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Search All Research Studies
Topics
- (-) Arthritis (15)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
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- Elderly (1)
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- Patient and Family Engagement (1)
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- Patient Self-Management (1)
- Quality of Life (1)
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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 15 of 15 Research Studies DisplayedLin E, Uhler LM, Finley EP
Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol.
This article describes a US-based 2-year, two-site hybrid type 1 study to assess clinical effectiveness and implementation of a machine learning-based patient decision aid integrating patient-reported outcomes and clinical variables to support shared decision-making for patients with knee osteoarthritis considering total knee replacement. Study results will be disseminated through conference presentations, publications and professional societies.
AHRQ-funded; HS027037.
Citation: Lin E, Uhler LM, Finley EP .
Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol.
BMJ Open 2022 Feb 21;12(2):e055933. doi: 10.1136/bmjopen-2021-055933..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Arthritis, Patient-Centered Outcomes Research, Orthopedics, Health Information Technology (HIT), Evidence-Based Practice
Brown TT, Hurley VB, Rodriguez HP
Association of patient engagement strategies with utilisation and spending for musculoskeletal problems in the USA: a cross-sectional analysis of Medicare patients and physician practices.
This cross-sectional study assessed the association of physician practice-level adoption of patient engagement strategies (PES), such as shared decision-making and motivational interviewing, with utilization and spending. The cohort included primary and secondary patients in 2190 practices who receiving treatment for hip (39,336), knee (48,362), and lower-back (67,940) issues who were Medicare beneficiaries that were matched to the 2017-2018 National Survey of Healthcare Organizations and Systems. Outcome measures were total knee replacement (TKR), total hip replacement (THR), 1-2 level posterior lumbar fusion (LF), total annual spending, and components of total annual spending. Spending was significantly lower in some categories for practices with relatively higher PES adoption, but did not differ for other practices. The odds of receiving THR were higher in independent practices for patients attributed to practices with moderate PES compared to patients in practices with low PES.
AHRQ-funded; HS024075.
Citation: Brown TT, Hurley VB, Rodriguez HP .
Association of patient engagement strategies with utilisation and spending for musculoskeletal problems in the USA: a cross-sectional analysis of Medicare patients and physician practices.
BMJ Open 2021 Nov 26;11(11):e053121. doi: 10.1136/bmjopen-2021-053121..
Keywords: Patient and Family Engagement, Healthcare Utilization, Healthcare Costs, Arthritis, Orthopedics
Kim C, Colborn KL, van Buuren S
Neighbors-based prediction of physical function after total knee arthroplasty.
The purpose of this study was to develop and test personalized predictions for functional recovery after Total Knee Arthroplasty (TKA) surgery, using a novel neighbors-based prediction approach. Findings showed that predictions were well-calibrated in out-of-sample testing. These predictions have the potential to inform care decisions both prior to and following TKA surgery.
AHRQ-funded; HS025692; HS024316.
Citation: Kim C, Colborn KL, van Buuren S .
Neighbors-based prediction of physical function after total knee arthroplasty.
Sci Rep 2021 Aug 18;11(1):16719. doi: 10.1038/s41598-021-94838-6..
Keywords: Orthopedics, Surgery, Arthritis
Griesemer I, Hausmann LR, Arbeeva L
Discrimination experiences and depressive symptoms among African Americans with osteoarthritis enrolled in a pain coping skills training randomized controlled trial.
This study evaluated the interaction between discrimination experiences and depressive symptoms among African Americans with osteoarthritis enrolled in a pain coping skills training (PCST) randomized controlled trial. The authors evaluated the interactions for 164 participants in linear regression models predicting depressive symptoms. There was a significant interaction between personal discrimination and experimental condition on depressive symptoms. Discrimination was associated with depressive symptoms among the control group but not among those who received PCST.
AHRQ-funded; HS000032.
Citation: Griesemer I, Hausmann LR, Arbeeva L .
Discrimination experiences and depressive symptoms among African Americans with osteoarthritis enrolled in a pain coping skills training randomized controlled trial.
J Health Care Poor Underserved 2021;32(1):145-55. doi: 10.1353/hpu.2021.0014..
Keywords: Racial and Ethnic Minorities, Pain, Arthritis, Orthopedics, Patient Experience, Depression
Lopez-Olivo MA, des Bordes JK, Lin H
A randomized controlled trial comparing two self-administered educational strategies for patients with knee osteoarthritis.
The authors conducted a randomized clinical trial in patients with knee osteoarthritis to assess the efficacy of providing a video for entertainment education, in combination with two booklets, compared with providing the booklets alone. They found that, although both education strategies were associated with improved knowledge and reduced decisional conflict at 6 months, receiving the video + booklets in combination, compared with receiving the booklets alone, proved to be more effective in changing behaviors and appeared to have some advantages for Spanish speakers and those who were less educated.
AHRQ-funded; HS019354.
Citation: Lopez-Olivo MA, des Bordes JK, Lin H .
A randomized controlled trial comparing two self-administered educational strategies for patients with knee osteoarthritis.
ACR Open Rheumatol 2021 Mar;3(3):185-95. doi: 10.1002/acr2.11222..
Keywords: Arthritis, Orthopedics, Education: Patient and Caregiver, Patient Self-Management, Patient Adherence/Compliance, Shared Decision Making, Health Promotion
Giardina JC, Cha T, Atlas SJ
Validation of an electronic coding algorithm to identify the primary indication of orthopedic surgeries from administrative data.
The purpose of this study was to develop and validate an algorithm to identify patients receiving four elective orthopedic surgeries to promote shared decision-making. The surgeries included were: 1) knee arthroplasty to treat knee osteoarthritis (KOA); 2) hip arthroplasty to treat hip osteoarthritis (HOA); 3) spinal surgery to treat lumbar spinal stenosis (SpS); and 4) spinal surgery to treat lumber herniated disc (HD). Electronic medical records were reviewed to ascertain a “gold standard” determination of the procedure and primary indication status. Each case had electronic algorithms consisting of ICD-10 and CPT codes for each combination and indication applied to their record. A total of 790 procedures were included in the study. The sensitivity of the algorithms ranged from 0.70 (HD) to 0.92 (KOA). Specificity ranged from 0.94 (SpS) to 0.99 (HOA, KOA).
AHRQ-funded; HS000055.
Citation: Giardina JC, Cha T, Atlas SJ .
Validation of an electronic coding algorithm to identify the primary indication of orthopedic surgeries from administrative data.
BMC Med Inform Decis Mak 2020 Aug 12;20(1):187. doi: 10.1186/s12911-020-01175-1.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Orthopedics, Surgery, Arthritis, Shared Decision Making
Gaskin DJ, Karmarkar TD, Maurer A
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
This study examined whether using a decision-making tool would aid Latina and African-American women over age 45 years with arthritic knee pain in making more informed treatment decisions. The researchers conducted 4 focus groups of Latina and African-American women and 2 focus groups with primary care providers who treated them for knee pain. They found that minority women and primary care providers all endorsed the use of a decision-making tool that provided information on the impact of treatment on quality of life, medical care costs, and work productivity.
AHRQ-funded; HS000029.
Citation: Gaskin DJ, Karmarkar TD, Maurer A .
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
Arthritis Care Res 2020 May;72(5):692-98. doi: 10.1002/acr.23903..
Keywords: Arthritis, Orthopedics, Pain, Quality of Life, Healthcare Costs, Shared Decision Making, Racial and Ethnic Minorities, Women
Lange JK, DiSegna ST, Yang W
Using cluster analysis to identify patient factors linked to differential functional gains after total knee arthroplasty.
This study used cluster analysis to identify patient factors linked to different outcomes following total knee arthroplasty (TKA). The study analyzed Short Form 36 Physical Component Score (PCS) trajectories of 656 patients at 3 time points over a 1-year period. The MultiExperiment View (MeV) built-in bootstrapping method was used to assess statistical significance of the clusters. They found two distinct clusters: Cluster 1 included 550 patients (84%) who demonstrated persistent improvement at 6 and 12 months. The remainder of patients consisted of Cluster 2 who demonstrated decline in PCS at 6 months but improved by 12 months. Cluster 1 was found to have higher baseline mental health scores, lower baseline PCS, and a significantly higher proportion of non-Hispanic Whites compared to Cluster 2.
AHRQ-funded; HS018910.
Citation: Lange JK, DiSegna ST, Yang W .
Using cluster analysis to identify patient factors linked to differential functional gains after total knee arthroplasty.
J Arthroplasty 2020 Jan;35(1):121-26.e6. doi: 10.1016/j.arth.2019.08.039..
Keywords: Orthopedics, Surgery, Arthritis, Outcomes, Chronic Conditions
Kim SC, Jin Y, Lee YC
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
The purpose of this study was to determine the association of preoperative opioid use among patients 65 years and older with mortality and other complications at 30 days post-total knee replacement (TKR). Findings show that continuous opioid users had a higher risk of revision operations, vertebral fractures, and opioid overdose at 30 days post-TKR but not of in-hospital or 30-day mortality, compared with opioid-naive patients. Highlights include the need for better understanding of patient characteristics associated with chronic opioid use to optimize preoperative assessment of overall risk after TKR.
AHRQ-funded; HS018910.
Citation: Kim SC, Jin Y, Lee YC .
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
JAMA Netw Open 2019 Jul 3;2(7):e198061. doi: 10.1001/jamanetworkopen.2019.8061..
Keywords: Opioids, Medication, Surgery, Orthopedics, Elderly, Patient-Centered Outcomes Research, Mortality, Outcomes, Arthritis, Evidence-Based Practice
Gandek B, Roos EM, Franklin PD
A 12-item short form of the Hip disability and Osteoarthritis Outcome Score (HOOS-12): tests of reliability, validity and responsiveness.
The goal of this study was to measure validity, reliability and responsiveness of the 12-item version of the 40-item Hip disability and Osteoarthritis Outcome Score (HOOS) surveys that measure joint-specific pain, function and quality of life (QOL) for patients. The shorter forms were given to 1,281 hip OA patients from the FORCE-TJR cohort who had previously completed the HOOS surveys before and after total joint replacement surgery. The HOOS-12 survey was compared to the full-length HOOS, HOOS-PS, and HOOS, JR surveys. Internal consistency reliability was above 0.70 for all HOOS-12 scales and above 0.90 for the Summary score. Validity and responsiveness were also found to be comparable to full-length HOOS scales.
AHRQ-funded; HS024632; HS018910.
Citation: Gandek B, Roos EM, Franklin PD .
A 12-item short form of the Hip disability and Osteoarthritis Outcome Score (HOOS-12): tests of reliability, validity and responsiveness.
Osteoarthritis Cartilage 2019 May;27(5):754-61. doi: 10.1016/j.joca.2018.09.017..
Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Orthopedics
Gandek B, Roos EM, Franklin PD
Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12).
The goal of this study was to develop 12-item versions of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) and 40-item Hip disability and Osteoarthritis Outcome Score (HOOS) surveys that measure joint-specific pain, function and quality of life (QOL) for patients. The shorter forms were given to 1,395 knee osteoarthritis (OA) and 1,281 hip OA patients from the FORCE-TJR cohort who had previously completed the KOOS and HOOS surveys before and after total joint replacement surgery. The KOOS-12 and HOOS-12 surveys were found to successfully measure pain and function items of the patients as well as the 42-item versions.
AHRQ-funded; HS024632; HS018910.
Citation: Gandek B, Roos EM, Franklin PD .
Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12).
Osteoarthritis Cartilage 2019 May;27(5):746-53. doi: 10.1016/j.joca.2018.11.011..
Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Orthopedics
Lamplot JD, Bansal A, Nguyen JT
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
The purpose of this study using HCUP data was to determine how demographic and other patient-specific factors are associated with the risk of subsequent joint replacement in the contralateral or a different joint following an index joint replacement for osteoarthritis. Results showed a relatively high risk of subsequent replacement of the contralateral joint and a relatively low risk of subsequent replacement of a different joint within 5 to 8 years after an index total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty. Obesity was associated with a higher risk of subsequent replacement of the contralateral joint or a different joint.
AHRQ-funded; HS019455.
Citation: Lamplot JD, Bansal A, Nguyen JT .
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
J Bone Joint Surg Am 2018 Oct 17;100(20):1750-56. doi: 10.2106/jbjs.17.00948..
Keywords: Arthritis, Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Orthopedics, Healthcare Utilization
Urish KL, Qin Y, Li BY
Predictors and cost of readmission in total knee arthroplasty.
The Comprehensive Care for Joint Replacement bundle was created to decrease total knee arthroplasty (TKA) cost. To help accomplish this, there is a focus on reducing TKA readmissions. The study’s authors used the Nationwide Readmission Database to examine national readmission rates, predictors of readmission, and associated readmission costs for elective TKA procedures.
AHRQ-funded; HS018726.
Citation: Urish KL, Qin Y, Li BY .
Predictors and cost of readmission in total knee arthroplasty.
J Arthroplasty 2018 Sep;33(9):2759-63. doi: 10.1016/j.arth.2018.04.008..
Keywords: Arthritis, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Orthopedics
Goodman SM, Mandi LA, Mehta B
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
The authors assessed the interaction between education and poverty on 2-year Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function. They found that having no college was associated with worse pain and function at baseline and 2 years and that living in a poor neighborhood was associated with worse 2-year pain and function. There was a strong interaction between individual education and community poverty with WOMAC scores at 2 years. Patients without college living in poor communities had pain scores that were ~10 points worse than those with some college; in wealthy communities, college was associated with a 1-point difference in pain. Function was similar. The authors recommended further study on how education protects those in impoverished communities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandi LA, Mehta B .
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
Arthritis Care Res 2018 Jun;70(6):884-91. doi: 10.1002/acr.23442..
Keywords: Arthritis, Education, Low-Income, Orthopedics, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Pitta M, Esposito CI, Li Z
Failure after modern total knee arthroplasty: a prospective study of 18,065 knees.
The investigators sought to determine the mechanism of failure among primary total knee arthroplasties (TKAs) performed at a single high-volume institution. They found that the most common reasons for failure within 2 years after TKA were infection and stiffness. They suggested that the study identified preoperative risk factors for failure of primary TKAs, which may be useful information for developing strategies to improve outcomes following TKA.
AHRQ-funded; HS016075.
Citation: Pitta M, Esposito CI, Li Z .
Failure after modern total knee arthroplasty: a prospective study of 18,065 knees.
J Arthroplasty 2018 Feb;33(2):407-14. doi: 10.1016/j.arth.2017.09.041..
Keywords: Arthritis, Orthopedics