Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

I have been treated for gout in urgent care /er situations many times. Depending on the provider, the treatment was drastically different. The results were drastically different as well. I will explain below.

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

Within the Kaiser Permanente system, in which I was a member for 15 years, they have a completely different and effective set of treatment procedures than the local Sutter affiliated Vaca Valley Hospital. At Kaiser, they would immediately feel the heat from my swollen knee and ankle(it was ALWAYS my left knee and ankle) request blood test checking for raised uric acid levels. Of course this would be verified and they would frovide me with Allopurinol(to prevent) and Colch (to break up crystals fast) This was VERY EFFECTIVE and costs were minimal.

The story was quite different at Vaca Valley Hospital. They immediately looked at my knee and ankle and even after I had told them I KNOW IT IS MY GOUT FLARING UP, proceded to run a gamate of diagnostic tests starting with an ultrasound of my upper left thigh. I asked why and was told that my symptoms direct them to a BLOOD CLOT IN MY LEG! It wasn't until they had done the ultrasound, a chest xray and an EKG that they bothered to do the blood test. I was furious and it showed so then they hooked up an IV because I looked distressed! GUESS WHAT? Came back with elevated uric acid levels.

Well on top of that they provided me with PAIN PILLS to take while it worked it's self out. I had already been taking the same med for 4 days for releif(left over from a surgical procedure) and sent me home.

OH by the way did I mention I was sent home with a $12000 bill?

This was in January 2009. Since then I HAVE CURED GOUT!!! I started taking Hydroxycut 7 day Cleanse every 90 days starting in Feb 2009. 10 months later I have not had even the slightest problem with gout, except when I did my own clinical test and waited an extra 3 weeks off the schedule. My ankle started to swell and I immediately started the cleanse. Within 2 days the tightness lightened up. The 3rd day it was in my right ankle(which I have NEVER had a problem with) the 4th days it was in my right knee(again NEVER had a problem) and by the 5th day I was walking with NO PAIN again.

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

I think that a trial needs to be done to evaluate the effectiveness of Hydroxycut 7 day Cleanse. IT DOES WORK AND CONTINUES TO BE MY HOLY GRAIL.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Describe any health-related risks, side effects, or harms that you are concerned about.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Arthritis and nontraumatic joint disorders
• Depression and other mental health disorders
• Functional limitations and disability
• Obesity

AHRQ Priority Populations

• Low income groups
• Minority groups
• Women
• Elderly
• Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care

Federal Health Care Program

• Medicaid
• Medicare
• Other

Importance

Describe why this topic is important.

I had suffered with disabling gout to the point where I could not get up out of bed for days and my home became nearly unlivable. I was depressed. I gained 50lbs. My blood pressure went thru the roof. I was diagnosed with Pre Diabetes. I could not get medical insurance when I lost my job because of the PreExisting Conditions. I was a 13 year baseball coach that eventually could not walk much less run. ON A LARK WHILE WAITING FOR MY MEDS AT WALMART I LOOKED AT THE INTERNAL CLEANSING preparations.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

If yes, please explain:

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

Describe the timeframe in which an answer to your question is needed.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program