National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- 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
Topics
- Access to Care (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (2)
- Blood Clots (1)
- (-) Cancer (13)
- Cancer: Breast Cancer (1)
- Cancer: Prostate Cancer (1)
- Cancer: Skin Cancer (2)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Comparative Effectiveness (2)
- Digestive Disease and Health (1)
- Evidence-Based Practice (3)
- Genetics (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Delivery (1)
- Healthcare Utilization (4)
- Hospitals (1)
- Medicare (1)
- Medication (1)
- Men's Health (1)
- Nursing (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (5)
- Patient Adherence/Compliance (1)
- Practice Patterns (1)
- Provider (1)
- Provider: Nurse (1)
- Quality of Care (3)
- Risk (1)
- Skin Conditions (1)
- Social Determinants of Health (1)
- Surgery (5)
- (-) Treatments (13)
- Uninsured (1)
- Vulnerable Populations (1)
- Women (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
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 DisplayedDinan MA, Wilson LE, Reed SD
Association of 21-gene assay (OncotypeDX) testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption.
This study looked at trends in the association of 21-gene assay testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption from 2001 to 2011. The investigators looked at updated SEER-Medicare data from 2004 and 2011. The cohort included 26,009 patients who met inclusion criteria. Assay use was associated with a decrease in absolute percentage use of chemotherapy by 4.5%, which became even more pronounced from 2008-2011 with a decrease of 6.8%.
AHRQ-funded; HS022189.
Citation: Dinan MA, Wilson LE, Reed SD .
Association of 21-gene assay (OncotypeDX) testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption.
Clin Breast Cancer 2020 Dec;20(6):487-94.e1. doi: 10.1016/j.clbc.2020.05.010..
Keywords: Cancer: Breast Cancer, Cancer, Treatments, Genetics, Medicare, Women, Healthcare Utilization
Friese CR, Fauer AJ, Kuisell C
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
The purpose of this study was to examine the feasibility of soliciting outcomes from adults who received chemotherapy treatment for cancer and to describe the patterns and correlates of patient-reported toxicities. Results determined that querying patients on chemotherapy treatment experiences and toxicities was feasible. Toxicity rates varied across practices, informing quality improvement. Toxicity severity and service use incidence exceed previously published trial data, particularly for pain, fatigue, and gastrointestinal issues. Open-text questions enabled exploration with newer treatment regimens.
AHRQ-funded; HS024914.
Citation: Friese CR, Fauer AJ, Kuisell C .
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
Health Serv Res 2020 Dec;55(6):966-72. doi: 10.1111/1475-6773.13574..
Keywords: Ambulatory Care and Surgery, Cancer, Treatments, Quality of Care, Patient-Centered Outcomes Research, Outcomes
Schlick CJR, Merkow RP, Yang AD
Post-discharge venous thromboembolism after pancreatectomy for malignancy: predicting risk based on preoperative, intraoperative, and postoperative factors.
Extended chemoprophylaxis is recommended for high-risk patients following pancreatectomy for malignancy. However, quantifying risk remains difficult. In this study, the investigators sought to (a) identify factors associated with post-discharge venous thromboembolism (VTE) following pancreatectomy for malignancy and (b) develop a post-discharge VTE risk calculator to identify high-risk patients. The investigators concluded that preoperative, intraoperative, and postoperative factors were associated with post-discharge VTE following pancreatectomy for malignancy.
AHRQ-funded; HS026385.
Citation: Schlick CJR, Merkow RP, Yang AD .
Post-discharge venous thromboembolism after pancreatectomy for malignancy: predicting risk based on preoperative, intraoperative, and postoperative factors.
J Surg Oncol 2020 Sep 15;122(4):675-83. doi: 10.1002/jso.26046..
Keywords: Cancer, Surgery, Treatments, Blood Clots, Risk
Lafferty M, Fauer A, Wright N
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
The purpose of this study was to examine the causes and consequences of chemotherapy treatment delays and possible solutions to improve quality of care. The authors identified four primary themes from the analysis that affect delays. They suggest future investigations to examine nurses' communication practices in the context of timely chemotherapy administration since communication and documentation technologies within healthcare settings continuously evolve.
AHRQ-funded; HS024914.
Citation: Lafferty M, Fauer A, Wright N .
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
Oncol Nurs Forum 2020 Jul 1;47(4):417-27. doi: 10.1188/20.Onf.417-427..
Keywords: Treatments, Cancer, Ambulatory Care and Surgery, Quality of Care, Clinician-Patient Communication, Communication, Provider: Nurse, Provider, Nursing, Chronic Conditions
Heneghan MB, Hussain T, Barrera L
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
This study examined parent- and patient-reported barriers to oral chemotherapy adherence with children with pediatric acute lymphoblastic leukemia (ALL). The medicine most often used was 6-mercaptopurine (6-MP). Forty-nine parents and 15 patients were surveyed and most reported at least one adherence barrier. Most of the barriers were about meeting other patients with ALL or meeting other parents. Patients also reported difficulty in finding out what their medications are, and what 6-MP does. These barriers can lead to relapse if they are not addressed.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
Pediatr Blood Cancer 2020 May;67(5):e28216. doi: 10.1002/pbc.28216..
Keywords: Children/Adolescents, Treatments, Cancer, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Herb JN, Dunham LN, Ollila DW
Use of completion lymph node dissection for sentinel lymph node-positive melanoma.
This study examined the use and time trends of completion lymph node dissection (CLND) for sentinel lymph node-positive melanoma (SNPM). There has been found to be no benefit for CLND in SNPM patients. The National Cancer Database was used to find patients 18 years and older from 2012 to 2016 with SNPM. During that time period, 7,146 patients were identified with SNPM. From 2012 to 2014 the proportion of patients undergoing CLND was steady (61-63%) but decreased to 57% in 2015 and 50% in 2016. Use was less likely for women and increasing age. Higher use was more likely at high-volume centers, and associated with increased Breslow depth and ulceration.
Citation: Herb JN, Dunham LN, Ollila DW .
Use of completion lymph node dissection for sentinel lymph node-positive melanoma.
J Am Coll Surg 2020 Apr;230(4):515-24. doi: 10.1016/j.jamcollsurg.2019.12.010..
Keywords: Cancer: Skin Cancer, Cancer, Skin Conditions, Treatments
Ellis RJ, Ho JW, Schlick CJR
National use of chemotherapy in initial management of stage I pancreatic cancer and failure to perform subsequent resection.
This paper investigated rates of resection surgery after upfront chemotherapy for patients treated for clinical stage I pancreatic adenocarcinoma. The authors used the National Cancer Database to identify eligible patients and a total of 17,495 patients were included. A total of 26.6% received upfront chemotherapy. Chemotherapy was most common in patients 80 years old or greater, had a T2 tumor, or were treated at a low-volume center. Only 33.5% of patients receiving upfront chemotherapy underwent subsequent resection. Resection was more likely in patients with T1 tumors or receiving treatment at a high-volume center. Rates of surgical resection after upfront chemotherapy are relatively low, but should be considered as part of an internal quality-of-cancer-care measure.
AHRQ-funded; HS023011; HS000078.
Citation: Ellis RJ, Ho JW, Schlick CJR .
National use of chemotherapy in initial management of stage I pancreatic cancer and failure to perform subsequent resection.
Ann Surg Oncol 2020 Mar;27(3):909-18. doi: 10.1245/s10434-019-08023-1..
Keywords: Cancer, Treatments, Surgery
Ellis RJ, Schlick CJR, Feinglass J
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
This study examined hospital variation in cancer patients who did not receive recommended chemotherapy. Patients with breast, colon, and lung cancers who did not receive chemotherapy from 2000 to 2015 were identified from the National Cancer Database. A total of 183,148 patients at 1281 hospitals were included. For breast cancer, 3.5% of patients failed to receive recommended chemotherapy, and 6.6% with colon, and 10.7% with lung cancer. Sociodemographic factors showed that patients were less likely to receive chemotherapy if they were uninsured or on Medicaid, as were non-Hispanic black patients with both breast and colon cancer. There was also significant hospital variation with failure to administer as high as 21.8% for breast, 40.2% for colon, and 40.0% for lung cancer.
AHRQ-funded; HS000078; HS026385.
Citation: Ellis RJ, Schlick CJR, Feinglass J .
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
BMJ Qual Saf 2020 Feb;29(2):103-12. doi: 10.1136/bmjqs-2019-009742..
Keywords: Treatments, Cancer, Healthcare Delivery, Access to Care, Healthcare Utilization, Social Determinants of Health, Vulnerable Populations, Uninsured, Hospitals, Quality of Care
Cornell M, Kaderka R, Hild SJ
Noninferiority study of automated knowledge-based planning versus human-driven optimization across multiple disease sites.
This study compared fully automated knowledge-based planning (KBP) versus human-driven plan optimization for dosimetry treatment across multiple disease types. Treatment site clinical KBP automated planning routines were developed for prostate, prostatic fossa, hypofractionated lung, and head and neck locations. Overall, fully automated KBP was noninferior to human-driven plan optimization and for many sites showed superiority.
AHRQ-funded; HS025440.
Citation: Cornell M, Kaderka R, Hild SJ .
Noninferiority study of automated knowledge-based planning versus human-driven optimization across multiple disease sites.
Int J Radiat Oncol Biol Phys 2020 Feb;106(2):430-39. doi: 10.1016/j.ijrobp.2019.10.036..
Keywords: Cancer, Treatments
Drucker AM, Adam GP, Rofeberg V
Treatments for primary squamous cell carcinoma and squamous cell carcinoma in situ of the skin: a systematic review and network meta-analysis summary of an Agency for Healthcare Research and Quality comparative effectiveness review.
This article discusses the results of a systematic review and network meta-analysis summary of treatments for primary squamous cell carcinoma (SCC) and squamous cell carcinoma in situ (SCCi) AHRQ comparative effective review. The authors included English-language randomized controlled trials (RCTs) with information on recurrence, histologic clearance, clinical clearance, cosmesis, and quality of life. They excluded studies enrolling less than 10 body lesions total or arms that had 5 or less lesions. They included 7 RCTs with a total of 418 participants. While they found some evidence of the best treatment options, there was little evidence to guide treatment of SC. There were no RCTs found on surgical modalities which is the first line of treatment for SCC.
AHRQ-funded; 290201500002I.
Citation: Drucker AM, Adam GP, Rofeberg V .
Treatments for primary squamous cell carcinoma and squamous cell carcinoma in situ of the skin: a systematic review and network meta-analysis summary of an Agency for Healthcare Research and Quality comparative effectiveness review.
J Am Acad Dermatol 2020 Feb;82(2):479-82. doi: 10.1016/j.jaad.2019.06.030..
Keywords: Cancer: Skin Cancer, Cancer, Comparative Effectiveness, Treatments, Evidence-Based Practice, Patient-Centered Outcomes Research
Khorfan R, Schlick CJR, Yang AD
Utilization of minimally invasive surgery and its association with chemotherapy for locally advanced gastric cancer.
This study compared outcomes of patients with T3 or greater and/or N+ gastric carcinoma who had minimally invasive surgery (MIS) or traditional open surgery. Patients who received MIS had a greater likelihood of receiving postoperative chemotherapy. Patients from the National Cancer Database (21,872) from 2010 to 2015 were identified. The majority (72.2%) received open surgery although MIS rates went up during that time period. Predictors of MIS were Asian race, any insurance coverage and treatment at high-volume centers. Survival rates were higher for MIS patients although that could be explained by their increased likelihood of receiving adjuvant chemotherapy.
AHRQ-funded; HS026385.
Citation: Khorfan R, Schlick CJR, Yang AD .
Utilization of minimally invasive surgery and its association with chemotherapy for locally advanced gastric cancer.
J Gastrointest Surg 2020 Feb;24(2):243-52. doi: 10.1007/s11605-019-04410-x.
.
.
Keywords: Surgery, Treatments, Cancer, Digestive Disease and Health, Healthcare Utilization, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Hoffman KE, Penson DF, Zhao Z
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
This study compared different treatment of men with favorable-risk prostate cancer and those with unfavorable-risk disease and their functional outcomes 5 years post-treatment. Treatment options for favorable-risk disease include active surveillance, nerve-sparing prostatectomy, external beam radiation therapy (EBRT), or low-dose-rate brachytherapy with prostatectomy being the most common. Treatment options for men with unfavorable-risk disease is prostatectomy or EBRT with androgen deprivation therapy (ADT). The cohort analyzed included men diagnosed with prostate cancer in 2011 through 2012, accrued from 5 Surveillance, Epidemiology and End Results Program sites and a US prostate cancer registry, using surveys through September 2017. A total of 2005 men met inclusion criteria. For men with favorable-risk disease low-dose-rate brachytherapy was associated with worse urinary irritative, and sexual and bowel function at 1 year compared with active surveillance. Nerve-sparing prostatectomy was associated with worse urinary incontinence at 5 years and sexual function at 3 years compared with active surveillance. EBRT was not associated with clinically different function changes from active surveillance at any point during the 5 years. For men with unfavorable-risk disease, EBRT with ADT was associated with lower hormonal function at 6 months, bowel function at 1 year, but better sexual function and incontinence than prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Hoffman KE, Penson DF, Zhao Z .
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
JAMA 2020 Jan 14;323(2):149-63. doi: 10.1001/jama.2019.20675..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Treatments, Men's Health, Adverse Events, Surgery
Ellis RJ, Schlick CJR, Yang AD
Utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy in the United States.
This paper discusses utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy (CRS/IPC) treatment for patients with peritoneal metastases (PM) in the United States. This treatment is becoming more popular in the US. The authors used the National Inpatient Sample to identify patients from 2006 to 2015 who underwent CRS/IPC. The number of CRS/IPC treatments increased from 189 to 1540. The most common indication was for appendiceal cancer, followed by ovarian and colorectal cancers. The procedure was performed the most in large teaching hospitals. The authors recommend the creation of a national registry dedicated to cases of IPC to help evaluate further use and outcomes.
AHRQ-funded; HS000078; HS026385.
Citation: Ellis RJ, Schlick CJR, Yang AD .
Utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy in the United States.
Ann Surg Oncol 2020 Jan;27(1):214-21. doi: 10.1245/s10434-019-07492-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Treatments, Cancer, Practice Patterns, Healthcare Utilization, Surgery