Medical questions subject of research

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? 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:

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

* What's best for early stage prostate cancer -- various surgeries, different types of radiation, or so-called watchful waiting?

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

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