National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Adverse Events (1)
- Arthritis (4)
- Clinical Decision Support (CDS) (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (2)
- Health Promotion (1)
- Imaging (1)
- Medical Errors (1)
- (-) Orthopedics (9)
- Pain (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Self-Management (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Rehabilitation (1)
- (-) Shared Decision Making (9)
- Surgery (6)
- Women (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 9 of 9 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
Graber J, Lockhart S, Matlock DD
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
In this qualitative study, researchers sought to understand patients' and physical therapists' perspectives related to decision making during outpatient rehabilitation after total knee arthroplasty (TKA) and further to describe potential barriers and opportunities for shared decision making (SDM) in this setting. They found that physical therapists described using decision-making strategies with varying levels of patient involvement, while both patients and physical therapists described barriers to routine use of SDM in the outpatient setting. They also presented actionable strategies for overcoming these barriers for providers and organizations seeking consistently to use SDM in outpatient TKA rehabilitation.
AHRQ-funded; HS025692.
Citation: Graber J, Lockhart S, Matlock DD .
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
J Eval Clin Pract 2022 Feb;28(1):99-107. doi: 10.1111/jep.13591..
Keywords: Shared Decision Making, Rehabilitation, Orthopedics, Surgery, Patient-Centered Healthcare
Chrenka EA, Solberg LI, Asche SE
Is shared decision-making associated with better patient-reported outcomes? A longitudinal study of patients undergoing total joint arthroplasty.
This study examined whether shared decision making (SDM) provides better outcomes using patients undergoing total joint arthroplasty as a test case. This observational longitudinal survey-based study surveyed patients receiving an initial THA or TKA from a large, multispecialty medical group in the Midwestern United States after they were scheduled for surgery and again at 12 months after their procedure. The majority of included patients were white (1255 of 1344) with only 3% using Medicaid benefits at the time of surgery. The three-item collaboRATE measure of SDM was added to existing patient surveys of patient-reported outcome measures (PROMs). Patient responses were analyzed in regression models to estimate the association between preoperative collaborate scores and Oxford knee or hip scores at 12 months postoperatively. There was a moderate, positive association between preoperative collaborate scores and the Oxford scores at 12 months. The association suggests that SDM could be one tool to encourage better outcomes.
AHRQ-funded; HS025618.
Citation: Chrenka EA, Solberg LI, Asche SE .
Is shared decision-making associated with better patient-reported outcomes? A longitudinal study of patients undergoing total joint arthroplasty.
Clin Orthop Relat Res 2022 Jan;480(1):82-91. doi: 10.1097/corr.0000000000001920..
Keywords: Shared Decision Making, Patient-Centered Outcomes Research, Orthopedics, Surgery
Whitebird RR, Solberg LI, Ziegenfuss JY
Personalized outcomes for hip and knee replacement: the patients point of view.
Patient reported outcome measures (PROMs) are increasingly being incorporated into clinical and surgical care for assessing outcomes. This study examined outcomes important to patients in their decision to have hip or knee replacement surgery, their perspectives on PROMs and shared decision-making, and factors they considered important for postoperative care.
AHRQ-funded; HS025618.
Citation: Whitebird RR, Solberg LI, Ziegenfuss JY .
Personalized outcomes for hip and knee replacement: the patients point of view.
J Patient Rep Outcomes 2021 Nov 4;5(1):116. doi: 10.1186/s41687-021-00393-z..
Keywords: Orthopedics, Surgery, Patient-Centered Outcomes Research, Patient Experience, Shared Decision Making
Long S, Thomas GW, Karam MD
Surgical skill can be objectively measured from fluoroscopic images using a novel image-based Decision Error Analysis (IDEA) score.
This study introduces and evaluates a novel Image-based Decision Error Analysis (IDEA) score that captures performance during fluoroscopically assisted wire navigation. Findings showed that the fluoroscopic images obtained in the course of placing a guide wire contained a rich amount of information related to surgical skill. The IDEA scoring provided a basis for evaluating the competence of a resident. The score can be used to assess skill at key timepoints throughout residency, such as when rotating onto/off of a new surgical service and before performing certain procedures in the operating room, or as a tool for debriefing/providing feedback after a procedure is completed.
AHRQ-funded; HS022077; HS025353.
Citation: Long S, Thomas GW, Karam MD .
Surgical skill can be objectively measured from fluoroscopic images using a novel image-based Decision Error Analysis (IDEA) score.
Clin Orthop Relat Res 2021 Jun;479(6):1386-94. doi: 10.1097/corr.0000000000001623..
Keywords: Orthopedics, Surgery, Shared Decision Making, Medical Errors, Adverse Events, Imaging
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.
.
.
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
Hurley VB, Rodriguez HP, Kearing S
The impact of decision aids on adults considering hip or knee surgery.
Investigators analyzed data for 2012-2015 about patients within the ten High Value Healthcare Collaborative member systems who were exposed to condition-specific decision aids in the context of consultations for hip and knee osteoarthritis, with the intention that the aids be used to support shared decision making. They found that, compared to matched patients not exposed to the decision aids, those exposed had two-and-a-half times the odds of undergoing hip replacement surgery and nearly twice the odds of undergoing knee replacement surgery within six months of the consultation. Their findings suggest that health care systems adopting decision aids developed for use in shared decisionmaking, and used in conjunction with hip and knee osteoarthritis consultations, should not expect reduced surgical utilization.
AHRQ-funded; HS024075.
Citation: Hurley VB, Rodriguez HP, Kearing S .
The impact of decision aids on adults considering hip or knee surgery.
Health Aff 2020 Jan;39(1):100-07. doi: 10.1377/hlthaff.2019.00100..
Keywords: Shared Decision Making, Surgery, Orthopedics, Patient and Family Engagement