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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 10326 Research Studies Displayed
Yakovchenko V, Morgan TR, Chinman MJ
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
While few countries and healthcare systems are on track to meet the World Health Organization's hepatitis C virus (HCV) elimination goals, the US Veterans Health Administration (VHA) has been a leader in these efforts. In this study the investigators aimed to determine which implementation strategies were associated with successful national viral elimination implementation within the VHA. They conducted a five-year, longitudinal cohort study of the VHA Hepatic Innovation Team (HIT) Collaborative between October 2015 and September 2019.
AHRQ-funded; HS019461.
Citation:
Yakovchenko V, Morgan TR, Chinman MJ .
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
BMC Health Serv Res 2021 Dec 18;21(1):1348. doi: 10.1186/s12913-021-07312-4..
Keywords:
Hepatitis, Chronic Conditions, Veterans
Wurcel AG, Essien UR, Ortiz C
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
This cohort study examined antibiotics prescribed and variations by race among hospitalized patients with skin and soft tissue infections (SSTIs). A subanalysis of multisite, cross-sectional data collected through a national survey of acute care hospital groups within Vizient, Inc. considering adult inpatients treated for SSTIs was used. Of the 1242 adult inpatients included from 91 US hospitals, 45% were female, 18% were Black, and 69% were White with a mean age of 58 years. Penicillin allergy with hives was found in 23%, 19% with rash, and 18% with unknown effects, with allergy found more frequent in Black patients (23%) versus White (18%). Adjusting for multiple factors, White inpatients were at an increased risk of cefazolin use and decreased risk of clindamycin use compared with Black inpatients. Cefazolin use with less likely to be prescribed to Black inpatients than White inpatients and they were likely to be prescribed clindamycin. Cefazolin is considered a first-line SSTI treatment with clindamycin not recommended given frequent dosing and high potential for adverse effects including Clostridioides difficile infection (CDI). Although penicillin allergy is described as more prevalent among White patients, the authors observed an increased prevalence among Black inpatients compared with White inpatients treated for SSTI.
Citation:
Wurcel AG, Essien UR, Ortiz C .
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
JAMA Netw Open 2021 Dec;4(12):e2140798. doi: 10.1001/jamanetworkopen.2021.40798..
Keywords:
Antibiotics, Skin Conditions, Racial / Ethnic Minorities, Practice Patterns, Medication
Sorra J, Zebrak K, Yount N
Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices.
Given rising costs and changing payment models, healthcare organisations are increasingly focused on value and efficiency. The goal of this study was to develop survey items to assess clinician and staff perspectives about the extent to which the organizational culture in hospitals and medical offices supports value and efficiency. The investigators concluded when added to the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture, the item sets they developed extended those surveys by assessing additional dimensions of organizational culture that affect care delivery.
AHRQ-funded; 290201000025I.
Citation:
Sorra J, Zebrak K, Yount N .
Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices.
BMJ Qual Saf 2022 Jul;31(7):493-502. doi: 10.1136/bmjqs-2020-012407..
Keywords:
Surveys on Patient Safety Culture, Organizational Change, Value
McQueen A, Kreuter MW, Herrick CJ
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
The purpose of this study was to determine the number and types of social needs experienced by Medicaid beneficiaries with type 2 diabetes and how these social needs are associated with key health indicators. Findings showed that having more social needs was associated with a wide range of indicators of poor health and well-being. Study participants with the greatest social need burden were most open to intervention.
AHRQ-funded; HS019455.
Citation:
McQueen A, Kreuter MW, Herrick CJ .
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
Health Soc Care Community 2022 May;30(3):1035-44. doi: 10.1111/hsc.13296..
Keywords:
Diabetes, Chronic Conditions, Medicaid, Social Determinants of Health
Lowry KP, Bissell MCS, Miglioretti DL
Breast biopsy recommendations and breast cancers diagnosed during the COVID-19 pandemic.
The authors sought to examine breast biopsy recommendations and breast cancers diagnosed before and during the COVID-19 pandemic by mode of detection and women's characteristics. Using data from the Breast Cancer Surveillance Consortium, they found that there were substantially fewer breast biopsies with cancer diagnoses during the COVID-19 pandemic from March to September 2020 compared to the same period in 2019, with Asian and Hispanic women experiencing the largest declines followed by Black women.
AHRQ-funded; HS018366.
Citation:
Lowry KP, Bissell MCS, Miglioretti DL .
Breast biopsy recommendations and breast cancers diagnosed during the COVID-19 pandemic.
Radiology 2022 May;303(2):287-94. doi: 10.1148/radiol.2021211808..
Keywords:
COVID-19, Cancer: Breast Cancer, Cancer, Diagnostic Safety and Quality
Marino M, Solberg L, Springer R
Cardiovascular disease preventive services among smaller primary care practices.
This cross-sectional study utilized linear regression modeling to examine the association of aspirin use, blood pressure control, and smoking-cessation support performance with practice characteristics that included structural attributes, practice capacity and contextual characteristics, health information technology, and patient panel demographics. Findings showed that, on average, practice performance on aspirin use, blood pressure control, and smoking-cessation support quality measures was 64% for aspirin, 63% for blood pressure, and 62% for smoking-cessation support. Practice characteristics associated with aspirin use, blood pressure control, and smoking-cessation support performance included ownership, rurality, and disruptions.
AHRQ-funded; HS023940.
Citation:
Marino M, Solberg L, Springer R .
Cardiovascular disease preventive services among smaller primary care practices.
Am J Prev Med 2022 May;62(5):e285-e95. doi: 10.1016/j.amepre.2021.10.011..
Keywords:
Cardiovascular Conditions, Primary Care, Prevention
Hollowell M, Hudmon KS, Perkins SM
Evaluation of a modified and abbreviated scale for assessing chronic illness care for medication therapy management practice.
The purpose of the study was to evaluate the validity and internal consistency of the Assessment of Chronic Illness Care (ACIC) abbreviated, 12-item scale as a novel instrument for measuring Medication Therapy Management (MTM) care delivery. Researchers administered the instrument to pharmacists employed at 27,560 community pharmacies. The study concluded that when applied to the measurement of chronic illness care within the MTM setting, the abbreviated ACIC showed acceptable validity and internal consistency, and could serve as a valuable tool.
AHRQ-funded; HS022119.
Citation:
Hollowell M, Hudmon KS, Perkins SM .
Evaluation of a modified and abbreviated scale for assessing chronic illness care for medication therapy management practice.
Res Social Adm Pharm 2022 May;18(5):2804-10. doi: 10.1016/j.sapharm.2021.06.006..
Keywords:
Chronic Conditions, Medication, Provider: Pharmacist, Care Management
Kranz AM, Steiner ED, Mitchell JM
School-based health services in Virginia and the COVID-19 pandemic.
The purpose of this study was to examine how the COVID-19 pandemic may have impacted the provision of school health services and related student needs. In May 2021, all 1178 Virginia public elementary schools received a web-based survey regarding the impact of the pandemic on school-based health services, with 65% of schools responding (N=767). Schools reported providing fewer school-based health services during the pandemic than before, with dental screenings declining the most (51% before vs 15% after). The study also reported that mental health as a top concern for students increased from 15% before the pandemic to 27% during the pandemic. The study concluded that schools reported providing fewer health services to students during pandemic in the 2020-2021 school year and increased concern about students' mental health.
AHRQ-funded; HS025430.
Citation:
Kranz AM, Steiner ED, Mitchell JM .
School-based health services in Virginia and the COVID-19 pandemic.
J Sch Health 2022 May;92(5):436-44. doi: 10.1111/josh.13147..
Keywords:
COVID-19, Children/Adolescents, Public Health, Healthcare Delivery, Community-Based Practice
Kukhareva PV, Caverly TJ, Li H
Inaccuracies in electronic health records smoking data and a potential approach to address resulting underestimation in determining lung cancer screening eligibility.
The authors sought to characterize EHR smoking data issues and to propose an approach to addressing these issues using longitudinal smoking data. They found that over 80% of evaluated records had inaccuracies, including missing packs-per-day or years-smoked, outdated data, missing years-quit, and a recent change in packs-per-day resulting in inaccurate lifetime pack-years estimation. Further, addressing these issues by using longitudinal data enabled the identification of 49.4% more patients potentially eligible for lung cancer screening.
AHRQ-funded; HS026198.
Citation:
Kukhareva PV, Caverly TJ, Li H .
Inaccuracies in electronic health records smoking data and a potential approach to address resulting underestimation in determining lung cancer screening eligibility.
J Am Med Inform Assoc 2022 Apr 13;29(5):779-88. doi: 10.1093/jamia/ocac020..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Screening, Cancer: Lung Cancer, Cancer
Grauer A, Kneifati-Hayek J, Reuland B
Indication alerts to improve problem list documentation.
This study examined the effects of alerts integrated into the inpatient and outpatient computerized provider order entry systems to assist in adding problems to the problems list when ordering medications that lacked a corresponding indication. Medication orders from 2 healthcare systems that used an innovative indication alert were analyzed. Data from site 1 was collected between December 2018 and January 2020, and at site 2 between May and June 2021. Alerts were triggered 131,34 times at site 1, and 6178 times at site 2. The authors reviewed samples of 100 charts that had problems added in response to the alert. Of those, reviewers deemed 88% ± 3% at site 1 and 91% ± 3% at site 2 to be accurate, respectively.
AHRQ-funded; HS024945; HS026121.
Citation:
Grauer A, Kneifati-Hayek J, Reuland B .
Indication alerts to improve problem list documentation.
J Am Med Inform Assoc 2022 Apr 13;29(5):909-17. doi: 10.1093/jamia/ocab285..
Keywords:
Clinical Decision Support (CDS), Health Information Technology (HIT)
Huppert J
Adolescents with vulvar ulcers: COVID-19 disease, COVID-19 vaccines, and the value of case reports.
The author indicates that there are too few cases reporting aphthosis after COVID disease or COVID-19 vaccination to infer a statistical association, but that case reports are a valuable source of rich details about conditions that are difficult to study with more rigorous designs and can be synthesized to help guide medical care. She recommends that it is time for a high-quality systematic review of vulvar aphthosis in order for clinicians to incorporate the existing evidence into decision-making and best care for patients.
AHRQ-authored.
Citation:
Huppert J .
Adolescents with vulvar ulcers: COVID-19 disease, COVID-19 vaccines, and the value of case reports.
J Pediatr Adolesc Gynecol 2022 Apr;35(2):109-11. doi: 10.1016/j.jpag.2022.01.006..
Keywords:
Children/Adolescents, COVID-19, Vaccination, Research Methodologies
Mao J, Sedrakyan A, Sun T
Assessing adverse event reports of hysteroscopic sterilization device removal using natural language processing.
This study’s objective was to develop an annotation model to develop natural language processing (NLP) to device adverse event reports and to implement the model to evaluate the most frequently experienced events among women reporting a sterilization device removal. Adverse event reports from the Manufacturer and User Facility Device Experience database from January 2005 to June 2018 were included. The authors used an iterative process to develop an annotation model that extracts six categories of desired information and applied the annotation model to train an NLP algorithm. A total of 16,535 reports of device removal were analyzed with the most frequently reported patient and device events being abdominal/pelvic/genital pain (79.6%) and device dislocation/migration (19.2%), respectively. A total of 7,932 patients reported an additional sterilization procedure of a hysterectomy or salpingectomy. One-fifth of the cases that had device removal timing specified reported a removal 7 years after original insertion.
AHRQ-funded; HS026291.
Citation:
Mao J, Sedrakyan A, Sun T .
Assessing adverse event reports of hysteroscopic sterilization device removal using natural language processing.
Pharmacoepidemiol Drug Saf 2022 Apr;31(4):442-51. doi: 10.1002/pds.5402..
Keywords:
Adverse Events, Surgery, Medical Devices, Patient Safety
McBain RK, Cantor JH, Kofner A
Brief report: Medicaid expansion and growth in the workforce for autism spectrum disorder.
This study examined the role that state Medicaid expansion has played in utilization of child psychiatrists, board-certified behavioral analysts (BCBAs) and pediatricians for children with autism spectrum disorder (ASD). Health workforce data from HRSA was used to examine workforce growth from 2008-2017. State Medicaid expansion was associated with a 9% increase in BCBAs per 100,000 children one year after enactment, and a 5% increase in child psychiatrists, but no association with growth in pediatrician utilization.
AHRQ-funded; HS025750.
Citation:
McBain RK, Cantor JH, Kofner A .
Brief report: Medicaid expansion and growth in the workforce for autism spectrum disorder.
J Autism Dev Disord 2022 Apr;52(4):1881-89. doi: 10.1007/s10803-021-05044-2..
Keywords:
Children/Adolescents, Autism, Medicaid, Workforce, Behavioral Health
Jacobs PD, Abdus S
Changes in preventive service use by race and ethnicity after Medicare eligibility in the United States.
Researchers examined whether widespread eligibility for Medicare at age 65 narrows disparate preventive service use by race and ethnicity. Using MEPS data and examining six preventive services, they found that, for non-Hispanic Black adults, preventive service use increased after age 65. Further, for all four preventive health measures that were lower for Hispanic adults compared with non-Hispanic White adults prior to age 65, service use was indistinguishable between these groups after reaching the Medicare eligibility age. They concluded that Medicare eligibility appeared to reduce most racial and ethnic disparities in preventive service use.
AHRQ-authored.
Citation:
Jacobs PD, Abdus S .
Changes in preventive service use by race and ethnicity after Medicare eligibility in the United States.
Prev Med 2022 Apr;157:106996. doi: 10.1016/j.ypmed.2022.106996..
Keywords:
Medical Expenditure Panel Survey (MEPS), Racial / Ethnic Minorities, Medicare, Prevention, Access to Care, Disparities, Health Insurance
Cope EL, Johnson M, Khan M
Contextual factors affecting implementation of pediatric quality improvement programs.
Researchers assessed the role of contextual factors in influencing the efforts of 5 diverse quality improvement projects as part of the Pediatric Quality Measure Program (PQMP) directed by AHRQ. In a mixed methods study, they conducted semistructured interviews, followed by structured worksheets, of 5 PQMP grantees. They found that using a determinant framework, such as the Tailored Implementation for Chronic Diseases, is valuable in facilitating comparisons across heterogeneous projects, allowing identification of key contextual factors influencing the implementation of pediatric quality measures across a diverse range of clinical topics and settings.
AHRQ-authored.
Citation:
Cope EL, Johnson M, Khan M .
Contextual factors affecting implementation of pediatric quality improvement programs.
Acad Pediatr 2022 Apr;22(3S):S81-S91. doi: 10.1016/j.acap.2021.08.016..
Keywords:
Children/Adolescents, Quality Measures, Quality Improvement, Quality of Care, Implementation
Mistry KB, Sagatov RDF, Schur C
Design and implementation of the Pediatric Quality Measures Program 2.0.
This AHRQ-authored research discusses the design and implementation of the Pediatric Quality Measures Program (PQMP) 2.0. The PQMP was established in response to the Children’s Health Insurance Program Reauthorization Act of 2009. AHRQ and CMS awarded 6 grants to Centers of Excellence (COEs) and a contract to facilitate collaboration and learning across the COEs. The COEs partnered with stakeholders from multiple levels to field test real-world implementation and refinement of pediatric quality measures and quality improvement initiatives. A PQMP Learning Collaborative (PQMP-LC) consisting of AHRQ, CMS, the 6 COEs, and L&M Policy Research, LLC was created to complete literature reviews, conduct key informant interviews, and collect data to develop reports to address the Research Foci. It also aided with development of measure implementation and quality improvement toolkits; conceptualized an implementation science framework, analysis, and roadmap; and facilitated dissemination of learnings and products. The various products created are intended to support the uptake of PQMP measures and inform future pediatric measurement and improvement work.
AHRQ-authored.
Citation:
Mistry KB, Sagatov RDF, Schur C .
Design and implementation of the Pediatric Quality Measures Program 2.0.
Acad Pediatr 2022 Apr;22(3s):S59-S64. doi: 10.1016/j.acap.2021.12.021..
Keywords:
Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Kim HN, Nance RM, Lo Re V
Development and validation of a model for prediction of end-stage liver disease in people with HIV.
The authors developed and validated a risk-prediction model for end-stage liver disease (ESLD) among people with HIV (PWH). They developed and validated a risk prediction model for ESLD among PWH who received care in 12 cohorts of the North American AIDS Cohort Collaboration on Research and Design and found that their model of readily accessible clinical parameters predicted ESLD in a large diverse population of PWH.
AHRQ-funded; 90047713.
Citation:
Kim HN, Nance RM, Lo Re V .
Development and validation of a model for prediction of end-stage liver disease in people with HIV.
J Acquir Immune Defic Syndr 2022 Apr;89(4):396-404. doi: 10.1097/qai.0000000000002886..
Keywords:
Chronic Conditions, Human Immunodeficiency Virus (HIV), Risk
Richmond J, Boynton MH, Ozawa S
Development and validation of the trust in my doctor, trust in doctors in general, and trust in the health care team scales.
The authors sought to develop and test updated trust measures that are multidimensional and inclusive of relevant domains. They developed three trust measures: the Trust in My Doctor (T-MD), Trust in Doctors in General (T-DiG), and Trust in the Health Care Team (T-HCT) scales. Following an online survey, they concluded that the multidimensional T-MD, T-DiG, and T-HCT scales have sound psychometric properties and may be useful for researchers evaluating trust-related interventions or conducting studies where trust is an important construct or main outcome.
AHRQ-funded; HS026122.
Citation:
Richmond J, Boynton MH, Ozawa S .
Development and validation of the trust in my doctor, trust in doctors in general, and trust in the health care team scales.
Soc Sci Med 2022 Apr;298:114827. doi: 10.1016/j.socscimed.2022.114827..
Keywords:
Patient Experience, Clinician-Patient Communication
Schnipper JL, Reyes Nieva H, Mallouk M
Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study.
This study was a follow-up of the first Multicenter Medication Reconciliation Quality Improvement Study (MARQUIS1) that demonstrated mentored implementation of a medication reconciliation best practices toolkit. The toolkit decreased total unintentional medication discrepancies in five hospitals, but results varied by site. The toolkit has been refined with lessons learned and retooled as MARQUIS2. The tool was implemented at 18 North American hospitals or hospital systems from 2016 to 2018, offering 17 system-level and 6-patient-level interventions. One of eight physicians coached each site remotely via monthly calls and one or two site visits. A total of 4947 patients were sampled, with 1229 preimplementation and 3718 postimplementation. A steady decline in medication discrepancy rates were experienced from 2.85 discrepancies per patient down to 0.98 discrepancies. An interrupted time series analysis of the 17 sites showed the intervention was associated with a 5% relative decrease in discrepancies per month.
AHRQ-funded; HS025486; HS023757.
Citation:
Schnipper JL, Reyes Nieva H, Mallouk M .
Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study.
BMJ Qual Saf 2022 Apr;31(4):278-86. doi: 10.1136/bmjqs-2020-012709..
Keywords:
Medication, Evidence-Based Practice, Tools & Toolkits, Implementation, Quality Improvement, Quality of Care, Medication: Safety, Patient Safety
Huo T, Li Q, Cardel MI
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
The authors sought to examine the extent to which body mass index (BMI) was available in electronic health records for Florida Medicaid recipients aged 5 to 18 years taking Second-Generation Antipsychotics (SGAP). They concluded that meeting the 2030 CMS goal of digital monitoring of quality of care will require continuing expansion of clinical encounter data capture to provide the data needed for digital quality monitoring. Using linked electronic health records and claims data allows identifying children at higher risk for SGAP-induced weight gain.
AHRQ-authored; AHRQ-funded; HS025298.
Citation:
Huo T, Li Q, Cardel MI .
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
Acad Pediatr 2022 Apr;22(3S):S140-S49. doi: 10.1016/j.acap.2021.11.012..
Keywords:
Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Obesity, Obesity: Weight Management, Quality Measures, Quality of Care
Gregory ME, Nyein KP, Scarborough S
Examining the dimensionality of trust in the inpatient setting: exploratory and confirmatory factor analysis.
The purpose of this study was to examine the dimensionality of a measure of trust in the inpatient setting. Participants were patients hospitalized in six hospitals in the midwestern US. Findings showed that, while measures of trust in the outpatient setting have been validated as unidimensional, in the inpatient setting, trust appears to be composed of two factors: cognitive and affective trust. Suggestions included encouraging inpatient providers to work to ensure patients see them as both competent and caring in order to gain their trust.
AHRQ-funded; HS024091; HS024379.
Citation:
Gregory ME, Nyein KP, Scarborough S .
Examining the dimensionality of trust in the inpatient setting: exploratory and confirmatory factor analysis.
J Gen Intern Med 2022 Apr;37(5):1108-14. doi: 10.1007/s11606-021-06928-w..
Keywords:
Inpatient Care
Lin Y, Sharma B, Thompson HM
External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients.
This study’s objective was to validate a machine learning approach to alcohol screening using a natural language processing (NLP) classifier developed at an independent medical center. This retrospective cohort study took place at a midwestern US tertiary-care, urban medical center that has an inpatient structured universal screening model for unhealthy substance use and an active addiction consult service. The cohort included 57,605 unplanned admissions of adult patients between October 23, 2017 and December 31, 2019 with electronic health record (EHR) documentation of manual alcohol screening. The authors examined error in manual screening and reviewed discordance between the NLP classifier and AUDIT-derived reference. The classifier demonstrated adequate sensitivity and specificity for routine clinical use as an automated screening tool for identifying at-risk patients.
AHRQ-funded; HS026385.
Citation:
Lin Y, Sharma B, Thompson HM .
External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients.
Addiction 2022 Apr;117(4):925-33. doi: 10.1111/add.15730..
Keywords:
Alcohol Use, Behavioral Health, Screening, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bardach NS, Harder VS, McCulloch CE
Follow-up after asthma emergency department visits and its relationship with subsequent asthma-related utilization.
Researchers sought to assess the association between follow-up after an asthma-related emergency department (ED) visit and the likelihood of subsequent asthma-related ED utilization. Using data from California Medicaid, Vermont, and Massachusetts all-payer claims databases, they found a protective association between outpatient 14-day follow-up and asthma-related ED revisits. They suggested that this may reflect improved asthma control as providers follow the NHLBI guideline stepwise approach.
AHRQ-funded; HS025297; HS020518.
Citation:
Bardach NS, Harder VS, McCulloch CE .
Follow-up after asthma emergency department visits and its relationship with subsequent asthma-related utilization.
Acad Pediatr 2022 Apr;22(3S):S125-S32. doi: 10.1016/j.acap.2021.10.015..
Keywords:
Children/Adolescents, Asthma, Emergency Department, Respiratory Conditions, Healthcare Utilization
Berger AC, Simchoni N, Auerbach A
Implementation of clinical practice guidelines for hospitalized patients with COVID-19 in academic medical centers.
This study was a survey of members of the Hospital Medicine Reengineering Network to determine the rate at which US academic medical centers have adopted evidence-based practice guidelines for COVID-19. Of 83 hospitals contacted, 53 responded. Fifty-one sites issued internal COVID-19 management guidance. Guidance types included for infectious disease (98%), infection control (90%), hospital medicine (88%) and critical care (83%). Of the 51 sites with internal COVID-19 management guidance, recommendations were most commonly disseminated through email, institutional websites, and integration into electronic health records as COVID-19-specific order sets and note templates. Three themes emerged from the researcher’s analysis. First, translation from evidence to practice guidelines was remarkably complete for interventions supported by aligned national guidelines and high-quality studies. Second, institutions favored treatment over not treatment, particularly when guidelines diverged from each other. Lastly, academic medical centers demonstrated a willingness to innovate across a range of interventions.
AHRQ-funded; HS027369.
Citation:
Berger AC, Simchoni N, Auerbach A .
Implementation of clinical practice guidelines for hospitalized patients with COVID-19 in academic medical centers.
JAMA Netw Open 2022 Apr;5(4):e225657. doi: 10.1001/jamanetworkopen.2022.5657..
Keywords:
COVID-19, Guidelines, Inpatient Care
Álvares-da-Silva MR, Oliveira CP, Fagan A
Interaction of microbiome, diet, and hospitalizations between Brazilian and American patients with cirrhosis.
This study’s objective was to compare cirrhosis patients from the United States with cirrhosis patients from Brazil with respect to diet, microbiota, and impact on hospitalizations. This case-control study had participants undergo dietary recall and provide stool samples for 16S ribosomal RNA sequencing. Demographics and medications/cirrhosis details were also compared. Cirrhosis patients were followed up for 90-day hospitalizations. More Americans were men, had higher hepatic encephalopathy and alcohol/hepatitis C etiology with lower nonalcoholic fatty liver disease than Brazilians. Model for end-stage liver disease (MELD), diabetes, ascites, and albumin were similar. Within participants with cirrhosis, microbial diversity was higher for Brazilians, and among Brazilians high diversity was related to Brazilian origin, age, and cereal intake. High MELD scores and ascites was related to lower diversity. Beneficial taxa and taxa associated with yogurt intake was higher was pathobionts were lower in Brazilians. More Americans were hospitalized than Brazilians.
AHRQ-funded; HS025412; HS024004.
Citation:
Álvares-da-Silva MR, Oliveira CP, Fagan A .
Interaction of microbiome, diet, and hospitalizations between Brazilian and American patients with cirrhosis.
Clin Gastroenterol Hepatol 2022 Apr;20(4):930-40. doi: 10.1016/j.cgh.2021.03.045..
Keywords:
Hospitalization
