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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedTabatneck ME, He W, Lamb GS
Interferon gamma release asssay results and testing trends among patients younger than 2 years old at two US health centers.
Researchers performed a retrospective cohort study of interferon-gamma release assay (IGRA) use for the diagnosis of tuberculosis infection in patients under 2 years old in two large Boston healthcare systems. A total of 321 IGRA results were analyzed; over 90 percent were valid. The proportion of invalid/indeterminate results was found to be significantly higher among immunocompromised patients. The researchers concluded that the high proportion of valid IGRA test results in patients less than 2 years of age in a low TB prevalence setting supported the adoption of IGRAs for this age group in certain clinical scenarios. They note that the interpretation of IGRAs, particularly in immunocompromised patients, should consider the broader clinical context.
AHRQ-funded; HS000063.
Citation: Tabatneck ME, He W, Lamb GS .
Interferon gamma release asssay results and testing trends among patients younger than 2 years old at two US health centers.
Pediatr Infect Dis J 2023 Mar; 42(3):189-94. doi: 10.1097/inf.0000000000003794..
Keywords: Newborns/Infants, Diagnostic Safety and Quality, Infectious Diseases
Starnes LS, Krehnbrink M, Carroll AR
A pain in the neck: an adolescent with neck pain.
This case study involves a 15-year-old boy who presents with several years of intermittent neck pain, which has acutely worsened during the past 4 days. Patient history, diagnosis (Salmonella osteomyelitis.), and treatment are explored.
AHRQ-funded; HS026122.
Citation: Starnes LS, Krehnbrink M, Carroll AR .
A pain in the neck: an adolescent with neck pain.
Pediatr Rev 2022 Mar;43(3):174-77. doi: 10.1542/pir.2020-004168..
Keywords: Children/Adolescents, Infectious Diseases, Diagnostic Safety and Quality, Case Study, Evidence-Based Practice
Miller AC, Koeneman SH, Arakkal AT
Incidence, duration, and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: a population-based longitudinal study.
This retrospective cohort study determined the frequency and duration of diagnostic delays for herpes simplex encephalitis (HSE) that are associated with increased morbidity and mortality. Data from the IBM Marketscan Databases from 2001-2017 was used. The authors estimated the number of visits with HSE-related symptoms before diagnosis that would be expected to occur in the absence of delays and compared this estimate to the observed pattern of visits. Then a simulation-based approach was used to compute the number of visits representing a delay. They identified 2667 patients diagnosed with HSE and estimated 45.9% of patients experienced at least 1 missed opportunity, with 21.9% of patients having delays lasting >7 days. Risk factors for delays included being seen only in the emergency department, age 65 or older, or a history of sinusitis or schizophrenia.
AHRQ-funded; HS027375.
Citation: Miller AC, Koeneman SH, Arakkal AT .
Incidence, duration, and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: a population-based longitudinal study.
Open Forum Infect Dis 2021 Sep;8(9):ofab400. doi: 10.1093/ofid/ofab400..
Keywords: Infectious Diseases, Neurological Disorders, Diagnostic Safety and Quality, Risk
Michelson KA, Neuman MI, Pruitt CM
Height of fever and invasive bacterial infection.
This study evaluated the association of higher fevers with invasive bacterial infection (IBI) among febrile infants ≤60 days of age. Maximum temperatures of febrile infants with IBI were compared to infants without IBI. The median temperature was higher for infants with IBI (38.8°C) compared to those without IBI (38.4°C). Temperatures ranges of 39°C-39.4°C and 39.5°C-39.9°C were associated with a higher likelihood of IBI, although 30.4% of febrile infants with IBI had maximum temperatures <38.5°C.
AHRQ-funded; HS026006; HS026503.
Citation: Michelson KA, Neuman MI, Pruitt CM .
Height of fever and invasive bacterial infection.
Arch Dis Child 2021 Jun;106(6):594-96. doi: 10.1136/archdischild-2019-318548..
Keywords: Newborns/Infants, Infectious Diseases, Diagnostic Safety and Quality, Risk
Asti L, Hopley C, Avelis C
The potential clinical and economic value of a human papillomavirus primary screening test that additionally identifies genotypes 31, 45, 51, and 52 individually.
This study looked at the potential clinical and economic value of a human papillomavirus (HPV) primary screening test that additionally identified genotypes 31,45,51, and 52 along with genotypes 16 and 18. The authors developed a Markov model of the HPV disease course and evaluated the clinical and economic value of HPV primary screening with Onclarity. Currently HPV primary screening results in 25,194 invasive procedures and 48 invasive cervical cancer (ICC) cases per 100,000 women. Screening with extended genotyping and later screening women with certain genotypes averted 903 to 3163 invasive procedures and results in 0 to 3 more ICC cases compared with current primary screening tests. Extended genotyping was cost effective when costing $75 and cost saving when costing $43. When the probabilities of disease progression increased 2-4 times, it was not cost-effective because it resulted in more ICC cases and accrued fewer quality-adjusted life-years.
AHRQ-funded; HS023317.
Citation: Asti L, Hopley C, Avelis C .
The potential clinical and economic value of a human papillomavirus primary screening test that additionally identifies genotypes 31, 45, 51, and 52 individually.
Sex Transm Dis 2021 May;48(5):370-80. doi: 10.1097/olq.0000000000001327.
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Keywords: Sexual Health, Infectious Diseases, Screening, Diagnostic Safety and Quality, Genetics, Cancer: Cervical Cancer, Cancer, Women
Rodriguez PJ, Roberts DA, Meisner J
Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study.
Dual HIV and syphilis testing might help to prevent mother-to-child transmission (MTCT) of HIV and syphilis through increased case detection and treatment. In this study, the investigators aimed to model and assess the cost-effectiveness of dual testing during antenatal care in four countries with varying HIV and syphilis prevalence. The authors concluded that incorporating dual rapid diagnostic tests in antenatal care could be cost-saving across countries with varying HIV prevalence.
AHRQ-funded; HS013853.
Citation: Rodriguez PJ, Roberts DA, Meisner J .
Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study.
Lancet Glob Health 2021 Jan;9(1):e61-e71. doi: 10.1016/s2214-109x(20)30395-8..
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Prevention, Pregnancy, Women, Diagnostic Safety and Quality, Healthcare Costs
Iribarren S, Lentz C, Sheinfil AZ
Using an HIV self-test kit to test a partner: attitudes and preferences among high-risk populations.
Researchers explored attitudes and preferences among HIV-negative men who have sex with men and HIV-negative transgender women using an HIV self-testing (HIVST) kit to test partners. They found that most preferred gum swab over fingerprick tests, but would prefer a blood test if it gave results for other sexually transmitted infections (STIs). They concluded that efforts to improve HIVST uptake should focus on incorporating testing for other STIs, reducing test kit size, and reducing cost.
AHRQ-funded; HS026383.
Citation: Iribarren S, Lentz C, Sheinfil AZ .
Using an HIV self-test kit to test a partner: attitudes and preferences among high-risk populations.
AIDS Behav 2020 Nov;24(11):3232-43. doi: 10.1007/s10461-020-02885-3..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Infectious Diseases, Prevention
Fleischer E, Aronson PL
Rapid diagnostic tests for meningitis and encephalitis-BioFire.
This article reports on the BioFire FilmArray Meningitis/Encephalitis Panel, the first FDA-cleared multiplex polymerase chain reaction for the evaluation of cerebrospinal fluid samples. This newer rapid diagnostic tool has an overall high sensitivity and specificity for the diagnosis of meningitis and encephalitis (ME), with a fast turnaround time and the potential to improve resource utilization for patients presenting with suspicion of ME. However, further research is recommended to determine its optimal use in the evaluation of patients with suspected ME.
AHRQ-funded; HS026006.
Citation: Fleischer E, Aronson PL .
Rapid diagnostic tests for meningitis and encephalitis-BioFire.
Pediatr Emerg Care 2020 Aug;36(8):397-401. doi: 10.1097/pec.0000000000002180..
Keywords: Diagnostic Safety and Quality, Neurological Disorders, Infectious Diseases
Brower LH, Wilson PM, Murtagh-Kurowski E
Evaluation for neonatal HSV in infants undergoing workup for serious bacterial infection: a 5-year retrospective review.
The purpose of this study was to describe the characteristics of infants evaluated for serious bacterial infection, focusing on empirical testing and treatment of herpes simplex virus (HSV) and describe the characteristics of HSV-positive patients. The investigators concluded that the absence of fever should not preclude a workup for HSV in neonates, and when a workup is initiated, emphasis should be placed on obtaining samples from serum, cerebrospinal fluid, and surface specimens.
AHRQ-funded; HS026763.
Citation: Brower LH, Wilson PM, Murtagh-Kurowski E .
Evaluation for neonatal HSV in infants undergoing workup for serious bacterial infection: a 5-year retrospective review.
Hosp Pediatr 2020 Jun;10(6):463-70. doi: 10.1542/hpeds.2020-0033..
Keywords: Newborns/Infants, Infectious Diseases, Diagnostic Safety and Quality
Aronson PL, Cruz AT, Freedman SB
Association of herpes simplex virus testing with hospital length of stay for infants </=60 days of age undergoing evaluation for meningitis.
The objective of this study was to examine the association of cerebrospinal fluid herpes simplex virus polymerase chain reaction (CSF HSV PCR) testing with length of stay in a 20-center retrospective cohort of hospitalized infants aged </=60 days undergoing evaluation for meningitis after adjustment for patient-level factors and clustering by center. The investigators found that of 20,496 eligible infants, 7,399 (36.1%) had a CSF HSV PCR test performed, and 46 (0.6% of those tested) had a positive test.
AHRQ-funded; HS026006.
Citation: Aronson PL, Cruz AT, Freedman SB .
Association of herpes simplex virus testing with hospital length of stay for infants </=60 days of age undergoing evaluation for meningitis.
J Hosp Med 2019 Aug;14(8):492-95. doi: 10.12788/jhm.3202..
Keywords: Diagnostic Safety and Quality, Infectious Diseases, Newborns/Infants
Schneider JG, Wood JB, Schmitt BH
Susceptibility Provision Enhances Effective De-escalation (SPEED): utilizing rapid phenotypic susceptibility testing in Gram-negative bloodstream infections and its potential clinical impact.
In this study, the investigators evaluated the performance and time to result for pathogen identification (ID) and antimicrobial susceptibility testing (AST) of the Accelerate Pheno system (AXDX) compared with standard of care (SOC) methods. They also assessed the hypothetical improvement in antibiotic utilization if AXDX had been implemented. The authors indicated that by providing fast and reliable ID and AST results, AXDX has the potential to improve antimicrobial utilization and enhance antimicrobial stewardship.
AHRQ-funded; HS026390.
Citation: Schneider JG, Wood JB, Schmitt BH .
Susceptibility Provision Enhances Effective De-escalation (SPEED): utilizing rapid phenotypic susceptibility testing in Gram-negative bloodstream infections and its potential clinical impact.
J Antimicrob Chemother 2019 Jan;74(Suppl 1):i16-i23. doi: 10.1093/jac/dky531..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Antibiotics, Medication, Diagnostic Safety and Quality
Muenks CE, Hogan PG, Burnham CD
Comparing the yield of Staphylococcus aureus recovery with static versus agitated broth incubation.
This study sought to compare the yield of Staphylococcus aureus with a broth enrichment method when incubated in agitated versus static conditions. The investigators found that when broth enrichment was used (both static and agitated), the burden of S. aureus growth was higher compared to the direct plating culture method.
AHRQ-funded; HS021736; HS024269.
Citation: Muenks CE, Hogan PG, Burnham CD .
Comparing the yield of Staphylococcus aureus recovery with static versus agitated broth incubation.
J Pathog 2018 Jul 26;2018:1462671. doi: 10.1155/2018/1462671..
Keywords: Diagnostic Safety and Quality, Research Methodologies, Infectious Diseases
Linder JA
Sore throat: avoid overcomplicating the uncomplicated.
In this editorial, the author described issues involving sore throat diagnosis and delineated various points concerning an article within the same journal issue, concluding that physicians should remember that the prevalence of group A streptococcus in adults with a sore throat is approximately 10%; and that they should use the Centor scoring criteria; selectively use rapid antigen-detection testing; limit antibiotic treatment to patients most likely to have group A streptococcus; and most of the time when prescribing antibiotics, use penicillin.
AHRQ-funded; HS018419.
Citation: Linder JA .
Sore throat: avoid overcomplicating the uncomplicated.
Ann Intern Med 2015 Feb 17;162(4):311-2. doi: 10.7326/m14-2899.
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Keywords: Antibiotics, Diagnostic Safety and Quality, Infectious Diseases, Medication, Pneumonia, Respiratory Conditions, Practice Patterns