- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
- Access to Care (371)
- Adverse Drug Events (ADE) (302)
- Adverse Events (697)
- Alcohol Use (57)
- Ambulatory Care and Surgery (188)
- Antibiotics (215)
- Antimicrobial Stewardship (139)
- Anxiety (43)
- Arthritis (127)
- Asthma (115)
- Autism (31)
- Back Health and Pain (55)
- Behavioral Health (619)
- Blood Clots (59)
- Blood Pressure (91)
- Blood Thinners (67)
- Brain Injury (59)
- Breast Feeding (18)
- Burnout (53)
- Cancer (704)
- Cancer: Breast Cancer (183)
- Cancer: Cervical Cancer (18)
- Cancer: Colorectal Cancer (111)
- Cancer: Lung Cancer (70)
- Cancer: Ovarian Cancer (9)
- Cancer: Prostate Cancer (95)
- Cancer: Skin Cancer (12)
- Cardiovascular Conditions (640)
- Care Coordination (100)
- Caregiving (212)
- Care Management (224)
- Case Study (101)
- Catheter-Associated Urinary Tract Infection (CAUTI) (54)
- Centers for Education and Research on Therapeutics (CERTs) (12)
- Central Line-Associated Bloodstream Infections (CLABSI) (58)
- Children's Health Insurance Program (CHIP) (40)
- Children/Adolescents (1384)
- Chronic Conditions (644)
- Clinical Decision Support (CDS) (176)
- Clinician-Patient Communication (262)
- Clostridium difficile Infections (51)
- Colonoscopy (36)
- Communication (353)
- Community-Acquired Infections (54)
- Community-Based Practice (136)
- Community Partnerships (17)
- Comparative Effectiveness (462)
- Complementary and Alternative Medicine (22)
- Comprehensive Unit-based Safety Program (CUSP) (9)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (79)
- COVID-19 (236)
- Critical Care (203)
- Cultural Competence (56)
- Data (177)
- Decision Making (563)
- Dementia (93)
- Dental and Oral Health (58)
- Depression (225)
- Diabetes (346)
- Diagnostic Safety and Quality (495)
- Dialysis (24)
- Digestive Disease and Health (107)
- Disabilities (65)
- Disparities (396)
- Domestic Violence (27)
- Ear Infections (4)
- Education (30)
- Education: Academic (24)
- Education: Continuing Medical Education (154)
- Education: Curriculum (22)
- Education: Patient and Caregiver (225)
- Elderly (895)
- Electronic Health Records (EHRs) (685)
- Electronic Prescribing (E-Prescribing) (23)
- Emergency Department (509)
- Emergency Medical Services (EMS) (158)
- Emergency Preparedness (23)
- Evidence-Based Practice (847)
- Eye Disease and Health (29)
- Falls (80)
- Family Health and History (65)
- Genetics (92)
- Guidelines (339)
- Healthcare-Associated Infections (HAIs) (398)
- Healthcare Cost and Utilization Project (HCUP) (345)
- Healthcare Costs (747)
- Healthcare Delivery (519)
- Healthcare Utilization (371)
- Health Information Exchange (HIE) (48)
- Health Information Technology (HIT) (1265)
- Health Insurance (399)
- Health Literacy (117)
- Health Promotion (74)
- Health Services Research (HSR) (317)
- Health Status (129)
- Health Systems (91)
- Heart Disease and Health (429)
- Hepatitis (40)
- Home Healthcare (128)
- Hospital Discharge (202)
- Hospitalization (497)
- Hospital Readmissions (307)
- Hospitals (695)
- Human Immunodeficiency Virus (HIV) (244)
- Hypertension (26)
- Imaging (224)
- Implementation (177)
- Infectious Diseases (241)
- Influenza (39)
- Injuries and Wounds (193)
- Innovations and Emerging Issues (18)
- Inpatient Care (197)
- Intensive Care Unit (ICU) (244)
- Kidney Disease and Health (179)
- Labor and Delivery (106)
- Learning Health Systems (36)
- Lifestyle Changes (133)
- Long-Term Care (210)
- Low-Income (158)
- Maternal Care (133)
- Medicaid (326)
- Medical Devices (58)
- Medical Errors (184)
- Medical Expenditure Panel Survey (MEPS) (181)
- Medical Liability (26)
- Medicare (531)
- Medication (1546)
- Medication: Safety (211)
- Men's Health (49)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (71)
- Mortality (377)
- Neonatal Intensive Care Unit (NICU) (43)
- Neurological Disorders (182)
- Newborns/Infants (234)
- Nursing (102)
- Nursing Homes (306)
- Nutrition (127)
- Obesity (235)
- Obesity: Weight Management (97)
- Opioids (273)
- Organizational Change (70)
- Orthopedics (99)
- Osteoporosis (30)
- Outcomes (755)
- Pain (199)
- Palliative Care (134)
- Patient-Centered Healthcare (431)
- Patient-Centered Outcomes Research (1017)
- Patient Adherence/Compliance (219)
- Patient and Family Engagement (264)
- Patient Experience (243)
- Patient Safety (1242)
- Patient Self-Management (132)
- Payment (188)
- Pneumonia (75)
- Policy (409)
- Practice-Based Research Network (PBRN) (16)
- Practice Improvement (31)
- Practice Patterns (296)
- Pregnancy (290)
- Pressure Ulcers (27)
- Prevention (737)
- Primary Care (661)
- Primary Care: Models of Care (87)
- Provider (300)
- Provider: Clinician (62)
- Provider: Health Personnel (81)
- Provider: Nurse (95)
- Provider: Pharmacist (84)
- Provider: Physician (212)
- Provider: Physician Assistant (1)
- Provider Performance (183)
- Public Health (163)
- Public Reporting (41)
- Quality Improvement (527)
- Quality Indicators (QIs) (135)
- Quality Measures (221)
- Quality of Care (937)
- Quality of Life (187)
- Racial / Ethnic Minorities (679)
- Registries (146)
- Rehabilitation (84)
- Research Methodologies (395)
- Respiratory Conditions (332)
- Risk (723)
- Rural Health (111)
- Safety Net (85)
- Screening (413)
- Sepsis (127)
- Sex Factors (62)
- Sexual Health (104)
- Sickle Cell Disease (46)
- Simulation (44)
- Skin Conditions (113)
- Sleep Problems (62)
- Social Determinants of Health (324)
- Social Media (45)
- Social Stigma (50)
- Spinal Cord Injury (9)
- Stress (70)
- Stroke (151)
- Substance Abuse (263)
- Surgery (1035)
- Surveys on Patient Safety Culture (13)
- System Design (15)
- Teams (130)
- TeamSTEPPS (16)
- Telehealth (216)
- Tobacco Use (78)
- Tobacco Use: Smoking Cessation (20)
- Tools & Toolkits (47)
- Training (136)
- Transitions of Care (177)
- Transplantation (128)
- Trauma (93)
- Treatments (181)
- U.S. Preventive Services Task Force (USPSTF) (196)
- Uninsured (73)
- Urban Health (83)
- Urinary Tract Infection (UTI) (65)
- Vaccination (148)
- Value (198)
- Veterans (115)
- Vitamins and Supplements (28)
- Vulnerable Populations (196)
- Web-Based (84)
- Women (477)
- Workflow (58)
- Workforce (86)
- Young Adults (80)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 11113 Research Studies Displayed
Garrett SB, Walia A, Miller F
Antibias efforts in United States maternity care: a scoping review of the publicly funded health equity intervention pipeline.
Clin Obstet Gynecol 2023 Mar 1; 66(1):110-23. doi: 10.1097/grf.0000000000000761.
Citation: Garrett SB, Walia A, Miller F . Antibias efforts in United States maternity care: a scoping review of the publicly funded health equity intervention pipeline. Clin Obstet Gynecol 2023 Mar 1; 66(1):110-23. doi: 10.1097/grf.0000000000000761..
Keywords: Maternal Care, Women, Training, Evidence-Based Practice
Schuttner L, Guo R, Wong E
High-risk patient experiences associated with an intensive primary care management program in the Veterans Health Administration.
This study assessed high-risk patient experiences associated with an intensive primary care management program conducted at the Veterans Health Administration (VHA). The authors assessed patient experience using a patient survey based on the CAHPS Survey in 2019. Patient experience was assessed among 1) prior enrollees (n = 59) of an intensive management program (2014-2018); (2) nonenrollees (n = 356) at program sites; and (3) nonprogram site patients (n = 728). The VHA Office of Primary Care used a patient-centered medical home model (PACT) to deliver coordinated, continuous primary care through multidisciplinary teams. The PACT-Intensive Management (PIM) program was piloted at 5 sites from 2014 to 2018. Outcomes examined included patient ratings of patient-centered care; overall health care experience; and satisfaction with their usual outpatient care provider. Enrollees were more satisfied with their current provider versus nonenrollees within program sites. However, the authors weren’t sure if the benefits persisted after program conclusion.
Citation: Schuttner L, Guo R, Wong E . High-risk patient experiences associated with an intensive primary care management program in the Veterans Health Administration. J Ambul Care Manage 2023 Jan-Mar;46(1):45-53. doi: 10.1097/jac.0000000000000428..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Veterans, Patient Experience, Primary Care
Gay HC, Yu J, Persell SD
Comparison of sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist prescribing in patients with diabetes mellitus with and without cardiovascular disease.
Researchers sought to describe trends in prescribing for sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) to reduce cardiovascular events and mortality in adult patients with type 2 diabetes mellitus (T2DM) in diverse care settings. Their focus was on outpatient clinics in a midwestern integrated health system and small- and medium-sized community-based primary care practices and health centers in three Midwestern states. Results showed that an increase in prescription rates was greater for SGLT2is than for GLP1-RAs in a large integrated medical center and community primary care practices; overall, prescription rates for eligible patients were low, and the researchers observed racial disparities.
AHRQ-funded; HS026385; HS023921.
Citation: Gay HC, Yu J, Persell SD . Comparison of sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist prescribing in patients with diabetes mellitus with and without cardiovascular disease. Am J Cardiol 2023 Feb 15; 189:121-30. doi: 10.1016/j.amjcard.2022.10.041..
Keywords: Diabetes, Cardiovascular Conditions, Chronic Conditions, Medication, Primary Care
Gregory ME, MacEwan SR, Sova LN
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
The objective of this study was to investigate the role of interprofessional teamwork in the prevention of health care-associated infections (HAIs), focusing on central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) prevention. The authors interviewed participating physicians, nurses, and other staff from 18 hospitals about interprofessional collaboration, and proposed an Input-Mediator-Output-Input (IMOI) model as well as strategies to support teamwork for the prevention of HAIs.
Citation: Gregory ME, MacEwan SR, Sova LN . A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions. Med Care Res Rev 2023 Feb;80(1):30-42. doi: 10.1177/10775587221103973..
Keywords: Teams, Prevention, Healthcare-Associated Infections (HAIs)
Djulbegovic B, Hozo I, Lizarraga D
Evaluation of a fast-and-frugal clinical decision algorithm ('pathways') on clinical outcomes in hospitalised patients with COVID-19 treated with anticoagulants.
The objective of this study was to assess if delivery of anticoagulant prophylaxis according to an algorithm improved clinical outcomes in patients hospitalized with COVID-19 in comparison with anticoagulant treatment given at individual practitioners' discretion. Findings indicated that the algorithm did not reduce death, venous thromboembolism, nor major bleeding, but helped avoid longer hospital stay and admission to an intensive-care unit.
Citation: Djulbegovic B, Hozo I, Lizarraga D . Evaluation of a fast-and-frugal clinical decision algorithm ('pathways') on clinical outcomes in hospitalised patients with COVID-19 treated with anticoagulants. J Eval Clin Pract 2023 Feb; 29(1):3-12. doi: 10.1111/jep.13780..
Keywords: COVID-19, Clinical Decision Support (CDS), Blood Thinners, Medication, Evidence-Based Practice, Health Information Technology (HIT)
De Roo AC, Ha J, Regenbogen SE
Impact of Medicare eligibility on informal caregiving for surgery and stroke.
The purpose of this study was to assess whether the intensity of family and friend care changes after older individuals enroll in Medicare at 65. Researchers used Health and Retirement Study survey data covering a 20-year period to compare informal care received by patients who had been hospitalized for stroke, heart surgery, or joint surgery, and who were stratified into propensity-weighted pre- and post-Medicare eligibility cohorts. Their results showed that onset of Medicare eligibility was associated with a substantial decrease in family and friend caregiving use received by stroke patients, but not in the other acute care cohorts. They concluded that this effect of Medicare coverage on informal caregiving had implications for patient function and caregiver burden, and should be considered in episode-based reimbursement models that alter professional rehabilitative care intensity.
Citation: De Roo AC, Ha J, Regenbogen SE . Impact of Medicare eligibility on informal caregiving for surgery and stroke. Health Serv Res 2023 Feb; 58(1):128-39. doi: 10.1111/1475-6773.14019..
Keywords: Medicare, Caregiving, Surgery, Stroke, Cardiovascular Conditions
Bartels K, Howard-Quijano K, Prin M
Meeting report: first Cardiovascular Outcomes Research in Perioperative Medicine conference.
This article summarized the background and objectives of the first Cardiovascular Outcomes Research in Perioperative Medicine (COR-PM) conference. It also described the conduct of the conference and outlined future directions for scientific meetings which are focused on the fostering of high-quality clinical research in the broader perioperative medicine community.
Citation: Bartels K, Howard-Quijano K, Prin M . Meeting report: first Cardiovascular Outcomes Research in Perioperative Medicine conference. Anesth Analg 2023 Feb; 136(2):418-20. doi: 10.1213/ane.0000000000006248..
Keywords: Cardiovascular Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Fishbein AB, Lor J, Penedo FJ
Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: cross-sectional study of the patient reported outcomes measurement information system pediatric sleep measures and actigraphy.
The purposes of this cross-sectional study were to test the Patient-Reported Outcomes Measurement Information System (PROMIS) sleep measures in pediatric atopic dermatitis (AD) and to develop an algorithm to screen, evaluate, and intervene to reduce sleep disturbances. Participants were children with AD aged 5 to 17 and one parent who completed sleep, itch, and AD-specific questionnaires. Clinicians assessed disease severity. PROMIS sleep disturbance parent proxy reliability was high and was differentiated among Patient-Oriented Eczema Measure (POEM)-determined disease severity groups. The authors concluded that sleep disturbance in pediatric AD should be screened using the POEM sleep question, and further assessment using the PROMIS sleep disturbance measure or objective sleep monitoring if it is needed.
Citation: Fishbein AB, Lor J, Penedo FJ . Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: cross-sectional study of the patient reported outcomes measurement information system pediatric sleep measures and actigraphy. J Am Acad Dermatol 2023 Feb; 88(2):348-56. doi: 10.1016/j.jaad.2020.05.138..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice
Difazio RL, Shore BJ, Melvin P
Pneumonia after hip surgery in children with neurological complex chronic conditions.
The purpose of this retrospective cohort study was to estimate rates of postoperative pneumonia in children with neurological complex chronic conditions (CCC) undergoing hip surgery, to determine the effect of pneumonia on postoperative hospital resource use, and to identify predictors. Researchers used data from the Pediatric Health Information System for children 4 years and older with a neurological CCC who had undergone hip surgery from 2016 to 2018 in U.S. children's hospitals. Findings indicate that postoperative pneumonia in children with a neurological CCC was associated with longer length-of-stay, readmissions, and higher costs. Children who had undergone pelvic osteotomies and who had multimorbidity needed additional clinical support to prevent postoperative pneumonia and to decrease resource utilization.
Citation: Difazio RL, Shore BJ, Melvin P . Pneumonia after hip surgery in children with neurological complex chronic conditions. Dev Med Child Neurol 2023 Feb; 65(2):232-42. doi: 10.1111/dmcn.15339..
Keywords: Children/Adolescents, Surgery, Neurological Disorders, Pneumonia, Respiratory Conditions, Hospital Readmissions, Adverse Events
Iantorno SE, Ulugia JG, Kastenberg ZJ
Postdischarge racial and ethnic disparities in pediatric appendicitis: a mediation analysis.
This retrospective cohort study sought to explore whether racial and ethnic disparities for children presenting with acute appendicitis persist after initial management and hospital discharge. The cohort included children under 18 years who underwent treatment for acute appendicitis in 47 U.S. Children's Hospitals from 2017 to 2019. Findings showed that children of racial and ethnic minorities were more likely to visit the emergency department after treatment for acute appendicitis, but Hispanic/Latinx patients did not have a corresponding increase in readmission. These differences were mediated mainly by insurance status and urban residence.
Citation: Iantorno SE, Ulugia JG, Kastenberg ZJ . Postdischarge racial and ethnic disparities in pediatric appendicitis: a mediation analysis. J Surg Res 2023 Feb;282:174-82. doi: 10.1016/j.jss.2022.09.027..
Keywords: Children/Adolescents, Racial / Ethnic Minorities, Disparities, Hospital Discharge, Surgery
Ali MM, McClellan C, Mutter R
AHRQ Author: McClellan C
Recreational marijuana laws and the misuse of prescription opioids: evidence from National Survey on Drug Use and Health microdata.
Using micro data from the National Survey on Drug Use and Health, researchers examined the relationship between recreational marijuana laws (RMLs) and the misuse of prescription opioids. They found that RML adoption reduced the likelihood of misusing prescription opioids; however, this initial effect appeared to dissipate 2 or 3 years after RML adoption, when the relationship to the likelihood of misusing prescription opioids became positive.
Citation: Ali MM, McClellan C, Mutter R . Recreational marijuana laws and the misuse of prescription opioids: evidence from National Survey on Drug Use and Health microdata. Health Econ 2023 Feb; 32(2):277-301. doi: 10.1002/hec.4620..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Policy
Ervin JN, Vitous CA, Wells EE
Rescue Improvement Conference: a novel tool for addressing failure to rescue.
The objective of this study was to understand the effectiveness of the Rescue Improvement Conference, a forum that addresses failure to rescue (FTR). FTR is the phenomenon where delayed recognition or response to surgical complications leads to a progressive cascade of adverse events culminating in patient death. The authors used 5 indicators of effectiveness: educational value, conference takeaways, discussion time, changes to surgical practice, and opportunities for improvement and conducted semi-structured interviews. The results showed that conference felt that the Rescue Improvement Conference was effective in all five indicators. The authors concluded that the conference has the potential to support other surgical departments in developing system-level strategies to recognize and manage postoperative complications that contribute to FTR.
AHRQ-funded; HS024403; HS023621.
Citation: Ervin JN, Vitous CA, Wells EE . Rescue Improvement Conference: a novel tool for addressing failure to rescue. Ann Surg 2023 Feb; 277(2):233-37. doi: 10.1097/sla.0000000000004832..
Keywords: Surgery, Adverse Events, Patient Safety, Quality of Care, Quality Improvement
Carey K, Lin MY
Safety-net hospital performance under comprehensive care for joint replacement.
The objective of this study was to investigate the relative progress of safety-net hospitals (SNHs) under Medicare's Comprehensive Care for Joint Replacement (CJR) mandatory bundled payment model and to identify contributors to SNHs' realization of success under the CJR program. Secondary data on all CJR hospitals from 2016-2020 were taken from CMS public use files and from the American Hospital Association. The findings indicated that SNHs were less successful in meeting spending targets when compared to CJR hospitals overall. The authors concluded that the formula used by CMS to determine spending targets may not be sufficient to address disparities in SNH financial performances under mandatory bundled payment.
Citation: Carey K, Lin MY . Safety-net hospital performance under comprehensive care for joint replacement. Health Serv Res 2023 Feb; 58(1):101-06. doi: 10.1111/1475-6773.14042..
Keywords: Safety Net, Hospitals, Surgery, Orthopedics, Provider Performance
Aswani MS, Roberts ET
Social risk adjustment in the hospital readmission reduction program: pitfalls of peer grouping, measurement challenges, and potential solutions.
The objective of this study was to investigate the limitations of peer grouping and associated challenges in the measurement of social risk in Medicare's Hospital Readmission Reduction Program (HRRP). Public data on hospitals in the HRRP were used to examine the relationship between hospital dual share and readmission rates within peer groups as well as changes in hospital peer group assignments, readmission rates, and penalties, and the relationship between state Medicaid eligibility rules and peer groups. The findings indicated that peer grouping is limited in the extent to which it accounts for differences in hospitals' patient populations. The authors concluded that problems arise from the construction of peer groups and the measure of social risk used to define them.
Citation: Aswani MS, Roberts ET . Social risk adjustment in the hospital readmission reduction program: pitfalls of peer grouping, measurement challenges, and potential solutions. Health Serv Res 2023 Feb; 58(1):51-59. doi: 10.1111/1475-6773.13969..
Keywords: Hospital Readmissions, Hospitals, Risk
Boltri JM, Tracer H, Strogatz D
AHRQ Author: Tracer H
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to prevent diabetes in people with prediabetes.
This article described the recommendations of a National Clinical Care Commission subcommittee focused primarily on the prevention of type 2 diabetes in people with prediabetes. The goal of these recommendations is to improve current Federal diabetes prevention activities by increasing awareness of and diagnosis of prediabetes on a population basis, facilitating FDA review and approval of metformin for diabetes prevention, and supporting research to enhance the effectiveness of diabetes prevention. The recommendations also highlight the importance of research to advance understanding of the etiology of and opportunities for prevention of type 1 diabetes.
Citation: Boltri JM, Tracer H, Strogatz D . The National Clinical Care Commission report to Congress: leveraging federal policies and programs to prevent diabetes in people with prediabetes. Diabetes Care 2023 Feb; 46(2):e39-e50. doi: 10.2337/dc22-0620..
Keywords: Diabetes, Prevention, Chronic Conditions
Conlin PR, Boltri JM, Bullock A
The National Clinical Care Commission report to Congress: summary and next steps.
This article summarized recommendations of the National Clinical Care Commission (NCCC) to prevent and control diabetes and its complications more effectively. The NCCC has determined that diabetes should not be considered solely as a medical problem but must also as a societal problem. Its recommendations cover policies and programs of both non-health-related and health-related federal agencies, including three recommendations that: non-health-related and health-related federal agencies coordinate their activities to better address diabetes; all federal agencies and departments ensure health equity as a guiding principle for their policies and programs that impact diabetes; all Americans have access to comprehensive and affordable health care. The NCCC also recommends that a coordinating Office of National Diabetes Policy be established.
Citation: Conlin PR, Boltri JM, Bullock A . The National Clinical Care Commission report to Congress: summary and next steps. Diabetes Care 2023 Feb; 46(2):e60-e63. doi: 10.2337/dc22-0622..
Keywords: Diabetes, Chronic Conditions, Policy, Prevention
Conley CC, Wernli KJ, Knerr S
Using protection motivation theory to predict intentions for breast cancer risk management: intervention mechanisms from a randomized controlled trial.
The objective of this study was to evaluate direct and indirect effects of a web-based, Protection Motivation Theory (PMT)-informed education and decision support tool for risk-reducing medication and breast MRI among women with high risk of breast cancer. Findings indicated that PMT-informed intervention effected behavioral intentions. No direct intervention effect on intentions for risk-reducing medication or MRI were found, but there were significant indirect effects on risk-reducing medication intentions via perceived risk, self-efficacy, and response efficacy, and on MRI intentions via perceived risk and response efficacy, The authors suggested that future research should extend these findings from intentions to behavior.
Citation: Conley CC, Wernli KJ, Knerr S . Using protection motivation theory to predict intentions for breast cancer risk management: intervention mechanisms from a randomized controlled trial. J Cancer Educ 2023 Feb; 38(1):292-300. doi: 10.1007/s13187-021-02114-y..
Keywords: Cancer: Breast Cancer, Cancer, Risk, Education: Patient and Caregiver, Health Information Technology (HIT)
Becker MW, Kashy DA, Harben A
A novel strategy to optimize critical information on over the counter labels for older adults.
In this article, the authors described two experiments in which they evaluated the impact of over-the-counter (OTC) medication label designs that employ highlighting and warning labels placed on package fronts on the attention and use of critical information by older consumers. In both experiments. participants aged 65 or over were required to access and use critical label information to respond correctly to questions. Highlighting or placing critical information on the front of packaging significantly improved response accuracy. The authors concluded that these results are relevant for regulations which dictate label design to further ease and safety of use of medications for older adults.
Citation: Becker MW, Kashy DA, Harben A . A novel strategy to optimize critical information on over the counter labels for older adults. Health Sci Rep 2023 Jan 25; 6(1):e1062. doi: 10.1002/hsr2.1062..
Keywords: Elderly, Medication: Safety, Medication, Patient Safety, Communication
Beaulieu ND, Chernew ME, McWilliams JM
Organization and performance of US health systems.
The objectives of this evidence review were to identify and describe health systems in the US, to assess differences between physicians and hospitals in and outside of health systems, and to compare quality and cost of care delivered by physicians and hospitals in and outside of health systems. A total of 580 health systems in a great variety of sizes were identified; prices for physician, hospital services, and total spending were assessed in 2018 commercial claims data. Health system physicians and hospitals were shown to deliver a large portion of medical services. Clinical quality performance and patient experience measures were slightly better in systems; however, spending and prices were significantly higher, especially in small practices. The authors concluded that slight quality differentials in combination with large price differentials suggested that health systems have not realized their potential for better care at equal or lower cost.
Citation: Beaulieu ND, Chernew ME, McWilliams JM . Organization and performance of US health systems. JAMA 2023 Jan 24; 329(4):325-35. doi: 10.1001/jama.2022.24032..
Keywords: Health Systems, Healthcare Delivery, Provider Performance, Quality Measures, Quality of Care, Hospitals
Apathy NC, Hare AJ, Fendrich S
I had not time to make it shorter: an exploratory analysis of how physicians reduce note length and time in notes.
The authors analyzed observed reductions in physicians’ note length and documentation time, both of which contribute to EHR burden and burnout. Their study used EHR metadata for ambulatory physician Epic users and examined changes in note composition of physicians who decreased note length and/or documentation time. Their findings showed that note length decreases were primarily attributable to reductions in copy/paste text and templated text, while note time decreases were primarily attributable to reductions in manual text. They concluded that future research should explore scalable burden-reduction initiatives that are responsive to both note bloat and documentation time.
Citation: Apathy NC, Hare AJ, Fendrich S . I had not time to make it shorter: an exploratory analysis of how physicians reduce note length and time in notes. J Am Med Inform Assoc 2023 Jan18; 30(2):355-60. doi: 10.1093/jamia/ocac211..
Keywords: Provider: Physician, Burnout, Electronic Health Records (EHRs), Health Information Technology (HIT)
Duan KI, Birger M, Au DH
Health care spending on respiratory diseases in the United States, 1996-2016.
The objectives of this study were to estimate health care spending in the U.S. for 11 respiratory conditions from 1996 to 2016, and to provide an evaluation of factors associated with spending growth and detailed trends. Data was taken from the Institute of Health Metrics and Evaluation's Disease Expenditure Project Database. The results showed that spending on respiratory conditions is high, particularly for chronic conditions like asthma and chronic obstructive pulmonary disease. The authors concluded that these findings suggest that service price and intensity should be a key focus for policymakers who seek to reduce health care spending growth.
Citation: Duan KI, Birger M, Au DH . Health care spending on respiratory diseases in the United States, 1996-2016. Am J Respir Crit Care Med 2023 Jan 15; 207(2):183-92. doi: 10.1164/rccm.202202-0294OC..
Keywords: Respiratory Conditions, Healthcare Costs, Asthma, Chronic Conditions
Treadwell JR, Kessler SK, Wu M
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this systematic review study was to assess the effectiveness and harms of pharmacologic and dietary treatments for epilepsy in children aged 1-36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 to identify studies reporting data on children aged 1-36 months receiving pharmacologic or dietary treatments for epilepsy. Twenty-three studies met the inclusion criteria. The study found that Levetiracetam leads to seizure freedom in some infants but the data on 6 other medications (lamotrigine, phenytoin, rufinamide, stiripentol, topiramate, and vigabatrin) were too limited to allow conclusions about their effectiveness. Three medications (lamotrigine, levetiracetam, and topiramate) were rarely discontinued due to adverse effects, and severe events were also rare. In the category of diets, the ketogenic diet lead to seizure freedom in some infants and both the ketogenic diet and modified Atkins diet reduced average seizure frequency.
Citation: Treadwell JR, Kessler SK, Wu M . Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review. Neurology 2023 Jan 3;100(1):e16-e27. doi: 10.1212/wnl.0000000000201026..
Keywords: Children/Adolescents, Neurological Disorders, Newborns/Infants, Medication, Nutrition, Treatments, Evidence-Based Practice
Tsou AY, Kessler SK, Wu M
Surgical treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this article was to summarize the findings of a systematic review commissioned by the American Epilepsy Society to evaluate evidence and describe evidence gaps for surgical treatments for epilepsy in children aged 1 to 36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 and included studies reporting data on children aged 1 month to 36 months or less enrolled in surgical interventions or neurostimulation for epilepsy. Eighteen studies met inclusion criteria. The review found that seizure freedom for infants undergoing hemispherectomy/hemispherotomy ranged from 7% to 76% at 1 year after surgery. For non-hemispheric surgeries seizure freedom ranged from 40% to 70%. Over half of infants undergoing hemispherectomy/hemispherotomy achieved a favorable outcome (Engel I or II, ILAE I to IV, or >50% seizure reduction) at follow-up of over 1 year. The researchers note that the studies had important limitations. The researchers concluded that while evidence remains sparse and low quality, some infants achieve seizure freedom after surgery and 50% or greater achieve favorable outcomes.
Citation: Tsou AY, Kessler SK, Wu M . Surgical treatments for epilepsies in children aged 1-36 months: a systematic review. Neurology 2023 Jan 3;100(1):e1-e15. doi: 10.1212/wnl.0000000000201012..
Keywords: Children/Adolescents, Newborns/Infants, Surgery, Treatments, Evidence-Based Practice
Aiken LH, Sloane DM, McHugh MD
A repeated cross-sectional study of nurses immediately before and during the Co
The goal of this cross-sectional study was to establish whether hospital nursing care shortages are primarily due to the COVID pandemic, and therefore likely to subside, or if shortages are due to understaffing and poor working conditions that predated the pandemic. The study considered registered nurses in New York and Illinois, and a subset of staff nurses employed in 357 hospitals, before and during the pandemic. While no evidence was found to show that large numbers of nurses left in the first 18 months of the pandemic, the study’s findings indicate that nurses in hospitals with better staffing and more favorable work environments prior to the pandemic reported significantly better outcomes. The authors concluded that policies that prevent chronic understaffing have the most potential to stabilize the hospital nurse workforce.
Citation: Aiken LH, Sloane DM, McHugh MD . A repeated cross-sectional study of nurses immediately before and during the Co Nurs Outlook 2023 Jan-Feb; 71(1):101903. doi: 10.1016/j.outlook.2022.11.007..
Keywords: COVID-19, Provider: Nurse, Workforce, Burnout
Stockdill ML, Dionne-Odom JN, Wells R
African American recruitment in early heart failure palliative care trials: outcomes and comparison with the ENABLE CHF-PC randomized trial.
This study examined African American (AA) clinical trial recruitment and enrollment in a palliative care randomized controlled trial (RCT) for heart failure (HF) patients and compared patient baseline characteristics to other HF palliative care RCTs. The authors used the ENABLE CHF-PC (Educate, Nurture, Advise, Before Life Ends: Comprehensive Heartcare for Patients and Caregivers) RCT using bivariate statistics to compare racial and patient characteristics and differences through recruitment stages. They then compared the baseline sample characteristics among three palliative HF trials. They screened 785 patients, of whom 566 with NYHA classification III-IV were approached, with 461 enrolled and then 415 randomized. African Americans were more likely to consent than Caucasians (55%), were younger, had a lower ejection fraction, were more likely to be single, and lack an advanced directive. AAs reported higher goal setting, care coordination, and used more “denial” coping strategies. Compared to two recent HF RCTs, the ENABLE CHF-PC sample had a higher proportion of AAs.
Citation: Stockdill ML, Dionne-Odom JN, Wells R . African American recruitment in early heart failure palliative care trials: outcomes and comparison with the ENABLE CHF-PC randomized trial. J Palliat Care 2023 Jan;38(1):52-61. doi: 10.1177/0825859720975978..
Keywords: Racial / Ethnic Minorities, Palliative Care, Heart Disease and Health, Cardiovascular Conditions