National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Blood Clots (1)
- (-) Clinical Decision Support (CDS) (7)
- COVID-19 (1)
- Dementia (1)
- (-) Diagnostic Safety and Quality (7)
- Electronic Health Records (EHRs) (1)
- Emergency Department (2)
- Evidence-Based Practice (2)
- Health Information Technology (HIT) (3)
- Imaging (2)
- Neurological Disorders (1)
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- Pneumonia (1)
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- Respiratory Conditions (2)
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- Sepsis (1)
- Shared Decision Making (4)
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 7 of 7 Research Studies DisplayedGale BM, Hall KK
The use of patient monitoring systems to improve sepsis recognition and outcomes: a systematic review.
This systematic review’s aim was to determine the impact of automated patient monitoring systems (PMSs) on sepsis recognition and outcomes. The review was conducted using articles published from 2008 through 2018. Nineteen articles were identified for inclusion with 4 systematic reviews and 15 individual studies. Study results for outcome measures were mixed, with more than half the studies showing a significant improvement in at least one outcome measure (eg mortality, intensive care unit length of stay, ICU transfer). Evidence for process measure improvement was of moderate strength across multiple hospital units.
AHRQ-funded; 233201500013I.
Citation: Gale BM, Hall KK .
The use of patient monitoring systems to improve sepsis recognition and outcomes: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S8-s11. doi: 10.1097/pts.0000000000000750..
Keywords: Clinical Decision Support (CDS), Sepsis, Diagnostic Safety and Quality, Screening, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Joshi RP, Pejaver V, Hammarlund NE
A predictive tool for identification of SARS-CoV-2 PCR-negative emergency department patients using routine test results.
This retrospective case-control study investigated whether the use of a prediction tool based on complete blood count results and patient sex can better allocate testing for SARS-CoV-2 PCR testing in hospital emergency departments. Participants were emergency department patients who had concurrent complete blood counts and SARS-CoV-2 PCR testing in Northern California, Seattle, Washington, Chicago Illinois, and South Korea. A hypothetical scenario of 1000 patients requiring testing was developed, but in this scenario testing resources are limited to 60% of patients. This tool would allow a 33% increase in properly allocated resources.
AHRQ-funded; HS026385.
Citation: Joshi RP, Pejaver V, Hammarlund NE .
A predictive tool for identification of SARS-CoV-2 PCR-negative emergency department patients using routine test results.
J Clin Virol 2020 Aug;129:104502. doi: 10.1016/j.jcv.2020.104502..
Keywords: Emergency Department, COVID-19, Pneumonia, Respiratory Conditions, Diagnostic Safety and Quality, Clinical Decision Support (CDS)
Westafer LM, Kunz A, Bugajska P
Provider perspectives on the use of evidence-based risk stratification tools in the evaluation of pulmonary embolism: a qualitative study.
Providers often pursue imaging in patients at low risk of pulmonary embolism (PE), resulting in imaging yields <10% and false-positive imaging rates of 10% to 25%. Attempts to curb overtesting have had only modest success and no interventions have used implementation science frameworks. The objective of this study was to identify barriers and facilitators to the adoption of evidence-based diagnostic testing for PE.
AHRQ-funded; HS025701.
Citation: Westafer LM, Kunz A, Bugajska P .
Provider perspectives on the use of evidence-based risk stratification tools in the evaluation of pulmonary embolism: a qualitative study.
Acad Emerg Med 2020 Jun;27(6):447-56. doi: 10.1111/acem.13908..
Keywords: Respiratory Conditions, Evidence-Based Practice, Diagnostic Safety and Quality, Imaging, Shared Decision Making, Clinical Decision Support (CDS), Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Carayon P, Hoonakker P, Hundt AS
Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.
This study used a scenario-based simulation to compare a human factor (HF)-based clinician decision support (CDS) with a web-based CDS (MDCalc) for clinicians to diagnose pulmonary embolism (PE) in the emergency department. A total of 32 emergency physicians participated using both CDS types. Emergency physicians made more appropriate diagnoses decisions with the PE-Dx CDS (94%) than with the web-based CDS (84%). Experimental tasks were also performed faster (average 96 seconds per scenario versus 117 seconds). They also reported lower workload and higher satisfaction with the HF-based CDS.
AHRQ-funded; HS024342; HS024558; HS022086.
Citation: Carayon P, Hoonakker P, Hundt AS .
Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.
BMJ Qual Saf 2020 Apr;29(4):329-40. doi: 10.1136/bmjqs-2019-009857..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Diagnostic Safety and Quality, Emergency Department
Richardson S, Cohen S, Khan S
Higher imaging yield when clinical decision support is used.
Increased utilization of CT pulmonary angiography (CTPA) for the evaluation of pulmonary embolism has been associated with decreasing diagnostic yields and rising concerns about the harms of unnecessary testing. The objective of this study was to determine whether clinical decision support (CDS) use would be associated with increased imaging yields after controlling for selection bias.
AHRQ-funded; HS022061.
Citation: Richardson S, Cohen S, Khan S .
Higher imaging yield when clinical decision support is used.
J Am Coll Radiol 2020 Apr;17(4):496-503. doi: 10.1016/j.jacr.2019.11.021.
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Keywords: Clinical Decision Support (CDS), Imaging, Diagnostic Safety and Quality, Shared Decision Making, Blood Clots
Meyer AND, Giardina TD, Spitzmueller C
Patient perspectives on the usefulness of an artificial intelligence-assisted symptom checker: cross-sectional survey study.
This study examined patients’ experiences using an artificial intelligence (AI)-assisted online symptom checker and their doctors’ reactions to that use. From March 2 through March 15, 2018 an online survey was conducted of US users of the Isabel Symptom Checker within 6 months of their use. The majority of users were women, white, and had a mean age of 48. Overall, patients had a positive experience with the symptom checker and felt they would use it again (91.4%). About 48% discussed the findings with their physician and felt about 40% of their physicians were interested. Patients who had previously experienced diagnostic errors were more likely to use the symptom checker to determine if they should seek care.
AHRQ-funded; HS025474; HS027363.
Citation: Meyer AND, Giardina TD, Spitzmueller C .
Patient perspectives on the usefulness of an artificial intelligence-assisted symptom checker: cross-sectional survey study.
J Med Internet Res 2020 Jan 30;22(1):e14679. doi: 10.2196/14679..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Diagnostic Safety and Quality, Patient Safety
Barnes DE, Zhou J, Walker RL
Development and validation of eRADAR: a tool using EHR Data to detect unrecognized dementia.
The goal of this retrospective cohort study was to develop and validate an electronic health record (EHR)-based tool to help detect patients with unrecognized dementia. The tool was named EHR Risk of Alzheimer’s and Dementia Assessment Rule (eRADAR). This study was conducted at Kaiser Permanente Washington (KPWA) using participants in the Adult Changes in Thought (ACT) study who undergo comprehensive testing every 2 years to detect and diagnose dementia and have linked KPWA EHR data. Overall, 1015 ACT visits resulted in a diagnosis of incident dementia, of which 49% were previously unrecognized in the EHR. The final 31-predictor model included markers of dementia-related symptoms, healthcare utilization patterns, and dementia risk factors. The study showed good discrimination in the development interval and validation samples.
AHRQ-funded; HS022982.
Citation: Barnes DE, Zhou J, Walker RL .
Development and validation of eRADAR: a tool using EHR Data to detect unrecognized dementia.
J Am Geriatr Soc 2020 Jan;68(1):103-11. doi: 10.1111/jgs.16182..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Dementia, Neurological Disorders, Diagnostic Safety and Quality, Clinical Decision Support (CDS), Shared Decision Making