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To retain resources or to justify allocation of additional resources, it's essential to demonstrate the value that outcomes projects bring to organizations. The Agency for Healthcare Research and Quality's project review process serves as a useful model for how to do so. This month's column explores the AHRQ process for following up and communicating the results of outcomes projects conducted at various practice settings.

Contraryto hypothetical additive benefits, a combination of aspirin and warfarinappears to be no more effective than aspirin alone for preventing vascularevents and death after acute myocardial infarction (MI). So concludes arandomized, open-label Department of Veterans Affairs study in 5,059 post-MIpatients.

Direct thrombin inhibitors are superior to heparin in preventing death or myocardial infarction (MI) in patients with acute coronary syndromes (ACS), according to a meta-analysis of 11 randomized trials.

Medications currently available to treat osteoporosis slow the rate of bone loss primarily by reducing bone resorption. The purported advantage of the anabolic agent teriparatide is that it actually promotes new bone growth. Clinical trials have shown the drug to be effective for vertebral fracture prevention in postmenopausal women at high risk. Additional evidence is accumulating to support teriparatide's use in other populations (including men) with osteoporosis. This injectable is likely to receive FDA approval in the second half of this year.

Pharmacologic therapy is the second cornerstone of the medical management of reflux esophagitis. Because the merits of various drug classes for reflux esophagitis have been widely discussed, the focus of this article is on differing strategies for using these classes. The management strategies - and the rationale and evidence for promoting or rejecting them - are discussed for step-up therapy, empiric therapy, ste-down therapy, on-demand proton pump inhibitor use, combination therapies, and other considerations.