Many of you may already be familiar with the systematic and comparative effectiveness reviews produced by the Agency for Healthcare Research and Quality (AHRQ), such as these reviews of the available evidence for birth-related interventions such as labor induction, maternal request c-section, VBAC, and episiotomy.
Recently, AHRQ has become more active in soliciting public input to the review process, and today they posted for public comment the key questions and background materials for a review that will be conducted soon, Comparative Effectiveness of Nitrous Oxide for the Management of Labor Pain.
Nitrous oxide is commonly available to women for labor pain relief in many other countries, but is almost completely unavailable as an option for women in the United States. The comparative effectiveness review on this topic will examine the available evidence and look at specific questions such as its effectiveness, adverse effects, effects on women’s satisfaction with their birth experience and pain management, and health system factors influencing whether nitrous oxide is available to women who would like that option.
The public is invited to comment on this list of key questions to be addressed by the review, and can also review some background information describing the current use of nitrous oxide in the United States, the nature of the available literature, and the outcomes the review will examine.
Public comment is being accepted through December 8, 2010 via this online form; the site also provides a document to download and submit by mail if you prefer.
This project is of particular interest to me because of my work with the AHRQ Evidence-based Practice Center conducting this review. I have been involved with this topic in its preliminary stages by helping to examine the literature and writing up background information to inform the feasibility and potential impact of a full comparative effectiveness review. I will continue to be involved with the project team when the full review begins, and of course will update here when the review is completed and released.
For additional discussion of nitrous oxide for labor pain relief, please see our 2008 post with guest commentary from Judith Rooks, who has been advocating for expanded access to this choice for U.S. women.
AHRQ also accepts nominations for new review topics from the general public; the nitrous oxide topic itself was submitted by an anonymous consumer. To suggest a new review topic, visit http://www.effectivehealthcare.ahrq.gov/index.cfm/submit-a-suggestion-for-research/.