In The News

The U.S. Preventive Services Task Force (USPSTF or Task Force) has released its “Eighth Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services.”

In this annual report, the USPSTF highlights seven recent topics related to cancer prevention and cardiovascular health, the leading causes of death among adults in the United States, for which more research is needed. The report also calls for more research in populations who are disproportionally affected by these conditions, yet often underrepresented in studies.

Topics highlighted in the report include:

Cancer Prevention

• Screening for Cervical Cancer, Especially Among Diverse Populations
• Screening for Prostate Cancer, Especially Among African American Men and Men With a Family History
• Screening and Behavioral Counseling for Skin Cancer

Cardiovascular Health

• Screening for Atrial Fibrillation With Electrocardiography
• Screening for Cardiovascular Disease Risk With Electrocardiography
• Risk Assessment for Cardiovascular Disease With Nontraditional Risk Factors
• Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment With the Ankle-Brachial Index

Future research in these areas can help fill these gaps and could result in important new recommendations that will help to improve the health of Americans.

Please click here to read the complete USPSTF report.

Introduction

Significant variation exists in both the types and definitions of outcome measures used in patient registries, even within the same clinical area. This variation reduces the utility of registries, making it difficult to compare, link, and aggregate data across the spectrum of clinical care and reporting. To address these limitations, the Agency for Healthcare Research and Quality (AHRQ) developed the Outcome Measures Framework (OMF), a conceptual model for classifying outcomes that are relevant to patients and providers across most conditions; it is intended to serve as a content model for developing harmonized outcome measures for specific clinical areas.^a

AHRQ is assessing the feasibility of using the OMF to develop standardized libraries of outcome measures in five clinical areas, including (1) Atrial fibrillation, (2) Asthma, (3) Depression, (4) Lung cancer, and (5) Lumbar spondylolisthesis.^b These clinical areas represent diverse populations and care settings, different treatment modalities, and varying levels of harmonization. For each clinical area, the relevant registries and observational studies are identified, and registry sponsors, informaticists, and clinical subject matter experts are invited to participate in a registry group that focuses on harmonizing outcome measures through a series of in-person and web-based meetings. A stakeholder group, including payers, patient representatives, Federal partners and health system leaders, is also assembled to discuss challenges and provide feedback on the harmonization effort.

A key goal of this effort is to standardize the definitions of the components that make up the outcome measures, so users can understand the level of comparability between measures across different systems and studies. As a final step in the harmonization process, clinical informaticists map the narrative definitions (generated by the workgroups) to standardized terminologies to produce a library of common data definitions.

This document describes the technical approach used to prepare the Standardized Library of Atrial Fibrillation Outcome Measures workbook. For reference, the narrative definitions for the minimum set of outcome measures produced by the Atrial Fibrillation Workgroup are included in Appendix A. The harmonization methodology and rationale for the measure definitions are discussed in a related publication.

A key goal of this effort is to standardize the definitions of the components that make up the outcome measures, so users can understand the level of comparability between measures across different systems and studies. As a final step in the harmonization process, clinical informaticists map the narrative definitions (generated by the workgroups) to standardized terminologies to produce a library of common data definitions.

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Federal physical activity guidance updated for the first time since 2008

(Chicago) – Today, Adm. Brett P. Giroir, M.D., assistant secretary for health, announced the release of the U.S. Department of Health and Human Services’ second edition of the Physical Activity Guidelines for Americans at the American Heart Association’s Scientific Sessions meeting. The second edition provides evidence-based recommendations for youth ages 3 through 17 and adults to safely get the physical activity they need to stay healthy. There are new key guidelines for children ages 3 through 5 and updated guidelines for youth ages 6 through 17, adults, older adults, women during pregnancy and the postpartum period, adults with chronic health conditions, and adults with disabilities.

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You might consider "giving the axe" to these 11 drug classes, particularly in older patients, to increase safety and reduce pill burden.

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Get resources and guidance on how to implement effective team-based opioid management strategies in primary care by participating in the AHRQ-funded “Six Building Blocks” project. Selected practices will implement the Six Building Blocks toolkit to improve opioid prescribing and collect metrics to monitor progress. An anticipated 15 participating practices will each receive technical assistance and a $2,500 honorarium to offset costs of producing metrics required for program evaluation The estimated start date for practices is January 2019.

Learn more about the project, including how to participate.

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Chartbook on Patient Safety

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Jeff Brady, M.D., M.P.H., director of AHRQ’s Center for Quality Improvement and Patient Safety, and Karen Chaves, M.H.S, Director of AHRQ’s National Healthcare Quality and Disparities Report Program, highlight data in the  newly released Chartbook on Patient Safety. The Chartbook, based on AHRQ’s recently released 2017 National Healthcare Quality and Disparities Report, shows that the nation’s efforts to improve the safety of health care resulted in some encouraging overall gains between 2000 and 2016. However, there is much room for improvement, particularly for people of color and people in poor households. The Chartbook findings also identify ongoing safety concerns. Quantifying these challenges provides essential information to inform future quality improvement efforts.

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AHRQ Views—Blog Post: Preventing One Million Heart Attacks and Strokes: Start With the ABCS.