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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 148 Research Studies DisplayedRundell SD, Goode AP, Friedly JL
Role of health services research in producing high-value rehabilitation care.
The overall purpose of this article is to present a framework to help clinicians, researchers, educators, and policy makers better understand the role of health services research in developing and evaluating evidence on value in rehabilitation. The authors believe that rehabilitation professionals have a great opportunity to increase their engagement in describing, evaluating, delivering, and disseminating high-value care, but there are several barriers they need to consider to be most successful.
AHRQ-Funded HS022982.
Citation: Rundell SD, Goode AP, Friedly JL .
Role of health services research in producing high-value rehabilitation care.
Phys Ther 2015 Dec;95(12):1703-11. doi: 10.2522/ptj.20150033..
Keywords: Health Services Research (HSR), Rehabilitation, Patient-Centered Outcomes Research, Comparative Effectiveness
Chou R, Gore JL, Buckley D
Urinary biomarkers for diagnosis of bladder cancer: a systematic review and meta-analysis.
The authors systematically reviewed the evidence on the accuracy of urinary biomarkers for diagnosis of bladder cancer in adults who have signs or symptoms of the disease or are undergoing surveillance for recurrent disease. Their review concluded that urinary biomarkers miss a substantial proportion of patients with bladder cancer and are subject to false-positive results in others.
AHRQ-funded; 290201200014I.
Citation: Chou R, Gore JL, Buckley D .
Urinary biomarkers for diagnosis of bladder cancer: a systematic review and meta-analysis.
Ann Intern Med 2015 Dec 15;163(12):922-31. doi: 10.7326/m15-0997.
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Keywords: Cancer, Comparative Effectiveness, Diagnostic Safety and Quality
Amick HR, Gartlehner G, Gaynes BN
Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.
This systematic review sought to identify the benefits and harms of second generation antidepressants and cognitive behavioral therapies (CBTs) in the initial treatment of a current episode of major depressive disorder in adults. It concluded that the available evidence suggests no difference in treatment effects of second generation antidepressants and CBT, either alone or in combination, although small numbers may preclude detection of small but clinically meaningful differences.
AHRQ-funded; 290-2012-00008I
Citation: Amick HR, Gartlehner G, Gaynes BN .
Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.
BMJ 2015 Dec 8;351:h6019. doi: 10.1136/bmj.h6019..
Keywords: Medication, Behavioral Health, Comparative Effectiveness, Depression
DeLia D, Wang HE, Kutzin J
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
This study provides a real world evaluation of the effectiveness of post-arrest care in therapeutic hypothermia (TH) centers during a time of growing TH dissemination in the state of New Jersey. It concluded that post-arrest outcomes are more favorable at TH centers but these improved outcomes are not apparent until after hospital discharge.
AHRQ-funded; HS020097.
Citation: DeLia D, Wang HE, Kutzin J .
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
BMC Health Serv Res 2015 Dec 2;15:533. doi: 10.1186/s12913-015-1199-z.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Emergency Medical Services (EMS), Outcomes
Chen Y, Chu H, Luo S
Bayesian analysis on meta-analysis of case-control studies accounting for within-study correlation.
In this article, the researchers first extend the published results on a single 2 x 2 table to allow within study prior correlation while retaining the advantage of closed-form posterior formula, and then extend the results to multiple 2 x 2 tables and regression setting. The hyperparameters, including within study correlation, are estimated via an empirical Bayes approach.
AHRQ-funded; HS020666.
Citation: Chen Y, Chu H, Luo S .
Bayesian analysis on meta-analysis of case-control studies accounting for within-study correlation.
Stat Methods Med Res 2015 Dec;24(6):836-55. doi: 10.1177/0962280211430889.
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Keywords: Comparative Effectiveness, Research Methodologies
Stockmann C, Ampofo K, Pavia AT
Comparative effectiveness of oral versus outpatient parenteral antibiotic therapy for empyema.
This study compared outcomes between oral therapy and (outpatient parenteral antibiotic therapy (OPAT) for pediatric parapneumonic empyema (PPE) . The frequency of complications was similar with oral therapy and OPAT for children with PPE. Oral antibiotics may be considered safe and effective for children with PPE who will be discharged to complete therapy in the outpatient setting.
AHRQ-funded; HS023320.
Citation: Stockmann C, Ampofo K, Pavia AT .
Comparative effectiveness of oral versus outpatient parenteral antibiotic therapy for empyema.
Hosp Pediatr 2015 Dec;5(12):605-12. doi: 10.1542/hpeds.2015-0100.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Medication, Hospitalization, Children/Adolescents
Moore CL, Broder J, Gunn ML
Comparative effectiveness research: alternatives to "traditional" computed tomography use in the acute care setting.
The goal was to seek consensus in identifying and prioritizing research questions and themes that involve the comparative effectiveness of "traditional" computed tomography use versus alternative diagnostic strategies in the acute care setting. A modified Delphi technique was used that included input from emergency physicians, emergency radiologists, medical physicists, and an industry expert to achieve this.
AHRQ-funded; HS021271; HS023498.
Citation: Moore CL, Broder J, Gunn ML .
Comparative effectiveness research: alternatives to "traditional" computed tomography use in the acute care setting.
Acad Emerg Med 2015 Dec;22(12):1465-73. doi: 10.1111/acem.12831.
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Keywords: Comparative Effectiveness, Imaging, Critical Care, Emergency Medical Services (EMS)
Krouse RS, You YN
Prospective comparative effectiveness trial for malignant bowel obstruction: SWOG S1316.
This paper is an update on the status of the Prospective Comparative Effectiveness Trial for Malignant Bowel Obstruction trial (S1316), the aim of which is to assess the quality of life outcome of “good days” for patients with malignant bowel obstruction (MBO) who receive surgical intervention in comparison with patients who undergo nonsurgical intervention.
AHRQ-funded; HS021491.
Citation: Krouse RS, You YN .
Prospective comparative effectiveness trial for malignant bowel obstruction: SWOG S1316.
Bull Am Coll Surg 2015 Dec;100(12):49-50.
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Keywords: Comparative Effectiveness, Digestive Disease and Health, Patient-Centered Outcomes Research, Quality of Life
Yun H, Xie F, Delzell E
The comparative effectiveness of biologics among older adults and disabled rheumatoid arthritis patients in the Medicare population.
Older and disabled rheumatoid arthritis (RA) patients are often not present in large numbers in clinical trials or registries. Using a novel, claims-based clinical effectiveness algorithm with the potential to compare the effectiveness of different biologics among this population using large administrative databases, researchers found that abatacept, adalimumab and etanercept are more effective than infliximab among RA patients initiating biologics.
AHRQ-funded; HS021694; HS023009; HS018517.
Citation: Yun H, Xie F, Delzell E .
The comparative effectiveness of biologics among older adults and disabled rheumatoid arthritis patients in the Medicare population.
Br J Clin Pharmacol 2015 Dec;80(6):1447-57. doi: 10.1111/bcp.12709.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Elderly, Arthritis, Medicare
Miligkos M, Bannuru RR, Alkofide H
Leukotriene-receptor antagonists versus placebo in the treatment of asthma in adults and adolescents: a systematic review and meta-analysis.
The purpose of this study was to determine the benefits and harms of leukotriene-receptor antagonists (LTRAs) as monotherapy or in combination with inhaled corticosteroids compared with placebo in adults and adolescents with asthma. It found that leukotriene-receptor antagonists as monotherapy improved asthma control compared with placebo, but which patients are most likely to respond to treatment with LTRAs remains unclear.
AHRQ-funded; HS021396.
Citation: Miligkos M, Bannuru RR, Alkofide H .
Leukotriene-receptor antagonists versus placebo in the treatment of asthma in adults and adolescents: a systematic review and meta-analysis.
Ann Intern Med 2015 Nov 17;163(10):756-67. doi: 10.7326/m15-1059.
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Keywords: Asthma, Children/Adolescents, Medication, Comparative Effectiveness
Curtis JR, Sarsour K, Napalkov P
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor alpha agents, a retrospective cohort study.
Interstitial lung disease (ILD) is a common extra-articular condition in rheumatoid arthritis (RA), but few studies have systematically investigated its incidence and risk factors in patients receiving anti-tumor necrosis factor-alpha (anti-TNFα) agents or alternate mechanisms of action (MOAs). After examining 13,795 episodes of biologic exposure in 11,219 patients, researchers found no significant differences in the risk of ILD and its related complications between RA patients receiving anti-TNFα agents and those receiving alternate MOA agents.
AHRQ-funded; HS018517.
Citation: Curtis JR, Sarsour K, Napalkov P .
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor alpha agents, a retrospective cohort study.
Arthritis Res Ther 2015 Nov 11;17:319. doi: 10.1186/s13075-015-0835-7..
Keywords: Arthritis, Comparative Effectiveness, Medication, Respiratory Conditions, Risk
Meeker D, Jiang X, Matheny ME
A system to build distributed multivariate models and manage disparate data sharing policies: implementation in the scalable national network for effectiveness research.
The authors’ objective was to implement infrastructure that supports the functionality of some existing research networks (e.g., cohort discovery, workflow management, and estimation of multivariate analytic models on centralized data) while adding additional important new features. They were able to implement massively parallel (map-reduce) computation methods and a new policy management system to enable each study initiated by network participants to define the ways in which data may be processed, managed, queried, and shared.
AHRQ-funded; HS019913.
Citation: Meeker D, Jiang X, Matheny ME .
A system to build distributed multivariate models and manage disparate data sharing policies: implementation in the scalable national network for effectiveness research.
J Am Med Inform Assoc 2015 Nov;22(6):1187-95. doi: 10.1093/jamia/ocv017..
Keywords: Communication, Comparative Effectiveness, Data, Health Information Technology (HIT), Policy, Research Methodologies
Stevens AD, Hernandez C, Jones S
Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: a randomized crossover trial.
The study’s goal was to evaluate novel, prefilled medication syringes labeled with color-coded volumes corresponding to the weight-based dosing of the Broselow Tape, compared to conventional medication administration, in simulated prehospital pediatric resuscitation scenarios. It found that the novel syringes decreased time to medication administration and significantly reduced critical dosing errors by paramedics during simulated prehospital pediatric resuscitations.
AHRQ-funded; HS017526.
Citation: Stevens AD, Hernandez C, Jones S .
Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: a randomized crossover trial.
Resuscitation 2015 Nov;96:85-91. doi: 10.1016/j.resuscitation.2015.07.035..
Keywords: Medication, Emergency Medical Services (EMS), Children/Adolescents, Medical Errors, Comparative Effectiveness
Gagne JJ, Kesselheim AS, Choudhry NK
Comparative effectiveness of generic versus brand-name antiepileptic medications.
The objective of this study was to compare treatment persistence and rates of seizure-related events in patients who initiate antiepileptic drug (AED) therapy with a generic versus a brand-name product. It concluded that patients who initiated generic AEDs had fewer adverse seizure-related clinical outcomes and longer continuous treatment periods before experiencing a gap than those who initiated brand-name versions.
AHRQ-funded; HS018465.
Citation: Gagne JJ, Kesselheim AS, Choudhry NK .
Comparative effectiveness of generic versus brand-name antiepileptic medications.
Epilepsy Behav 2015 Nov;52(Pt A):14-8. doi: 10.1016/j.yebeh.2015.08.014.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Comparative Effectiveness, Medication, Medication: Safety, Neurological Disorders, Patient Safety
Simmons SF, Keeler E, An R
Cost-effectiveness of nutrition intervention in long-term care.
The researchers sought to determine the cost-effectiveness of two nutrition interventions on food, beverage, and supplement intake and body weight. They found that oral liquid nutrition supplements and snack offers were efficacious in promoting caloric intake when coupled with assistance to promote consumption and a variety of options, but neither intervention resulted in significant weight gain.
AHRQ-funded; HS018580.
Citation: Simmons SF, Keeler E, An R .
Cost-effectiveness of nutrition intervention in long-term care.
J Am Geriatr Soc 2015 Nov;63(11):2308-16. doi: 10.1111/jgs.13709..
Keywords: Elderly, Long-Term Care, Nursing Homes, Nutrition, Comparative Effectiveness
Berkman ND, Lohr KN, Ansari MT, et al.
AHRQ Author: Chang S
Grading the strength of a body of evidence when assessing health care interventions: an EPC update.
The purpose of this article is to revise the 2010 guidance on grading the strength of evidence (SOE) of the effectiveness of drugs, devices, and other preventive and therapeutic interventions produced by AHRQ’s Evidence-based Practice Center program. It concluded that no single approach for grading SOE suits all reviews, but a more consistent and transparent approach to reporting summary information will make reviews more useful.
AHRQ authored; AHRQ-funded 290200710056I
Citation: Berkman ND, Lohr KN, Ansari MT, et al..
Grading the strength of a body of evidence when assessing health care interventions: an EPC update.
J Clin Epidemiol. 2015 Nov;68(11):1312-24. doi: 10.1016/j.jclinepi.2014.11.023..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Research Methodologies, Quality Measures
Berkman ND, Lohr KN, Ansari MT
Grading the strength of a body of evidence when assessing health care interventions: an EPC update.
The authors discussed the state of revision of 2010 guidance on grading the strength of evidence (SOE) of the effectiveness of drugs, devices, and other preventive and therapeutic interventions in systematic reviews produced by AHRQ's Evidence-based Practice Center (EPC) program. They concluded that EPC working groups will consider ongoing challenges and modify guidance as needed, on issues such as combining trials and observational studies in bodies of evidence, weighting domains, and combining qualitative and quantitative syntheses.
AHRQ-funded; 290200710056I.
Citation: Berkman ND, Lohr KN, Ansari MT .
Grading the strength of a body of evidence when assessing health care interventions: an EPC update.
J Clin Epidemiol 2015 Nov;68(11):1312-24. doi: 10.1016/j.jclinepi.2014.11.023.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Quality of Care, Patient-Centered Outcomes Research, Research Methodologies
Bangalore S, Ogedegbe G, Gyamfi J
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
The study’s objective was to evaluate the effectiveness of angiotensin-converting enzyme inhibitors when compared with other antihypertensive agents in hypertensive blacks. It found that in a large cohort of hypertensive blacks, angiotensin-converting enzyme inhibitors were associated with less benefit when compared with calcium channel blockers or thiazide diuretics.
AHRQ-funded; HS018589.
Citation: Bangalore S, Ogedegbe G, Gyamfi J .
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
Am J Med 2015 Nov;128(11):1195-203. doi: 10.1016/j.amjmed.2015.04.034..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Outcomes, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness
Epstein RA, Fonnesbeck C, Potter S
Psychosocial interventions for child disruptive behaviors: a meta-analysis.
The researchers conducted a systematic review and meta-analysis to synthesize existing literature on the comparative effectiveness of psychosocial interventions for children and adolescents, 18 years of age with disruptive behavior disorders. It concluded that the 3 intervention categories were more effective than the control conditions. Interventions with a parent component, either alone or in combination with other components, were likely to have the largest effect.
AHRQ-funded; 290201200009I.
Citation: Epstein RA, Fonnesbeck C, Potter S .
Psychosocial interventions for child disruptive behaviors: a meta-analysis.
Pediatrics 2015 Nov;136(5):947-60. doi: 10.1542/peds.2015-2577..
Keywords: Behavioral Health, Children/Adolescents, Comparative Effectiveness, Patient-Centered Outcomes Research
LeBlanc A, Herrin J, Williams MD
Shared decision making for antidepressants in primary care: a cluster randomized trial.
The researchers estimated the effect of the Depression Medication Choice (DMC) encounter decision aid on quality of the decision‐making process and depression outcomes. They found that the DMC decision aid helped primary care clinicians and patients with moderate to severe depression select antidepressants together, improving the decision-making process without extending the visit.
AHRQ-funded; HS019214.
Citation: LeBlanc A, Herrin J, Williams MD .
Shared decision making for antidepressants in primary care: a cluster randomized trial.
JAMA Intern Med 2015 Nov;175(11):1761-70. doi: 10.1001/jamainternmed.2015.5214..
Keywords: Medication, Comparative Effectiveness, Shared Decision Making, Primary Care
Wechsler ME, Yawn BP, Fuhlbrigge AL
Anticholinergic vs long-acting beta-agonist in combination with inhaled corticosteroids in Black adults with asthma: the BELT randomized clinical trial.
The researchers compared the effectiveness and safety of tiotropium vs long-acting beta agonists (LABAs), when used with inhaled corticosteroids (ICS) in black adults with asthma. They found that among black adults with asthma treated with ICS, adding a LABA did not improve time to asthma exacerbation compared with adding tiotropium. These findings were not affected by polymorphisms at the Arg16Gly locus of ADRB2.
AHRQ-funded; HS019408.
Citation: Wechsler ME, Yawn BP, Fuhlbrigge AL .
Anticholinergic vs long-acting beta-agonist in combination with inhaled corticosteroids in Black adults with asthma: the BELT randomized clinical trial.
JAMA 2015 Oct 27;314(16):1720-30. doi: 10.1001/jama.2015.13277..
Keywords: Comparative Effectiveness, Patient Safety, Asthma, Medication
Veluswamy RR, Ezer N, Mhango G
Limited resection versus lobectomy for older patients with early-stage lung cancer: Impact of histology.
The researchers used population-based data to assess the equivalency of limited resection versus lobectomy among older patients with stage IA invasive adenocarcinoma and squamous cell carcinoma less than 2 cm in size. They found generally that limited resection is not equivalent to lobectomy in older patients with invasive non–small-cell lung cancer, although segmentectomy may be equivalent in patients with adenocarcinoma.
AHRQ-funded; HS019670.
Citation: Veluswamy RR, Ezer N, Mhango G .
Limited resection versus lobectomy for older patients with early-stage lung cancer: Impact of histology.
J Clin Oncol 2015 Oct 20;33(30):3447-53. doi: 10.1200/jco.2014.60.6624..
Keywords: Cancer, Cancer: Lung Cancer, Comparative Effectiveness, Surgery
Fritz JM, Magel JS, McFadden M
Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.
This study evaluated whether early physical therapy (manipulation and exercise) is more effective than usual care in improving disability for patients with LBP fitting a decision rule. It concluded that among adults with recent-onset LBP, early physical therapy resulted in statistically significant improvement in disability, but the improvement was modest and did not achieve the minimum clinically important difference compared with usual care.
AHRQ-funded; HS018672.
Citation: Fritz JM, Magel JS, McFadden M .
Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.
JAMA 2015 Oct 13;314(14):1459-67. doi: 10.1001/jama.2015.11648..
Keywords: Back Health and Pain, Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research
Hazlehurst BL, Kurtz SE, Masica A
CER Hub: An informatics platform for conducting comparative effectiveness research using multi-institutional, heterogeneous, electronic clinical data.
The authors describe the CER Hub, a web-based informatics platform for developing and conducting research studies that combine comprehensive electronic clinical data from multiple health care organizations. They conclude that CER requires coordinated and scalable methods for extracting, aggregating, and analyzing complex, multi-institutional clinical data.
AHRQ-funded; HS019828.
Citation: Hazlehurst BL, Kurtz SE, Masica A .
CER Hub: An informatics platform for conducting comparative effectiveness research using multi-institutional, heterogeneous, electronic clinical data.
Int J Med Inform 2015 Oct;84(10):763-73. doi: 10.1016/j.ijmedinf.2015.06.002..
Keywords: Comparative Effectiveness, Health Information Technology (HIT), Data, Web-Based
Vogel JA, Seleno N, Hopkins E
Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma.
The objective of this study was to compare prognostic accuracies of the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score, ED Sequential Organ Failure Assessment (SOFA) score, and ED base deficit and ED lactate for inhospital mortality in adult trauma patients. It concluded that The Denver ED TOF Score more accurately predicts inhospital mortality in adult trauma patients compared to the other three.
AHRQ-funded; HS017526.
Citation: Vogel JA, Seleno N, Hopkins E .
Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma.
Am J Emerg Med 2015 Oct;33(10):1440-4. doi: 10.1016/j.ajem.2015.07.006..
Keywords: Emergency Medical Services (EMS), Risk, Mortality, Comparative Effectiveness, Emergency Department