National Healthcare Quality and Disparities Report
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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 25 of 51 Research Studies DisplayedAnderson TS, Marcantonio ER, McCarthy EP
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
The purpose of this retrospective cohort study was to examine whether patients with dementia have a higher risk of adverse outcomes post-discharge. The researchers included Medicare beneficiaries hospitalized in 2016 and evaluated the co-primary outcomes of mortality and readmission within 30 days of hospital discharge. The final cohort included 1,089,109 hospitalizations of which 19.3% were of patients with diagnosed dementia and 886,411 were of patients without dementia. The study found that at 30 days following discharge, 5.7% of patients with dementia had died compared to 3.1% of patients without dementia. At 30 days following discharge, 17.7% of patients with dementia had been readmitted compared to 13.1% of patients without dementia. Patients with dementia who were discharged to the community had an increased likelihood of being readmitted than those who were discharged to nursing facilities, and, when readmitted, had an increased likelihood of dying during the readmission. The study concluded that diagnosed dementia was related with a substantially increased risk of mortality and a modestly increased risk of readmission within 30 days of discharge.
AHRQ-funded; HS026215.
Citation: Anderson TS, Marcantonio ER, McCarthy EP .
Association of diagnosed dementia with post-discharge mortality and readmission among hospitalized Medicare beneficiaries.
J Gen Intern Med 2022 Dec;37(16):4062-70. doi: 10.1007/s11606-022-07549-7..
Keywords: Dementia, Neurological Disorders, Medicare, Elderly, Hospital Readmissions, Mortality
Gaugler JE, Rosebush CA, Zmora R
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
The purpose of this study was to evaluate whether Remote Activity Monitoring (RAM) technology was associated with reductions in negative health transitions and service utilization for persons with Alzheimer's disease or a related dementia over an 18-month period. The researchers enrolled 88 recipients and their caregivers in a clinical trial, with 88 care recipients and their caregivers in the RAM intervention arm and 91 care recipients and their caregivers in the control arm. The treatment group had the RAM system installed in their home. The attention control group did not receive RAM technology. Baseline and follow-up surveys assessed whether the care recipient had fallen or wandered in the past 6 months (yes/no). Caregivers were also asked whether the care recipient had used any of the following healthcare services in the past 6 months: nursing home stays, assisted living stays other residential care stays, hospital stays, or emergency room visits. The study found that in adjusted models, emergency department visits were almost 50% lower in the intervention group compared with the control group. In addition, the odds of experiencing a higher frequency of falls versus a lower frequency of falls was 0.36 for those in the intervention group compared with controls. The RAM technology did not have a statistically significant effect on any other outcome. The researchers concluded that although RAM did not provide direct support for the management of behaviors for persons with AD/ADRD, the findings imply that this technology may prevent some adverse health events for people living with dementia in the community. The ongoing, unobtrusive monitoring and system alerts of RAM may have resulted in caregivers identifying activity or the lack thereof that may
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
AHRQ-funded; HS022836.
Citation: Gaugler JE, Rosebush CA, Zmora R .
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
J Am Geriatr Soc 2022 Aug;70(8):2439-42. doi: 10.1111/jgs.17839..
Keywords: Elderly, Dementia, Neurological Disorders, Telehealth, Health Information Technology (HIT), Outcomes, Caregiving
Saldanha IJ, Cao W, Bhuma MR
Systematic reviews can guide clinical practice and new research on primary headaches in pregnancy: an editorial on the 2022 American Headache Society Members' Choice Award paper.
This article describes the systematic review paper that was done on management of primary headaches during pregnancy, postpartum, and breastfeeding, which won the 2021 American Headache Society’s Member’s Choice Award. The findings are summarized in this paper, which discusses different pharmacologic interventions and their possible effects on the fetus/child and mother. Evidence was summarized for prevention and treatment of primary headache. The authors did not find a lot of evidence for harms or benefits but called for more studies to be done.
AHRQ-funded; 290201500002I.
Citation: Saldanha IJ, Cao W, Bhuma MR .
Systematic reviews can guide clinical practice and new research on primary headaches in pregnancy: an editorial on the 2022 American Headache Society Members' Choice Award paper.
Headache 2022 Jul;62(7):774-76. doi: 10.1111/head.14332..
Keywords: Neurological Disorders, Pregnancy, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research
Nelson KE, Chakravarti V, Diskin C
Validation of neurologic impairment diagnosis codes as signifying documented functional impairment in hospitalized children.
This study’s objective was to assess the performance of previously published high-intensity neurologic impairment (NI) diagnosis codes in identification of hospitalized children with clinical NI. This retrospective study of 500 randomly selected discharges in 2019 was conducted at a freestanding children’s hospital. Charts were reviewed for: 1) NI discharge diagnosis codes and 2) documentation of clinical NI (a neurologic diagnosis and indication of functional impairment like medical technology). Diagnosis codes identified clinically documented NI with 88.1% specificity, and 79.4% sensitivity; negative predictive value (NPV) was 96.7%, and positive predictive value (PPV) was 49%. Including children with milder functional impaired results in NPV of 95.7% and PPV of 77.5%. Restriction to children with more severe functional impairment increased NPV and decreased PPV. Misclassification was mostly due to inclusion of children without functional impairments.
AHRQ-funded; HS025138.
Citation: Nelson KE, Chakravarti V, Diskin C .
Validation of neurologic impairment diagnosis codes as signifying documented functional impairment in hospitalized children.
Acad Pediatr 2022 Jul;22(5):782-88. doi: 10.1016/j.acap.2021.07.014..
Keywords: Children/Adolescents, Neurological Disorders, Diagnostic Safety and Quality
Givan A, Downer B, Chou LN
Cognitive impairment and low physical function among older Mexican Americans: findings from a 20-year follow-up(☆).
This longitudinal study’s aim was to examine the association between cognitive impairment and low physical function over a 20-year follow-up period among Mexican Americans aged 65 and older. The final sample included 1545 community-dwelling Mexican Americans from the Hispanic Established Population for the Epidemiological Study of the Elderly, who scored moderate-high on Short Physical Performance Battery (SPPB) and were non-disabled at baseline (1993/94). The Mini Mental State Examination scale defines cognitive impairment as less than 21 points. General Estimating Equation was used to estimate the odds of having low physical function (defined with the SPPB at <7 points) over time as a function of cognitive impairment, adjusting for socio-demographics, self-reported medical conditions, body mass index, and depressive symptoms. Participants with cognitive impairment had increased odds of lower physical function over time compared to those without cognitive impairment.
AHRQ-funded; HS026133.
Citation: Givan A, Downer B, Chou LN .
Cognitive impairment and low physical function among older Mexican Americans: findings from a 20-year follow-up(☆).
Ann Epidemiol 2022 Jun;70:9-15. doi: 10.1016/j.annepidem.2022.03.006..
Keywords: Elderly, Racial and Ethnic Minorities, Neurological Disorders
Green RK, Shah MN, Clark LR
Comparing emergency department use among individuals with varying levels of cognitive impairment.
This study compared the frequency of emergency department (ED) use among a cohort of individuals with mild to well-defined cognitive impairment. This retrospective cohort study of English-speaking, community-dwelling individuals was conducted at four health system-based multidisciplinary clinics from 2014 to 2016. The authors obtained demographic and clinical data, including neuropsychological testing results, through chart review and linkage to electronic health record data. They characterized the frequency and quantity of ED use within one year (6 months before and after) of cognitive evaluation and compared ED use between the three groups using bivariate and multivariate approaches. Of the 779 eligible patients, 89 were diagnosed as cognitively intact, 372 as having mild cognitive impairment (MCI), and 318 as having Alzheimer’s Disease and related dementias (ADRD). The proportion of subjects with any annual ED use did not significantly increase with greater cognitive impairment. The average number of ED visits also did not increase significantly with patients with MCI or ADRD having an elevated but non-significant risk of an ED visit compared to cognitively intact individuals.
AHRQ-funded; HS024558.
Citation: Green RK, Shah MN, Clark LR .
Comparing emergency department use among individuals with varying levels of cognitive impairment.
BMC Geriatr 2022 May 2;22(1):382. doi: 10.1186/s12877-022-03093-5..
Keywords: Emergency Department, Neurological Disorders, Healthcare Utilization
Washington KT, Kukulka K, Govindarjan R
Engaging specialist palliative care in the management of amyotrophic lateral sclerosis: a patient-, family-, and provider-based approach.
Investigators sought to describe key stakeholders' perspectives on specialist palliative care and its integration into the management of amyotrophic lateral sclerosis (ALS). Individual interviews were conducted with 42 stakeholders; the interview transcriptions were analyzed using inductive thematic analysis techniques. The investigators found that stakeholders expressed limited or inaccurate understandings of palliative care's definition and purpose. Stakeholders generally supported the integration of specialist palliative care into ALS management and recognized the value of early integration of palliative services in both the community and the clinical setting.
AHRQ-funded; HS022140.
Citation: Washington KT, Kukulka K, Govindarjan R .
Engaging specialist palliative care in the management of amyotrophic lateral sclerosis: a patient-, family-, and provider-based approach.
J Palliat Care 2022 Apr;37(2):170-76. doi: 10.1177/0825859719895827..
Keywords: Palliative Care, Neurological Disorders
Rafferty MR, Held Bradford EC, Fritz S
Health promotion and wellness in neurologic physical therapy: strategies to advance practice.
The purpose of this special interest article was to provide consensus-driven strategies to address barriers to implementing health promotion and wellness (HPW)-related neurologic physical therapy (PT) practice. Four key strategies emerged, and recommendations included having clinicians practice to their full scope of HPW-related PT practice, including optimizing movement, including physical activity and fitness, and reinforcing the importance of healthy sleep, nutrition, stress, and smoking cessation.
AHRQ-funded; HS025077.
Citation: Rafferty MR, Held Bradford EC, Fritz S .
Health promotion and wellness in neurologic physical therapy: strategies to advance practice.
J Neurol Phys Ther 2022 Apr 1;46(2):103-17. doi: 10.1097/npt.0000000000000376..
Keywords: Health Promotion, Neurological Disorders
Hua CL, Thomas KS, Bunker JN
Dementia diagnosis in the hospital and outcomes among patients with advanced dementia documented in the Minimum Data Set.
This retrospective cohort study examined the association between a dementia diagnosis listed on a hospital claim and patient outcomes among individuals with a Minimum Data Set (MDS) assessment. The cohort was comprised of hospitalized patients aged 66 years and older with advanced dementia noted on an MDS assessment completed within 120 days prior to their first hospitalization in 2017. Among 120,989 patients with advanced dementia and a nursing home stay, 90.6% had a dementia diagnosis on their hospital claims. Documentation of a dementia diagnosis was associated with lower use of intensive care unit or coronary care unit, use of invasive mechanical ventilation, and 30-day mortality. These patients also had a shorter hospital length of stay.
AHRQ-funded; HS000011.
Citation: Hua CL, Thomas KS, Bunker JN .
Dementia diagnosis in the hospital and outcomes among patients with advanced dementia documented in the Minimum Data Set.
J Am Geriatr Soc 2022 Mar;70(3):846-53. doi: 10.1111/jgs.17564..
Keywords: Dementia, Diagnostic Safety and Quality, Medicare, Hospitals, Neurological Disorders
Yadgir SR, Engstrom C, Jacobsohn GC
Machine learning-assisted screening for cognitive impairment in the emergency department.
Researchers developed and evaluated an automated screening tool to identify a subset of patients at high risk for cognitive impairment (CI). Using the Blessed Orientation Memory Concentration (BOMC) test, administered in the emergency department, they found that an algorithm based on electronic health record data can define a subset of patients at higher risk for CI. They recommended that incorporating such an algorithm into a screening workflow could allow screening efforts and resources to be focused where they have the most impact.
AHRQ-funded; HS024558.
Citation: Yadgir SR, Engstrom C, Jacobsohn GC .
Machine learning-assisted screening for cognitive impairment in the emergency department.
J Am Geriatr Soc 2022 Mar;70(3):831-37. doi: 10.1111/jgs.17491..
Keywords: Neurological Disorders, Screening, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT), Elderly
Lee W, Gray SL, Zaslavsky O
Association between having a family member with dementia and perceptions of dementia preventability.
This study examined how having a family history of dementia and caregiving experience are associated with perceptions about and self-efficacy for dementia preventability. Participants were surveyed whether they had a family member with dementia, and if they need whether they served as a caregiver. Of 1,575 respondents, 71% had a family member with dementia, and of those 42% served as a caregiver. People with a family member with dementia were less likely to believe that dementia is preventable and had lower self-efficacy for dementia prevention. Survey participants who were also caregivers had an even lower perception about dementia preventability.
AHRQ-funded; HS022982.
Citation: Lee W, Gray SL, Zaslavsky O .
Association between having a family member with dementia and perceptions of dementia preventability.
Aging Ment Health 2022 Feb;26(2):270-76. doi: 10.1080/13607863.2020.1839866..
Keywords: Dementia, Caregiving, Family Health and History, Prevention, Neurological Disorders
Diskin C, Malik K, Gill PJ
Research priorities for children with neurological impairment and medical complexity in high-income countries.
This paper describes a modified three-stage Delphi study using online surveys to identify the highest-priority clinical research areas related to children with neurological impairment and medical complexity among clinicians and caregivers. Round 1 comprised of a diverse international expert panel of 49 clinicians and 12 family caregivers suggesting clinical topics and related questions that require research to support this subgroup of children. A steering committee refined the suggestions, and then participants contributed to 1 (family caregivers) or 2 (clinicians) subsequent rounds to develop a prioritized list. A total of 601 responses were provided, with the responses distilled into 26 clinical topics comprising 126 related questions. Top clinical topics prioritized for research were irritability and pain, child mental health, disorders of tone, polypharmacy, sleep, aspiration, behavior, dysautonomia, and feeding intolerance. Ten specific research questions were also prioritized by the clinician expert panel.
AHRQ-funded; HS025138.
Citation: Diskin C, Malik K, Gill PJ .
Research priorities for children with neurological impairment and medical complexity in high-income countries.
Dev Med Child Neurol 2022 Feb; 64(2):200-08. doi: 10.1111/dmcn.15037..
Keywords: Children/Adolescents, Neurological Disorders
Rosenthal M, Poling J, Wec A
"Medication is just one piece of the whole puzzle": how nursing homes change their use of antipsychotic medications.
This article investigated health professionals’ experiences with decision-making during changes under the National Partnership to Improve Dementia Care in Nursing Homes and its companion coalitions. These programs were introduced in 2012 for the purpose of encouraging reductions in antipsychotic use and increasing use of nonpharmacological treatments for dementia. Interviews were conducted with 40 nursing home physicians and staff in seven states. The authors found that reducing antipsychotics is more time and resource-intensive than relying on medication. However, respondents supported reductions in antipsychotic use. They indicated that with supported staffing, effective communications, and training, they could create or implement individualized treatments.
AHRQ-funded; HS023464.
Citation: Rosenthal M, Poling J, Wec A .
"Medication is just one piece of the whole puzzle": how nursing homes change their use of antipsychotic medications.
J Appl Gerontol 2022 Jan;41(1):62-72. doi: 10.1177/0733464820958919..
Keywords: Elderly, Medication, Nursing Homes, Dementia, Neurological Disorders, Long-Term Care, Shared Decision Making
Kerber KA, Carender W, Telian SA
Patient self-management of benign paroxysmal positional vertigo: instructional video development and preliminary evaluation of behavioral outcomes.
Researchers sought to develop and preliminarily evaluate a patient-oriented benign paroxysmal positional vertigo of the posterior canal (PC-BPPV) self-management instructional video. They found that participants rated the PC-BPPV self-management video favorably on measures that contribute to behavioral intent to perform the Dix-Hallpike test or the canalith repositioning maneuver. These findings provide support that the video is appropriate to use in future studies that evaluate patient self-performance accuracy and outcomes.
AHRQ-funded; HS022258.
Citation: Kerber KA, Carender W, Telian SA .
Patient self-management of benign paroxysmal positional vertigo: instructional video development and preliminary evaluation of behavioral outcomes.
Otol Neurotol 2022 Jan;43(1):e105-e15. doi: 10.1097/mao.0000000000003360..
Keywords: Patient Self-Management, Education: Patient and Caregiver, Neurological Disorders
Bayer ND, Hall M, LI Y
Trends in health care use and spending for young children with neurologic impairment.
This retrospective study examined trends in health care use and spending for young children with neurologic impairment (NI) during their first 5 years of life. This study of 13,947 children with NI used data in the multistate IBM Medicaid MarketScan Database from 2009 to 2017. Inpatient service use decreased from 66.8% during the first year down to 5.8% during the fifth year. Emergency department (ED) use decreased more gradually from 67.8% during the first year to 44.4% during the fifth year. Per-member-per-year spending decreased from $83,352 during the first year down to $1944 in the fifth year.
AHRQ-funded; HS025138.
Citation: Bayer ND, Hall M, LI Y .
Trends in health care use and spending for young children with neurologic impairment.
Pediatrics 2022 Jan;149(1). doi: 10.1542/peds.2021-050905.
AHRQ-funded; HS025138..
AHRQ-funded; HS025138..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Utilization, Neurological Disorders
Rafferty MR, MacDonald J, Byskosh A
Using implementation frameworks to provide proactive physical therapy for people with Parkinson disease: case report.
European clinical practice guidelines recommend physical therapy for people with Parkinson disease (PD) soon after diagnosis to provide education, physical activity advice, and individualized interventions when needed. However, therapy is frequently not used until after gait and balance problems occur. The purpose of this administrative case study was to present the application of a proactive physical therapy (PAPT) approach at 1 rehabilitation center using implementation frameworks to support the (1) implementation process, (2) determinants of implementation success, and (3) implementation evaluation.
AHRQ-funded; HS025077.
Citation: Rafferty MR, MacDonald J, Byskosh A .
Using implementation frameworks to provide proactive physical therapy for people with Parkinson disease: case report.
Phys Ther 2019 Dec 16;99(12):1644-55. doi: 10.1093/ptj/pzz129..
Keywords: Neurological Disorders, Rehabilitation, Case Study
Williams CN, Eriksson CO, Kirby A
Hospital mortality and functional outcomes in pediatric neurocritical care.
Pediatric neurocritical care (PNCC) outcomes research is scarce. In this study, the investigators aimed to expand knowledge about outcomes in PNCC by evaluating death and changes in Functional Status Scale (FSS) from baseline among PNCC diagnoses. The investigators concluded that PNCC patients had high rates of death and new disability at discharge, varying significantly between PNCC diagnoses. Multiple domains of disability were affected, underscoring the ongoing multidisciplinary health care needs of survivors.
AHRQ-funded; HS022981.
Citation: Williams CN, Eriksson CO, Kirby A .
Hospital mortality and functional outcomes in pediatric neurocritical care.
Hosp Pediatr 2019 Dec;9(12):958-66. doi: 10.1542/hpeds.2019-0173..
Keywords: Children/Adolescents, Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Neurological Disorders, Mortality, Hospitals, Inpatient Care, Outcomes, Patient-Centered Outcomes Research
McCreedy E, Ogarek JA, Thomas KS
The minimum data set agitated and reactive behavior scale: measuring behaviors in nursing home residents with dementia.
Researchers in this study test the internal consistency and construct validity of the Agitated and Reactive Behavior Scale (ARBS), a measure created to measure agitated and aggressive behaviors in dementia residents at nursing homes (NHs). This cross-sectional study used data from the 2016 national sample of 15,326 Centers for Medicare and Medicaid Services-certified NHs. The sample included 489,854 new admissions and 765,367 long-stay residents (defined as 90 days or more) all diagnosed with dementia. The ARBS is a composite measure of physical and verbal agitation or aggressiveness towards other people; other behavioral symptoms not directed at other people; and rejection of care. The study found that 1) the ARBS score has borderline-adequate internal consistency in the national population of NH residents with dementia; 2) only 18% of new admissions, and 21% of long-stay residents with dementia displayed any aggressive or agitated behaviors in the previous week; and 3) the ARBS demonstrated good construct validity. Conclusions were that nationally available MDS data may significantly underestimate the prevalence of agitated and aggressive behaviors among NH dementia patients.
AHRQ-funded; HS000011.
Citation: McCreedy E, Ogarek JA, Thomas KS .
The minimum data set agitated and reactive behavior scale: measuring behaviors in nursing home residents with dementia.
J Am Med Dir Assoc 2019 Dec;20(12):1548-52. doi: 10.1016/j.jamda.2019.08.030..
Keywords: Elderly, Dementia, Neurological Disorders, Nursing Homes, Long-Term Care, Behavioral Health
Dickerson LK, Rouhizadeh M, Korotkaya Y
Language impairment in adults with end-stage liver disease: application of natural language processing towards patient-generated health records.
This study examined the association between language and cognitive impairment in adults with end-stage liver disease (ESLD) and patients post-transplant where the impairments have resolved themselves. Patients showed great improvement after transplant, and the natural language processing (NLP) impairment can be used to detect cognitive impairment in ESLD.
AHRQ-funded; HS023876.
Citation: Dickerson LK, Rouhizadeh M, Korotkaya Y .
Language impairment in adults with end-stage liver disease: application of natural language processing towards patient-generated health records.
NPJ Digit Med 2019 Nov 4;2:106. doi: 10.1038/s41746-019-0179-9..
Keywords: Chronic Conditions, Neurological Disorders, Health Information Technology (HIT)
Oh ES, Needham DM, Nikooie R
Antipsychotics for preventing delirium in hospitalized adults: a systematic review.
The purpose of this study was to conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Results showed that there was little evidence demonstrating neurologic harms associated with short-term use of antipsychotics for treating delirium in adult inpatients, but potentially harmful cardiac effects tended to occur more frequently. Current evidence does not support routine use of haloperidol or second-generation antipsychotics to treat delirium in adult inpatients.
AHRQ-funded; 290201500006I.
Citation: Oh ES, Needham DM, Nikooie R .
Antipsychotics for preventing delirium in hospitalized adults: a systematic review.
Ann Intern Med 2019 Oct 1;171(7):474-84. doi: 10.7326/m19-1859..
Keywords: Neurological Disorders, Medication, Hospitalization, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness, Behavioral Health, Prevention
Nikooie R, Neufeld KJ, Oh ES
Antipsychotics for treating delirium in hospitalized adults: a systematic review.
The purpose of this study was to conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Results showed that there was little evidence demonstrating neurologic harms associated with short-term use of antipsychotics for treating delirium in adult inpatients, but potentially harmful cardiac effects tended to occur more frequently. Current evidence does not support routine use of haloperidol or second-generation antipsychotics to treat delirium in adult inpatients.
AHRQ-funded; 290201500006I.
Citation: Nikooie R, Neufeld KJ, Oh ES .
Antipsychotics for treating delirium in hospitalized adults: a systematic review.
Ann Intern Med 2019 Oct 1;171(7):485-95. doi: 10.7326/m19-1860.
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Keywords: Neurological Disorders, Medication, Hospitalization, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness, Behavioral Health
Madapana N, Gonzalez G, Taneja R
Preference elicitation: obtaining gestural guidelines for PACS in neurosurgery.
The objectives of this study were to: a) Elicit gestures from neurosurgeons to analyze their preferences, b) Develop heuristics for gestural interfaces, and c) Produce a lexicon that maximizes surgeons' preferences. The elicitation study resulted in nine gesture lexicons, each comprised of 28 gestures. Results showed that neurosurgeons do agree on fundamental characteristics of gestures to perform image manipulation tasks. The proposed heuristics could potentially guide the development of future gesture-based interaction of Picture Archiving and Communication Systems for the operating room.
AHRQ-funded; HS024887.
Citation: Madapana N, Gonzalez G, Taneja R .
Preference elicitation: obtaining gestural guidelines for PACS in neurosurgery.
Int J Med Inform 2019 Oct;130:103934. doi: 10.1016/j.ijmedinf.2019.07.013..
Keywords: Guidelines, Neurological Disorders, Patient Safety, Surgery
Kukulka K, Washington KT, Govindarajan R
Stakeholder perspectives on the biopsychosocial and spiritual realities of living with ALS: implications for palliative care teams.
The purpose of this study was to generate a rich description of the realities of living with amyotrophic lateral sclerosis (ALS), equipping palliative care teams with an in-depth understanding of the experiences and needs of patients with ALS and their family caregivers. Study findings illustrated the intricacies of living with ALS and the importance of eliciting individualized values when caring for patients with ALS and their families. The investigators concluded that the complex biopsychosocial needs experienced by patients and family caregivers suggested numerous opportunities for meaningful palliative care involvement.
AHRQ-funded; HS022140.
Citation: Kukulka K, Washington KT, Govindarajan R .
Stakeholder perspectives on the biopsychosocial and spiritual realities of living with ALS: implications for palliative care teams.
Am J Hosp Palliat Care 2019 Oct;36(10):851-57. doi: 10.1177/1049909119834493..
Keywords: Palliative Care, Patient-Centered Outcomes Research, Neurological Disorders, Patient-Centered Healthcare, Patient and Family Engagement, Caregiving
Possin KL, Merrilees JJ, Dulaney S
Effect of collaborative dementia care via telephone and internet on quality of life, caregiver well-being, and health care use: the Care Ecosystem randomized clinical trial.
Few health systems have adopted effective dementia care management programs. The Care Ecosystem is a model for delivering care from centralized hubs across broad geographic areas to caregivers and persons with dementia (PWDs) independently of their health system affiliations. The purpose of this study was to determine whether the Care Ecosystem was effective in improving outcomes important to PWDs, their caregivers, and payers beyond those achieved with usual care.
AHRQ-funded; HS022241.
Citation: Possin KL, Merrilees JJ, Dulaney S .
Effect of collaborative dementia care via telephone and internet on quality of life, caregiver well-being, and health care use: the Care Ecosystem randomized clinical trial.
JAMA Intern Med 2019 Sep 30;179(12):1658-67. doi: 10.1001/jamainternmed.2019.4101..
Keywords: Dementia, Neurological Disorders, Telehealth, Health Information Technology (HIT), Care Management, Healthcare Delivery, Caregiving, Quality of Life
Wissel BD, Greiner HM, Glauser TA
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes.
Racial disparities in the utilization of epilepsy surgery are well documented, but it is unknown whether a natural language processing (NLP) algorithm trained on physician notes would produce biased recommendations for epilepsy presurgical evaluations. To assess this, an NLP algorithm was trained to identify potential surgical candidates using 1097 notes from 175 epilepsy patients with a history of resective epilepsy surgery and 268 patients who achieved seizure freedom without surgery (total N = 443 patients).
AHRQ-funded; HS024977.
Citation: Wissel BD, Greiner HM, Glauser TA .
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes.
Epilepsia 2019 Sep;60(9):e93-e98. doi: 10.1111/epi.16320..
Keywords: Neurological Disorders, Surgery, Clinical Decision Support (CDS), Healthcare Utilization, Health Information Technology (HIT), Shared Decision Making