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
101 to 125 of 140 Research Studies DisplayedHill LM, Maseko B, Chagomerana M
HIV risk, risk perception, and PrEP interest among adolescent girls and young women in Lilongwe, Malawi: operationalizing the PrEP cascade.
The objective of this study was to understand the level of interest in oral pre-exposure prophylaxis (PrEP) among adolescent girls and young women (AGYW) at highest HIV risk and the potential role of perceived risk in motivating PrEP interest. Findings highlighted key relationships between epidemiologic HIV risk, risk perception, and interest in PrEP. The high number of participants with risk scores below the high-risk cutoff who both expressed high perceived risk and interest in PrEP suggested that the demand for PrEP among AGYW may not be well-aligned with epidemiologic risk.
AHRQ-funded; HS000032.
Citation: Hill LM, Maseko B, Chagomerana M .
HIV risk, risk perception, and PrEP interest among adolescent girls and young women in Lilongwe, Malawi: operationalizing the PrEP cascade.
J Int AIDS Soc 2020 Jun;23 Suppl 3:e25502. doi: 10.1002/jia2.25502..
Keywords: Human Immunodeficiency Virus (HIV), Risk, Prevention, Women, Children/Adolescents, Young Adults
Gandhi TK, Singh H
Reducing the risk of diagnostic error in the COVID-19 era.
This perspective article discusses anticipated diagnoses errors for positive or negative COVID-19 results. The errors are classified using user-friendly nomenclature. Mitigation strategies are discussed including technology for cognitive support, optimized workflow and communication, people-focused interventions, organizational strategies, and state/federal policies and regulations.
AHRQ-funded; HS027363.
Citation: Gandhi TK, Singh H .
Reducing the risk of diagnostic error in the COVID-19 era.
J Hosp Med 2020 Jun;15(6):363-66. doi: 10.12788/jhm.3461..
Keywords: Diagnostic Safety and Quality, Risk, Medical Errors, COVID-19
Abrams EM, Greenhawt M
Risk communication during COVID-19.
This article focuses on ways the healthcare community can best communicate risk of COVID-19 to the public. Poor risk communication results in hoarding behavior which can lead to lack of medications and personal protective equipment. Utilizing social media channels to ensure an ongoing consistent media presence is one potential way to ensure appropriate risk communication. Including all stakeholders in broader public health messaging is also important.
AHRQ-funded; HS024599.
Citation: Abrams EM, Greenhawt M .
Risk communication during COVID-19.
J Allergy Clin Immunol Pract 2020 Jun;8(6):1791-94. doi: 10.1016/j.jaip.2020.04.012..
Keywords: COVID-19, Communication, Risk, Public Health, Emergency Preparedness
Eden KB, Ivlev I, Bensching KL
Use of an online breast cancer risk assessment and patient decision aid in primary care practices.
A cross-sectional study evaluating a web-based breast cancer risk assessment and decision aid (MammoScreen) was conducted in an academic general internal medicine clinic. Breast cancer risk assessment and mammography screening decision support were efficiently implemented through a web-based tool for patients sent through an electronic patient portal. Findings indicated that integration of patient decision aids with risk algorithms in clinical practice may help support the implementation of USPSTF recommendations that include risk assessment and shared decision-making.
AHRQ-funded; HS026370.
Citation: Eden KB, Ivlev I, Bensching KL .
Use of an online breast cancer risk assessment and patient decision aid in primary care practices.
J Womens Health 2020 Jun;29(6):763-69. doi: 10.1089/jwh.2019.8143..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Screening, Shared Decision Making, Risk, Health Information Technology (HIT), Prevention, Women
Kole MJ, Shea P, Albrecht JS
Utility of the Hijdra sum score in predicting risk of aneurysm in patients with subarachnoid hemorrhage: a single-center experience with 550 patients.
This study’s objective was to generate a model to assist in predicting risk of aneurysm in patients with subarachnoid hemorrhage (SAH). A retrospective cohort study was conducted of all patients 18 years and older admitted to a single center from March 2008 to March 2018 with non-traumatic SAH (n = 550). Risk factors examined included female sex, higher modified Fisher or Hijdra score, nonperimesencephalic location, presence of intracerebral hemorrhage, World Federation of Neurological Societies (WFNS) score ≥3, need for cerebrospinal fluid diversion on admission, and history of tobacco use. Greater modified Fisher, greater Hijdra score, WFNS ≥3, and hydrocephalus present on admission presented a significantly greater risk of an aneurysm. The authors concluded a simple scoring tool based on patient sex, SAH location and SAH burden can assist in predicting the presence of an aneurysm in patients with nontraumatic SAH.
AHRQ-funded; HS024560.
Citation: Kole MJ, Shea P, Albrecht JS .
Utility of the Hijdra sum score in predicting risk of aneurysm in patients with subarachnoid hemorrhage: a single-center experience with 550 patients.
Neurosurgery 2020 Jun;86(6):783-91. doi: 10.1093/neuros/nyz346.
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Keywords: Cardiovascular Conditions, Neurological Disorders, Risk
Shang J, Russell D, Dowding D
A predictive risk model for infection-related hospitalization among home healthcare patients.
Infection prevention is a high priority for home healthcare (HHC), but tools are lacking to identify patients at highest risk of developing infections. The purpose of this study was to develop and test a predictive risk model to identify HHC patients at risk of an infection-related hospitalization or emergency department visit. A nonexperimental study using secondary data was conducted.
AHRQ-funded; HS024723.
Citation: Shang J, Russell D, Dowding D .
A predictive risk model for infection-related hospitalization among home healthcare patients.
J Healthc Qual 2020 May/Jun;42(3):136-47. doi: 10.1097/jhq.0000000000000214..
Keywords: Elderly, Home Healthcare, Infectious Diseases, Community-Acquired Infections, Risk, Hospitalization, Emergency Department
Trubiano JA, Vogrin S, Chua KYL
Development and validation of a penicillin allergy clinical decision rule.
Penicillin allergy is a significant public health issue for patients, antimicrobial stewardship programs, and health services. Validated clinical decision rules are urgently needed to identify low-risk penicillin allergies that potentially do not require penicillin skin testing by a specialist. The objective of this study was to develop and validate a penicillin allergy clinical decision rule that enables point-of-care risk assessment of patient-reported penicillin allergies.
AHRQ-funded; HS026395.
Citation: Trubiano JA, Vogrin S, Chua KYL .
Development and validation of a penicillin allergy clinical decision rule.
JAMA Intern Med 2020 May;180(5):745-52. doi: 10.1001/jamainternmed.2020.0403..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Clinical Decision Support (CDS), Risk
Danilack VA, Hutcheon Triche, EW EW
Development and validation of a risk prediction model for cesarean delivery after labor induction.
The goal of this study was to develop and validate a prediction model for cesarean delivery after labor induction that included factors known before the start of induction. The model contained eight variables, was well calibrated with good risk stratification at the extremes of predicted probability, and performed well on internal validation. The authors concluded that their prediction model can help providers estimate a woman's risk of cesarean delivery when planning a labor induction.
AHRQ-funded; HS025013.
Citation: Danilack VA, Hutcheon Triche, EW EW .
Development and validation of a risk prediction model for cesarean delivery after labor induction.
J Womens Health 2020 May;29(5):656-69. doi: 10.1089/jwh.2019.7822.
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Keywords: Labor and Delivery, Pregnancy, Women, Risk
Schlick CJR, Khorfan R, Odell DD
Margin positivity in resectable esophageal cancer: are there modifiable risk factors?
Patients with esophageal cancer have poor overall survival, with positive resection margins worsening survival. Margin positivity rates are used as quality measures in other malignancies, but modifiable risk factors are necessary to develop actionable targets for improvement. The objectives of this study were to (1) evaluate trends in esophageal cancer margin positivity, and (2) identify modifiable patient/hospital factors associated with margin positivity.
AHRQ-funded; HS026385.
Citation: Schlick CJR, Khorfan R, Odell DD .
Margin positivity in resectable esophageal cancer: are there modifiable risk factors?
Ann Surg Oncol 2020 May;27(5):1496-507. doi: 10.1245/s10434-019-08176-z..
Keywords: Cancer, Risk, Surgery
Greenzang KA, Al-Sayegh H, Ma C
Parental considerations regarding cure and late effects for children with cancer.
The purpose of this study was to learn how parents and physicians consider late-effects risks against a potential survival benefit when making treatment decisions. Parents of children with cancer and physicians at Dana-Farber/Boston Children's Cancer and Blood Disorders Center were surveyed. Investigators found that avoidance of severe neurocognitive impairment was the predominant driver of parent and physician treatment preferences, even over an increased chance of cure. They concluded that their study highlights the importance of exploring parental late-effects priorities when discussing treatment options.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Al-Sayegh H, Ma C .
Parental considerations regarding cure and late effects for children with cancer.
Pediatrics 2020 May;145(5):e20193552. doi: 10.1542/peds.2019-3552..
Keywords: Children/Adolescents, Cancer, Shared Decision Making, Caregiving, Risk
Mahorter SS, Knerr S, Bowles EJA
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
This study examined knowledge of breast density as an important breast cancer risk factor among a set of women in a health system-embedded trial who had clinically elevated breast cancer risk 1 year before state-mandated density disclosure. The majority of the women (91%) had heard of breast density and were aware of its masking effect (87%). Only 60% had ever discussed their breast density with a provider.
AHRQ-funded; HS022982.
Citation: Mahorter SS, Knerr S, Bowles EJA .
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
Cancer 2020 Apr 15;126(8):1614-21. doi: 10.1002/cncr.32711..
Keywords: Cancer: Breast Cancer, Cancer, Women, Communication, Clinician-Patient Communication, Risk, Patient-Centered Outcomes Research
Donovan BM, Abreo A, Ding T
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
This study examined the association between dose, timing and type of infant antibiotic use and the risk of childhood asthma. The study examined a cohort of 152,622 children enrolled in the Tennessee Medicaid Program. At least 79% had at least one antibiotic prescription fill during infancy. There was a 20% increase in odds of childhood asthma for each additional antibiotic filled. There was no significant association between timing, formulation, anaerobic coverage and class of antibiotics and childhood asthma. However, broad spectrum antibiotic fills increased the odds of development of childhood asthma compared to narrow spectrum only fills.
AHRQ-funded; HS018454.
Citation: Donovan BM, Abreo A, Ding T .
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
Clin Infect Dis 2020 Apr 10;70(8):1658-65. doi: 10.1093/cid/ciz448..
Keywords: Newborns/Infants, Children/Adolescents, Antibiotics, Medication, Asthma, Respiratory Conditions, Risk, Chronic Conditions
Katz D, Petersen T, Amado S
An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder.
The impact of concurrent diagnosis posttraumatic stress disorder (PTSD) on persons with bipolar disorder (BD) was analyzed to determine if there was a higher risk of suicidal ideation. Baseline data from the 482 individuals enrolled in the Clinical and Health Outcomes Initiative in Comparative Effectiveness for bipolar disorder study (Bipolar CHOICE) was used. The association of comorbid PTSD with increased suicidal ideation was assessed by the Concise Health Risk Tracking Scale (CHRT) total and factor scores. As the authors hypothesized, diagnosis of comorbid PTSD was a significant predictor of the CHRT total score. All participants with comorbid PTSD (n=58) endorsed current suicidal ideation and were more likely to have had a previous suicide attempt compared to those without PTSD.
AHRQ-funded; HS019371.
Citation: Katz D, Petersen T, Amado S .
An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder.
J Affect Disord 2020 Apr 1;266:49-56. doi: 10.1016/j.jad.2020.01.091..
Keywords: Behavioral Health, Risk, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Depression
Chen DW, Reyes-Gastelum D, Wallner LP
Disparities in risk perception of thyroid cancer recurrence and death.
The authors studied risk perception among survivors of thyroid cancer. Patients diagnosed with differentiated thyroid cancer from the Surveillance, Epidemiology, and End Results registries were surveyed and an analytic cohort defined by a 5% or greater risk of disease recurrence and mortality. The authors found that less educated patients and Hispanic patients were more likely to report inaccurate risk perceptions, which were associated with worry and a decreased quality of life.
AHRQ-funded; HS024512.
Citation: Chen DW, Reyes-Gastelum D, Wallner LP .
Disparities in risk perception of thyroid cancer recurrence and death.
Cancer 2020 Apr 1;126(7):1512-21. doi: 10.1002/cncr.32670..
Keywords: Disparities, Cancer, Risk, Quality of Life, Social Determinants of Health, Racial and Ethnic Minorities
Brown CS, Wakam GK, Englesbe MJ
Increased-risk donors and solid organ transplantation: current practices and opportunities for improvement.
This study looked at recent developments in decision making for use of CDC-labeled increased-risk donor (IRD) use for solid organ transplantation. The implementation of nucleic acid testing for HIV and hepatitis C virus has resulted in decreasing risk of window-period infection often by an order of magnitude or more. However, surgeons still are hesitant to utilize IRD organs. The authors conclude that rate of transmission of window-period infection from IRD organs is exceptionally low and the harms regarding the increased risk classification outweigh the benefits for patients who need organ transplantation.
AHRQ-funded; HS000053.
Citation: Brown CS, Wakam GK, Englesbe MJ .
Increased-risk donors and solid organ transplantation: current practices and opportunities for improvement.
Curr Opin Organ Transplant 2020 Apr;25(2):139-43. doi: 10.1097/mot.0000000000000735..
Keywords: Transplantation, Surgery, Risk
Shah SC, Boffetta P, Johnson KC SC, Boffetta P, Johnson KC
Occupational exposures and odds of gastric cancer: a StoP project consortium pooled analysis.
Gastric cancer pathogenesis represents a complex interaction of host genetic determinants, microbial virulence factors and environmental exposures. The primary aim of this study was to determine the association between occupations/occupational exposures and odds of gastric cancer. Based on a large pooled analysis, the investigators identified several occupations and related exposures that were associated with elevated odds of gastric cancer.
AHRQ-funded; HS026395.
Citation: Shah SC, Boffetta P, Johnson KC SC, Boffetta P, Johnson KC .
Occupational exposures and odds of gastric cancer: a StoP project consortium pooled analysis.
Int J Epidemiol 2020 Apr 1;49(2):422-34. doi: 10.1093/ije/dyz263..
Keywords: Cancer, Risk, Digestive Disease and Health
Heller CG, Parsons AS, Chambers EC
Social risks among primary care patients in a large urban health system.
The objective of this study was to understand the variability in the number and types of social risks overall and in population subgroups among primary care patients routinely screened in a large urban health system. Participants across nineteen ambulatory sites in the Bronx, New York, completed a 10-item screener. Findings showed that there were important differences in the prevalence of overall and individual social risks by subgroup. These findings should be considered to inform clinical care and social risk screening and interventions.
AHRQ-funded; HS026396.
Citation: Heller CG, Parsons AS, Chambers EC .
Social risks among primary care patients in a large urban health system.
Am J Prev Med 2020 Apr;58(4):514-25. doi: 10.1016/j.amepre.2019.11.011..
Keywords: Social Determinants of Health, Primary Care, Urban Health, Risk, Vulnerable Populations
Fan T, Fakolade A
AHRQ Author: Fan T
Medication use to reduce risk of breast cancer.
In this case study, a 40-year-old woman comes to her doctor’s office for a routine gynecologic visit. She is not taking any medications and is generally healthy. She is sexually active, and her last menstrual period started 10 days ago. She states that her mother was diagnosed with bilateral breast cancer at 49 years of age and that she would like to discuss her options for reducing the risk of breast cancer. Three questions are posed about risk-reducing medications.
AHRQ-authored
Citation: Fan T, Fakolade A .
Medication use to reduce risk of breast cancer.
Am Fam Physician 2020 Mar 15;101(6):373-74..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Medication, Risk, Prevention, Case Study, Women
Basciotta M, Zhou W, Ngo L
Antipsychotics and the risk of mortality or cardiopulmonary arrest in hospitalized adults.
Investigators sought to evaluate the risk of death or nonfatal cardiopulmonary arrest in hospitalized adults exposed to antipsychotics. They found that, in hospitalized adults, typical antipsychotics were associated with increased mortality or cardiopulmonary arrest, whereas atypical antipsychotics were only associated with increased risk among adults age 65 years and older. They recommended that providers be thoughtful when prescribing antipsychotic medications, especially to older adults in settings where data regarding benefit are lacking.
AHRQ-funded; HS026215.
Citation: Basciotta M, Zhou W, Ngo L .
Antipsychotics and the risk of mortality or cardiopulmonary arrest in hospitalized adults.
J Am Geriatr Soc 2020 Mar;68(3):544-50. doi: 10.1111/jgs.16246..
Keywords: Medication, Risk, Hospitalization, Cardiovascular Conditions, Mortality, Elderly
Sun CJ, Seloilwe ES, Magowe M
Association of adolescent- and parent-reported relationship functioning with HIV sexual risk among adolescents in Botswana.
Globally, adolescents in sub-Saharan Africa are the youth most affected by HIV. Parent-adolescent relationships can be protective in child and adolescent development and may be implicated in lowered adolescent HIV sexual risk. This dyadic study simultaneously assessed both parents' and adolescents' perceptions of family functioning and their relationships with adolescent sexual behaviors in Botswana.
AHRQ-funded; HS022981.
Citation: Sun CJ, Seloilwe ES, Magowe M .
Association of adolescent- and parent-reported relationship functioning with HIV sexual risk among adolescents in Botswana.
AIDS Behav 2020 Mar;24(3):975-83. doi: 10.1007/s10461-019-02429-4..
Keywords: Children/Adolescents, Human Immunodeficiency Virus (HIV), Risk, Sexual Health
Muzaale AD, Massie AB, Al Ammary F
Donor-recipient relationship and risk of ESKD in live kidney donors of varied racial groups.
Risk factors for kidney failure are the basis of live kidney donor candidate evaluation. In this retrospective cohort study, the investigators quantified risk for end-stage kidney disease (ESKD) by the biological relationship of the donor to the recipient, a risk factor that is not addressed by current clinical practice guidelines. The investigators found that marked differences in risk for ESKD across types of donor-recipient relationship were observed for Asian, black, and white donors.
AHRQ-funded; HS024600.
Citation: Muzaale AD, Massie AB, Al Ammary F .
Donor-recipient relationship and risk of ESKD in live kidney donors of varied racial groups.
Am J Kidney Dis 2020 Mar;75(3):333-41. doi: 10.1053/j.ajkd.2019.08.020..
Keywords: Transplantation, Kidney Disease and Health, Racial and Ethnic Minorities, Risk, Registries
Pruitt LCC, Skarda DE, Rollins MD
Hirschsprung-associated enterocolitis in children treated at US children's hospitals.
The incidence of and risk factors for Hirschsprung's-associated enterocolitis (HAEC) following pull-through have been limited to single institutions studies. In this retrospective cohort study, the investigators characterized the incidence of, risk factors for, and consequences of post-operative HAEC. The investigators concluded that HAEC following pull-through occurs in a large proportion of infants with HD and predicts reoperation. They suggest that multicenter studies are needed to develop prediction models and treatment protocols for HAEC.
AHRQ-funded; HS025776.
Citation: Pruitt LCC, Skarda DE, Rollins MD .
Hirschsprung-associated enterocolitis in children treated at US children's hospitals.
J Pediatr Surg 2020 Mar;55(3):535-40. doi: 10.1016/j.jpedsurg.2019.10.060.
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Keywords: Children/Adolescents, Digestive Disease and Health, Surgery, Adverse Events, Risk, Hospitals
Arbaje AI, Werner NE, Kasda EM
Learning from lawsuits: using malpractice claims data to develop care transitions planning tools.
This study used malpractice claims data to evaluate safety risks during care transitions from hospital to home and to help develop care transitions planning tools and pilot test them. The authors analyzed closed malpractice claims for 230 adult patients discharged from 4 hospital sites. Two structured focus groups were also conducted for stakeholders to review concerns. This led to the development of two care transitions planning tools – one for patients/caregivers and one for healthcare providers. Feasibility on 53 patient discharges were tested for both tools. A total of 33 risk factors corresponding to hospital work system elements, care transitions processes, and care outcomes were found using qualitative analysis. Providers found the tool easy to use and patients felt the length and response of the tool was acceptable.
AHRQ-funded; HS022916; HS019519.
Citation: Arbaje AI, Werner NE, Kasda EM .
Learning from lawsuits: using malpractice claims data to develop care transitions planning tools.
J Patient Saf 2020 Mar;16(1):52-57. doi: 10.1097/pts.0000000000000238.
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Keywords: Medical Liability, Transitions of Care, Risk, Hospital Discharge, Hospitals, Patient Safety
Yuce TK, Khorfan R, Soper NJ
Post-operative complications and readmissions associated with smoking following bariatric surgery.
The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. In this study, the investigators describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. The investigators concluded that smokers undergoing bariatric surgery experienced significantly worse 30-day outcomes when compared with non-smokers.
AHRQ-funded; HS000078.
Citation: Yuce TK, Khorfan R, Soper NJ .
Post-operative complications and readmissions associated with smoking following bariatric surgery.
J Gastrointest Surg 2020 Mar;24(3):525-30. doi: 10.1007/s11605-019-04488-3..
Keywords: Surgery, Tobacco Use, Adverse Events, Hospital Readmissions, Obesity: Weight Management, Obesity, Risk, Outcomes
Probst MA, Gupta M, Hendey GW
Prevalence of intracranial injury in adult patients with blunt head trauma with and without anticoagulant or antiplatelet use.
In this study, the investigators determined the prevalence of significant intracranial injury among adults with blunt head trauma who are receiving preinjury anticoagulant or antiplatelet medications. The investigators concluded that patients receiving preinjury warfarin or a combination of aspirin and clopidogrel were at increased risk for significant intracranial injury, but not those receiving aspirin alone. They suggested that clinicians should have a low threshold for neuroimaging when evaluating patients receiving warfarin or a combination of aspirin and clopidogrel.
AHRQ-funded; HS009699.
Citation: Probst MA, Gupta M, Hendey GW .
Prevalence of intracranial injury in adult patients with blunt head trauma with and without anticoagulant or antiplatelet use.
Ann Emerg Med 2020 Mar;75(3):354-64. doi: 10.1016/j.annemergmed.2019.10.004..
Keywords: Brain Injury, Injuries and Wounds, Blood Thinners, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Risk