New AHRQ Research Review Updates Findings on Treatment of Clostridium difficile Infections

Issue 513
AHRQ's Electronic Newsletter summarizes Agency research and programmatic activities.
April 12, 2016

AHRQ Stats: Disparities in Access to Care

Blacks ranked lower than whites on 12 of 22 measures commonly used to evaluate access to health care in 2013. For example, 20 percent of blacks reported delays in care compared with 13 percent of whites. (Source: Agency for Healthcare Research and Quality, National Healthcare Quality and Disparities Report, Chartbook on Health Care for Blacks.)

Today's Headlines

  1. New AHRQ Research Review Updates Findings on Treatment of Clostridium difficile Infections.
  2. Health Affairs Issue Features AHRQ-Funded Research on Consumer Engagement.
  3. New Research and Data From AHRQ.
  4. Register Now for Health Datapalooza.
  5. Medical Care Received by Minority Military Veterans Examined in New AHRQ Study.
  6. AHRQ Study Shows Link Between Electronic Medical Record Tasks and Physician Performance.
  7. AHRQ in the Professional Literature.

1. New AHRQ Research Review Updates Findings on Treatment of Clostridium difficile Infections

A new AHRQ research review updates findings on the treatment of Clostridium difficile (C. difficile) infections, a serious health care-associated infection that can be difficult to treat. Researchers reviewed 93 studies and concluded that the antibiotic vancomycin is more effective than metronidazole for initial treatment of C. difficile. But for prevention of recurrent C. difficile, fidaxomicin is more effective than vancomycin, the review found. C. difficile is becoming more common in the United States and globally, and extremely infectious strains have emerged since 2000. There were an estimated 293,000 cases of C. difficile in the United States in 2011. About 55 of every 100,000 infected people 65 and older will die, making C. difficile the 17th leading cause of death in this age group. Early diagnosis and effective treatment, including appropriate use of antibiotics, are essential. The review also concluded that nucleic acid amplification tests are effective for diagnosing C. difficile, and that, while research is limited, fecal transplantation and probiotics may be effective treatments. Access the report.

2. Health Affairs Issue Features AHRQ-Funded Research on Consumer Engagement

April’s themed issue of Health Affairs examines consumers’ use of evidence in making health care decisions. It features four articles by AHRQ-funded researchers on consumer engagement in health care, including patient-reported outcomes, public deliberation and public reporting. Access abstracts to the four articles:

In addition, the issue features a personal narrative from Cindy Brach, MPP, a senior health policy researcher at AHRQ, titled Even In An Emergency, Doctors Must Make Informed Consent An Informed Choice. Read an AHRQ Views blog post from AHRQ Acting Director Sharon B. Arnold, Ph.D., about this research.

3. New Research and Data From AHRQ

4. Register Now for Health Datapalooza

Registration is open for Health Datapalooza, May 8-11 in Washington, D.C. Health Datapalooza brings together people and organizations creating knowledge from data and pioneering innovations to drive health policy and practice. At this conference, you’ll learn how data sharing, use and transparency fuel innovative applications and business models for value-driven health care.

5. Medical Care Received by Minority Military Veterans Examined in New AHRQ Studyty

A new AHRQ-funded study suggests that minority military veterans are getting disproportionately less care at Veterans Health Administration (VHA) facilities that have not fully adopted Patient Aligned Care Team (PACT). PACT is based on the patient-centered medical home model of medical teams that provide proactive, personalized patient care geared toward wellness and disease prevention. Because most minority veterans obtain care at VHA facilities that are less likely to have implemented PACT, they may not benefit from likely improvements in care if PACT had been in place, according to the study. However, the authors added that disparities may be due to variations in care across different VHA facilities, rather than minorities being treated differently than whites at the same facilities. The analysis included nearly 830 VHA outpatient primary care facilities serving 6 million veterans during FY 2012. Facilities were categorized as "high," "medium" and "low" based on the percentage of their minority patients. The study found that facilities with higher percentages of minority patients were associated with lower levels of PACT implementation. The study, "A First Look at PCMH Implementation for Minority Veterans: Room for Improvement," and abstract were published in the March issue of Medical Care.

6. AHRQ Study Shows Link Between Electronic Medical Record Tasks and Physician Performance

Among physicians using electronic medical records (EMRs), performance is impacted by "task demands" such as computer pointer movements, click behavior and task duration, according to a new AHRQ-funded study. Using a simulated environment, researchers explored the relationship between task demands and workload, task demands and performance and workload and performance. Researchers performed two experiments on two different EMR systems. Each physician completed a set of pre-specified tasks on three routine clinical EMR-based scenarios: urinary tract infection, pneumonia and heart failure. Both experiments showed a significant relationship only between task demands and performance. This result suggests that task demands (such as more clicks or more time) are related to physician performance (such as more omission errors). The authors called for more research to learn whether human-computer behavioral data, as well as time spent to complete EMR-based tasks, could be used as a quality metric to represent performance and perhaps patient outcomes. The study, "Towards a Better Understanding of Task Demands, Workload, and Performance During Physician-Computer Interactions," appeared in the March 28 issue of the Journal of the American Medical Informatics Association. Access the abstract.

7. AHRQ in the Professional Literature

Change score or followup score? Choice of mean difference estimates could impact meta-analysis conclusions. Fu R, Holmer HK. J Clin Epidemiol 2016 Feb 27 [Epub ahead of print]. Access the abstract in PubMed®.

Expenditures for persons living with HIV enrolled in Medicaid, 2006-2010. Fleishman JA, Monroe AK, Voss CC, et al. J Acquir Immune Defic Syndr 2016 Mar 11 [Epub ahead of print]. Access the abstract in PubMed®.

Validation of the pregnancy asthma control test. Palmsten K, Schatz M, Chan PH, et al. J Allergy Clin Immunol Pract 2016 Mar-Apr;4(2):310-15.e1. Epub 2016 Jan 5. Access the abstract in PubMed®.

Optimizing patient-centered communication and multidisciplinary care coordination in emergency diagnostic imaging: A research agenda. Sabbatini AK, Merck LH, Froemming AT, et al. Acad Emerg Med 2015 Dec;22(12):1427-34. Epub 2015 Nov 17. Access the abstract in PubMed®.

Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial. Persell SD, Brown T, Lee JY. et al. Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):560-6. Epub 2015 Nov 10. Access the abstract in PubMed®.

Association between clinician computer use and communication with patients in safety-net clinics. Ratanawongsa N, Barton JL, Lyles CR, et. al. JAMA Intern Med 2016 Jan 1;176(1):125-8. Access the abstract in PubMed®.

Monte Carlo analysis of payer and provider risks in shared savings arrangements. DeLia D. Med Care Res Rev 2015 Nov 27 [Epub ahead of print]. Access the abstract in PubMed®.

Team science approach to developing consensus on research good practices for practice-based research networks: a case study. Campbell-Voytal K, Daly JM, Nagykaldi ZJ, et al. Clin Transl Sci 2015 Dec;8(6):632-7. Epub 2015 Nov 25. Access the abstract in PubMed®.

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Page last reviewed April 2016
Page originally created April 2016
Internet Citation: New AHRQ Research Review Updates Findings on Treatment of Clostridium difficile Infections. Content last reviewed April 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/513.html