AHRQ Research Studies

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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.

Simianu VV, Flum DR
Rethinking elective colectomy for diverticulitis: a strategic approach to population health.
The authors argue that a rethinking of elective colectomy should come from a patient-centered approach that considers the risks of recurrence, quality of life, patient wishes and experiences about surgical and medical treatment options as well as operative morbidity and risks.
World J Gastroenterol 2014 Nov 28;20(44):16609-14. doi: 10.3748/wjg.v20.i44.16609.
AHRQ-funded; HS020025.
View abstract on the National Library of Medicine site.
Keywords: Patient-Centered Outcomes Research, Comparative Effectiveness, Surgery, Adverse Medical Events, Risk Factors
Linder SK, Kamath GR, Pratt GF
Citation searches are more sensitive than keyword searches to identify studies using specific measurement instruments.
This study compared the effectiveness of two search methods in identifying studies that used the Control Preferences Scale (CPS), a health care decision-making instrument commonly used in clinical settings. It found that keyword searches in bibliographic databases yielded high average precision (90%) but low average sensitivity (16%). PubMed was the most precise, followed closely by Scopus and WOS.
J Clin Epidemiol 2015 Apr;68(4):412-7. doi: 10.1016/j.jclinepi.2014.10.008.
AHRQ-funded; HS022134.
View abstract on the National Library of Medicine site.
Keywords: Research Methodologies, Decisionmaking, Evidence-based Research
Chen J, Hsieh AF, Dharmarajan K
National trends in heart failure hospitalization after acute myocardial infarction for Medicare beneficiaries: 1998-2010.
This study used a complete national sample of 2 789 943 AMI hospitalizations of Medicare fee-for-service beneficiaries from 1998 through 2010, we evaluated annual changes in the incidence of subsequent heart failure (HF) hospitalization and mortality using Poisson and survival analysis models. It found that HF hospitalization after AMI decreased from 1998 to 2010, which may indicate improvements in the management of AMI.
Circulation 2013 Dec 17;128(24):2577-84. doi: 10.1161/circulationaha.113.003668.
AHRQ-funded; HS018781.
View abstract on the National Library of Medicine site.
Keywords: Hospitalization, Medicare, Myocardial Infarction, Heart Failure, Mortality
Chung S, Zhao B, Lauderdale D
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
The researchers examined patterns and predictors of initiation of treatment for incident diabetes in an ambulatory care setting in the US. They found that only half of patients were treated during the first year following diabetes incidence, and only 20% of patients received both medication prescription and lifestyle modification interventions.
Prim Care Diabetes 2015 Feb;9(1):23-30. doi: 10.1016/j.pcd.2014.04.005.
AHRQ-funded; HS019815.
View abstract on the National Library of Medicine site.
Keywords: Diabetes, Prevention and Care Management, Health Care Utilization, Primary Care
Shirley DK, Kaner RJ, Glesby MJ
Screening for chronic obstructive pulmonary disease (COPD) in an urban HIV clinic: a pilot study.
This study aimed to determine the predictive value of a COPD screening strategy validated in the general population and to identify HIV-related factors associated with decreased lung function. It found that questionnaire and peak flow together had low sensitivity, but abnormal peak flow shows potential as a screening tool for COPD in HIV/AIDS. These data suggest that lung function may be influenced by HIV-related factors.
AIDS Patient Care STDS 2015 May;29(5):232-9. doi: 10.1089/apc.2014.0265.
AHRQ-funded; HS000066.
View abstract on the National Library of Medicine site.
Keywords: Human Immunodeficiency Virus (HIV), Screening, Chronic Obstructive Pulmonary Disease (COPD)
Wittie M, Ngo-Metzger Q, Lebrun-Harris L
Enabling quality: electronic health record adoption and meaningful use readiness in federally funded health centers.
This study, the first to examine the adoption and use of electronic health records (EHRs) among all 1,128 federally funded health centers, found that, as of 2011, 80 percent of health centers reported using an EHR, and high proportions reported using many advanced EHR functionalities. There were no indications of disparities in EHR adoption by census region, urban/rural location, patient sociodemographic compositions, physician staffing or health center funding.
J Healthc Qual. 2016 Jan-Feb;38(1):42-51. doi: 10.1111/jhq.12067.
View abstract on the National Library of Medicine site.
Keywords: Health IT, Electronic Health Records (EHRs), Disparities, Socioeconomic Factors
AHRQ Author: Ngo-Metzger Q
Grainger R, Dalbeth N, Keen H
Imaging as an outcome measure in gout studies: Report from the OMERACT Gout Working Group.
Discussion in the Outcome Measures in Rheumatology (OMERACT) working group was focused to consider (1) features of gout that should be recorded using imaging, (2) best methods of measuring these features, and (3) joints that should be imaged. The working group identified 3 relevant domains for imaging in gout studies: urate deposition (tophus burden), joint inflammation, and structural joint damage.
J Rheumatol 2015 Dec;42(12):2460-4. doi: 10.3899/jrheum.141164.
AHRQ-funded; HS021110.
View abstract on the National Library of Medicine site.
Keywords: Imaging, Patient-Centered Outcomes Research, Outcomes, Chronic Conditions
Risko R, Merdan S, Womble PR
Clinical predictors and recommendations for staging computed tomography scan among men with prostate cancer.
This study identified clinical variables associated with a positive computed tomography (CT) scan and estimated the performance of imaging recommendations in patients with newly diagnosed prostate cancer. It found that implementation of criterion for CT imaging that includes PSA levels greater than 20, a Gleason score of 8 or higher, or locally advanced disease (interpreted as cT3/4) would ensure that CT scans are performed for almost all men who would test positive for metastases.
Urology. 2014 Dec;84(6):1329-34. doi: 10.1016/j.urology.2014.07.051.
AHRQ-funded; HS018346
View abstract on the National Library of Medicine site.
Keywords: Computed Tomography (CT) Scan, Cancer: Prostate Cancer, Screening, Diagnosis, Diagnostics
Ndumele CD, Sommers BD, Trivedi AN
The ACA's 65th birthday challenge: moving from Medicaid to Medicare.
Following the Affordable Care Act’s coverage expansion, many newly-insured older enrollees will lose Medicaid coverage on their 65th birthday and transition from Medicaid to Medicare as their primary insurer. This article discusses the transition in primary health insurance coverage that includes changes to benefits, patient cost-sharing, and provider reimbursement, which could have profound consequences on the use of health services and associated health outcomes for low-income seniors.
J Gen Intern Med 2015 Nov;30(11):1704-6. doi: 10.1007/s11606-015-3328-0.
AHRQ-funded; HS021291.
View abstract on the National Library of Medicine site.
Keywords: Health Insurance, Affordable Care Act, Medicare, Elderly, Low-Income Population
Miller GE, Sarpong EM, Hill SC
Does increased adherence to medications change health care financial burdens for adults with diabetes?
The aim of the present study was to investigate increased out-of-pocket drug costs and financial burdens of achieving adherence to oral antidiabetic medications and medications for prevalent comorbidities. The researchers found that the mean simulated additional out-of-pocket drug costs of achieving adherence were $310 for uninsured adults treated for diabetes. These additional drug costs would increase the percentage of uninsured adults with financial burden.
J Diabetes 2015 Nov;7(6):872-80. doi: 10.1111/1753-0407.12292.
View abstract on the National Library of Medicine site.
Keywords: Medical Expenditure Panel Survey (MEPS), Health Care Costs, Diabetes, Patient Adherence, Medications
AHRQ Author: Miller GE, Sarpong EM, Hill SC
Berkman ND, Lohr KN, Ansari MT, 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.
J Clin Epidemiol. 2015 Nov;68(11):1312-24. doi: 10.1016/j.jclinepi.2014.11.023.
AHRQ authored; AHRQ-funded 290200710056I
View abstract on the National Library of Medicine site.
Keywords: Comparative Effectiveness, Evidence-based Medicine, Evidence-based Practice Centers (EPCs), Research Methodologies
AHRQ Author: Chang S
Abdus S, Zuvekas SH
Racial/ethnic differences in the relationship between obesity and depression treatment.
This study examined the relationship between obesity and the treatment of depression across racial/ethnic subgroups, controlling for depressive symptoms, self-rated mental health, health status, and socioeconomic characteristics. It found that the association between obesity and depression-related medication was significant for white women but not for black or Hispanic women. The results for men were, in general, mixed and inconsistent.
J Behav Health Serv Res 2015 Oct;42(4):486-503. doi: 10.1007/s11414-014-9391-1.
View abstract on the National Library of Medicine site.
Keywords: Obesity, Depression, Socioeconomic Factors, Racial and Ethnic Minority Groups, MEPS
AHRQ Author: Abdus S, Zuvekas SH
Murphy DR, Thomas EJ, Meyer AN
Development and validation of electronic health record-based triggers to detect delays in follow-up of abnormal lung imaging findings.
In this study, the researchers developed an electronic health record (EHR)-based trigger algorithm to identify delays in follow-up evaluation of patients with imaging findings suggestive of lung cancer. After validating the trigger with retrospective data, they concluded that EHR-based triggers can be used to identify patients with suspicious imaging findings in whom follow-up diagnostic evaluation was delayed.
Radiology 2015 Oct;277(1):81-7. doi: 10.1148/radiol.2015142530.
AHRQ-funded; HS017820.
View abstract on the National Library of Medicine site.
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Cancer: Lung Cancer, Diagnostics
Kronick R, Berkwits M
The future of AHRQ's health services research.
In this article, AHRQ Director Richard Kronick, PhD, sat down with JAMA to talk about the agency’s work and its relationship with other federal health research entities. Dr. Kronick explains how AHRQ’s work is focused on figuring out how to improve health outcomes that patients care about. He also discusses how AHRQ’s mission differs from that of the National Institutes of Health and the Patient-Centered Outcomes Research Institute.
JAMA 2015 Sep 8;314(10):979-81. doi: 10.1001/jama.2015.10260.
View abstract on the National Library of Medicine site.
Keywords: Health Services Research (HSR), AHRQ Director, Outcomes
AHRQ Author: Kronick R
Likosky DS, Paone G, Zhang M
Red blood cell transfusions impact pneumonia rates after coronary artery bypass grafting.
This study describes the relationship between red blood cell (RBC) transfusion and postoperative pneumonia after CABG. It found a significant volume dependent association between an increasing number of RBCs and the odds of pneumonia, which persisted after risk adjustment. It included a total of 16,182 consecutive patients who underwent isolated CABG between 2011 and 2013 at 1 of 33 hospitals in the state of Michigan.
Ann Thorac Surg 2015 Sep;100(3):794-801. doi: 10.1016/j.athoracsur.2015.03.089.
AHRQ-funded; HS022535; HS022909.
View abstract on the National Library of Medicine site.
Keywords: Surgery, Cardiovascular Conditions, Patient Safety
Darlow S, Wen KY
Development testing of mobile health interventions for cancer patient self-management: a review.
The purpose of the current study was to conduct a review of published articles that describe the development process of mobile health interventions for patients’ cancer care self-management. The following trends emerged: importance of stakeholder engagement during the development process, addressing the unique needs and experiences of cancer patients and care providers, ensuring user satisfaction with the system, and identifying perceived benefits and limitations of the system.
Health Informatics J 2015 Sep;22(3):633-50. doi: 10.1177/1460458215577994.
AHRQ-funded; HS019001.
View abstract on the National Library of Medicine site.
Keywords: Self Management, Cancer, Chronic Care: Self-Management
Cha S, Chapman DA, Wan W
Intimate partner violence and postpartum contraceptive use: the role of race/ethnicity and prenatal birth control counseling.
The objective of the study was to examine the extent to which intimate partner violence (IPV) around the time of pregnancy is associated with postpartum contraceptive use among women in the United States. Approximately 6.2 percent of women reported IPV, and 15.5 percent reported no postpartum contraceptive use. Regardless of the timing of abuse, IPV-exposed women were significantly less likely to report contraceptive use after delivery.
Contraception 2015 Sep;92(3):268-75. doi: 10.1016/j.contraception.2015.04.009.
AHRQ-funded; HS023724.
View abstract on the National Library of Medicine site.
Keywords: Domestic Violence, Pregnancy, Contraception
Andrews RM
Statewide hospital discharge data: Collection, use, limitations, and improvements.
The purpose of the article is to provide background information on statewide hospital discharge data and the context for the other articles in this special issue of HSR that focus on the products and lessons learned by the Enhanced State Data grantees. The author provides an overview of statewide hospital discharge data, including content and coverage, and its evolution and improvement over time.
Health Serv Res 2015 Aug;50 Suppl 1:1273-99. doi: 10.1111/1475-6773.12343.
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Hospital Data
AHRQ Author: Andrews RM
Grundmeier RW, Song L, Ramos MJ
Imputing missing race/ethnicity in pediatric electronic health records: Reducing bias with use of U.S. census location and surname data.
The researchers assessed the utility of imputing race/ethnicity using U.S. Census race/ethnicity, residential address, and surname information compared to standard missing data methods in a pediatric cohort. In a simulation experiment, they constructed dichotomous and continuous outcomes with pre-specified associations with known race/ethnicity. They found that imputation using U.S. Census information reduced bias for both continuous and dichotomous outcomes.
Health Serv Res 2015 Aug;50(4):946-60. doi: 10.1111/1475-6773.12295.
AHRQ-funded; HS021645.
View abstract on the National Library of Medicine site.
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Pediatrics, Racial and Ethnic Minority Groups
DeVoe JE, Crawford C, Angier H
The association between Medicaid coverage for children and parents persists: 2002-2010.
The researchers assessed the likelihood of children’s having public health insurance coverage and their parents’ maintenance, gain, or loss of public coverage. The study found that, despite differing eligibility requirements, strong associations persisted between coverage continuity for parents and children in Oregon’s public health insurance program.
Matern Child Health J. 2015 Aug;19(8):1766-74. doi: 10.1007/s10995-015-1690-5.
AHRQ-funded; HS018569
View abstract on the National Library of Medicine site.
Keywords: Medicaid, Children, Health Insurance