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
26 to 50 of 156 Research Studies DisplayedKhan A, Rogers JE, Melvin P
Physician and nurse nighttime communication and parents' hospital experience.
The researchers examined relationships between nighttime communication and parents’ inpatient experience. They found that parents provided the highest percentage of top ratings for the individual item pertaining to whether nurses listened to their concerns (70.5 percent strongly agreed) and the lowest such ratings for regular communication with nighttime doctors (31.4 percent excellent).
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Rogers JE, Melvin P .
Physician and nurse nighttime communication and parents' hospital experience.
Pediatrics 2015 Nov;136(5):e1249-58. doi: 10.1542/peds.2015-2391..
Keywords: Children/Adolescents, Clinician-Patient Communication, Patient-Centered Outcomes Research
Epstein RA, Fonnesbeck C, Potter S
Psychosocial interventions for child disruptive behaviors: a meta-analysis.
The researchers conducted a systematic review and meta-analysis to synthesize existing literature on the comparative effectiveness of psychosocial interventions for children and adolescents, 18 years of age with disruptive behavior disorders. It concluded that the 3 intervention categories were more effective than the control conditions. Interventions with a parent component, either alone or in combination with other components, were likely to have the largest effect.
AHRQ-funded; 290201200009I.
Citation: Epstein RA, Fonnesbeck C, Potter S .
Psychosocial interventions for child disruptive behaviors: a meta-analysis.
Pediatrics 2015 Nov;136(5):947-60. doi: 10.1542/peds.2015-2577..
Keywords: Behavioral Health, Children/Adolescents, Comparative Effectiveness, Patient-Centered Outcomes Research
de St Maurice A, Grijalva CG, Fonnesbeck C
Racial and regional differences in rates of invasive pneumococcal disease.
This study assessed the impact of introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) on pediatric IPD rates, as well as changes in racial and regional differences in invasive pneumococcal disease (IPD), in Tennessee. It found that PCV13 introduction led to substantial declines in childhood IPD rates and was associated with reduced regional and racial differences in IPD rates in Tennessee.
AHRQ-funded; HS022342.
Citation: de St Maurice A, Grijalva CG, Fonnesbeck C .
Racial and regional differences in rates of invasive pneumococcal disease.
Pediatrics 2015 Nov;136(5):e1186-94. doi: 10.1542/peds.2015-1773..
Keywords: Children/Adolescents, Vaccination, Prevention
Johnco CJ, Salloum A, Lewin AB
Refining clinical judgment of treatment response and symptom remission identification in childhood anxiety using a signal detection analysis on the pediatric anxiety rating scale.
The purpose of this study was to determine guidelines for delineating treatment response and symptom remission for children with anxiety disorder based on the five item Pediatric Anxiety Rating Scale (PARS5), and replicate guidelines using the six item PARS (PARS6). Optimal prediction of treatment response based on gold standard criteria was achieved at 15-20 percent reduction in symptoms on the PARS5 (with 20 percent reduction achieving marginally higher accuracy), and 20 percent reduction on the PARS6.
AHRQ-funded; HS018665.
Citation: Johnco CJ, Salloum A, Lewin AB .
Refining clinical judgment of treatment response and symptom remission identification in childhood anxiety using a signal detection analysis on the pediatric anxiety rating scale.
J Child Adolesc Psychopharmacol 2015 Nov;25(9):674-83. doi: 10.1089/cap.2015.0102.
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Keywords: Children/Adolescents, Anxiety, Diagnostic Safety and Quality, Guidelines
Luo G, Stone BL, Fassl B
Predicting asthma control deterioration in children.
The researchers developed and tested the first set of models for predicting a child’s asthma control deterioration one week prior to occurrence. Their best model successfully predicted a child’s asthma control level one week ahead. With adequate accuracy, the model could be integrated into electronic asthma self-monitoring systems.
AHRQ-funded; HS018166; HS018678.
Citation: Luo G, Stone BL, Fassl B .
Predicting asthma control deterioration in children.
BMC Med Inform Decis Mak 2015 Oct 14;15:84. doi: 10.1186/s12911-015-0208-9..
Keywords: Asthma, Children/Adolescents, Health Information Technology (HIT), Patient Self-Management
Lai JS, Yount S, Beaumont JL
A patient-centered symptom monitoring and reporting system for children and young adults with cancer (SyMon-SAYS).
This study evaluated the feasibility of implementing a patient-centered, technology-based symptom monitoring and reporting system (SyMon-SAYS) in pediatric oncology clinics using fatigue as a prototypic symptom. It concluded that the majority of patients (93 percent) and parents (78 percent) felt it was very/extremely easy to complete SyMon-SAYS; 95 percent of parents were satisfied with the system.
AHRQ-funded; HS019071.
Citation: Lai JS, Yount S, Beaumont JL .
A patient-centered symptom monitoring and reporting system for children and young adults with cancer (SyMon-SAYS).
Pediatr Blood Cancer 2015 Oct;62(10):1813-8. doi: 10.1002/pbc.25550..
Keywords: Children/Adolescents, Cancer, Health Information Technology (HIT), Children/Adolescents, Children/Adolescents
Morelli JJ, Hogan PG, Sullivan ML
Antimicrobial susceptibility profiles of Staphylococcus aureus isolates recovered from humans, environmental surfaces, and companion animals in households of children with community-onset Methicillin-Resistant S. aureus infections.
The study objective was to determine the antibiotic susceptibility profiles of Staphylococcus aureus isolates recovered from 110 households of children with community-onset methicillin-resistant S. aureus (MRSA) infections. It found that the S. aureus isolates were heterogeneous, although more than half were methicillin resistant. The highest proportion of MRSA was found in bathrooms.
AHRQ-funded; HS021736.
Citation: Morelli JJ, Hogan PG, Sullivan ML .
Antimicrobial susceptibility profiles of Staphylococcus aureus isolates recovered from humans, environmental surfaces, and companion animals in households of children with community-onset Methicillin-Resistant S. aureus infections.
Antimicrob Agents Chemother 2015 Oct;59(10):6634-7. doi: 10.1128/aac.01492-15.
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Keywords: Antimicrobial Stewardship, Methicillin-Resistant Staphylococcus aureus (MRSA), Children/Adolescents
Rangachari P, Madaio M, Rethemeyer RK
Cumulative impact of periodic top-down communications on infection prevention practices and outcomes in two units.
The authors investigated the challenge of consistent implementation of evidence-based infection prevention practices at the unit level. Their results showed that the interventions cumulatively had a significant desired impact on central catheter use and helped validate the theoretical literature and identify evidence-based management strategies for practice change at the unit level. Further, periodic top-down communications have the potential to modify interprofessional knowledge exchanges and enable practice change at the unit level, leading to significantly improved outcomes and reduced costs.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Cumulative impact of periodic top-down communications on infection prevention practices and outcomes in two units.
Health Care Manage Rev 2015 Oct-Dec;40(4):324-36. doi: 10.1097/hmr.0000000000000038.
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Keywords: Communication, Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Children/Adolescents, Prevention
Chien AT, Kuhlthau KA, Toomey SL
Development of the children with disabilities algorithm.
The researchers developed the Children with Disabilities algorithm (CWDA), which uses International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes to identify CWD. They concluded that ICD-9-CM codes can be classified by their likelihood of indicating CWD. CWDA triangulates well with parent report and physician assessment of child disability status. CWDA is a new tool that can be used to assess care quality for CWD.
AHRQ-funded; HS020513.
Citation: Chien AT, Kuhlthau KA, Toomey SL .
Development of the children with disabilities algorithm.
Pediatrics 2015 Oct;136(4):e871-8. doi: 10.1542/peds.2015-0228..
Keywords: Children/Adolescents, Quality of Care, Data, Children/Adolescents
Nieman CL, Benke JR, Boss EF
Does race/ethnicity or socioeconomic status influence patient satisfaction in pediatric surgical care?
The researchers evaluated patient satisfaction in outpatient pediatric surgical care and assess differences in scores by race/ ethnicity and socioeconomic status. Their analysis found no disparities in the patient experience by individual- or community-level factors.
AHRQ-funded; HS022932.
Citation: Nieman CL, Benke JR, Boss EF .
Does race/ethnicity or socioeconomic status influence patient satisfaction in pediatric surgical care?
Otolaryngol Head Neck Surg 2015 Oct;153(4):620-8. doi: 10.1177/0194599815590592..
Keywords: Patient Experience, Social Determinants of Health, Surgery, Racial and Ethnic Minorities, Children/Adolescents
Burns KM, Encinosa WE, Pearson GD
AHRQ Author: Encinosa WE
Electrocardiogram in preparticipation athletic evaluations among insured youths.
The researchers retrospectively characterized electrocardiogram (ECG) use among preparticipation history and examinations (PPEs). They found that thirteen percent of PPEs with ECG and 0.5 percent of PPEs alone led to a cardiology referral. After PPEs with ECG, cardiac disease was identified in 18 percent (2 percent sports-limiting); after PPEs alone, cardiac disease was identified in 0.5 percent (0.03 percent sports-limiting).
AHRQ-authored.
Citation: Burns KM, Encinosa WE, Pearson GD .
Electrocardiogram in preparticipation athletic evaluations among insured youths.
J Pediatr 2015 Oct;167(4):804-09.e1. doi: 10.1016/j.jpeds.2015.06.011..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Radovic A, Reynolds K, McCauley HL
Parents' role in adolescent depression care: primary care provider perspectives.
This study aimed to understand how primary care providers (PCPs) perceive barriers to adolescent depression care in order to inform strategies to increase treatment engagement. PCPs perceived that parental unwillingness to accept the depression diagnosis, family dysfunction, and trauma were common barriers. PCPs contrasted this with examples of good family support they believed would enable adolescents to attend follow-up appointments and have a “life coach” at home.
AHRQ-funded; HS022989; HS019486.
Citation: Radovic A, Reynolds K, McCauley HL .
Parents' role in adolescent depression care: primary care provider perspectives.
J Pediatr 2015 Oct;167(4):911-8. doi: 10.1016/j.jpeds.2015.05.049..
Keywords: Caregiving, Children/Adolescents, Depression, Behavioral Health, Primary Care
Storch EA, Salloum A, Johnco C
Phenomenology and clinical correlates of family accommodation in pediatric anxiety disorders.
This study assessed the nature and clinical correlates of family accommodation in pediatric anxiety, as well as validating a mechanistic model. It concluded that family accommodation was associated with increased anxiety severity and externalizing behaviors, having a diagnosis of separation anxiety, and increased functional impairment. Family accommodation partially mediated the relationship between anxiety severity and functional impairment.
AHRQ-funded; HS018665.
Citation: Storch EA, Salloum A, Johnco C .
Phenomenology and clinical correlates of family accommodation in pediatric anxiety disorders.
J Anxiety Disord 2015 Oct;35:75-81. doi: 10.1016/j.janxdis.2015.09.001.
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Keywords: Children/Adolescents, Anxiety, Behavioral Health, Children/Adolescents, Family Health and History
Khan A, Nakamura MM, Zaslavsky AM
Same-hospital readmission rates as a measure of pediatric quality of care.
This study determined the prevalence of 30-day pediatric different hospital readmission (DHRs); to assess the effect of DHR on readmission performance; and to identify patient and hospital characteristics associated with DHR. It concluded that DHRs differentially affect hospitals’ pediatric readmission rates and anticipated performance, making same-hospital readmissions an incomplete surrogate for all-hospital readmissions—particularly for certain hospital types.
AHRQ-funded; HS000063; HS020513.
Citation: Khan A, Nakamura MM, Zaslavsky AM .
Same-hospital readmission rates as a measure of pediatric quality of care.
JAMA Pediatr 2015 Oct;169(10):905-12. doi: 10.1001/jamapediatrics.2015.1129..
Keywords: Children/Adolescents, Quality of Care, Hospital Readmissions, Quality Indicators (QIs), Children/Adolescents
Rangachari P, Mehta R, Rethemeyer RK
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
This study addresses the gap in understanding the extent of leverage that healthcare providers may have in preventing hospital revisits for asthma through effective communication of the Asthma-Action Plan (AAP) in the outpatient setting. The Children's Hospital of Georgia survey results suggest limited potential of effective provider communication of AAP in reducing outpatient revisits for pediatric asthma and indicate a need for broader community-based interventions to address patient life variables impacting self-management and hospital revisits for pediatric asthma.
AHRQ-funded; HS019785.
Citation: Rangachari P, Mehta R, Rethemeyer RK .
Short or long end of the lever? Associations between provider communication of the "asthma-action plan" and outpatient revisits for pediatric asthma.
J Hosp Adm 2015 Oct;4(5):26-39. doi: 10.5430/jha.v4n5p26.
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Keywords: Asthma, Children/Adolescents, Ambulatory Care and Surgery, Clinician-Patient Communication, Patient Self-Management
Gray SH, Trudell EK, Emans SJ
Total direct medical expenses and characteristics of privately insured adolescents who incur high costs.
This study assessed health care expenditures for high-cost adolescents and described the patient characteristics associated with high medical costs. It concluded that total direct medical expenses for privately insured high-cost adolescents are associated with medical complexity, mental health conditions, and obesity. Cost reduction strategies in similar populations should be tailored to these cost drivers.
AHRQ-funded; HS023092.
Citation: Gray SH, Trudell EK, Emans SJ .
Total direct medical expenses and characteristics of privately insured adolescents who incur high costs.
JAMA Pediatr 2015 Oct;169(10):e152682. doi: 10.1001/jamapediatrics.2015.2682..
Keywords: Access to Care, Children/Adolescents, Healthcare Costs, Health Insurance
Marin JR, Wang L, Winger DG
Variation in computed tomography imaging for pediatric injury-related emergency visits.
This study assessed variation in the use of computed tomography (CT) for pediatric injury-related emergency department (ED) visits. It found wide variation in CT imaging for pediatric injury-related visits not attributable solely to case mix. In multivariable analysis of nonpediatric EDs, trauma centers and nonacademic EDs were associated with CT use. Higher pediatric volume was associated with any CT use.
AHRQ-funded; HS023498.
Citation: Marin JR, Wang L, Winger DG .
Variation in computed tomography imaging for pediatric injury-related emergency visits.
J Pediatr 2015 Oct;167(4):897-904.e3. doi: 10.1016/j.jpeds.2015.06.052..
Keywords: Emergency Medical Services (EMS), Children/Adolescents, Children/Adolescents, Emergency Department, Imaging
Johnco CJ, Salloum A, De Nadai AS
Incidence, clinical correlates and treatment effect of rage in anxious children.
This study examined the incidence and clinical correlates of rage in children with anxiety disorders. Change in rage during treatment for anxiety was also examined. It found that rage was associated with a more severe clinical profile, including increased anxiety severity, functional impairment, family accommodation and caregiver strain, as well as poorer relationships with parents, siblings, extended family and peers.
AHRQ-funded; HS018665.
Citation: Johnco CJ, Salloum A, De Nadai AS .
Incidence, clinical correlates and treatment effect of rage in anxious children.
Psychiatry Res 2015 Sep 30;229(1-2):63-9. doi: 10.1016/j.psychres.2015.07.071..
Keywords: Anxiety, Behavioral Health, Children/Adolescents, Family Health and History
Johnco CJ, Salloum A, Lewin AB
The impact of comorbidity profiles on clinical and psychosocial functioning in childhood anxiety disorders.
This study compared the profile of children with a primary anxiety disorder without comorbidity to those with different comorbidity profiles in a treatment-seeking sample of 111 children recruited from community mental health settings. It found that anxiety severity and depressive symptomatology did not vary by comorbidity profile. Anxious children without comorbidity had lower levels of aggressive and externalizing behaviors compared to the comorbid ADHD group.
AHRQ-funded; HS018665.
Citation: Johnco CJ, Salloum A, Lewin AB .
The impact of comorbidity profiles on clinical and psychosocial functioning in childhood anxiety disorders.
Psychiatry Res 2015 Sep 30;229(1-2):237-44. doi: 10.1016/j.psychres.2015.07.027..
Keywords: Children/Adolescents, Anxiety, Behavioral Health
Gance-Cleveland B, Aldrich H, Dandreaux D
A virtual childhood obesity collaborative: satisfaction with online continuing education.
This descriptive study evaluated school-based health center (SBHC) providers’ satisfaction with Web based continuing education as part of a virtual childhood obesity intervention. Participation in the first two learning sessions was higher than the last two. Provider satisfaction of training modules by question type and content area was quite high. Many providers also reported plans to make changes in their practice after completing the training.
AHRQ-funded; HS018646.
Citation: Gance-Cleveland B, Aldrich H, Dandreaux D .
A virtual childhood obesity collaborative: satisfaction with online continuing education.
J Pediatr Health Care 2015 Sep-Oct;29(5):413-23. doi: 10.1016/j.pedhc.2015.01.006..
Keywords: Education: Continuing Medical Education, Obesity, Children/Adolescents, Prevention, Web-Based
Sawicki GS, Garvey KC, Toomey SL
Development and validation of the adolescent assessment of preparation for transition: a novel patient experience measure.
The authors developed an adolescent-reported measure of the quality of health care transition (HCT) preparation received from pediatric health care providers. They found that the Adolescent Assessment of Preparation for Transition (ADAPT) is a reliable, validated instrument measuring the quality of HCT preparation experiences reported by adolescents with chronic disease.
AHRQ-funded; HS020513.
Citation: Sawicki GS, Garvey KC, Toomey SL .
Development and validation of the adolescent assessment of preparation for transition: a novel patient experience measure.
J Adolesc Health 2015 Sep;57(3):282-7. doi: 10.1016/j.jadohealth.2015.06.004.
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Keywords: Children/Adolescents, Chronic Conditions, Patient Experience, Quality of Care, Transitions of Care
Costarino AT, Dai D, Feng R
Gastric acid suppressant prophylaxis in pediatric intensive care: current practice as reflected in a large administrative database.
The researchers described the use of histamine 2 receptor blockers and proton pump inhibitors and associated factors among a national sample of pediatric intensivecare unit (PICU) patients with stress-related gatrointestinal bleeding. Histamine 2 receptor blocker and proton pump inhibitor are prescribed in most PICU patients, but significant variation exists across health conditions and hospitals.
AHRQ-funded; HS018425.
Citation: Costarino AT, Dai D, Feng R .
Gastric acid suppressant prophylaxis in pediatric intensive care: current practice as reflected in a large administrative database.
Pediatr Crit Care Med 2015 Sep;16(7):605-12. doi: 10.1097/pcc.0000000000000427.
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Keywords: Children/Adolescents, Intensive Care Unit (ICU), Children/Adolescents, Medication
Michelson KA, Monuteaux MC, Neuman MI
Glucocorticoids and hospital length of stay for children with anaphylaxis: a retrospective study.
The objective of this study was to evaluate whether glucocorticoid administration is associated with improved outcomes in children with anaphylaxis. The investigators found that the use of glucocorticoids was inversely associated with prolonged length of stay among children hospitalized with anaphylaxis, but was not associated with 3-day emergency department revisits among discharged children, thus supporting the use of glucocorticoids in children hospitalized with anaphylaxis.
AHRQ-funded; HS000063.
Citation: Michelson KA, Monuteaux MC, Neuman MI .
Glucocorticoids and hospital length of stay for children with anaphylaxis: a retrospective study.
J Pediatr 2015 Sep;167(3):719-24.e1-3. doi: 10.1016/j.jpeds.2015.05.033.
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Keywords: Children/Adolescents, Medication, Respiratory Conditions, Respiratory Conditions, Patient-Centered Outcomes Research
Ricciardi R
AHRQ Author: Ricciardi R
I'm in an NP state of mind: a tribute to Dr. Henry K. Silver on the 50th anniversary of the nurse practitioner profession.
The author gives a personal tribute to Dr. Henry K Silver who co-founded the nurse practitioner role with Dr. Loretta Ford and founded the Child Health Associate/Physician Assistant program at the University of Colorado.
AHRQ-authored.
Citation: Ricciardi R .
I'm in an NP state of mind: a tribute to Dr. Henry K. Silver on the 50th anniversary of the nurse practitioner profession.
J Pediatr Health Care 2015 Sep-Oct;29(5):397-9. doi: 10.1016/j.pedhc.2015.06.009..
Keywords: Nursing, Children/Adolescents, Provider: Health Personnel
Rand CM, Blumkin A, Vincelli P
Parent preferences for communicating with their adolescent's provider using new technologies.
The researchers assessed the views of parents of adolescents on various means to communicate with their adolescents’ physicians about vaccine reminders and appointments, medication refills and test results including phone, mail, e-mail, text messages, and personal health records (PHR). They found that young parents of adolescents are most likely to accept text message vaccine reminders; suburban parents prefer e-mail reminders. Personal health records are accepted generally by those parents who are younger and suburban.
AHRQ-funded; HS017951.
Citation: Rand CM, Blumkin A, Vincelli P .
Parent preferences for communicating with their adolescent's provider using new technologies.
J Adolesc Health 2015 Sep;57(3):299-304. doi: 10.1016/j.jadohealth.2015.06.006..
Keywords: Health Information Technology (HIT), Clinician-Patient Communication, Children/Adolescents, Vaccination