07-07-2005   Portland, Ore.

The U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) today announced the first phase of research reviews to be performed under its new Effective Health Care Program. The program will largely include work funded under Section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

The Oregon Evidence-based Practice Center (EPC), a consortium of clinicians and researchers from Oregon Health & Science University, Kaiser Permanente's Center for Health Research and the Portland Veterans Affairs Medical Center, will serve as the Methodology Resource Center for the Effective Health Care Program.  

AHRQ, an agency of the U.S. Department of Health & Human Services, selected Oregon as one of 13 EPCs in North America in 2002. "Each EPC has extensive experience in conducting systematic reviews and technology assessments. We are very pleased to be able to provide them with assistance in carrying out work conducted for the Effective Health Care Program," said Marian McDonagh, Pharm.D., assistant professor of medical informatics and clinical epidemiology, OHSU School of Medicine, who will oversee the resource center's work on methodology issues, initial refinement of publicly nominated topics and questions, and ensuring consistency across the reviews conducted for the Effective Health Care Program.
 
"Good questions for comparative effectiveness research arise from the experience of clinicians, patients, consumer groups and the public," said Mark Helfand, M.D., M.P.H., project lead, director of the Oregon EPC, professor of medicine, Oregon Health & Science University, and staff physician at the Portland Veterans Affairs Medical Center. "Listening and responding to stakeholders, professionals, and the public will be the cornerstone of our work in the resource center."

The essential goals of the Section 1013 mandate are to develop evidence on the effectiveness of different treatments and clinical approaches for difficult health problems. AHRQ will support projects to review, synthesize and translate published and unpublished scientific evidence, as well as identify important issues for which existing scientific evidence is insufficient, to inform decisions about health care. The evidence will be available to all health care decision-makers in a variety of formats.

The first 10 research reviews will provide science-based information on the effectiveness of health care interventions, including prescription drugs, to enhance decision making by Medicare policy-makers, beneficiaries and providers. The reviews will address questions on the priority conditions of the Medicare program established by the Secretary of Health and Human Services in 2004, which were selected by a steering committee comprising representatives from AHRQ, the Centers for Medicare and Medicaid Services, the Food and Drug Administration and the HHS Office of the Secretary.

"Evaluating scientific evidence to provide guidance to those striving to improve health care is the heart of evidence-based medicine," said Evelyn Whitlock, M.D., M.P.H., project co-investigator and senior investigator, Kaiser Permanente Center for Health Research, "and it is the heart of our work here at the Oregon Evidence-based Practice Center. We are honored to be involved in this important initiative to improve U.S. health care being led by the Agency for Healthcare Quality and Research." Whitlock will oversee the Methodology Resource Center's program to identify studies to fill critical information gaps uncovered by the reviews.
 
The reviews will take seven to 12 months to complete; the first reviews will be available in October 2005. Initial topics to be addressed are:

* Management strategies for gastroesophageal reflux disease
* Benefits and safety of pain relievers for osteoarthritis
* New diagnostic technologies for evaluation of abnormal breast cancer screening
* Epoetin and Darbepoetin for managing anemia in patients undergoing cancer treatment
* Off-label use of atypical anti-psychotic medications
* Renal artery stenting compared to aggressive anti-hypertensive medical therapy for mild renal artery stenosis
* Therapies for localized prostate cancer
* Oral medications for diabetes management
* Medications for depression management
* Drug therapies and behavioral interventions (exercise, diet and vitamin supplementation) for osteoporosis and osteopenia

A list of reviews is available at www.ahrq.gov/news/press/pr2004/mmapr.htm

"These research reviews will provide invaluable information to providers and patients who need to make evidence-based decisions about treatments and interventions every day," said Carolyn Clancy, M.D., AHRQ's director. "The reviews also will help our federal partners and private-sector policy-makers make critical decisions by filling gaps in information on what works and doesn't work in health care services, and by identifying important gaps for future research."

Future reviews will address issues that relate to Medicaid and the State Children's Health Insurance Program. The results will be made available to the three public programs as well as to health plans, prescription drug plans, other health care providers and the public.