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 185 Research Studies DisplayedSmieliauskas F, Sharma H, Hurley C
State insurance mandates and off-label use of chemotherapy.
In this study, the investigators hypothesized that state health insurance mandates for private insurers to provide coverage for off-label use of cancer drugs cause higher rates of off-label use. They used Truven MarketScan data from 1999 to 2007 on utilization of 35 infused chemotherapy drugs in private health plans in the United States to study trends in off-label use of drugs, distinguishing between appropriate and inappropriate off-label use according to drug compendia, and estimated difference-in-difference regressions of the effect of state laws on off-label use.
AHRQ-funded; HS018535.
Citation: Smieliauskas F, Sharma H, Hurley C .
State insurance mandates and off-label use of chemotherapy.
Health Econ 2018 Jan;27(1):e55-e70. doi: 10.1002/hec.3537.
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Keywords: Access to Care, Cancer, Treatments, Health Insurance, Medication
Cai B, Li H, Yang D
Performance of a multi leaf collimator system for MR-guided radiation therapy.
The purpose of this study was to investigate and characterize the performance of a Multi Leaf Collimator (MLC) designed for Cobalt-60 based MR-guided radiation therapy system in a 0.35 T magnetic field. The authors concluded that the MRIdian MLC has a good RF noise shielding design, low radiation leakage, good positioning accuracy, comparable TG effect, and can be modeled by an independent Monte Carlo calculation platform.
AHRQ-funded; HS022888.
Citation: Cai B, Li H, Yang D .
Performance of a multi leaf collimator system for MR-guided radiation therapy.
Med Phys 2017 Dec;44(12):6504-14. doi: 10.1002/mp.12571..
Keywords: Imaging, Patient Safety, Treatments
Herbert MS, Goodin BR, Bulls HW
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
This study aimed to examine the relationship between cortisol and pain responses during a cold-pressor task (CPT) among African American (AA) and non-Hispanic White (NHW) adults with knee osteoarthritis (OA). Consistent with previous findings in young healthy adults, cold-pressor pain responses are related to pre-CPT cortisol concentrations in NHW persons with knee OA but not in their AA counterparts.
AHRQ-funded; HS013852.
Citation: Herbert MS, Goodin BR, Bulls HW .
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
Clin J Pain 2017 Sep;33(9):820-26. doi: 10.1097/ajp.0000000000000462.
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Keywords: Arthritis, Pain, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Treatments
Liotta EM, Prabhakaran S, Sangha RS
Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.
The researchers tested the hypothesis that admission serum magnesium levels are associated with hematoma volume, hematoma growth, and functional outcomes in patients with intracerebral hemorrhage (ICH). Their findings support the hypothesis that magnesium exerts a clinically meaningful influence on hemostasis in patients with ICH.
AHRQ-funded; HS023437.
Citation: Liotta EM, Prabhakaran S, Sangha RS .
Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.
Neurology 2017 Aug 22;89(8):813-19. doi: 10.1212/wnl.0000000000004249..
Keywords: Patient-Centered Outcomes Research, Treatments, Outcomes, Brain Injury
Wang SY, Kelly G, Gross C
Information needs of older women with early-stage breast cancer when making radiation therapy decisions.
The researchers identified the information older women with early-stage breast cancer need when making radiation therapy decisions, and who patients identify as the main decision maker. They found that older women consider themselves to be the main decision maker; they desire information and have more agency and input in the decision-making process than prior literature would suggest.
AHRQ-funded; HS023900.
Citation: Wang SY, Kelly G, Gross C .
Information needs of older women with early-stage breast cancer when making radiation therapy decisions.
Int J Radiat Oncol Biol Phys 2017 Jul 15;98(4):733-40. doi: 10.1016/j.ijrobp.2017.02.001.
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Keywords: Cancer: Breast Cancer, Shared Decision Making, Education: Patient and Caregiver, Treatments
Maitree R, Perez-Carrillo GJG, Shimony JS
Adaptive anatomical preservation optimal denoising for radiation therapy daily MRI.
An innovative method, adaptive anatomical preservation optimal denoising (AAPOD), was developed for optimal image denoising, i.e., to maximally reduce noise while preserving the tissue boundaries. The experimental results demonstrated that AAPOD was capable of reducing noise adaptively and optimally while avoiding tissue boundary losses.
AHRQ-funded; HS022888.
Citation: Maitree R, Perez-Carrillo GJG, Shimony JS .
Adaptive anatomical preservation optimal denoising for radiation therapy daily MRI.
J Med Imaging 2017 Jul;4(3):034004. doi: 10.1117/1.jmi.4.3.034004.
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Keywords: Imaging, Treatments, Cancer, Patient Safety
Shahu A, Schwartz J, Perez M
Discerning quality: an analysis of informed consent documents for common cardiovascular procedures.
In this study, the investigators aimed to assess variation in quality of informed consent documents associated with three commonly performed cardiovascular procedures: left heart catheterisation, transesophageal echocardiography and implantation of a cardioverter defibrillator. The authors focused on basic elements of consent documents with the goal of illuminating opportunities to establish minimum standards for informed consent.
AHRQ-funded; HS023000.
Citation: Shahu A, Schwartz J, Perez M .
Discerning quality: an analysis of informed consent documents for common cardiovascular procedures.
BMJ Qual Saf 2017 Jul;26(7):569-71. doi: 10.1136/bmjqs-2016-005663..
Keywords: Cardiovascular Conditions, Surgery, Treatments, Quality of Care
Ferrada P, Callcut R, Zielinski MD
Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: an Eastern Association for the Surgery of Trauma multicenter trial.
The objective of this study was to compare loop ileostomy (LI) and total colectomy (TC) procedures in a multicentric approach to help the surgeon decide what procedure was best suited for the patient in need. In this study, the investigators found that LI carried less mortality than TC.
AHRQ-funded; HS024547.
Citation: Ferrada P, Callcut R, Zielinski MD .
Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: an Eastern Association for the Surgery of Trauma multicenter trial.
J Trauma Acute Care Surg 2017 Jul;83(1):36-40. doi: 10.1097/ta.0000000000001498..
Keywords: Clostridium difficile Infections, Comparative Effectiveness, Infectious Diseases, Surgery, Treatments
Mehta HB, Vargas GM, Adhikari D
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
The objectives were to determine trends in the use of chemotherapy as the initial treatment and to evaluate the comparative effectiveness of initial chemotherapy vs resection of the primary tumor on survival (intention-to-treat analysis) in Stage IV colorectal cancer (CRC). Instrumental variable analysis found that, compared with resection, chemotherapy as the initial treatment offers similar or better 2-year survival in patients with Stage IV CRC.
AHRQ-funded; HS022134.
Citation: Mehta HB, Vargas GM, Adhikari D .
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
Colorectal Dis 2017 Jun;19(6):O210-o18. doi: 10.1111/codi.13659.
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Keywords: Cancer: Colorectal Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery
Taylor C, Correa C, Duane FK
Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
The researchers estimated the absolute long-term risks of modern breast cancer radiotherapy. They concluded that, for long-term smokers, the absolute risks of modern radiotherapy may outweigh the benefits, yet for most nonsmokers (and ex-smokers), the benefits of radiotherapy far outweigh the risks. Hence, smoking can determine the net effect of radiotherapy on mortality, but smoking cessation substantially reduces radiotherapy risk.
AHRQ-funded; HS021681.
Citation: Taylor C, Correa C, Duane FK .
Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
J Clin Oncol 2017 May 20;35(15):1641-49. doi: 10.1200/jco.2016.72.0722.
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Keywords: Adverse Events, Cancer: Breast Cancer, Risk, Treatments
Wilfond BS, Morales C, Taylor HA
Should patients be required to undergo standard chemotherapy before being eligible for novel phase I immunotherapy clinical trials?
Many Phase I oncology trials include an eligibility criterion requiring potential participants to fail standard chemotherapy. The rationale for this approach is to ensure that patients do not forgo established clinical approaches. The case described in this report has the additional feature of the consultation being requested by a research participant who wanted to challenge the ethical rationale for such an eligibility criterion.
AHRQ-funded; HS000029.
Citation: Wilfond BS, Morales C, Taylor HA .
Should patients be required to undergo standard chemotherapy before being eligible for novel phase I immunotherapy clinical trials?
Am J Bioeth 2017 Apr;17(4):66-67. doi: 10.1080/15265161.2017.1284934..
Keywords: Cancer, Treatments, Medication
Wilfond BS, Morales C, Taylor HA
Should patients be required to undergo standard chemotherapy before being eligible for novel phase I immunotherapy clinical trials?
Many Phase I oncology trials include an eligibility criterion requiring potential participants to fail standard chemotherapy. The rationale for this approach is to ensure that patients do not forgo established clinical approaches. The case described in this report has the additional feature of the consultation being requested by a research participant who wanted to challenge the ethical rationale for such an eligibility criterion.
AHRQ-funded; HS000029.
Citation: Wilfond BS, Morales C, Taylor HA .
Should patients be required to undergo standard chemotherapy before being eligible for novel phase I immunotherapy clinical trials?
Am J Bioeth 2017 Apr;17(4):66-67. doi: 10.1080/15265161.2017.1284934..
Keywords: Cancer, Treatments, Medication
Wang RC, Smith-Bindman R, Whitaker E
Effect of tamsulosin on stone passage for ureteral stones: a systematic review and meta-analysis.
The researchers performed a systematic review and meta-analysis to investigate the effect of tamsulosin on stone passage in patients receiving a diagnosis of ureteral stone. They concluded that tamsulosin significantly improves stone passage in patients with larger stones, whereas the effect of tamsulosin is diminished in those with smaller stones, who are likely to pass their stone regardless of treatment.
AHRQ-funded; HS021281.
Citation: Wang RC, Smith-Bindman R, Whitaker E .
Effect of tamsulosin on stone passage for ureteral stones: a systematic review and meta-analysis.
Ann Emerg Med 2017 Mar;69(3):353-61.e3. doi: 10.1016/j.annemergmed.2016.06.044.
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Keywords: Medication, Outcomes, Treatments
Stone B, Hester G, Jackson D
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Gastroesophageal reflux (GER), aspiration, and secondary complications lead to morbidity and mortality in children with neurologic impairment (NI), dysphagia, and gastrostomy feeding. Fundoplication and gastrojejunal (GJ) feeding can reduce risk. A comparison of GJ to fundoplication using first-year postprocedure reflux-related hospitalization (RRH) rates found that in children with NI, GER, and dysphagia,:fundoplication and GJ feeding have similar RRH outcomes.
AHRQ-funded; HS019862.
Citation: Stone B, Hester G, Jackson D .
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Hosp Pediatr 2017 Mar;7(3):140-48. doi: 10.1542/hpeds.2016-0126.
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Keywords: Children/Adolescents, Digestive Disease and Health, Neurological Disorders, Nutrition, Outcomes, Treatments
Greenhawt M, Oppenheimer J, Nelson M
Sublingual immunotherapy: a focused allergen immunotherapy practice parameter update.
The primary focus of the sublingual immunotherapy (SLIT) practice parameter is to provide guidance for effective, safe, and appropriate administration of the FDA-approved SLIT formulations. The SLIT practice parameters contain systematically developed statements with recommendations intended to optimize patient care and assist physicians and/or other health care practitioners and patients to make decisions regarding this therapy.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Oppenheimer J, Nelson M .
Sublingual immunotherapy: a focused allergen immunotherapy practice parameter update.
Ann Allergy Asthma Immunol 2017 Mar;118(3):276-82.e2. doi: 10.1016/j.anai.2016.12.009.
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Keywords: Evidence-Based Practice, Guidelines, Treatments
Roth JA, Goulart BH, Ravelo A
Survival gains from first-line systemic therapy in metastatic non-small cell lung cancer in the U.S., 1990-2015: progress and opportunities.
The objectives of this study were to quantify survival gains from 1990, when best supportive care only was standard, to 2015 and to estimate the impact of expanded use of new systemic therapies in clinically appropriate patients. By using simulation modeling to quantify metastatic non-small cell lung cancer survival gains from 1990-2015, the researchers estimated that the one-year survival proportion and mean per-patient survival increased by 14.1 percent and 4.2 months, respectively.
AHRQ-funded; HS022982.
Citation: Roth JA, Goulart BH, Ravelo A .
Survival gains from first-line systemic therapy in metastatic non-small cell lung cancer in the U.S., 1990-2015: progress and opportunities.
Oncologist 2017 Mar;22(3):304-10. doi: 10.1634/theoncologist.2016-0253.
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Keywords: Treatments, Health Status, Cancer: Lung Cancer, Mortality, Patient-Centered Outcomes Research
Zhang S, Cao J, Ahn C
Inference and sample size calculation for clinical trials with incomplete observations of paired binary outcomes.
The researchers investigated the estimation of intervention effect and sample size determination for experiments where subjects are supposed to contribute paired binary outcomes with some incomplete observations. They theoretically prove that if incomplete data are evenly distributed between the pre-intervention and post-intervention periods, the proposed estimator will always be more efficient than the traditional estimator.
AHRQ-funded; HS022418.
Citation: Zhang S, Cao J, Ahn C .
Inference and sample size calculation for clinical trials with incomplete observations of paired binary outcomes.
Stat Med 2017 Feb 20;36(4):581-91. doi: 10.1002/sim.7168.
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Keywords: Research Methodologies, Treatments, Comparative Effectiveness
Lidder AK, Detwiller KY, Price CP
Evaluating metrics of responsiveness using patient-reported outcome measures in chronic rhinosinusitis.
This study compares responsiveness of patient-reported outcome measures (PROMs) used in chronic rhinosinusitis (CRS) to inform the future development of a highly responsive instrument that accurately portrays CRS patients' symptom experiences. For both medical therapy (MT) patients and those undergoing endoscopic sinus surgery after failing MT, CRS-specific PROMs are more responsive to posttreatment clinical changes than general health measures.
AHRQ-funded; HS023011.
Citation: Lidder AK, Detwiller KY, Price CP .
Evaluating metrics of responsiveness using patient-reported outcome measures in chronic rhinosinusitis.
Int Forum Allergy Rhinol 2017 Feb;7(2):128-34. doi: 10.1002/alr.21866.
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Keywords: Chronic Conditions, Medication, Patient-Centered Outcomes Research, Treatments
Liu S, Mazur TR, Li H
A method to reconstruct and apply 3D primary fluence for treatment delivery verification.
In this study, a method is reported to perform IMRT and VMAT treatment delivery verification using 3D volumetric primary beam fluences reconstructed directly from planned beam parameters and treatment delivery records. The goals of this paper are to demonstrate that 1) 3D beam fluences can be reconstructed efficiently, and 2) quality assurance (QA) based on the reconstructed 3D fluences is capable of detecting additional treatment delivery errors, particularly for VMAT plans.
AHRQ-funded; HS022888.
Citation: Liu S, Mazur TR, Li H .
A method to reconstruct and apply 3D primary fluence for treatment delivery verification.
J Appl Clin Med Phys 2017 Jan;18(1):128-38. doi: 10.1002/acm2.12017.
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Keywords: Patient Safety, Imaging, Cancer: Lung Cancer, Treatments, Quality of Care
Linas BP, Morgan JR, Pho MT
Cost effectiveness and cost containment in the era of interferon-free therapies to treat hepatitis c virus genotype 1.
This study used Monte Carlo simulation to investigate budgetary impact and cost effectiveness of treatment policies for interferon-free regimens to treat hepatitis C virus (HCV) genotype 1 and to identify strategies that balance access with cost control. It found that among noncirrhotic patients, using the least costly interferon-free regimen, even if it is not single tablet or once daily, is the cost-control strategy that results in best outcomes.
AHRQ-funded; HS022433.
Citation: Linas BP, Morgan JR, Pho MT .
Cost effectiveness and cost containment in the era of interferon-free therapies to treat hepatitis c virus genotype 1.
Open Forum Infect Dis 2017 Winter;4(1):ofw266. doi: 10.1093/ofid/ofw266.
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Keywords: Hepatitis, Healthcare Costs, Healthcare Costs, Treatments
Cochran G, Field C, DiClemente C
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
The purpose of this study was to identify differential improvement in alcohol use among injured patients following brief intervention. Increases in both clinical trials for days abstinent were reported by classes characterized by multiple risks and minimal risks. Decreases in volume consumed for both studies were also reported by classes characterized by multiple risks and minimal risks.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, DiClemente C .
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
Behav Med 2016;42(1):29-38. doi: 10.1080/08964289.2014.951305.
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Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Treatments
Giordano SH, Niu J, Chavez-MacGregor M
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
The objective of the current study was to generate cost estimates for guideline-concordant adjuvant chemotherapy regimens from payers' and patients' perspectives in a large, insured US population. It concluded that the costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden.
AHRQ-funded; HS020263.
Citation: Giordano SH, Niu J, Chavez-MacGregor M .
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
Cancer 2016 Nov 15; 122(2):3447-3455. doi: 10.1002/cncr.30274.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Healthcare Costs
Raman G, Adam GP, Halladay CW
Comparative effectiveness of management strategies for renal artery stenosis: an updated systematic review.
This study compared benefits and harms of percutaneous transluminal renal angioplasty with stent placement (PTRAS) versus medical therapy alone in adults with atherosclerotic renal artery stenosis (ARAS). The strength of evidence regarding the relative benefits and harms of PTRAS versus medical therapy alone for patients with ARAS is low.
AHRQ-funded; 290201500002.
Citation: Raman G, Adam GP, Halladay CW .
Comparative effectiveness of management strategies for renal artery stenosis: an updated systematic review.
Ann Intern Med 2016 Nov;165(9):635-49. doi: 10.7326/m16-1053.
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Keywords: Kidney Disease and Health, Treatments, Comparative Effectiveness, Evidence-Based Practice
Devine EB, Alfonso-Cristancho R, Yanez ND
Effectiveness of a medical vs revascularization intervention for intermittent leg claudication based on patient-reported outcomes.
This study compared the effectiveness of a medical (walking program, smoking cessation counseling, and medications) vs revascularization (endovascular or surgical) intervention for intermittent claudication (IC) in the community, focusing on outcomes of greatest importance to patients. Among patients with IC, those in the revascularization cohort had significantly improved function (Walking Impairment Questionnaire), better health-related quality of life , and fewer symptoms at 12 months compared with those in the medical cohort.
AHRQ-funded; HS020025.
Citation: Devine EB, Alfonso-Cristancho R, Yanez ND .
Effectiveness of a medical vs revascularization intervention for intermittent leg claudication based on patient-reported outcomes.
JAMA Surg 2016 Oct 19;151(10):e162024. doi: 10.1001/jamasurg.2016.2024.
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Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Quality of Life, Treatments
Piccini JP, Fauchier L
Rhythm control in atrial fibrillation.
Many patients with atrial fibrillation have substantial symptoms despite ventricular rate control and require restoration of sinus rhythm to improve their quality of life. In patients who continue to have recurrent atrial fibrillation despite medical therapy, catheter ablation has been shown to substantially reduce recurrent atrial fibrillation, decrease symptoms, and improve quality of life.
AHRQ-funded; HS021092.
Citation: Piccini JP, Fauchier L .
Rhythm control in atrial fibrillation.
Lancet 2016 Aug 20;388(10046):829-40. doi: 10.1016/s0140-6736(16)31277-6.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Treatments