The Agency for Healthcare Research and Quality has released a meta-study on the comparative effectiveness of advanced treatments for venous ulcers. However, rather than coming up with a solution to the question of which treatments are most effective, the report points out an important problem: the body of research is not organized enough to come to useful conclusions.
Venous ulcers, a type of ulcer developed from varicose veins or deep vein thrombosis, are seen mostly in geriatric patients. Patients 65 years and older are the fastest-growing patient group today, as baby boomers continue to age. Problems that affect geriatric populations are therefore vitally important to address from both cost and value perspectives as geriatric patients increase in proportion to the general population.
Generally speaking, researchers found all venous ulcer treatments to have a neutral effect on healing, though they were doubtful of the validity of this conclusion. "Rather, the risk of bias and lack of adequate sample size prevented us from establishing statistically valid conclusions," they wrote. Additional problems within the 60 studies considered included poor study design, incomplete statistical analyses and small sample sizes.
The study authors called upon clinicians and researchers to "frame a series of commonly agreed upon definitions, develop model clinical research approaches, consider mutually agreed-upon schemes to classify patients, quantify healing parameters and consider the development of research wound healing networks to collect sufficient numbers of patients to produce valid conclusions."
While some standardized data sharing does exist — consider the National Healthcare Safety Network — the AHRQ report highlights the need for such strategies to be superimposed upon smaller areas in medicine in order to proceed with the expanded provision of evidence-based, valuable care.
AHRQ noted similar problems in a December 2013 report comparing the effectiveness of communication methods.
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