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Effectiveness Initiative Setting Priorities for Clinical Conditions (1989) / Chapter Skim
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Recommended Clinical Conditions for the Effectiveness Initiative
Pages 12-17

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From page 12...
... As the differences in importance accorded all five conditions are relatively minor, we view them as having essentially equivalent priority. Selecting among them should be done on other grounds, such as key management options of interest and advice from research methods experts.
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From page 13...
... All of the selected conditions appear to present good opportunities for examining issues related · ~ to screemug ant prevention. As mentioned, we also discussed some of the key patient management issues relevant to these conditions: prevention/screening, diagnosis, therapy, rehabilitation, and management of related or secondary problems, such as depression.
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From page 14...
... Angina as a clinical syndrome presents a large set of diagnostic issues, such as He comparative utility or desirability of nomnvaslve and invasive tests. Key topics for possible investigation include: risk factors; diagnostic issues techniques such as stress tests, angiograms, and radionuclide tracing; secondary testing to assess prognosis and to modify treatment regimens; treatment issues, including invasive options (angioplasty versus coronary artery bypass surgery)
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From page 15...
... ; staging of disease; therapeutic approaches, such as medical versus surgical interventions; alternative surgical options how extensive (radical) should surgery be in elderly women; use of radiology; use of adjuvantchemo~erapy; rehabilitation issues, including use and type of prostheses; and emotional dimensions (depression and anxiety)
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From page 16...
... Hip Fracture Hip fracture is the fifth condition we recommend for early investigation because of its overall high ranking on the major selection criteria. Because this is almost exclusively a disease of the elderly, because there is great consensus about the diagnosis, because it is universally treated in hospital, and because some long-term-care data will be available, we believe that hip fracture offers a good test of what the HCFA data bases and systems can do.
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From page 17...
... These center mostly on the major decision of surgical intervention versus conservative medical management, on choice of surgical procedure when surgery is elected, and on greater patient involvement in decision making. This condition has, however, been under intense scrutiny by university researchers and clinicians for several years and is expected to be a major target of investigation in research programs sponsored by the National Center for Health Services Research.
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Key Terms

  • congestive heart
  • myocardial infarction
  • acute myocardial
  • five conditions
  • hip fracture

  • breast cancer
  • top five
  • effectiveness initiative
  • selection criteria
  • depressive disorders

  • pharmacologic agents
  • major selection
  • diagnostic issues
  • precerebral arteries
  • angioplasty versus

  • surgical options
  • hcfa data
  • research methods
  • surgical interventions
  • management issues

  • coronary artery
  • methods experts
  • ischemic attack
  • hcfa effectiveness
  • management options

  • study condition
  • intense scrutiny
  • medical emergency
  • proposed meeting
  • programs sponsored


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