Evidence-based report focuses on assessment of unstable angina
There's new guidance for physicians attempting to predict the short-term risks of patients with unstable angina.
The federal Agency for Health Care Research and Quality recently released a new report outlining the current scientific literature. "Prediction of Risk for Patients with Unstable Angina," available online (http://www.ahrq.gov/clinic/unstabsum.htm), is the latest installment from the agency's evidence-based practice program.
That program was initiated several years ago after the agency decided to get out of the guideline development business. It still, however, sought a role in building a better evidence base under current medical practice. The goal of these reports is to develop scientific information to guide other agencies and organizations in crafting clinical practice guidelines, performance measures and other quality improvement tools.
This latest report was developed by AHRQ's UCSF-Stanford Evidence-based Practice Center. It focuses on clinical and laboratory markers of patient risk, including troponin values, stress testing, echocardiography and nuclear scintigraphy. It also assesses the efficacy of chest pain units and emergency department protocols.
New guidelines released in September by the American College of Cardiology and the American Heart Assn. are based in part on this evidence report. Those guidelines note that highly sensitive lab tests to detect certain cardiac markers, particularly troponin I and troponin T, now play a central role in early diagnosis of unstable angina and non-ST-segment-elevation myocardial infarctions.
The guidelines also recommend use of a triple drug therapy to inhibit the formation of blood clots. They update which patients should undergo procedures to keep the coronary artery open. And they call for an interventional approach for certain high-risk patients.
Core standards being drafted for accreditation of organizations
In an attempt to ensure consistency and eliminate redundancy in accreditation standards across different types of health care organizations, URAC/American Accreditation HealthCare Commission is drafting a set of core standards.
The standards will cover a number of functions for which all organizations should be accountable regardless of their specialization, officials said. Those include consumer protection, confidentiality of health information, oversight of delegated functions, staff qualifications and management, and quality management. These standards will be incorporated into all URAC accreditation programs.
The standards, a draft of which can be viewed online Web site (http://www.urac.org/), are scheduled to be completed later this year.
URAC has accredited more than 500 managed care organizations nationwide.
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