Advance Diagnostic Safety With AHRQ’s Evidence-Based Issue Briefs

Today’s Headlines:

• Advance Diagnostic Safety With AHRQ’s Evidence-Based Issue Briefs.
• Statistical Brief Compares Telehealth Use in Metropolitan, Nonmetropolitan Areas.
• Antibiotics Overprescribed for Many Pediatric Infections at Discharge.
• Targeted Interventions Improve Imaging Recommendations and Diagnostic Safety.
• Study Finds Over-the-Counter Hearing Aid Safe but Challenging to Set Up.
• Register for Upcoming Webinars.
• AHRQ Stats: Insurance Coverage for Heart Disease Treatment.  
• AHRQ in the Professional Literature.

Advance Diagnostic Safety With AHRQ’s Evidence-Based Issue Briefs

AHRQ’s Diagnostic Safety Issue Briefs provide accessible, evidence-based guidance to support healthcare systems in advancing diagnostic safety and quality. Each brief describes key concepts, examines emerging challenges, and highlights approaches that can be readily applied in practice. Explore the resources below to deepen your understanding and identify strategies that can strengthen diagnostic performance across your organization.

• Understanding the AI Wave: Foundational Knowledge for Improving Diagnosis and Beyond demystifies core artificial intelligence concepts and offers real-world examples to build foundational understanding. Grounded in evidence and informed by lessons from other high-risk industries, this issue brief provides practical, actionable guidance for healthcare leaders, clinicians, and patients.
• Four Pillars for Sustainable Centers of Excellence was developed to support AHRQ’s Diagnostic Center of Excellence grantees in shaping their sustainability plans. It provides recommendations, examples, and success stories that can benefit any type of Center of Excellence.
• Exploration of Foundational Terminology and Paradigms for Improving Diagnosis explores different diagnostic terminology and offers questions that can help define which terms and definitions are most suitable for discussions about diagnosis. 

Statistical Brief Compares Telehealth Use in Metropolitan, Nonmetropolitan Areas

As part of AHRQ’s stated priority to define appropriate and cost-effective use of telehealth, a new statistical brief from the agency’s Medical Expenditure Panel Survey (MEPS) project estimates the use of telehealth services between 2021 and 2023 for both rural and urban patients. Compared with patients in metropolitan areas, nonmetropolitan patients used telehealth services for a significantly smaller percentage of medical visits. While telehealth accounted for just over 26 percent of mental health visits in rural areas, urban patients used telehealth for nearly half of all mental health visits. The statistical brief also estimates telehealth use by insurance type and other patient and provider characteristics. Learn more. 

Antibiotics Overprescribed for Many Pediatric Infections at Discharge

Only one in five children discharged from the hospital with a diagnosis of infection received optimal prescriptions for antibiotics in both selection and duration, according to an AHRQ-funded study in Infection Control and Hospital Epidemiology. Researchers analyzed electronic health records from 1,206 encounters across four children’s hospitals with antibiotic stewardship programs throughout 2021, including 226 cases of community-acquired pneumonia, 417 urinary tract infections, and 563 skin or soft-tissue infections. They defined optimal prescribing as selecting medications and treatment durations recommended by national and hospital guidelines—for example, a 4- to 6-day course of amoxicillin for pneumonia. Overall, the choice of antibiotic was optimal in 77 percent of encounters, treatment duration was optimal in only 26 percent, and only 20 percent were optimal in choice and duration. The findings point to a need for stewardship interventions that target discharge prescribing, an area often overlooked in current programs. 

Targeted Interventions Improve Imaging Recommendations and Diagnostic Safety

An AHRQ-funded study in Radiology found that specific interventions reduced recommendations for additional imaging by 44 percent and made the remaining recommendations 7.6 times more actionable. About 10 percent of radiology exams include recommendations for additional imaging, which are meant to help clarify diagnoses but may contribute to unnecessary testing when not actionable. Researchers analyzed more than 7.5 million radiology reports from 1,323,459 patients across two hospitals between 2015 and 2022, comparing a control site with one that implemented targeted interventions. These interventions—radiologist education, a closed-loop tracking tool, and personalized feedback—reduced the rate of additional imaging recommendations from 10 percent to 5.6 percent and increased the proportion of actionable recommendations from 5.6 percent to 42.3 percent, while rates at the control site remained stable. The results highlight the potential for targeted interventions to improve patient safety by reducing diagnostic errors, while also promoting more efficient and appropriate use of imaging across radiologic subspecialties.

Study Finds Over-the-Counter Hearing Aid Safe but Challenging to Set Up

An over-the-counter hearing aid for adults with mild to moderate hearing loss is safe but could be difficult for users to set up, according to an AHRQ-funded study. Published in JMIR Human Factors. The study tested the hearing aid with 41 adults to see how easy and safe it was to use before release to the general public. Researchers also tested whether people who should not use the device, such as those with severe hearing loss or tinnitus, could recognize whether it was appropriate for them to use. Common problems among users included pairing the hearing aids with a phone and being able to tell the right and left earbuds apart. Researchers recommended clearer instructions, larger print, and more visible warnings on the box and in the app to help consumers use the device correctly and safely. The manufacturer addressed most of the identified issues prior to commercial release, demonstrating the benefit of rigorous human factors evaluation of over-the-counter medical devices. Access the study.

Register for Upcoming Webinars

• AHRQ Safety Program for HAI Prevention: CAUTI Informational Webinar:
  • January 13, 3–3:30 p.m. ET.
  • January 22, 2–2:30 p.m. ET.
• January 20, 1–3 p.m. ET: AHRQ Evidence-based Practice Center Program Grand Rounds session on Workplace Safety and Well-Being.

AHRQ Stats: Insurance Coverage for Heart Disease Treatment

Medicare paid for 57.6 percent of heart disease treatment costs in 2022, the most of any insurance type. Private insurance was the second most common coverage source, accounting for 24.2 percent of costs. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #562, Healthcare Expenditures for Heart Disease among Adults Aged 18 and Older in the U.S. Civilian Noninstitutionalized Population, 2022.)

AHRQ in the Professional Literature

Physician variation in adopting opportunistic salpingectomy at the time of postpartum and interval sterilization for ovarian cancer risk reduction. Yoh K, Desai VB, Gross CP, et al. Gynecol Oncol 2025 Nov;202:1-13. Epub 2025 Sep 10. Access the abstract on PubMed®.

Advances, challenges, and future directions in trauma-related Findable, Accessible, Interoperable, Reusable (FAIR) data efforts. O'Neil M, De Haan A, Sadeh Y, et al. J Trauma Stress 2025 Oct;38(5):793-802. Epub 2025 Sep 7. Access the abstract on PubMed®.

Development and feasibility of a novel mHealth resource for food insecurity: mixed methods cohort study. Fritz CQ, Xu M, Stassun J, et al. J Med Internet Res 2025 Aug 26;27:e65852. Access the abstract on PubMed®.

The value of a cross-disciplinary approach to human and system performance research in obstetrics and neonatology: AHRQ's Patient Safety Learning Laboratory. Halamek LP, Galindo RB, Follmer S, et al. J Patient Saf 2025 Oct 1;21(7Supp):S52-S9. Epub 2025 Sep 23. Access the abstract on PubMed®.

Venous thromboembolism prophylaxis in adults with acute traumatic brain injury: a systematic review. Forte ML, Brandt S, Claussen AM, et al. Trauma Surg Acute Care Open 2025 Jun 22;10(2):e001691. Access the abstract on PubMed®.

Postacute care use and outcomes among Medicare Advantage vs traditional Medicare beneficiaries. Roy I, Hutchins F, Rose L, et al. JAMA Netw Open 2025 Oct;8(10):e2540347. Access the abstract on PubMed®.

Facilitation as an effective strategy to reduce excessive antibiotic prophylaxis in children's hospitals: a stepped-wedge cluster randomized controlled trial. McKay V, Malone S, Tetteh E, et al. Implement Sci 2025 Oct 21;20(1):45. Access the abstract on PubMed®.

Hospital staffing and patient outcomes after private equity acquisition. Kannan S, Bruch JD, Zubizarreta JR, et al. Ann Intern Med 2025 Nov;178(11):1529-38. Epub 2025 Sep 23. Access the abstract on PubMed®.