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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 71 Research Studies DisplayedKostick-Quenet KM, Lang B, Dorfman N
Patients' and physicians' beliefs and attitudes towards integrating personalized risk estimates into patient education about left ventricular assist device therapy.
This study explored stakeholder attitudes toward the utility, acceptability, usefulness, and best practices for integrating personalized risk (PR) estimates into patient education and decision making about Left Ventricular Assist Device (LVAD). This was a 5-year multi-institutional AHRQ project where the authors conducted 40 interviews with stakeholders (physicians, nurse coordinators, patients, and caregivers) and analyzed using Thematic Content Analysis. All stakeholder groups voiced positive views towards PR integration in decision making. Physicians felt PR can improve their decision making by enhancing insight into outcomes, enhance tailored pre-emptive care, increase confidence in decisions, and reduce bias and subjectivity. All stakeholder groups raised concerns about accuracy, representativeness and relevance of algorithms; predictive uncertainty; utility in relation to physician's expertise; potential negative reactions among patients; and overreliance.
AHRQ-funded; HS027784.
Citation: Kostick-Quenet KM, Lang B, Dorfman N .
Patients' and physicians' beliefs and attitudes towards integrating personalized risk estimates into patient education about left ventricular assist device therapy.
Patient Educ Couns 2024 May; 122:108157. doi: 10.1016/j.pec.2024.108157.
Keywords: Education: Patient and Caregiver, Risk, Cardiovascular Conditions
Ashburn NP, McCord JK, Snavely AC
Navigating the observation zone: do risk scores help stratify patients with indeterminate high-sensitivity cardiac troponins?
In this research letter the authors described their secondary analysis of the High-Sensitivity Cardiac Troponin I Assays in the United States (HIGH-US) study; their purpose was to assess the best way to evaluate observation zone patients who did not have an ischemic ECG. Their primary finding was that risk scores were unlikely to identify a subset of observation zone patients for early discharge without further monitoring, additional troponin measures, and stress testing or coronary angiography.
AHRQ-funded; HS029017.
Citation: Ashburn NP, McCord JK, Snavely AC .
Navigating the observation zone: do risk scores help stratify patients with indeterminate high-sensitivity cardiac troponins?
Circulation 2024 Jan 2; 149(1):70-72. doi: 10.1161/circulationaha.123.065030..
Keywords: Cardiovascular Conditions, Risk
Devine JW, Tadrous M, Hernandez I
A retrospective cohort study of the 2018 angiotensin receptor blocker recalls and subsequent drug shortages in patients with hypertension.
Researchers compared the risk of adverse events between hypertensive patients who used valsartan and a propensity score-matched group who used nonrecalled angiotensin receptor blockers and angiotensin-converting enzyme inhibitors. Valsartan usage at the time of its recall was associated with higher risks of all-cause hospitalization, emergency department or urgent care use, and the composite of cardiac events within 6 months after the recall. The valsartan recall and shortage affected hypertensive patients. Local- and national-level systems need to be enhanced to protect patients from drug shortages by providing safe and reliable medication alternatives.
AHRQ-funded; HS027985.
Citation: Devine JW, Tadrous M, Hernandez I .
A retrospective cohort study of the 2018 angiotensin receptor blocker recalls and subsequent drug shortages in patients with hypertension.
J Am Heart Assoc 2024 Jan 2; 13(1):e032266. doi: 10.1161/jaha.123.032266.
Keywords: Blood Pressure, Medication, Cardiovascular Conditions
Engelberg RS, Scheidell JD, Islam N
Associations between incarceration history and risk of hypertension and hyperglycemia: consideration of differences among Black, Hispanic, Asian and White Subgroups.
This study’s objective was to assess racial/ethnic group differences in the association between incarceration and hypertension and hyperglycemia. The authors performed a secondary data analysis using the National Longitudinal Survey of Adolescent to Adult Health (Add Health). They used Poisson regression to estimate the associations between lifetime history of incarceration reported during early adulthood with hypertension and hyperglycemia outcomes measured in mid-adulthood, including incident diagnosis. They evaluated whether associations varied by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and Asian) with an analytic sample of 4,015 Add Health respondents. Outcome measures included hypertension, systolic blood pressure >130 mmHG, and hyperglycemia. There was no evidence of an association between incarceration and measured health outcomes among non-Hispanic Black and non-Hispanic White participants. Among Hispanic participants, incarceration was associated with hyperglycemia (Adjusted Risk Ratio (ARR): 2.1), but not with hypertension risk. Incarceration was associated with elevated systolic blood pressure (ARR: 3.1) and hypertension (ARR: 1.7) among Asian participants, but not with hyperglycemia risk. Incarceration was associated with incident hypertension (ARR 2.5) among Asian subgroups.
AHRQ-funded; HS026120.
Citation: Engelberg RS, Scheidell JD, Islam N .
Associations between incarceration history and risk of hypertension and hyperglycemia: consideration of differences among Black, Hispanic, Asian and White Subgroups.
J Gen Intern Med 2024 Jan; 39(1):5-12. doi: 10.1007/s11606-023-08327-9..
Keywords: Vulnerable Populations, Racial and Ethnic Minorities, Blood Pressure, Cardiovascular Conditions, Risk
Quinn M, Horowitz JK, Krein SL
The role of hospital-based vascular access teams and implications for patient safety: a multi-methods study.
The purpose of this study was to examine the roles, functions, and composition of vascular access teams (VATs) related to the use and management of PICC and midline catheters. The researchers administered an online survey of 62 hospitals participating in a quality improvement consortium and qualitative interviews with 74 hospital-based clinicians in 10 sites. The study found that more than 77% of hospitals had an on-site VAT. The average team size was seven nurses; their main function was device insertion. Findings from the interviews revealed variations in team characteristics and functions. Interviewees characterized the broad role that teams play in device insertion, care, and removal, and in educating/training hospital staff. The researchers found that teams' role in decision making, especially related to appropriate device selection, was limited an was met with physician resistance in some cases.
AHRQ-funded; HS025891.
Citation: Quinn M, Horowitz JK, Krein SL .
The role of hospital-based vascular access teams and implications for patient safety: a multi-methods study.
J Hosp Med 2024 Jan; 19(1):13-23. doi: 10.1002/jhm.13253..
Keywords: Patient Safety, Inpatient Care, Cardiovascular Conditions
Chrisinger BW, Grossestreuer AV, Laguna MC
Characteristics of automated external defibrillator coverage in Philadelphia, PA, based on land use and estimated risk.
The authors investigated how well the likelihood of out-of-hospital cardiac arrest was met by the supply of automated external defibrillators (AED) in a dense urban environment. This article offers one method by which local officials can use spatial data to prioritize attention for AED placement and coverage.
AHRQ-funded; HS018362.
Citation: Chrisinger BW, Grossestreuer AV, Laguna MC .
Characteristics of automated external defibrillator coverage in Philadelphia, PA, based on land use and estimated risk.
Resuscitation 2016 Dec;109:9-15. doi: 10.1016/j.resuscitation.2016.09.021.
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Keywords: Medical Devices, Health Insurance, Urban Health, Cardiovascular Conditions
Vandigo J, Oloyede E, Aly A
Continuous patient engagement in cardiovascular disease clinical comparative effectiveness research.
The Patient-Centered Outcomes Research Institute has created an Engagement Rubric to guide meaningful engagement in the research process. A 10-step systematic framework to enhance patient engagement throughout the comparative effectiveness research process also has been proposed. This special report identifies the relationship between these two approaches to patient engagement and describes examples of how patients could be engaged in a hypothetical CVD study.
AHRQ-funded; HS022135.
Citation: Vandigo J, Oloyede E, Aly A .
Continuous patient engagement in cardiovascular disease clinical comparative effectiveness research.
Expert Rev Pharmacoecon Outcomes Res 2016;16(2):193-8. doi: 10.1586/14737167.2016.1163222.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Patient-Centered Outcomes Research, Patient and Family Engagement
Yakoob MY, Micha R, Khatibzadeh S
Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia: analysis from the 2010 Global Burden of Disease Study.
This article's objective is to quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. The authors used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. They found suboptimal diet to be the leading cuase of cardiometabolic mortality in 4 of 5 countries. They concluded that important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities.
AHRQ-funded; HS000062.
Citation: Yakoob MY, Micha R, Khatibzadeh S .
Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia: analysis from the 2010 Global Burden of Disease Study.
Am J Public Health 2016 Dec;106(12):2113-25. doi: 10.2105/ajph.2016.303368.
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Keywords: Cardiovascular Conditions, Diabetes, Mortality, Risk
Flory JH, Ukena JK, Floyd JS
Novel anti-glycemic drugs and reduction of cardiovascular risk in diabetes: expectations realized, promises unmet.
The researchers review evidence on cardiovascular risks and benefits of new treatments for type 2 diabetes mellitus. Their review reports new evidence suggesting that the newest diabetes drugs are safe from a cardiovascular perspective. Evidence on benefit from at least some members of the GLP-1 receptor agonist and SGLT-2 inhibitor classes is encouraging but not yet decisive.
AHRQ-funded; HS023898.
Citation: Flory JH, Ukena JK, Floyd JS .
Novel anti-glycemic drugs and reduction of cardiovascular risk in diabetes: expectations realized, promises unmet.
Curr Atheroscler Rep 2016 Dec;18(12):79. doi: 10.1007/s11883-016-0633-y.
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Keywords: Patient-Centered Outcomes Research, Medication, Diabetes, Cardiovascular Conditions, Risk
Bachmann JM, Goggins KM, Nwosu SK
Perceived health competence predicts health behavior and health-related quality of life in patients with cardiovascular disease.
The authors sought to evaluate the effect of perceived health competence on health behavior and health-related quality of life. They found that perceived health competence was highly associated with health behaviors and health-related quality of life, while low perceived health competence was associated with a decrease in health-related quality of life between hospitalization and 90 days after discharge. They concluded that perceived health competence predicts health behavior and health-related quality of life in patients hospitalized with cardiovascular disease as well as change in health-related quality of life after discharge.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Goggins KM, Nwosu SK .
Perceived health competence predicts health behavior and health-related quality of life in patients with cardiovascular disease.
Patient Educ Couns 2016 Dec;99(12):2071-79. doi: 10.1016/j.pec.2016.07.020.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Health Literacy, Patient Adherence/Compliance, Quality of Life
Prey JE, Qian M, Restaino S
Reliability and validity of the patient activation measure in hospitalized patients.
The objectives of this article are to describe the internal consistency reliability and construct validity of the PAM-13 for hospitalized cardiology and oncology patients and to examine the predictors of low patient activation in the same population. The authors found that patients with unplanned admissions were more likely to have low activation than patients with planned admissions. They also found that PAM-13 was modestly correlated with each of the PROMIS Global Health components: global, physical and mental health. They concluded that this study demonstrates the PAM-13 is a reliable and valid measure for use in the inpatient hospital setting and that type of admission is an important predictor of patient activation.
AHRQ-funded; HS021816.
Citation: Prey JE, Qian M, Restaino S .
Reliability and validity of the patient activation measure in hospitalized patients.
Patient Educ Couns 2016 Dec;99(12):2026-33. doi: 10.1016/j.pec.2016.06.029.
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Keywords: Cancer, Cardiovascular Conditions, Hospitalization, Inpatient Care, Patient and Family Engagement
Chou R, Dana T, Blazina I
Statins for prevention of cardiovascular disease in adults: Evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this report systematically reviewed benefits and harms of statins for prevention of cardiovascular disease (CVD), in order to inform the US Preventive Services Task Force. It concluded that in adults at increased CVD risk but without prior CVD events, statin therapy was associated with reduced risk of all-cause and cardiovascular mortality and CVD events, with greater absolute benefits in patients at greater baseline risk.
AHRQ-funded; 2902012000015I.
Citation: Chou R, Dana T, Blazina I .
Statins for prevention of cardiovascular disease in adults: Evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Nov 15;316(19):2008-24. doi: 10.1001/jama.2015.15629.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Cardiovascular Conditions, Medication, Evidence-Based Practice
Hollingsworth JM, Funk RJ, Garrison SA
Association between physician teamwork and health system outcomes after coronary artery bypass grafting.
The researchers tested whether teamwork (assessed with the bipartite clustering coefficient) among multiple providers dispersed across many care locations is a determinant of surgical outcomes by examining national Medicare data from patients undergoing CABG. They found that health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality.
AHRQ-funded; HS020927.
Citation: Hollingsworth JM, Funk RJ, Garrison SA .
Association between physician teamwork and health system outcomes after coronary artery bypass grafting.
Circ Cardiovasc Qual Outcomes 2016 Nov;9(6):641-48. doi: 10.1161/circoutcomes.116.002714.
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Keywords: Teams, Outcomes, Medicare, Surgery, Hospital Readmissions, Cardiovascular Conditions
Riehle-Colarusso TJ, Bergersen L, Broberg CS
AHRQ Author: Gray DT
Databases for congenital heart defect public health studies across the lifespan.
Key experts and stakeholders have identified public health knowledge gaps about congenital heart defects (CHDs). These gaps, and strategies to address them, formed the basis of a CHD public health science agenda. The strategies included leveraging information in existing databases to examine the epidemiology, health outcomes, and health service utilization of the CHD population. The authors discuss this complex constellation of databases, their relative characteristics and possible linkages.
AHRQ-authored.
Citation: Riehle-Colarusso TJ, Bergersen L, Broberg CS .
Databases for congenital heart defect public health studies across the lifespan.
J Am Heart Assoc 2016 Oct 26;5(11). doi: 10.1161/jaha.116.004148.
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Keywords: Cardiovascular Conditions, Public Health, Data
McNellis RJ, Beswick-Escanlar V
AHRQ Author: McNellis RJ
Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer.
This case study involves a a 55-year-old man who presents to your office for a routine refill of his antihypertension medication, his 65-year-old brother who also visits you to ask about taking low-dose aspirin, and his 55-year-old wife, also your patient, who recently experienced abdominal pain,. It poses three multiple choice questions focused on the use of low-dose aspirin, together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: McNellis RJ, Beswick-Escanlar V .
Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer.
Am Fam Physician 2016 Oct 15;94(8):661-62.
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Keywords: Cancer: Colorectal Cancer, Cardiovascular Conditions, Medication, Prevention, U.S. Preventive Services Task Force (USPSTF), Case Study
Parchman ML, Fagnan LJ, Dorr DA
Study protocol for "Healthy Hearts Northwest": a 2 x 2 randomized factorial trial to build quality improvement capacity in primary care.
The researchers describe the protocol of the "Healthy Hearts Northwest" (H2N) study, a randomized trial designed to address to quality improvement (QI) capacity within smaller primary care practices while improving risk factors for cardiovascular disease. The study is utilizing a two-by-two factorial design to assess four different combinations of practice support: practice facilitation (PF) alone, PF with educational outreach, PF with shared learning opportunities, or PF with both.
AHRQ-funded; HS023908.
Citation: Parchman ML, Fagnan LJ, Dorr DA .
Study protocol for "Healthy Hearts Northwest": a 2 x 2 randomized factorial trial to build quality improvement capacity in primary care.
Implement Sci 2016 Oct 13;11(1):138.
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Keywords: Primary Care, Evidence-Based Practice, Quality Improvement, Patient-Centered Outcomes Research, Cardiovascular Conditions
Sumner JA, Khodneva Y, Muntner P
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
Using data from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study, the authors examined associations among depressive symptoms and stress, alone and in combination, and incident cardiovascular disease (CVD) and all-cause mortality as a function of socioeconomic status. They found that screening for a combination of elevated depressive symptoms and stress in low-income persons may help identify those at increased risk of incident CVD and mortality.
AHRQ-funded; HS023009.
Citation: Sumner JA, Khodneva Y, Muntner P .
Effects of concurrent depressive symptoms and perceived stress on cardiovascular risk in low- and high-income participants: findings from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study.
J Am Heart Assoc 2016 Oct 10;5(10). doi: 10.1161/jaha.116.003930.
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Keywords: Cardiovascular Conditions, Depression, Social Determinants of Health, Stress, Stroke
Strobel RJ, Liang Q, Zhang M
A preoperative risk model for postoperative pneumonia after coronary artery bypass grafting.
The authors developed a preoperative prediction model for postoperative pneumonia after coronary artery bypass grafting (CABG). In this article, they describe and discuss their model, which may be used to provide individualized risk estimation and to identify opportunities to reduce a patient's preoperative risk of pneumonia through prehabilitation.
AHRQ-funded; HS022535.
Citation: Strobel RJ, Liang Q, Zhang M .
A preoperative risk model for postoperative pneumonia after coronary artery bypass grafting.
Ann Thorac Surg 2016 Oct;102(4):1213-9. doi: 10.1016/j.athoracsur.2016.03.074.
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Keywords: Cardiovascular Conditions, Pneumonia, Adverse Events, Risk, Patient Safety
Masterson Creber RM, Hickey KT, Maurer MS
Gerontechnologies for older patients with heart failure: what is the role of smartphones, tablets, and remote monitoring devices in improving symptom monitoring and self-care management?
The authors discussed the role of gerontechnologies, specifically the use of mobile applications available on smartphones and tablets as well as remote monitoring systems, for outpatient disease management among older adults with heart failure.
AHRQ-funded; HS021816.
Citation: Masterson Creber RM, Hickey KT, Maurer MS .
Gerontechnologies for older patients with heart failure: what is the role of smartphones, tablets, and remote monitoring devices in improving symptom monitoring and self-care management?
Curr Cardiovasc Risk Rep 2016 Oct;10(10). doi: 10.1007/s12170-016-0511-8.
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Keywords: Elderly, Telehealth, Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Patient Self-Management
Carney RM, Freedland KE, Steinmeyer BC
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
The purpose of this study was to determine whether collaborative care (CC) for patients who screen positive for depression during an outpatient cardiology visit results in greater improvement in depression symptoms and better medical outcomes than seen in patients who screen positive for depression but receive only usual care (UC). Tthis trial did not show that CC produces better depression outcomes than UC.
AHRQ-funded; HS018335.
Citation: Carney RM, Freedland KE, Steinmeyer BC .
Collaborative care for depression symptoms in an outpatient cardiology setting: a randomized clinical trial.
Int J Cardiol 2016 Sep 15;219:164-71. doi: 10.1016/j.ijcard.2016.06.045.
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Keywords: Care Management, Cardiovascular Conditions, Depression, Healthcare Delivery, Behavioral Health, Outcomes, Ambulatory Care and Surgery, Teams
Womack VY, De Chavez PJ, Albrecht SS
A longitudinal relationship between depressive symptoms and development of metabolic syndrome: the Coronary Artery Risk Development in Young Adults study.
The researchers tested whether baseline and time-varying depressive symptoms were associated with metabolic syndrome incidence in black and white men and women from the Coronary Artery Risk Development in Young Adults study. They found that, over 15 years, the incidence rate of metabolic syndrome varied by race and sex, with the highest rate in black women followed by white men, black men, and white women. Depressive symptoms were associated with incident metabolic syndrome in white men and white women. However, they found no significant association between depression and metabolic syndrome among black men or black women.
AHRQ-funded; HS023009.
Citation: Womack VY, De Chavez PJ, Albrecht SS .
A longitudinal relationship between depressive symptoms and development of metabolic syndrome: the Coronary Artery Risk Development in Young Adults study.
Psychosom Med 2016 Sep;78(7):867-73. doi: 10.1097/psy.0000000000000347.
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Keywords: Cardiovascular Conditions, Depression, Racial and Ethnic Minorities, Sex Factors, Young Adults
Adedinsewo D, Taka N, Agasthi P
Prevalence and factors associated with statin use among a nationally representative sample of US Adults: National Health and Nutrition Examination Survey, 2011-2012.
The researchers estimated the prevalence and likelihood of statin use among a statin benefit group with diabetes and a second group with arteriosclerosis. In adjusted models, uninsured and Hispanic adults were less likely to be on a statin compared with white adults; 59.5 percent of all adults in the diabetes statin benefit group, and 63.5 percent of all adults in the srteriosclerosis group were on a statin.
AHRQ-funded; HS022444.
Citation: Adedinsewo D, Taka N, Agasthi P .
Prevalence and factors associated with statin use among a nationally representative sample of US Adults: National Health and Nutrition Examination Survey, 2011-2012.
Clin Cardiol 2016 Sep;39(9):491-6. doi: 10.1002/clc.22577.
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Keywords: Cardiovascular Conditions, Diabetes, Medication, Disparities, Racial and Ethnic Minorities
Bangalore S, Guo Y, Xu J
Rates of invasive management of cardiogenic shock in New York before and after exclusion from public reporting.
The purpose of the study was to evaluate whether the referral rates for cardiac catheterization, percutaneous coronary intervention (PCI), or coronary artery bypass graft have improved in New York since cardiogenic shock was excluded from public reporting in 2008 and compare them with corresponding rates in Michigan, New Jersey, and California. Although rates of PCI, invasive management, and revascularization have increased substantially after the exclusion of cardiogenic shock from public reporting in New York, these rates remain consistently lower than those observed in other states without public reporting.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Xu J .
Rates of invasive management of cardiogenic shock in New York before and after exclusion from public reporting.
JAMA Cardiol 2016 Sep 1;1(6):640-7. doi: 10.1001/jamacardio.2016.0785..
Keywords: Healthcare Cost and Utilization Project (HCUP), Public Reporting, Surgery, Cardiovascular Conditions
Stillman AE, Gatsonis C, Lima JA
Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.
This article describes the RESCUE trial, which is based on the hypothesis that coronary computed tomography angiography as a diagnostic tool is associated with no increase in cardiac risk, decreased cost, and reduced radiation exposure compared with single photon emission computed tomography myocardial perfusion imaging.
AHRQ-funded; HS019403.
Citation: Stillman AE, Gatsonis C, Lima JA .
Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.
Am Heart J 2016 Sep;179:19-28. doi: 10.1016/j.ahj.2016.06.003.
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Keywords: Comparative Effectiveness, Imaging, Cardiovascular Conditions
Connor JA, Larson C, Baird J
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
The authors aimed to identify and develop standardized measures representative of pediatric nursing care of the cardiovascular patient for benchmarking within freestanding children's hospitals. The Consortium of Congenital Cardiac Care-Measurement of Nursing Practice members developed quality measures within working groups and then individually critiqued all drafted measures. The process resulted in 10 measures eligible for testing. The Consortium will continue with implementation and testing of each measure, supporting the development of benchmarks and the evaluation of the association of the measures with patient outcomes.
AHRQ-funded; HS000063.
Citation: Connor JA, Larson C, Baird J .
Use of a pediatric cardiovascular nursing consortium for development and evaluation of quality measures: The C4-MNP experience.
J Pediatr Nurs 2016 Sep-Oct;31(5):471-7. doi: 10.1016/j.pedn.2016.04.010.
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Keywords: Children/Adolescents, Cardiovascular Conditions, Nursing, Quality Measures, Hospitals