Study aims to decide best treatments

WASHINGTON (AP) — Irregular heartbeat. Prostate cancer. Back pain. Hearing loss. The government is about to spend millions to try to uncover the best treatments for scores of ailments — and how to handle these four biggies leads a list of top 100 questions that doctors need answered.

One of medicine’s secrets: Doctors often have to guess at which treatment or test is best for a certain patient. There’s very little good scientific evidence comparing them. As part of the economic stimulus package, Congress set aside a down payment of $1.1 billion to start figuring that out, so patients don’t waste time and money on poor choices.

But where to start? On Tuesday, the prestigious Institute of Medicine delivered a blueprint — the top 100 priorities to study first.

“This program is a program about improving decisions for patients,” said Dr. Harold Sox of the American College of Physicians, who co-chaired the IOM report.

Some of the questions may surprise patients and families. High on the list:

UIs medication or a surgical fix better for the irregular heartbeat called atrial fibrillation that afflicts 2 million Americans?

UWhat’s best for early-stage prostate cancer — various surgeries, different types of radiation, or so-called watchful waiting?

UWhat are the pros and cons of new hearing aids, cochlear implants and other devices for age-related hearing loss?

UHow effective are numerous treatments for attention deficit hyperactivity disorder — medications, cognitive-behavioral therapy, biofeedback, parent training?

UWhen should cancer patients have an MRI, a CT scan or PET scan, and when are the scans a waste?

UWhich of myriad treatments, from anti-inflammatories to exercises, are best for low back pain?