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. A number of research reports from the DEcIDE Network are available online. Go to http://effectivehealthcare.ahrq.gov/healthInfo.cfm?infotype=nr and select the topic of interest.

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

The Challenge of Comparative Effectiveness: Getting the Right Information to the Right People at the Right Time. M. Coopey, M. James, W. Lawrence, C. Clancy, Journal of Nursing Care Quality 23(1): January/March 2008, 1-5. Discusses the meaning of effectiveness in health care and describes how prior investments in outcomes research were used as a foundation for AHRQ's Effective Health Care program. (AHRQ 08-R031)

Effective Health Care Program Booklet. Agency for Healthcare Research and Quality, January 2006. Booklet discusses the Effective Health Care Program, which focus on a core set of priority health conditions. Describes the process of synthesizing, generating, and translating knowledge on topics concerning the particular topics. (AHRQ 06-EHC002)

Effective Health Care Program Kit. Agency for Healthcare Research and Quality, June 2006 (updated monthly). Includes fact sheets, background information, and report summaries from the Effective Health Care Program. (AHRQ 06-EHC004)

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)

A Progress Report on AHRQ's Effective Health Care Program: Commentary. C. Clancy, J. Slutsky, Health Services Research 42(5): October 2007, xi-xix. Provides an update on the progress of AHRQ's Effective Health Care Program, describes the interest that the program has garnered recently, and discusses some observations about the program since its inception in 2003. (AHRQ 08-R006)

Roundtable on Expanding Capacity for Comparative Effectiveness Research in the United States. S. Tunis, C. Clancy, W. Helms, et al., Health Services Research 44(2 Pt 1):April 2009, 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)

User's Guide to Registries Evaluating Patient Outcomes: Summary. Agency for Healthcare Research and Quality, April 2007, 219 pp. Serves as a guide to the design, implementation, analysis, interpretation, and evaluation of the quality of a registry for understanding patient outcomes. Report (AHRQ 07-EHC001-1) Summary (AHRQ 07-EHC001-2)

Clinician and Patient Guides

ACEIs or ARBs for Adults with Hypertension: Clinician's 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) Spanish language booklet (AHRQ 08(09)-EHC003-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 Antidepressants for Adults: Clinician's 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's 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's Guide. Agency for Healthcare Research and Quality, January 2007, 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)

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 Oral Medications for Adults with Type 2 Diabetes: Clinician's Guide. Agency for Healthcare Research and Quality, December 2007, 4 pp. Summarizes evidence from both observational studies and controlled trials that compared the effectiveness and safety of oral hypoglycemic medications. (AHRQ 07(08)-EHC010-3)

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)

Efficacy and Comparative Effectiveness of Off-Label Use of Atypical Antipsychotics. Agency for Healthcare Research and Quality, Executive Summary No. 6, January 2007, 8 pp. Reviews the scientific evidence on the safety and effectiveness of atypical antipsychotics for the following conditions: dementia and severe geriatric agitation, depression, obsessive-compulsive disorder, posttraumatic stress disorder, and personality disorders, as well as the management of Tourette's syndrome and autism in children. (AHRQ 07-EHC003-1) Summary for Clinicians and Policymakers, July 2007, 4 pp. (AHRQ 07-EHC003-2)

Fracture Prevention Treatments for Postmenopausal Women with Osteoporosis: Clinician's 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)

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)

Management of Atherosclerotic Renal Artery Stenosis: Clinician's 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)

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)

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)

Pills for Type 2 Diabetes: A Guide for Adults. Agency for Healthcare Research and Quality, December 2007, 13 pp. Booklet describes the various medications used to treat type 2 diabetes—including how they work, possible side effects, and cost—and presents information to help patients talk about these drugs with their doctors. (AHRQ 07(08)-EHC010-2A). Spanish language booklet (AHRQ 07(08)-EHC010-2B)

Premixed Insulin Analogues: Clinician's 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)

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 09-EHC017-A)

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)

Three Treatments for Osteoarthritis of the Knee: Evidence Shows Lack of Benefit, Clinician's 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 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)

Treatments for Clinically Localized Prostate Cancer: Clinician's 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)

Comparative Effectiveness Reviews

Comparative Effectiveness and Safety of Analgesics for Osteoarthritis. Agency for Healthcare Research and Quality, Executive Summary, No. 4, September 2006, 12 pp. Summarizes the available evidence comparing the benefits and harms of analgesics in the treatment of osteoarthritis. (AHRQ 06-EHC009-1)

Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults with Type 2 Diabetes. Agency for Healthcare Research and Quality. Executive Summary, No. 8, July 2007, 16 pp. Summarizes the available evidence on the safety and effectiveness of oral diabetes medications used by adults with type 2 diabetes. (AHRQ 07-EHC010-1).

Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (ARBs) for Treating Essential Hypertension. Agency for Healthcare Research and Quality, Executive Summary, No. 10, November 2007, 5 pp. Summarizes the evidence on the comparative long-term benefits and harms of ACEIs vs. ARBs, focusing on their use for treating essential hypertension in adults. (AHRQ 08-EHC003-1)

Comparative Effectiveness of Drug Therapy for Rheumatoid Arthritis and Psoriatic Arthritis in Adults. Agency for Healthcare Research and Quality, Executive Summary, No. 11, November 2007, 11 pp. Summarizes the evidence on the comparative efficacy, effectiveness, and harms of corticosteroids and synthetic and biologic disease-modifying antirheumatic drugs in the treatment of patients with rheumatoid arthritis or psoriatic arthritis. (AHRQ 08-EHC004-1)

Comparative Effectiveness of Epoetin and Darbepoetin for Managing Anemia in Patients Undergoing Cancer Treatment. Agency for Healthcare Research and Quality, Executive Summary, No. 3, May 2006. Focuses on use of epoetin and darbepoetin to manage anemia in patients undergoing cancer treatment with chemotherapy and/or radiation. (AHRQ 06-EHC008-1)

Comparative Effectiveness of Management Strategies for Gastroesophageal Reflux Disease. Agency for Healthcare Research and Quality, Executive Summary, No. 1, December 2005, 6 pp. Examines alternatives for managing the chronic symptoms of uncomplicated gastroesophageal reflux disease (GERD) in patients who may require long-term treatment. (AHRQ 06-EHC003-1)

Comparative Effectiveness of Management Strategies for Renal Artery Stenosis. Agency for Healthcare Research and Quality, Executive Summary, No. 5, October 2006, 12 pp. Summarizes the evidence evaluating the effect and safety of angioplasty with stent placements and medical therapies in the treatment of antherosclerotic renal artery stenosis, particularly after long-term followup. (AHRQ 06-EHC004-1).

Comparative Effectiveness of Management Strategies for Renal Artery Stenosis: 2007 Update. Agency for Healthcare Research and Quality, Executive Summary, No. 5, Update, November 2007. Evaluates the same questions, using the same eligibility criteria, as the previous review to update the literature search through April 23, 2007. (AHRQ 07(08)-EHC004-1U).

Comparative Effectiveness of Percutaneous Coronary Interventions and Coronary Artery Bypass Grafting for Coronary Artery Disease. Agency for Healthcare Research and Quality, Executive Summary, No. 9, October 2007, 16 pp. Evaluates the evidence for the comparative effectiveness of percutaneous coronary interventions and coronary artery bypass graft surgery in patients with certain types of coronary artery disease. (AHRQ 08-EHC002-1)

Comparative Effectiveness of Radiofrequency Catheter Ablation for Atrial Fibrillation. Agency for Healthcare Research and Quality, Executive Summary No. 15, July 2009, 8 pp. Summarizes the evidence for the clinical effectiveness and safety of radiofrequency catheter ablation for the management of atrial fibrillation. (AHRQ 09-EHC015-1)

Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression. Agency for Healthcare Research and Quality, Executive Summary, No. 7, January 2007, 16 pp. summarizes the available evidence on the comparative efficacy, effectiveness, and harms of 12 second-generation antidepressants in treating adult patients with depression. (AHRQ 07-EHC007-1)

Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer. Agency for Healthcare Research and Quality, Executive Summary, No. 13, February 2008, 20 pp. Summarizes the evidence comparing the benefits and harms of treatments for clinically localized prostate cancer, including watchful waiting, surgery to remove the prostate gland, external beam radiotherapy, interstitial radiotherapy, freezing the prostate, and androgen derivation therapy. (AHRQ 08-EHC010-1)

Comparative Effectiveness of Treatments to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis. Agency for Healthcare Research and Quality, Executive Summary, No. 12, December 2007, 6 pp. Summarizes the available evidence comparing the efficacy and safety of agents used to prevent or treat low bone density, including osteoporosis. (AHRQ 08-EHC008-1)

Comparative Effectiveness, Safety, and Indicators of Insulin Analogues in Premixed Formulations for Adults with Type 2 Diabetes. Agency for Healthcare Research and Quality, Executive Summary No. 14, September 2008, 13 pp. Summarizes the available evidence on the comparative effectiveness and safety of all premixed insulin analogues that are approved by the U.S. Food and Drug Administration and available in the United States. (AHRQ 08-EHC017-1)

Effectiveness of Noninvasive Diagnostic Tests for Breast Abnormalities. Agency for Healthcare Research and Quality, Executive Summary, No. 2, February 2006. Summarizes available data on the performance of noninvasive diagnostic tests in the evaluation of women presenting with breast abnormalities that suggest the possibility of breast cancer. (AHRQ 06-EHC005-1)

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://effectivehealthcare.ahrq.gov/reports/final.cfm.

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