National Healthcare Quality and Disparities Report
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Topics
- Ambulatory Care and Surgery (1)
- Asthma (1)
- Behavioral Health (1)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (1)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Communication (3)
- Critical Care (1)
- Data (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (4)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (4)
- Heart Disease and Health (1)
- Hospitalization (2)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Learning Health Systems (1)
- Nursing (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Orthopedics (2)
- (-) Outcomes (14)
- Palliative Care (1)
- (-) Patient-Centered Healthcare (14)
- Patient-Centered Outcomes Research (13)
- Patient and Family Engagement (2)
- Patient Experience (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Rehabilitation (1)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Surgery (2)
- Teams (2)
- Transitions of Care (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 14 of 14 Research Studies DisplayedGraber J, Kittelson A, Juarez-Colunga E
Comparing "people-like-me" and linear mixed model predictions of functional recovery following knee arthroplasty.
This study compared the relative strengths and weaknesses of 2 prediction model approaches for predicting functional recovery after knee arthroplasty: a neighbors-based "people-like-me" (PLM) approach and a linear mixed model (LMM) approach. The authors used 2 distinct datasets to train and then test PLM and LMM prediction approaches. They used the Timed Up and Go (TUG)-a common test of mobility-to operationalize physical function. Both approaches use patient characteristics and baseline postoperative TUG values to predict TUG recovery from days 1-425 following surgery. They then compared the accuracy and precision of the two approaches. A total of 317 patient records with 1379 TUG observations were used to train approaches, and 456 patient records with 1244 TUG observations were used to test the predictions. Both approaches performed similarly in terms of mean squared error and bias, but the PLM approach provided more accurate and precise estimates of prediction uncertainty.
AHRQ-funded; HS025692.
Citation: Graber J, Kittelson A, Juarez-Colunga E .
Comparing "people-like-me" and linear mixed model predictions of functional recovery following knee arthroplasty.
J Am Med Inform Assoc 2022 Oct 7;29(11):1899-907. doi: 10.1093/jamia/ocac123..
Keywords: Orthopedics, Surgery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes
Keeney T, Kumar A, Erler KS
Making the case for patient-reported outcome measures in big-data rehabilitation research: implications for optimizing patient-centered care.
This article discussed the potential of patient-reported outcome measures (PROMs) to transform clinical practice. It also provided examples of health systems that use PROMs to guide care and identified barriers to aggregating data from PROMs in conducting health services research. The authors proposed two priority areas which could help advance rehabilitation health services research: standardization of collecting PROMs data in electronic health records and increased partnerships between rehabilitation providers, researchers, and payors.
AHRQ-funded; HS000011.
Citation: Keeney T, Kumar A, Erler KS .
Making the case for patient-reported outcome measures in big-data rehabilitation research: implications for optimizing patient-centered care.
Arch Phys Med Rehabil 2022 May; 103(5s):S140-s45. doi: 10.1016/j.apmr.2020.12.028..
Keywords: Rehabilitation, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Health Information Technology (HIT), Outcomes
Aiyegbusi OL, Nair D, Peipert JD
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
This review discusses and summarizes evidence of the impact of electronic patient-reported outcomes measures (ePROMs) on clinical parameters and outcomes relevant to chronic diseases. Various studies have demonstrated the feasibility of ePROMs in routine clinical practice with patients increasing expressing a preference for an electronic mode of administration. These ePROMs could have significant impacts on outcomes valued by patients, healthcare providers, and researchers. Recently published literature.
AHRQ-funded; HS026395.
Citation: Aiyegbusi OL, Nair D, Peipert JD .
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
Ther Adv Chronic Dis 2021 May 24;12:20406223211015958. doi: 10.1177/20406223211015958..
Keywords: Chronic Conditions, Patient Experience, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice
Bell N, Wilkerson R, Mayfield-Smith K
Community social determinants and health outcomes drive availability of patient-centered medical homes.
This study assessed the geographic distribution of patient-centered medical homes and the community social determinants and health outcomes that drive availability. The authors assessed spatial clusters of mental and physical health surveys; health behaviors; as well as premature mortality with clusters of medical home saturation and community socioeconomic characteristics. Counties having lower uninsured rates and lower poverty rates were more likely to have medical homes.
AHRQ-funded; HS026263.
Citation: Bell N, Wilkerson R, Mayfield-Smith K .
Community social determinants and health outcomes drive availability of patient-centered medical homes.
Health Place 2021 Jan;67:102439. doi: 10.1016/j.healthplace.2020.102439..
Keywords: Social Determinants of Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes
Nijhawan AE, Bhattatiry M, Chansard M
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
Hospitalization represents an opportunity to re-engage out-of-care individuals, improve HIV outcomes, and reduce health disparities. The authors reviewed electronic health records of HIV-positive individuals hospitalized at an urban, public hospital between September 2013 and December 2015. They found that hospitalized patients with HIV had low rates of engagement in care, retention in care, and virologic suppression, though all three outcomes improved after hospitalization. A multidisciplinary transitions team improved care engagement and virologic suppression in those who received the intervention.
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Bhattatiry M, Chansard M .
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
AIDS Care 2020 Nov;32(11):1343-52. doi: 10.1080/09540121.2019.1698704.
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Keywords: Human Immunodeficiency Virus (HIV), Transitions of Care, Inpatient Care, Teams, Hospitalization, Patient and Family Engagement, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Kelly Costa D, Liu H, Boltey EM
The structure of critical care nursing teams and patient outcomes: a network analysis.
This examined the connectiveness of critical nursing teams and patient outcomes. The study measured “coreness” (the degree to which a network is represented by a densely integrated core) and “betweenness” (whether a nurse lies on the path of others not directly connected). The researchers used ICU data from a medical center during 2011 and looked at nurses who worked in surgical ICU (SICU) or neurosurgical ICU (NICU) during that same time period. The sample included 598 adult patients and 281 nurses. The researchers found that the greater the coreness of the team, and the more betweenness there was with ICU nurses the less likely patients were to die.
AHRQ-funded; HS024552.
Citation: Kelly Costa D, Liu H, Boltey EM .
The structure of critical care nursing teams and patient outcomes: a network analysis.
Am J Respir Crit Care Med 2020 Feb 15;201(4):483-85. doi: 10.1164/rccm.201903-0543LE..
Keywords: Intensive Care Unit (ICU), Critical Care, Nursing, Teams, Outcomes, Healthcare Delivery, Patient-Centered Outcomes Research, Patient-Centered Healthcare
Patel MR, Smith A, Leo H
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
This study assessed the effectiveness of providing physicians who use electronic health records (EHRs) education for communication strategies and its impact on patient outcomes. The evidence-based Physician Asthma Care Education (PACE) program was extended in a pilot program using 18 providers and 126 adult patients with persistent asthma. Outcomes were assessed at baseline and 3- and 6-month postintervention intervals. Providers who completed the EHR-PACE program felt more confident in communicating with their patients, but there was no significant changes in patient asthma outcomes or their perceptions of their provider’s communication skills.
AHRQ-funded; HS023786.
Citation: Patel MR, Smith A, Leo H .
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
Health Educ Behav 2019 Jun;46(3):484-93. doi: 10.1177/1090198118796879..
Keywords: Asthma, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Fish-Trotter H, Collins SP, Danagoulian S
Design and rationale of a randomized trial: using short stay units instead of routine admission to improve patient centered health outcomes for acute heart failure patients (SSU-AHF).
The evidence for existing acute heart failure (AHF) therapies are poor; currently used AHF treatment do not reliably improve long-term outcomes and emergency department treatment has changed little in 40 years. The authors of this article propose a robust clinical effectiveness trial to demonstrate the effectiveness of short-stay units for the management of AHF for lower-risk patients.
AHRQ-funded; HS025411.
Citation: Fish-Trotter H, Collins SP, Danagoulian S .
Design and rationale of a randomized trial: using short stay units instead of routine admission to improve patient centered health outcomes for acute heart failure patients (SSU-AHF).
Contemp Clin Trials 2018 Sep;72:137-45. doi: 10.1016/j.cct.2018.08.003..
Keywords: Patient-Centered Healthcare, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Outcomes, Hospitalization
Pellegrini CA, Chang RW, Dunlop DD
Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: a pilot study.
This article reports the results of a randomized pilot study that assessed changes in weight during a Patient Centered Weight Loss Program (PACE) initiated either before or after knee replacement. The feasibility of recruiting and retaining participants over 26 weeks was also examined. Recruitment outreach was extended to patients scheduled for knee replacement. Sixteen participants were randomly assigned to a 14-session weight loss program that started either at least 6 weeks before surgery or at 12 weeks following surgery. The authors conclude that behavioral intervention is challenging but feasible in a knee replacement population. Preliminary evidence suggests that initiating a program 12 weeks after surgery produces greater weight losses at 26 weeks when compared to a program that begins before knee replacement.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Chang RW, Dunlop DD .
Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: a pilot study.
Obes Res Clin Pract 2018 Sep - Oct;12(5):472-78. doi: 10.1016/j.orcp.2018.06.009..
Keywords: Orthopedics, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Obesity: Weight Management, Surgery, Obesity, Outcomes
Kamal AH, Kirkland KB, Meier DE
A person-centered, registry-based learning health system for palliative care: a path to coproducing better outcomes, experience, value, and science.
In this paper, the authors discuss measurement of the impact of palliative care, which is critical for determining what works for which patients in what settings, to learn, improve care, and ensure access to high value care for people with serious illness. The authors described an approach to codesigning and implementing a palliative care registry that functions as a learning health system, by combining patient and family inputs and clinical data to support person-centered care, quality improvement, accountability, transparency, and scientific research.
AHRQ-funded; HS023681.
Citation: Kamal AH, Kirkland KB, Meier DE .
A person-centered, registry-based learning health system for palliative care: a path to coproducing better outcomes, experience, value, and science.
J Palliat Med 2018 Mar;21(S2):S61-s67. doi: 10.1089/jpm.2017.0354..
Keywords: Palliative Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Learning Health Systems, Registries, Patient and Family Engagement
Yanez BR, Buitrago D, Buscemi J
Study design and protocol for My Guide: an e-health intervention to improve patient-centered outcomes among Hispanic breast cancer survivors.
This article describes a randomized controlled trial designed to investigate the feasibility and efficacy of a Smartphone application intended to improve health-related quality of life (HRQoL) among Hispanic breast cancer survivors. Participants are randomized to receive either the intervention application My Guide, or the health education control condition application My Health for six weeks, and also receive weekly telecoaching to enhance adherence to both applications. The study's outcomes are measured prior to intervention, immediately after, and eight weeks following initial application use.
AHRQ-funded; HS023011.
Citation: Yanez BR, Buitrago D, Buscemi J .
Study design and protocol for My Guide: an e-health intervention to improve patient-centered outcomes among Hispanic breast cancer survivors.
Contemp Clin Trials 2018 Feb;65:61-68. doi: 10.1016/j.cct.2017.11.018..
Keywords: Cancer, Cancer: Breast Cancer, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Quality of Life, Racial and Ethnic Minorities, Women
Arcia A, Woollen J, Bakken S
A systematic method for exploring data attributes in preparation for designing tailored infographics of patient reported outcomes.
Tailored visualizations of patient reported outcomes (PROs) are valuable health communication tools to support shared decision making, health self-management, and engagement with research participants, such as cohorts in the NIH Precision Medicine Initiative. The authors of the study present a systematic method to exploring data attributes, with a specific focus on application to self-reported health data. They present two case studies to illustrate how this method affected design decisions particularly with respect to outlier and non-missing zero values.
AHRQ-funded; HS019853; HS022961.
Citation: Arcia A, Woollen J, Bakken S .
A systematic method for exploring data attributes in preparation for designing tailored infographics of patient reported outcomes.
eGEMS 2018 Jan 24;6(1):2. doi: 10.5334/egems.190..
Keywords: Communication, Shared Decision Making, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Data
Bickman L, Douglas SR, De Andrade AR
Implementing a measurement feedback system: a tale of two sites.
A randomized experiment was conducted in two outpatient clinics evaluating contextualized feedback systems. Only one of the two participating clinics had an enhanced outcome because of feedback. Clinicians' questionnaire completion rate and feedback viewing were 50 % higher at this clinic. The discussion focused on the differences in implementation at each site and how these differences may have contributed to the different outcomes of the experiment.
AHRQ-funded; HS018036.
Citation: Bickman L, Douglas SR, De Andrade AR .
Implementing a measurement feedback system: a tale of two sites.
Adm Policy Ment Health 2016 May;43(3):410-25. doi: 10.1007/s10488-015-0647-8.
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Keywords: Behavioral Health, Outcomes, Ambulatory Care and Surgery, Patient-Centered Healthcare
Borden WB, Chiang YP, Kronick R
AHRQ Author: Kronick, R
Bringing patient-centered outcomes research to life.
Achieving better health outcomes requires both the generation of new patient-centered outcomes research (PCOR) knowledge and the appropriate and timely dissemination of that knowledge into practice. This article highlights the work AHRQ has done, is doing, and will do to improve the uptake of PCOR findings.
AHRQ-authored
Citation: Borden WB, Chiang YP, Kronick R .
Bringing patient-centered outcomes research to life.
Value Health. 2015 Jun;18(4):355-7. doi: 10.1016/j.jval.2015.01.010..
Keywords: Communication, Evidence-Based Practice, Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Implementation