vast set of carefully annotated links to important research and other information on patient safety ("The Collection"). Supported by a robust patient safety taxonomy and Web architecture, AHRQ PSNet provides powerful searching and browsing capability, as well as the ability for diverse users to customize the site around their interests ("My PSNet"). AHRQ WebM&M (Morbidity and Mortality Rounds on the Web) is the online journal and forum on patient safety and health care quality. This site features expert analysis of medical errors reported anonymously by our readers, Perspectives on Safety, and interactive learning modules on patient safety ("Spotlight Cases"). CME and CEU credit are available. The new look includes updated design elements, new summary displays, enhanced search functionality, and easier access to all content. AHRQ WebM&M and AHRQ PSNet launched in 2003 and 2005, respectively. Together the Web sites receive more than 2 million visits annually.

10. AHRQ Director Helps Consumers Navigate the Health Care System in a New Advice Column on the Web

AHRQ Director Carolyn M. Clancy, M.D., offers advice to consumers in new, brief, easy-to-understand columns. The biweekly columns will help consumers better navigate the health care system. Select to read Dr. Clancy's advice column on Health IT Tools Help with Care and Cost tells readers how more hospitals and doctor's offices are using health information technology and why this is "good news" for patients.

11. AHRQ Offers Full-Day HCUP Data Users' Workshop Set for May 11—Registration Now Open

AHRQ's Healthcare Cost and Utilization Project (HCUP) is sponsoring a free one-day workshop on May 11 at the AHRQ Conference Center in Rockville, MD to conduct revisit analyses using HCUP State data. The instructor-led workshop is targeted at intermediate-level data users or people with some HCUP familiarity. Computers are provided and programming examples are presented in SAS. HCUP is a family of health care databases, software tools, research publications, and support services created through a Federal-State-Industry partnership. HCUP is used for a broad range of health services research and policy issues at the national, State, and local market levels, including cost and quality of health services, medical practice patterns, access to health care, and outcomes of treatments. The workshop fills quickly so early registration is encouraged. Select to register.

12. AHRQ in the Professional Literature

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.

Carayon P. Human factors in patient safety as an innovation. Appl Ergon 2010 Sep; 41(5):657-65. Select to access the abstract on PubMed.®

Dudzinski DM, Hubert PC, Foglia MB, et al. The disclosure dilemma—large-scale adverse events. N Engl J Med 2010 Sep 2; 363(10):978-86. Select to access the abstract on PubMed.®

Kesselheim AS, Outterson K. Fighting antibiotic resistance: marrying new financial incentives to meeting public health goals. Health Aff 2010 Sep; 29(9):1689-96. Select to access the abstract on PubMed.®

Meltzer D, Chung J, Khalili P, et al. Exploring the use of social network methods in designing healthcare quality improvement teams. Soc Sci Med 2010 Sep; 71(6):1119-30. Select to access the abstract on PubMed.®

Evans LV, Dodge KL, Shah TD, et al. Simulation training in central venous catheter insertion: improved performance in clinical practice. Acad Med 2010 Sep; 85(9):1462-9. Select to access the abstract on PubMed.®

Ghaferi AA, Osborne NH, Birkmeyer JD, Dimick JB. Hospital characteristics associated with failure to rescue from complications after pancreatectomy. J Am Coll Surg 2010 Sep; 211(3):325-30. Select to access the abstract on PubMed.®

Fishman PA, Bonomi AE, Anderson ML, et al. Changes in health care costs over time following the cessation of intimate partner violence. J Gen Intern Med 2010 Sep; 25(9):920-5. Select to access the abstract on PubMed.®

Routh JC, Graham DA, Nelson CP. Epidemiological trends in pediatric urolithiasis at United States freestanding pediatric hospitals. J Urol 2010 Sep; 184(3):1100-4. Select to access the abstract on PubMed.®

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Current as of April 2011
Internet Citation: Treatments Show Promise in Reducing Autism-related Behaviors, But Some Have Significant Side Effects: Electronic Newsletter, Issue 311. April 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/311.html