New AHRQ Evidence Report on Active Surveillance Therapy for Localized Prostate Cancer Now Available

Electronic Newsletter, Issue 332

The AHRQ Electronic Newsletter is issued periodically and summarizes Agency research and programmatic activities.

December 16, 2011

AHRQ News and Numbers

The five most commonly treated medical conditions among children in 2008 were acute bronchitis, asthma, trauma-related disorders, middle-ear infections and mental disorders. [Source: Agency for Healthcare Research and Quality, MEPS Statistical Brief #349: Health Care Expenditures for the Five Most Common Children's Conditions, 2008.]

Today's Headlines

  1. New AHRQ evidence report on active surveillance therapy for localized prostate cancer now available.
  2. ADHD medications found not to increase heart attack, stroke risks in adults.
  3. ADHD medications not linked to serious cardiac outcomes in children and youth.
  4. Newer antidepressants equally effective in treating clinical depression.
  5. December issue of AHRQ Web M&M examines multi-tasking mishap.
  6. Calling all AHRQ researchers! "Help us to help you.".
  7. Do you know how AHRQ's research is being used?.
  8. AHRQ in the professional literature.

1. New AHRQ Evidence Report on Active Surveillance Therapy for Localized Prostate Cancer Now Available

The clinical benefit of active surveillance compared to immediate therapy with curative intent has not yet been demonstrated for early-stage, localized prostate cancer, a new evidence report from AHRQ has found. Active surveillance and watchful waiting are used by physicians to monitor patients after they have been diagnosed with early-stage prostate cancer. Under active surveillance using regular monitoring, physicians immediately intervene at the earliest sign of cancer progression with treatments such as surgery or radiation therapy. Watchful waiting, in contrast, involves interventions that are implemented when symptoms develop, with the chief aim to reduce symptoms rather than cure the disease. Researchers at AHRQ's Tufts Evidence-based Practice Center summarized existing evidence on the role of active surveillance in the management of early-stage, low-risk prostate cancer and identified that additional research is needed on observational therapies. The review was commissioned by the National Institutes of Health for presentation at its State-of-the-Science Conference on December 5-7, 2011. Select to access the report, The Role of Active Surveillance in the Management of Men With Localized Prostate Cancer.

2. ADHD Medications Found Not to Increase Heart Attack, Stroke Risks in Adults

Medications used to treat attention-deficit hyperactivity disorder (ADHD) in adults are not linked to increased risk of heart attack, sudden cardiac death or stroke, according to new research from AHRQ's Effective Health Care Program. The research results were published in the December 12 issue of the Journal of the American Medical Association. Researchers found no evidence of an increased risk of serious cardiac outcomes associated with current use compared to non-use or former use of ADHD medications. Researchers also found little support for an increased risk for any specific medication or with longer duration of current use. The study follows another recent AHRQ-funded study, published in the November 17 issue of the New England Journal of Medicine that showed no increased risk of serious cardiac outcomes in children and young adults ages 2 to 24 (see item below). Both studies resulted from research collaboration between AHRQ and the U.S. Food and Drug Administration, and were conducted by Vanderbilt University and the HMO Research Network DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) centers. Select to access the report and select to access the abstract on PubMed.®

3. ADHD Medications Not Linked to Serious Cardiac Outcomes in Children and Youth

Medications used to treat attention-deficit hyperactivity disorder (ADHD) are not linked to increased risk of heart attack, stroke, or other cardiovascular problems in children, according to new research from AHRQ's Effective Health Care Program. The research results were published in the November 17 issue of the New England Journal of Medicine. The study resulted from a research collaboration between AHRQ and the U.S. Food and Drug Administration. The study used data from more than 1.2 million children and young adults from ages 2 to 24. Study findings reported no evidence of increased risk of serious cardiovascular effects among children and young people who use ADHD medications. The possibility of a small risk cannot be ruled out because of the small number of cardiovascular events observed in the patients studied. The research was conducted by Vanderbilt University and the HMORN DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) centers. Select to access the report and select to access the abstract on PubMed.®

4. Newer Antidepressants Equally Effective in Treating Clinical Depression

An updated evidence review from AHRQ's Effective Health Care Program concludes that all second-generation antidepressants are equally effective in treating clinical depression. The review, Comparative Effectiveness of Second Generation Antidepressants in the Pharmacologic Treatment of Adult Depression—An Update to a 2007 Report, examines the comparative effectiveness and side effects of 13 second-generation antidepressants. Despite similar effectiveness, antidepressants cannot be considered identical; there are some differences among drugs related to response time, side effects, and measures of health-related quality of life. Additional research is needed on patient responses to antidepressants when initial treatment is unsuccessful and when medications are changed.

5. December Issue of AHRQ Web M&M Examines Multi-tasking Mishap

The December 2011 issue of AHRQ Web M&M features a Spotlight Case involving a patient whose anticoagulation treatment was continued in error when an incoming personal text message on a mobile device interrupted the physician's order to discontinue the medication. A commentary on the case is provided by John Halamka, M.D., Chief Information Officer at Harvard Medical School and Beth Israel Deaconess Medical Center. Also, the Perspectives on Safety section features an interview with Ann L. Heinrich, R.N., Ph.D., who is an expert on the problem of health care-associated falls and has developed a widely used risk assessment tool. Frances Healy, R.N., Ph.D., who heads patient safety activities for the UK's National Patient Safety Agency, discusses key steps health care organizations can take to prevent falls. Physicians and nurses can receive free CME, CEU or training certification by taking the Spotlight Quiz. Select to access AHRQ Web M&M Web site.

6. Calling All AHRQ Researchers! "Help Us to Help You."

As you may know, AHRQ can help you promote the findings of your AHRQ-funded research, but we can't do it without you. AHRQ has been successful in working with our grantees and contractors to promote findings to the media and to transfer knowledge based on the research to appropriate audiences in the health care community. However, we know that we can do better. To help us help you, please let us know when you have an article accepted for publication by sending us a copy of the manuscript, anticipated publication date, and contact information for the journal to journalpublishing@ahrq.hhs.gov. Your manuscript will be reviewed by AHRQ's project and public affairs officers to determine what level of marketing we will pursue. Please be assured that AHRQ always honors the journal embargo. Thank you for your cooperation.

7. Do You Know How AHRQ's Research Is Being Used?

We are always looking for ways in which AHRQ-funded research, products, and tools have changed people's lives, influenced clinical practice, improved policies, and affected patient outcomes. These impact case studies describe AHRQ research findings in action and are used in testimony, budget documents, and speeches. If your AHRQ-funded research has had an impact on health care policy, clinical practice, or patient outcomes, we would like to know. Contact AHRQ's Impact Case Studies Program at Jane.Steele@ahrq.hhs.gov or (301) 427-1243 with your impact stories.

8. AHRQ in the Professional Literature

We are providing the following hyperlinks to journal abstracts through PubMed® for your convenience. Access to the abstracts may be blocked because of firewalls or specific settings on individual computer systems. If you are having problems, ask your technical support staff for possible remedies.

Andersson KM, Owens KD, Paltiel AD. Scaling up circumcision programs in Southern Africa: the potential impact of gender disparities and changes in condom use behaviors on heterosexual HIV transmission. AIDS Behav 2011 Jul; 15(5):938-48. Select to access the abstract on PubMed.®

Wittenberg E, Prosser LA. Ordering errors, objections and invariance in utility survey responses: a framework for understanding who, why and what to do. Appl Health Econ Health Policy 2011 Jul 1; 9(4):225-41. Select to access the abstract on PubMed.®

Min LC, Reuben DB, Adams J, et al. Does better quality of care for falls and urinary incontinence result in better participant-reported outcomes? J Am Geriatr Soc 2011 Aug; 59(8):1435-43. Select to access the abstract on PubMed.®

Lebrun LA, Shi L. Nativity status and access to care in Canada and the U.S.: factoring in the roles of race/ethnicity and socioeconomic status. J Health Care Poor Underserved 2011 Aug; 22(3):1075-100. Select to access the abstract on PubMed.®

Willis CD, Elshaug AG, Milverton JL, et al. Diagnostic performance of serum cobalamin tests: a systematic review and meta-analysis. Pathology 2011 Aug; 43(5):472-81. Select to access the abstract on PubMed.®

Kahn JM, Hill NS, Lilly CM, et al. The research agenda in ICU telemedicine: a statement from the Critical Care Societies Collaborative. Chest 2011 Jul; 140(1):230-8. Select to access the abstract on PubMed.®

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Current as of December 2011
Internet Citation: New AHRQ Evidence Report on Active Surveillance Therapy for Localized Prostate Cancer Now Available: Electronic Newsletter, Issue 332. December 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/332.html