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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
51 to 75 of 12214 Research Studies DisplayedCassidy DE, Shao Z, Howard R
Variability in surgical approaches to hernias in patients with ascites.
This study investigated variability in surgical approaches to hernias in patients with ascites. The authors used data from the Michigan Surgical Quality Collaborative and its corresponding Core Optimization Hernia Registry (MSQC-COHR), which captures specific patient, hernia, and operative characteristics at a population level within the state. This retrospective cohort reviewed patients with ascites who had ventral or inguinal hernia repair surgery between January 2020 and May 3, 2022. The primary outcome observed was incidence and surgical approach for both ventral and inguinal hernia cohorts, and secondary outcomes included 30-day adverse clinical outcomes as listed here: (ED visits, readmission, reoperation, and complications) and surgical priority (urgent/emergent vs elective). In the cohort of 176 patients with ascites, only 1.4% of ventral hernia patients underwent hernia repair surgery, and only 0.2% of inguinal hernia patients. The post-operative 30-day adverse clinical outcomes in both hernia surgery cohorts were greatly increased compared to those without ascites (ventral: 32%; inguinal: 30%). Readmission was the most common complication, with a rate of 15.9% in the inguinal cohort, and 19.3% in the ventral hernia cohort. Open repair was the most common surgical approach (ventral: 86%, open: 77%). Ventral hernias were most commonly considered as urgent or emergency surgery (60%), while inguinal was mostly presented as elective surgery (72%).
AHRQ-funded; HS025778.
Citation: Cassidy DE, Shao Z, Howard R .
Variability in surgical approaches to hernias in patients with ascites.
Surg Endosc 2024 Feb; 38(2):735-41. doi: 10.1007/s00464-023-10598-6..
Keywords: Surgery
Kalofonos I, Zito M, Fletcher E
A pilot trial examining the effects of veteran voices and visions, an adaptation of hearing voices groups for a large public health system in the United States.
This paper described the effects of participation of a pilot trial of Veterans Voices and Visions (VVV) groups, which is an adaptation of the Hearing Voices (HV) groups which were created to assist patients undergoing psychosis. The trial was conducted at the VA and were co-led by clinicians and Veteran peer support specialists. Over a 16-week period, quantitative analysis showed a statistically significant reduction in distress, due to auditory hallucinations, as measured by the Psychotic Symptom Rating Scales (PSYRATS). A reduction in malevolence and omnipotence and an increase in benevolence related to auditory hallucinations was shown with the Beliefs about Voices Questionnaire- Revised (BAVQ-R), but there was no change in resistance. Qualitative data from Week 8 and the endpoint (Week 16) interviews revealed several perceived benefits from groups: 1) normalization and camaraderie, 2) increased hope and confidence, 3) self-understanding and reframing of experiences, and 4) building relationships outside of groups.
AHRQ-funded.
Citation: Kalofonos I, Zito M, Fletcher E .
A pilot trial examining the effects of veteran voices and visions, an adaptation of hearing voices groups for a large public health system in the United States.
Int J Soc Psychiatry 2024 Feb; 70(1):122-31. doi: 10.1177/00207640231196747.
Keywords: Community-Based Practice, Behavioral Health
McAteer J, Kalluri DD, Abedon RR
Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients.
This study examined COVID-19 m-RNA vaccine antibody responses 6 months following the third vaccine dose (D3) of the BNT162b2 mRNA vaccination among adolescent solid organ transplant recipients (aSOTRs). The 34 participants were surveyed after they received the third dose of the vaccine and were sampled at 1-, 3-, and 6-months post-D3. All had positive anti-RBD antibody titers 6 months post-D3. Variations in titers occurred between 3 and 6 months post-D3, with 29% having decreased antibody levels at 6 months compared to 3 months and 7% reporting increased titers at 6 months. The remaining 18 had unchanged antibody titers compared to 3-month post-D3 levels. A total of 12% reported breakthrough infection within 6 months and 9% reported infection after 6-12 months following the third dose of the SARS-CoV-2 mRNA vaccine.
AHRQ-funded; HS026510.
Citation: McAteer J, Kalluri DD, Abedon RR .
Anti-spike antibody durability after SARS-CoV-2 vaccination in adolescent solid organ transplant recipients.
Pediatr Transplant 2024 Feb; 28(1):e14671. doi: 10.1111/petr.14671.
Keywords: COVID-19, Vaccination, Transplantation, Children/Adolescents
Sneed NM, Heerman WJ, Shaw PA
Associations between gestational weight gain, gestational diabetes, and childhood obesity incidence.
Excessive maternal gestational weight gain (GWG) and gestational diabetes mellitus (GDM) have been linked to childhood obesity. This cohort study explored the association between maternal weight gain during pregnancy, GDM, and early childhood obesity. Findings revealed that excessive weight gain during the second and third trimesters increased the risk of childhood obesity by age 6. However, GDM was associated with a lower risk. No significant interaction between GWG and GDM was observed.
AHRQ-funded; HS026122.
Citation: Sneed NM, Heerman WJ, Shaw PA .
Associations between gestational weight gain, gestational diabetes, and childhood obesity incidence.
Matern Child Health J 2024 Feb; 28(2):372-81. doi: 10.1007/s10995-023-03853-8.
Keywords: Maternal Care, Women, Children/Adolescents, Obesity
Weiss CR, Roberts M, Florell M
Best Practices for telehealth in nurse-led care settings-a qualitative study.
This study explored the implementation of telehealth in nurse-led care models during the COVID-19 pandemic in Colorado. Through interviews with 18 providers and 30 patients, best practices such as: using multiple modalities, tailored triage and scheduling, safety measures, and managing patient relationships emerged. These findings indicate that telehealth can enhance equitable care delivery, particularly in diverse communities, with nurse leaders playing a vital role in its effective utilization.
AHRQ-funded; HS028085.
Citation: Weiss CR, Roberts M, Florell M .
Best Practices for telehealth in nurse-led care settings-a qualitative study.
Policy Polit Nurs Pract 2024 Feb; 25(1):47-57. doi: 10.1177/15271544231201417.
Keywords: Telehealth, Health Information Technology (HIT), Nursing, Provider: Nurse, COVID-19
Wnorowska JH, Naik V, Ramgopal S
Characteristics of pediatric behavioral health emergencies in the prehospital setting.
This retrospective cross-sectional study aimed to characterize pediatric behavioral health encounters in the United States and assess factors associated with sedative medication administration and physical restraint use. Analyzing data from 2019 to 2020, among 2,740,271 pediatric EMS encounters, 11.3% were for behavioral health. Sedatives were used in 2.2% and restraints in 3.0% of these encounters. Factors influencing medication and restraint use included age, disabilities, geographic region, and EMS system type.
AHRQ-funded; HS026385.
Citation: Wnorowska JH, Naik V, Ramgopal S .
Characteristics of pediatric behavioral health emergencies in the prehospital setting.
Acad Emerg Med 2024 Feb; 31(2):129-39. doi: 10.1111/acem.14833.
Keywords: Children/Adolescents, Behavioral Health, Emergency Medical Services (EMS)
Liu PH, Singal AG, Murphy CC
Colorectal cancer screening receipt does not differ by 10-year mortality risk among older adults.
This study examined receipt of past-year colorectal cancer (CRC screening) according to predicted 10-year mortality risk among 25,888 community-dwelling adults aged 65-84 years who were not up-to-date with screening in the nationwide National Health Interview Survey. Ten-year mortality risk was estimated using a validated index with the lowest to highest quintiles of the index ranging from 12%-79%. The authors also examined the proportion of screening performed among adults with life expectancy <10 years. They found that the prevalence of past-year CRC screening was 39.5%, 40.6%, 38.7%, 36.4%, and 35.4%, from the lowest to highest quintile of 10-year mortality risk, demonstrating that the odds of CRC screening did not differ in the lowest vs highest quintile. One-quarter of past-year CRC screening occurred in adults with life expectancy <10 years, and more than half (50.7%) of adults aged 75-84 years had 10-year mortality risk ≥50% at the time of screening. Invasive but not noninvasive screening increased as 10-year mortality risk increased among adults aged 70-79 years.
AHRQ-funded; HS022418.
Citation: Liu PH, Singal AG, Murphy CC .
Colorectal cancer screening receipt does not differ by 10-year mortality risk among older adults.
Am J Gastroenterol 2024 Feb; 119(2):353-63. doi: 10.14309/ajg.0000000000002536.
Keywords: Elderly, Cancer: Colorectal Cancer, Mortality, Screening, Colonoscopy
Geanacopoulos AT, Neuman MI, Michelson KA
Cost of pediatric pneumonia episodes with or without chest radiography.
Researchers sought to assess the costs of community-acquired pneumonia (CAP) episodes with and without chest radiograph (CXR) among children discharged from the pediatric emergency department. Their retrospective cohort study used data from the Healthcare Cost and Utilization Project State ED and Inpatient Databases on children aged 3 months to 18 years with CAP in eight states from 2014 to 2019. The results indicated that use of CXR for CAP diagnosis is associated with lower costs when considering the subsequent provision of care among patients who need additional health care after initial emergency department discharge.
AHRQ-funded; HS026503; HS000063.
Citation: Geanacopoulos AT, Neuman MI, Michelson KA .
Cost of pediatric pneumonia episodes with or without chest radiography.
Hosp Pediatr 2024 Feb; 14(2):146-52. doi: 10.1542/hpeds.2023-007506.
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Pneumonia, Respiratory Conditions, Community-Acquired Infections
Miller AC, Koeneman SH, Suneja M
Diurnal temperature variation and the implications for diagnosis and infectious disease screening: a population-based study.
This study’s objective was to describe individual variation in diurnal temperature patterns during episodes of febrile activity using millions of recorded temperatures and evaluate the probability of recording a fever by sex and for different age groups. The authors used timestamped deidentified temperature readings from thermometers across the US to construct illness episodes where continuous periods of activity in a single user included a febrile reading. They modeled the mean temperature recorded and probability of registering a fever across the course of a day using sinusoidal regression models while accounting for user age and sex. They then estimated the probability of recording a fever by time of day for children, working-age adults, and older adults. They found wide variation in body temperatures over the course of a day and across individual characteristics, with temperature patterns differing between men and women, and average temperatures declining for older age groups. There was a wide variation of the likelihood of fever detection by the time of day and by an individual’s age or sex.
AHRQ-authored; HS027375.
Citation: Miller AC, Koeneman SH, Suneja M .
Diurnal temperature variation and the implications for diagnosis and infectious disease screening: a population-based study.
Diagnosis 2024 Feb 1; 11(1):54-62. doi: 10.1515/dx-2023-0074.
Keywords: Infectious Diseases, Screening
Gyftopoulos S, Simon E, Swartz JL
Efficacy and impact of a multimodal intervention on CT pulmonary angiography ordering behavior in the emergency department.
The objective of this study was to evaluate the efficacy of a multimodal intervention to reduce overutilization of computed tomography pulmonary angiography (CTPA) for suspected pulmonary embolism in the emergency department. Results indicated that guideline concordance increased significantly after intervention. The authors concluded that their success in increasing guideline concordance demonstrated the efficacy of a mixed-methods, human-centered approach to behavior change; however, given that neither of the secondary outcomes improved, the results may demonstrate potential limitations to the guidelines directing the ordering of CTPA studies.
AHRQ-funded; HS024376.
Citation: Gyftopoulos S, Simon E, Swartz JL .
Efficacy and impact of a multimodal intervention on CT pulmonary angiography ordering behavior in the emergency department.
J Am Coll Radiol 2024 Feb; 21(2):309-18. doi: 10.1016/j.jacr.2023.02.033.
Keywords: Emergency Department, Respiratory Conditions, Imaging, Diagnostic Safety and Quality, Blood Clots
Khalaf N, Ali B, Liu Y
Emergency presentations predict worse outcomes among patients with pancreatic cancer.
This study evaluated the association between pancreatic emergency presentation (EP) and cancer stage, treatment, and survival. The authors conducted a retrospective cohort study among patients with pancreatic adenocarcinoma diagnosed from 2007 to 2019 at a tertiary-care Veterans Affairs medical center. They used electronic health records to identify EP cases, defined as a new pancreatic cancer diagnosis made within 30 days of an ED visit where cancer was suspected. Of 243 identified pancreatic cancer patients, 66.7% had EPs. Although there was no difference in stage by EP status, patients diagnosed through EPs were 72% less likely to receive cancer treatment compared to non-emergency presenters. Patients with EPs also had a 73% higher mortality risk. This difference in mortality remained statistically significant after adjusting for cancer stage and receipt of cancer treatment.
AHRQ-funded; HS029347; HS028595.
Citation: Khalaf N, Ali B, Liu Y .
Emergency presentations predict worse outcomes among patients with pancreatic cancer.
Dig Dis Sci 2024 Feb; 69(2):603-14. doi: 10.1007/s10620-023-08207-6.
Keywords: Cancer, Emergency Department, Outcomes
Sequeira GM, Asante PG, Bocek K
Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents.
An electronic consultation (e-consult) platform was introduced to conduct a study to aid pediatric primary care providers (PCPs) in providing gender-affirming care to transgender and nonbinary (TNB) adolescents. A study assessed its impact on PCP confidence and referral patterns. Results showed increased confidence and a 19% decrease in specialty referrals among PCPs. The platform received positive usability feedback, suggesting its potential to enhance care access and reduce specialty referrals for TNB adolescents.
AHRQ-funded; HS026393.
Citation: Sequeira GM, Asante PG, Bocek K .
Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents.
Telemed J E Health 2024 Feb; 30(2):595-600. doi: 10.1089/tmj.2023.0266.
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Primary Care, Vulnerable Populations
Pozzar RA, Wall JA, Tavormina A
Experiences of patients with peritoneal carcinomatosis-related complex care needs and their caregivers.
The study explored the needs of patients with peritoneal carcinomatosis (PC) and caregivers during care transitions. Findings showed limited prognostic understanding and advance care planning among patients, with most caregivers providing daily care without proper training. Many participants experienced anxiety and depression. Interviewees emphasized the lack of guidance and called for health system changes. The study concluded that interventions providing clinical training, facilitating serious illness conversations, and offering psychosocial support are necessary.
AHRQ-funded; HS013852.
Citation: Pozzar RA, Wall JA, Tavormina A .
Experiences of patients with peritoneal carcinomatosis-related complex care needs and their caregivers.
Gynecol Oncol 2024 Feb; 181:68-75. doi: 10.1016/j.ygyno.2023.12.013.
Keywords: Cancer, Caregiving, Palliative Care, Women
Loi MV, Lee JH, Huh JW
Ketamine use in the intubation of critically ill children with neurological indications: a multicenter retrospective analysis.
This study examined use of ketamine in children undergoing tubal intubation (TI) for a primary neurological indication. The authors conducted a retrospective observational cohort study of critically ill children undergoing TI for neurological indications in 53 international pediatric intensive care units and emergency departments. They screened all intubations from 2014 to 2020 entered into the multicenter National Emergency Airway Registry for Children (NEAR4KIDS) registry database. Of 21,562 TIs, 2,073 were performed for a primary neurological indication, including 190 for traumatic brain injury/trauma. Patients received ketamine in 495 TIs (23.9%), which increased from 10% in 2014 to 41% in 2020. Criteria for ketamine use includes a coindication of respiratory failure, difficult airway history, and use of vagolytic agents, apneic oxygenation, and video laryngoscopy. Composite adverse outcomes were reported in 289 (13.9%) TIs and were more common in the ketamine group (17.0% vs. 13.0%). After adjusting for location, patient age and co-diagnoses, the presence of respiratory failure and shock, difficult airway history, provider demographics, intubating device, and the use of apneic oxygenation, vagolytic agents, and neuromuscular blockade, ketamine use was not significantly associated with increased composite adverse outcomes. This paucity of association remained even when only neurotrauma intubations were considered (10.6% vs. 7.7%).
AHRQ-funded; HS022464, HS024511.
Citation: Loi MV, Lee JH, Huh JW .
Ketamine use in the intubation of critically ill children with neurological indications: a multicenter retrospective analysis.
Neurocrit Care 2024 Feb; 40(1):205-14. doi: 10.1007/s12028-023-01734-0.
Keywords: Children/Adolescents, Critical Care, Adverse Drug Events (ADE), Adverse Events, Patient Safety
Kalata S, Schaefer SL, Nuliyahu U
Low-volume elective surgery and outcomes in Medicare beneficiaries treated at hospital networks.
This cross-sectional study’s objective was to quantify low-volume surgery and associated outcomes within hospital networks. This study used Medicare Provider Analysis and Review data to examine fee-for-service beneficiaries aged 66 to 99 years who underwent 1 of 10 elective surgical procedures (abdominal aortic aneurysm repair, carotid endarterectomy, mitral valve repair, hip or knee replacement, bariatric surgery, or resection for lung, esophageal, pancreatic, or rectal cancers) in a network hospital from 2016 to 2018. Hospital volume for each procedure (calculated with the use of National Inpatient Sample data) was compared with yearly hospital volume standards for that procedure recommended by The Leapfrog Group. The authors analyzed primary outcomes which were postoperative complications, 30-day readmission, and 30-day mortality, stratified by the volume status of the hospital and network type. Secondary outcome was the availability of a different high-volume hospital within the same network or outside the network and its proximity to the patient (based on hospital referral region and zip code). In all, data were analyzed for 950,079 Medicare fee-for-service beneficiaries (average age 74.4 years; 621,138 females and 427,931 males) who underwent 1,049,069 procedures at 2469 hospitals within 382 networks. Of these networks, almost 100% [380 (99.5%)] had at least 1 low-volume hospital performing the elective procedure of interest. In 79.8% of procedures that were performed at low-volume hospitals, there was a hospital that met volume standards within the same network and hospital referral region located a median (IQR) distance of 29 (12-60) miles from the patient's home. In adjusted analyses, postoperative outcomes were inferior at low-volume hospitals compared with hospitals meeting volume standards, with a 30-day mortality of 8.1% at low-volume hospitals vs 5.5% at hospitals that met volume standards.
AHRQ-funded; HS028606.
Citation: Kalata S, Schaefer SL, Nuliyahu U .
Low-volume elective surgery and outcomes in Medicare beneficiaries treated at hospital networks.
JAMA Surg 2024 Feb; 159(2):203-10. doi: 10.1001/jamasurg.2023.6542.
Keywords: Surgery, Medicare, Hospitals, Outcomes
Melton K, Liu J, Sadeghi H
Predictors of transition outcomes in cystic fibrosis: analysis of National Patient Registry and CF RISE (Responsibility. Independence. Self-care. Education) data.
This retrospective cohort study’s goal was to identify predictors of transition outcomes in cystic fibrosis (CF) patients aged 16-25 years who transitioned to adult care from 2013 to 2019. The authors used data from the CF Foundation Patient Registry and the web-based transition program CF RISE (Responsibility. Independence. Self-care. Education). They modeled change in forced expiratory volume in 1 second % predicted and weight using linear regression fit with generalized estimating equations. Predictor variables included gap in care (time between last pediatric and first adult outpatient visit), transition program engagement, and sociodemographic and medical factors. Among 12,420 adolescents and young adults, 3876 transitioned to adult care with a median gap in care of 7.6 months. Patients from CF centers that have greater rates of CF RISE engagement had improved lung function and weight at their first adult outpatient visit. Patients with coverage on a parent's insurance plan and absence of CF complications predicted increased lung function. Sinus disease and history of a nonlung transplant predicted increased weight. Comorbid diabetes mellitus and gaps in care greater than 3 months predicted decreased lung function with longer gaps in care associated with greater decrease. Care gaps of 6 to 9 months predicted decreased weight. Other control variables including baseline forced expiratory volume in 1 second and weight, and exacerbation status were also statistically significant.
AHRQ-funded; HS000063.
Citation: Melton K, Liu J, Sadeghi H .
Predictors of transition outcomes in cystic fibrosis: analysis of National Patient Registry and CF RISE (Responsibility. Independence. Self-care. Education) data.
J Pediatr 2024 Feb; 265:113812. doi: 10.1016/j.jpeds.2023.113812.
Keywords: Chronic Conditions, Respiratory Conditions, Children/Adolescents, Transitions of Care
Ali KJ, Goeschel CA, DeLia DM
The PRIDx framework to engage payers in reducing diagnostic errors in healthcare.
The authors conducted a literature review and interviewed subject matter experts to develop a multi-component Payer Relationships for Improving Diagnoses (PRIDx) framework. The PRIDx framework can be used to encourage public and private payers to take specific actions to improve diagnostic safety. The authors noted that implementation of the PRIDx framework will require new types of partnerships, including external support from public and private payer organizations, and also require the creation of strong provider incentives.
AHRQ-funded; 2332015000221.
Citation: Ali KJ, Goeschel CA, DeLia DM .
The PRIDx framework to engage payers in reducing diagnostic errors in healthcare.
https://www.pubmed.ncbi.nlm.nih.gov/37795579.
Keywords: Diagnostic Safety and Quality, Quality of Care, Patient Safety
Kovacevic M, Montes M, Tirone V
Treating a common comorbidity: pain outcomes following a 3-week cognitive processing therapy-based intensive treatment for posttraumatic stress disorder address.
This study examined changes in pain, posttraumatic stress disorder (PTSD), and depressive symptoms among 125 veterans completing a 3-week cognitive processing therapy (CPT)-based intensive treatment program (ITP) for PTSD. The authors explored whether pretreatment pain interference predicted changes in PTSD and depressive symptom severity and whether larger changes in pain interference over the course of treatment were associated with larger changes in PTSD and depressive symptom severity. Higher levels of pretreatment pain interference were associated with higher PTSD, and depressive symptom severity, over time. Larger reductions in pain interference corresponded to more improvement in PTSD symptoms, but not depressive symptoms.
AHRQ-funded; HS028511.
Citation: Kovacevic M, Montes M, Tirone V .
Treating a common comorbidity: pain outcomes following a 3-week cognitive processing therapy-based intensive treatment for posttraumatic stress disorder address.
J Trauma Stress 2024 Feb; 37(1):47-56. doi: 10.1002/jts.22979.
Keywords: Pain, Behavioral Health, Outcomes, Chronic Conditions
Zhou Z, Yeung W, Soleymani S
Using explainable machine learning to uncover the kinase-substrate interaction landscape.
Researchers explored the challenge of understanding how human protein kinases selectively predict phosphorylate substrates. Leveraging recent peptide library datasets, the researchers developed an explainable Transformer model for kinase-peptide interaction prediction, achieving state-of-the-art performance. The model's multitask learning paradigm enables predictions on virtually any kinase-peptide pair. Using explainable machine learning methods, they uncovered the model's inner workings and provided a web interface for predicting kinase-substrate associations.
AHRQ-funded; HS029009.
Citation: Zhou Z, Yeung W, Soleymani S .
Using explainable machine learning to uncover the kinase-substrate interaction landscape.
Bioinformatics 2024 Feb; 40(2). doi: 10.1093/bioinformatics/btae033.
Keywords: Health Information Technology (HIT)
Hendren S, Ameling J, Rocker C
Validation of measures for perioperative urinary catheter use, urinary retention, and urinary catheter-related trauma in surgical patients.
This article described a retrospective cohort study to analyze the effects of non-infectious urinary catheter-related complications, such as measurements of indwelling urinary catheter overuse, catheter-related trauma, and urinary retention. Participants were 200 patients who were undergoing general surgery operations; 65% had an indwelling urinary catheter placed at the time of surgery, 16% had urinary retention, and 6% had urinary trauma. The authors concluded that this study suggests a persistent high rate of catheter use, significant rates of urinary retention and trauma, and variation in the management of retention.
AHRQ-funded; HS026912.
Citation: Hendren S, Ameling J, Rocker C .
Validation of measures for perioperative urinary catheter use, urinary retention, and urinary catheter-related trauma in surgical patients.
Am J Surg 2024 Feb; 228:199-205. doi: 10.1016/j.amjsurg.2023.09.027.
Keywords: Surgery, Adverse Events, Patient Safety
Liu SK, Bourgeois F, Dong J
What's going well: a qualitative analysis of positive patient and family feedback in the context of the diagnostic process.
This paper evaluated positive patient/family feedback to generate broader perspectives on what constitutes a "good" diagnostic process (DxP). Eligible participants included patients/families living with chronic conditions with visits in three urban pediatric subspecialty clinics (site 1) and one rural adult primary care clinic (site 2) who were then invited to complete a survey between December 2020 and March 2020. The authors adapted the Healthcare Complaints Analysis Tool (HCAT) to conduct a qualitative analysis on a subset of patient/family responses with ≥20 words. A total of 7,075 surveys were completed before 18,129 visits (39 %) at site 1, and 460 surveys were completed prior to 706 (65 %) visits at site 2. Positive feedback was provided by 1,578 participants, ranging from 1-79 words. Categories of 272 comments with ≥20 words described: Relationships (60 %), Clinical Care (36 %), and Environment (4 %). In the Relationships category patients/families most commonly noted: thorough and competent attention (46 %), clear communication and listening (41 %) and emotional support and human connection (39 %). For Clinical Care, patients highlighted: timeliness (31 %), effective clinical management (30 %), and coordination of care (25 %).
AHRQ-funded; HS027367.
Citation: Liu SK, Bourgeois F, Dong J .
What's going well: a qualitative analysis of positive patient and family feedback in the context of the diagnostic process.
Diagnosis 2024 Feb 1; 11(1):63-72. doi: 10.1515/dx-2023-0075.
Keywords: Diagnostic Safety and Quality, Clinician-Patient Communication, Communication, Patient and Family Engagement
Montgomery KB, Fazendin JM, Chen H
Contemporary trends in extent of surgery for differentiated thyroid cancer with extrathyroidal extension.
The study aimed to investigate trends in surgical approaches for differentiated thyroid cancer (DTC) with gross extrathyroidal extension (ETE). Using the National Cancer Database, patients with +ETE DTC from 2010 to 2020 were analyzed. Among 5,851 patients, 92% underwent total thyroidectomy (TT), but later years showed increased lobectomy rates. The results of the study suggest a potential shift towards preferring lobectomy in low-risk DTC cases, while raising concerns about undertreating high-risk patients.
AHRQ-funded; HS013852.
Citation: Montgomery KB, Fazendin JM, Chen H .
Contemporary trends in extent of surgery for differentiated thyroid cancer with extrathyroidal extension.
The study aimed to investigate trends in surgical approaches for differentiated thyroid cancer (DTC) with gross extrathyroidal extension (ETE). Using the National Cancer Database, patients with +ETE DTC from 2010 to 2020 were analyzed. Among 5,851 patients, 92% underwent total thyroidectomy (TT), but later years showed increased lobectomy rates. The results of the study suggest a potential shift towards preferring lobectomy in low-risk DTC cases, while raising concerns about undertreating high-risk patients..
Keywords: Cancer, Surgery, Cancer
De Castro GC, Slatnick LR, Shannon M
Impact of time-to-antibiotic delivery in pediatric patients with cancer presenting with febrile neutropenia.
Researchers abstracted episodes of febrile neutropenia (FN) in pediatric patients with cancer occurring at Vanderbilt Children's Hospital and Colorado Children's Hospital to capture time-to-antibiotic (TTA) metrics and clinical outcomes including major complications. Results showed that only 0.6% of episodes required immediate ICU management, with a median TTA of 28 minutes; for the remaining patients, the median TTA was 56 minutes. TTA was not associated with major nor any other complications in adjusted analysis. The researchers concluded that there was no clear evidence that a reduced TTA improves clinical outcomes in pediatric oncology FN and it should not be used as a primary quality measure.
AHRQ-funded; HS025696.
Citation: De Castro GC, Slatnick LR, Shannon M .
Impact of time-to-antibiotic delivery in pediatric patients with cancer presenting with febrile neutropenia.
JCO Oncol Pract 2024 Feb; 20(2):228-38. doi: 10.1200/op.23.00583..
Keywords: Children/Adolescents, Cancer, Antibiotics, Medication
Nacht CL, Jacobson N, Shiyanbola O
Perception of physicians' notes among parents of different health literacy levels.
The study explored how parents of varying health literacy levels perceive accessing physicians' notes during pediatric hospitalization. Thematic analysis of interviews with 28 parents revealed benefits like information recall and autonomy, with challenges including receiving bad news before face-to-face communication. The study found that parents with limited literacy found notes especially helpful for understanding the care of the child while reducing worry. Simplifying medical terms could enhance note accessibility for all parents, ensuring equitable access to healthcare information.
AHRQ-funded; HS027214.
Citation: Nacht CL, Jacobson N, Shiyanbola O .
Perception of physicians' notes among parents of different health literacy levels.
Hosp Pediatr 2024 Feb; 14(2):108-15. doi: 10.1542/hpeds.2023-007240.
Keywords: Children/Adolescents, Health Literacy, Caregiving, Clinician-Patient Communication, Communication
Clark SE, Bautista L, Neeb K
Post-acute sequelae of SARS-CoV-2 (PASC) in nursing home residents: a retrospective cohort study.
This retrospective cohort study was conducted at two nursing homes in Michigan to explore post-acute sequelae of SARS-CoV-2 (PASC) among residents. Minimum Data Set was used to examine trajectories of functional dependence and cognitive function. The results suggested that nursing-home residents experienced a significant functional decline persisting for nine months following acute infection. The authors concluded that further research is needed to determine whether increased rehabilitation services after COVID-19 may help mitigate this decline.
AHRQ-funded; 1HS025451.
Citation: Clark SE, Bautista L, Neeb K .
Post-acute sequelae of SARS-CoV-2 (PASC) in nursing home residents: a retrospective cohort study.
J Am Geriatr Soc 2024 Feb; 72(2):551-58. doi: 10.1111/jgs.18678.
Keywords: COVID-19, Nursing Homes