Outcomes and Effectiveness Research

Aprotinin Use in Thoracic Aortic Surgery: Safety and Outcomes. A. Sedrakyan, A. Wu, G. Sedrakyan, et al., Journal of Thoracic and Cardiovascular Surgery 132(4): October 2006, 909-917. Presents the results of an evaluation of using the medication aprotinin in patients undergoing thoracic aortic surgery for aneurysm repair, penetrating ulcers, and other conditions. (AHRQ 07-R016)

Are Lumbar Spine Reoperation Rates Falling with Greater Use of Fusion Surgery and New Surgical Technology? B. Martin, S. Mirza, B. Comstock, et al., Spine 32:2007, 2119-2126. Uses population-based hospital discharge data from Washington State to examine the cumulative incidence of second lumbar spine operation following an initial lumbar operation for degenerative conditions. (AHRQ 08-R015)

Cardiac Device Implantation in the United States from 1997 through 2004: A Population-Based Analysis. C. Zhan, W. Baine, A. Sedrakyan, et al., Journal of General Internal Medicine 23(Suppl 1): January 2008, 13-19. Uses hospital administrative data to assess cardiac device implantations in the United States, selected perioperative outcomes, and associated patient and hospital characteristics. (AHRQ 08-R037)

Centers for Education & Research on Therapeutics (CERTs) Brochure. Agency for Healthcare Research and Quality, September 2006. Provides information about the Centers for Education & Research on Therapeutics, a national initiative to improve the safety and effectiveness of drugs, medical devices, and biological products such as vaccines. (AHRQ 06-M038)

CERTs Annual Report, Year 7. Agency for Healthcare Research and Quality, May 2009, 48 pp. Highlights the ongoing work of AHRQ's Centers for Education & Research in Therapeutics (CERTs) program, presents summaries of several projects completed during the period October 2005-September 2006, and describes the efforts from newly formed centers. (AHRQ 09-0063)

CERTs Annual Report, Year 6. Agency for Healthcare Research and Quality, April 2007, 40 pp. Highlights a number of CERTs research and educational projects completed over the past year, as well as several projects currently in progress. (AHRQ 07-0030)

A Comparison of Outcomes Resulting from Generalist vs. Specialist Care for a Single Discrete Medical Condition. G. Smetana, B. Landon, A. Bindman, et al., Archives of Internal Medicine 167:2007, 10-20. Explores the influence of generalist vs. specialist care on outcomes for patients with a single discrete condition and discusses the methodologic shortcomings of current evidence. (AHRQ 07-R035)

Health-Related Quality of Life After Mitral Valve Repairs and Replacements. A. Sedrakyan, V. Vaccarino, J. Elefteriades, et al., Quality of Life Research 15:2006, 1153-1160. Examines whether changes in health-related quality of life following surgery are better for patients undergoing mitral valve repair compared with those who have mitral valve replacement and whether these outcomes should factor into clinical decisionmaking. (AHRQ 07-R015)

Incidence and Short-Term Outcomes of Primary and Revision Hip Replacement in the United States. C. Zhan, R. Kaczmarek, N. Loyo-Berrios, et al., Journal of Bone and Joint Surgery 89:2007, 526-533. Uses 2003 nationwide U.S. data to examine the incidences of primary total hip replacement, partial hip replacement, and revision hip replacement and assesses the short-term patient outcomes and factors associated with the outcomes from these surgeries. (AHRQ 07-R053)

Practice Makes Perfect: A Volume-Outcome Study of Hospital Patients with HIV Disease. F. Hellinger, Journal of Acquired Immune Deficiency Syndromes 46(2): February 2008, 226-233. Examines the relation between two measures of volume (the number of HIV-positive patients treated in a hospital and the number treated by the attending physician) and the probability of HIV-positive patients dying in the hospital. (AHRQ 08-R052)

The Prostate Cancer Intervention Versus Observation Trial: VA/NCI/AHRQ Cooperative Studies Program #407 (PIVOT): Design and Baseline Results of a Randomized Controlled Trial Comparing Radical Prostatectomy to Watchful Waiting for Men with Clinically Localized Prostate Cancer. T. Wilt, M. Brawer, M. Barry, et al., Contemporary Clinical Trials 30(1):January 2009, 81-87. Describes the study rationale, design, recruitment methods, and baseline characteristics of men enrolled in the PIVOT study comparing surgery to watchful waiting for men with prostate cancer that has not not spread. (AHRQ 09-R035)

Recent Improvements in Bariatric Surgery Outcomes. W. Encinosa, D. Bernard, D. Du, et al., Medical Care 47(5):May 2009, 531-535. Uses a nationwide, population-based sample to examine how 6-month complications of bariatric surgery improved between 2001 and 2006. (AHRQ 09-R050)

Reoperation Rates Following Lumbar Spine Surgery and the Influence of Spinal Fusion Procedures. B. Martin, S. Mirza, B. Comstock, et al., Spine 32(3): February 2007, 382-387. Discusses the incidence of reoperation following lumbar surgery for degenerative disease and, for specific diagnoses, compares the frequency of reoperation following fusion with that following decompression alone. (AHRQ 07-R034)

Transformation of Health Care at the Front Line. P. Conway, C. Clancy, Journal of the American Medical Association, 301(7):February 2009, 763-765. Commentary discusses the design and effects of pay-for-performance programs on treatment options, patient outcomes, and health care costs, as well as an approach to align incentives with quality of care and value at the front line where clinicians and patients meet. (AHRQ 09-R026)

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