AHRQ Research Studies

Sign up: mail-updates-icon 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.

Lou Y, Cao J, Zhang S
Sample size calculations for time-averaged difference of longitudinal binary outcomes.
In this study, the researchers investigated sample size calculation for the comparison of time-averaged responses between treatment groups in clinical trials with longitudinally observed binary outcomes. Their simulation showed that the nominal power and type I error are well preserved over a wide range of design parameters. The researchers believe that theirs is the first study to consider the mixture of missing patterns in sample size calculation.
Commun Stat Theory Methods 2017;46(1):344-53. doi: 10.1080/03610926.2014.991040.
AHRQ-funded; HS022418.
View abstract on the National Library of Medicine site.
Keywords: Research Methodologies, Comparative Effectiveness, Outcomes
Cosgrove L, Krimsky S, Wheeler EE
Conflict of interest policies and industry relationships of guideline development group members: A cross-sectional study of clinical practice guidelines for depression.
The purpose of the present study was to assess a) the disclosure requirements of guideline development groups in a cross-section of guidelines for major depression; and, b) the extent and type of conflicts of panel members. It found that most of the guidelines were developed by panels that had members with industry financial ties to drug companies that manufacture antidepressant medication.
Account Res 2017;24(2):99-115. doi: 10.1080/08989621.2016.1251319.
AHRQ-funded; HS022940.
View abstract on the National Library of Medicine site.
Keywords: Guidelines, Disclosure, Antidepressants, Depression, Pharmaceuticals
Ratanawongsa N, Chan LL, Fouts MM
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations.
This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, it presents evidence for the adoption of RxNorm and standardized naming and picklist options for high alert medications such as insulin.
J Diabetes Res 2017;2017:8983237. doi: 10.1155/2017/8983237.
AHRQ-funded; HS022561; HS023558.
View abstract on the National Library of Medicine site.
Keywords: Electronic Health Records (EHRs), Computer-Based Provider Order Entry (CPOE), Safety Net, Diabetes, Patient Safety
Davidov DM, Davis SM, Zhu M
Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States.
The objective of this study was to estimate the rate of intimate partner violence -related hospitalizations in Appalachia and the non-Appalachian United States for 2007-2011 and compare hospitalizations in each region by clinical and sociodemographic factors.. After adjusting for age and rurality, Appalachian counties had a 22 percent higher hospitalization rate than non-Appalachian counties.
PLoS One 2017 Sep 8;12(9):e0184222. doi: 10.1371/journal.pone.0184222.
AHRQ-authored.
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Domestic Violence, Hospitalization, Socioeconomic Factors, Rural Health
AHRQ Author: Stocks C
Singal AG, Gupta S, Skinner CS
Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial.
Researchers compared the effectiveness of fecal immunochemical test (FIT) outreach and colonoscopy outreach to increase completion of the colorectal cancer (CRC) screening process (screening initiation and follow-up) within 3 years. Among persons aged 50 to 64 years receiving primary care at a safety-net institution, mailed outreach invitations offering FIT or colonoscopy compared with usual care increased the proportion completing CRC screening process within 3 years.
JAMA 2017 Sep 5;318(9):806-15. doi: 10.1001/jama.2017.11389.
AHRQ-funded; HS022418.
View abstract on the National Library of Medicine site.
Keywords: Colorectal Cancer, Colonoscopy, Screening, Comparative Effectiveness, Patient-Centered Outcomes Research
Zhang M, Silverberg JI, Kaffenberger BH
Prescription patterns and costs of acne/rosacea medications in Medicare patients vary by prescriber specialty.
The researchers described the medications used for treating acne/rosacea in the Medicare population and evaluated differences in costs between specialties. They concluded that costs of prescriptions for acne/rosacea from specialists are higher than those from primary care physicians and could be reduced by choosing generic and less expensive options.
J Am Acad Dermatol 2017 Sep;77(3):448-55.e2. doi: 10.1016/j.jaad.2017.04.1127.
AHRQ-funded; HS023011.
View abstract on the National Library of Medicine site.
Keywords: Medications, Skin Conditions, Health Care Costs, Medicare, Elderly
Wang SY, Dang W, Aldridge MD
Associations of hospice disenrollment and hospitalization with continuous home care provision.
The researchers examined rates of hospice disenrollment and posthospice hospitalization among patients who are enrolled in hospices that provide continuous home care (CHC) (CHC hospices) compared with patients who are enrolled in hospices that do not offer CHC (non-CHC hospices). They concluded that CHC hospices had significantly lower rates of hospice disenrollment and posthospice hospitalization, suggesting CHC service available may enable higher quality of end-of-life care.
Med Care 2017 Sep;55(9):848-55. doi: 10.1097/mlr.0000000000000776.
AHRQ-funded; HS023900.
View abstract on the National Library of Medicine site.
Keywords: End-of-Life Care, Hospitalization, Home Care, Palliative Care, Elderly
Vistnes JP, Rohde F, Miller GE
Substantial churn in health insurance offerings by small employers, 2014-15.
New data for 2014-15 from the Medical Expenditure Panel Survey-Insurance Component longitudinal survey show substantial churn in insurance offers by small employers (those with fifty or fewer workers), with 14.6 percent of employers that offered insurance in 2014 having dropped it in 2015 and 5.5 percent of those that did not offer it adding coverage.
Health Aff 2017 Sep;36(9):1632-36. doi: 10.1377/hlthaff.2017.0431.
AHRQ-authored.
View abstract on the National Library of Medicine site.
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Employer-Sponsored Health Insurance
AHRQ Author: Vistnes JP, Rohde F, Miller GE, Cooper PF
Spector WD, Limcangco R, Furukawa MF
The marginal costs of adverse drug events associated with exposures to anticoagulants and hypoglycemic agents during hospitalization.
The researchers estimated the marginal cost of care associated with anticoagulants and hypoglycemic agents for adults in 5 patient groups during their hospital stay and the total annual ADE costs for all patients exposed to these drugs during their stay. The 2013 hospital cost estimates for adverse drug events associated with anticoagulants and hypoglycemic agents were >$2.5 billion for each drug class.
Med Care 2017 Sep;55(9):856-63. doi: 10.1097/mlr.0000000000000780.
AHRQ-authored.
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Adverse Drug Events, Blood Thinners, Hospitalization, Health Care Costs
AHRQ Author: Spector WD, Limcangco R, Furukawa MF, Encinosa WE
Ratanawongsa N, Matta GY, Lyles CR
Multitasking and silent electronic health record use in ambulatory visits.
The researchers studied time allocation and transitions into and out of silent electronic health record (EHR) use in clinics after EHR implementation. Silent EHR use (n = 193 instances) occurred while clinicians viewed (39.4 percent) or entered (24.4 percent) information, prescribed (13.5 percent), reconciled medications (8.3 percent), arranged appointments (5.2 percent), ordered tests or referrals (5.2 percent),and sought or typed patient education (3.1 percent).
JAMA Intern Med 2017 Sep;177(9):1382-85. doi: 10.1001/jamainternmed.2017.2668.
AHRQ-funded; HS022408; HS023558; HS022561.
View abstract on the National Library of Medicine site.
Keywords: Electronic Health Records, Outpatient Care, Health Information Technology (HIT)
Nothelle SK, Sharma R, Oakes AH
Determinants of potentially inappropriate medication use in long-term and acute care settings: a systematic review.
The authors searched for studies conducted in the United States that described determinants of Potentially inappropriate medications (PIMs) use in adults >/=60 years of age in a nursing home or residential care facility, in the emergency department (ED), or in the hospital. They concluded that among older adults, those who are on many medications are at increased risk for PIM use across multiple settings.
J Am Med Dir Assoc 2017 Sep;18(9):806.e1-06.e17. doi: 10.1016/j.jamda.2017.06.005.
AHRQ-funded; HS000029.
View abstract on the National Library of Medicine site.
Keywords: Medications, Medication Safety, Long-Term Care, Acute Care, Elderly
Monroe AK, Fleishman JA, Voss CC
Assessing antiretroviral use during gaps in HIV primary care using multisite Medicaid claims and clinical data.
Some individuals who appear poorly retained by clinic visit-based retention measures are using antiretroviral therapy (ART) and maintaining viral suppression. Researchers examined whether individuals with a gap in HIV primary care (>/=180 days between HIV outpatient clinic visits) obtained ART during that gap after 180 days. They found that Medicaid-insured individuals commonly receive ART during gaps in HIV primary care, but almost half do not.
J Acquir Immune Defic Syndr 2017 Sep 1;76(1):82-89. doi: 10.1097/qai.0000000000001469.
AHRQ-authored; AHRQ-funded; 290201100007C.
View abstract on the National Library of Medicine site.
Keywords: Human Immunodeficiency Virus (HIV), Primary Care, Antiretroviral Therapy, Access to Care
AHRQ Author: Fleishman JA
Kwa MC, Ardalan K, Laumann AE
Predictors of hospitalization, length of stay and costs of care among adults with dermatomyositis in the United States.
The researchers sought to determine the prevalence and risk factors for hospitalization with dermatomyositis and to assess inpatient burden of dermatomyositis. They concluded that there is a significant and increasing inpatient burden for dermatomyositis in the US. Also, there appear to be racial differences as non-whites have higher prevalence of admission, increased length of stay and cost of care.
Arthritis Care Res 2017 Sep;69(9):1391-99. doi: 10.1002/acr.23190.
AHRQ-funded; HS023011.
View abstract on the National Library of Medicine site.
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Health Insurance, Skin Conditions
Hudson JL, Moriya AS
Medicaid expansion for adults had measurable 'welcome mat' effects on their children.
This study used data from the 2013-15 American Community Survey to provide the first national-level (analytical) estimates of welcome-mat effects on children's coverage post Affordable Care Act (ACA). It estimated that 710,000 low-income children gained coverage through these effects. The study was also the first to show a link between parents' eligibility for Medicaid and welcome-mat effects for their children under the ACA.
Health Aff 2017 Sep;36(9):1643-51. doi: 10.1377/hlthaff.2017.0347.
AHRQ-authored.
View abstract on the National Library of Medicine site.
Keywords: Children, Health Insurance, Health Reform, Low-Income Population
AHRQ Author: Hudson JL, Moriya AS
Hernandez-Boussard T, Graham LA, Desai K
The fifth vital sign: postoperative pain predicts 30-day readmissions and subsequent emergency department visits.
The researchers hypothesized that inpatient postoperative pain trajectories are associated with 30-day inpatient readmission and emergency department (ED) visits. After analyzing National Veterans Affairs Surgical Quality Improvement data on inpatient general, vascular, and orthopedic surgery from 2008 to 2014, they concluded that postoperative pain trajectories identify populations at risk for 30-day readmissions and ED visits, and do not seem to be mediated by postdischarge complications.
Ann Surg 2017 Sep;266(3):516-24. doi: 10.1097/sla.0000000000002372.
AHRQ-funded; HS024096.
View abstract on the National Library of Medicine site.
Keywords: Pain, Readmissions, Emergency Department, Emergency Medical Services
Fehr JJ, McBride ME, Boulet JR
The simulation-based assessment of pediatric rapid response teams.
The researchers created scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. The greater scores achieved by intensivist-in-training-led teams provides some evidence to support the validity of the assessment.
J Pediatr 2017 Sep;188:258-62.e1. doi: 10.1016/j.jpeds.2017.03.030.
AHRQ-funded; HS018734.
View abstract on the National Library of Medicine site.
Keywords: Pediatrics, Training, Team Work, Medical Education, Critical Care
Saiman L, Maykowski P, Murray M
Incidence, risks, and types of infections in pediatric long-term care facilities.
The researchers described the types of infections diagnosed in residents of pediatric long-term care facilities, calculate infection rates, and identified risk factors for respiratory tract infections (RTIs). RTIs were the most common infections diagnosed, but modifiable risk factors for RTIs were not identified. Also included in the study were skin and soft-tissue infections; chronic comorbid conditions, including neurologic and respiratory disorders; and device use.
JAMA Pediatr 2017 Sep;171(9):872-78. doi: 10.1001/jamapediatrics.2017.1482.
AHRQ-funded; HS021470.
View abstract on the National Library of Medicine site.
Keywords: Healthcare-Associated Infections, Long-Term Care, Patient Safety, Children, Risk Factors
Patterson BW, Smith MA, Repplinger MD
Using chief complaint in addition to diagnosis codes to identify falls in the emergency department.
The researchers compared incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information. They concluded that identifying individuals in the ED who have fallen based on diagnosis codes underestimates the true burden of falls.
J Am Geriatr Soc 2017 Sep;65(9):E135-E40. doi: 10.1111/jgs.14982.
AHRQ-funded; HS024558.
View abstract on the National Library of Medicine site.
Keywords: Falls, Emergency Medical Services, Emergency Department
Neuman MI, Hall M, Lipsett SC
Utility of blood culture among children hospitalized with community-acquired pneumonia.
The researchers sought to determine the prevalence of bacteremia and characterize the microbiology and penicillin-susceptibility patterns of positive blood culture results among children hospitalized with community-acquired pneumonia (CAP). Among children without comorbidities hospitalized with CAP in a non-ICU setting, the rate of bacteremia was low, and isolated pathogens were usually susceptible to penicillin. Blood cultures may not be needed for most children hospitalized with CAP.
Pediatrics 2017 Sep;140(3):pii: e20171013. doi: 10.1542/peds.2017-1013.
AHRQ-funded; HS022342; HS019862.
View abstract on the National Library of Medicine site.
Keywords: Hospitalization, Children, Child/Adolescent Health, Medications
Fowler AC, Grabowski DC, Gambrel RJ
Corporate investors increased common ownership in hospitals and the postacute care and hospice sectors.
The researchers used data from the Provider Enrollment, Chain, and Ownership System of the Centers for Medicare and Medicaid Services to identify common investor ownership linkages across the acute care, postacute care, and hospice sectors within the same geographic markets. To our knowledge, this study provides the first description of common investor ownership trends in these sectors.
Health Aff 2017 Sep;36(9):1547-55. doi: 10.1377/hlthaff.2017.0591.
AHRQ-funded; HS024072.
View abstract on the National Library of Medicine site.
Keywords: Hospitals, health care delivery, Organization and Administration, Acute Care

Pages