Contents

Feature Story

• Research comparing diabetes medications helps patients and clinicians choose the right one

Patient Safety and Quality

• Hospitals vary greatly in the quality of their trauma care
• Flawed State apology and disclosure laws dilute their intended impact on malpractice suits
• Simulation training improves insertion of central venous catheters
• Nurses with higher education levels rate themselves as having more clinical expertise and are sought out for their guidance

Health Care Costs and Financing

• Trauma care costs less at hospitals with lower mortality rates
• Routing ambulances to cardiac surgery-equipped hospitals more cost effective than building more such hospitals
• Many factors are likely to slow the adoption of pay for performance in dentistry

Emergency Medicine

• Nearly one-third of emergency department visits involve nonideal care events
• Emergency departments have increasingly become the health care safety net for adults insured by Medicaid
• Routine opt-out HIV emergency department screening only slightly improves identification of patients with HIV infection

Child/Adolescent Health

• Pilot study finds a low level of medication errors for look-alike, sound-alike drugs prescribed for children
• Telephone coaching improves quality of life for parents of children with asthma
• Ketorolac, a pain medication, is underused in children operated on for bladder reflux

Women's Health

• More than half of women do not get regular mammograms
• Vaginal births after cesarean are safe for most women
• Prenatal screening for Group B streptococci often fails to live up to current screening and treatment guidelines

Elderly/Long-Term Care

• Nurse-facilitated guided care for elders and their caregivers leads to improved perceptions of quality of care
• Use of physician extenders associated with increase in antidepressant prescribing in nursing homes

Outcomes/Effectiveness Research

• Cardiac procedures can lead to substantial radiation exposure for patients
• Contrast-enhanced CT scans do not increase the risk of kidney failure in patients with acute stroke
• Arterial and perfusion imaging help guide treatment for stroke patients when symptom onset is unknown
• Higher in-hospital complication rate for primary posterior versus primary anterior cervical fusion
• Pre-existing cardiovascular conditions linked to lower stimulant prescribing rates for adults with ADHD

Disparities/Minority Health

• Poorer patients less likely to receive specific treatment for head and neck cancer
• Regular home blood pressure measurement raises the likelihood of blood pressure control among Korean Americans
• Gender trumps religiosity in older Mexican Americans' views on physician-assisted suicide

Primary Care Research

• Primary care physicians' performance ratings depend on the makeup of their patient population
• Primary care practices that take part in research networks report benefits beyond the study itself

Health Information Technology

• Clinicians' adoption and use of electronic prescribing is likely linked to their views on technology

Agency News and Notes

• The number of U.S. adults treated for diabetes more than doubled between 1996 and 2007
• One in 16 women hospitalized for childbirth has diabetes
• U.S. employers lost nearly 3 weeks of work per employee due to sick days
• More than one in five hospital patients in 2008 were born in 1933 or earlier

Announcements

• Report available on clinical decision support tool to assess patients' risk for deleterious BRCA mutations
• AHRQ publishes evidence report on the relationship of alcohol consumption to breast and colorectal cancer
• AHRQ updates 2001 evidence report on treating acute otitis media
• New Federal resources help hospitals plan, carry out, and evaluate emergency preparedness exercises
• AHRQ 2010 Annual Conference plenary session videos available
• Archive of Webcast on integrating comparative effectiveness research into everyday practice available

Research Briefs