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 12 of 12 Research Studies DisplayedPanupattanapong S, Stwalley DL, White AJ
Epidemiology and outcomes of granulomatosis with polyangiitis in pediatric and working-age adult populations In the United States: analysis of a large national claims database.
This retrospective cohort study examined the epidemiology and outcomes of granulomatosis with polyangiitis (GPA) in pediatric and working-age adult populations in the US. The study used data from the 2006-2014 Truven Health Analytics MarketScan Commercial Claims and Encounters Database. The incidence is rare in children, with a total of 214 (3.8%) out of 5,562 cases identified as pediatric onset. The incidence rate in children was 1.8 cases per 1 million person-years as opposed to 12.8 cases per 1 million person-years in working age adults. Children were more like to have frequent hospitalizations and severe infections including leukopenia, neutropenia, and hypogammaglobulinemia than the non-elderly adults.
AHRQ-funded; HS019455.
Citation: Panupattanapong S, Stwalley DL, White AJ .
Epidemiology and outcomes of granulomatosis with polyangiitis in pediatric and working-age adult populations In the United States: analysis of a large national claims database.
Arthritis Rheumatol 2018 Dec;70(12):2067-76. doi: 10.1002/art.40577..
Keywords: Children/Adolescents, Hospitalization, Respiratory Conditions, Cardiovascular Conditions
Burgermaster M, Murray M, Saiman L
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
This study investigated the outcomes of children and a subsample of infants in pediatric long-term care facilities are need enteral nutrition (EN). Those patients who need EN had a higher risk of acute pediatric infection (ARI) and a lower odds of discharge than those who did not. Infants had a particular higher risk of comorbidities and infections when they were fed using percutaneous feeding tubes.
AHRQ-funded; HS021470.
Citation: Burgermaster M, Murray M, Saiman L .
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
Nutr Clin Pract 2018 Dec;33(6):865-71. doi: 10.1002/ncp.10017..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Nutrition, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions, Long-Term Care
Kaiser SV, Lam R, Joseph GB
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
Researcher sought to determine if a National Quality Forum (NQF)-endorsed measure for pediatric lower respiratory illness (LRI) 30-day readmission rates can meaningfully identify high- and low-performing hospitals. Subjects were children with LRI (bronchiolitis, influenza, or pneumonia as primary diagnosis, or with an LRI as a secondary diagnosis with a primary diagnosis of respiratory failure, sepsis, bacteremia, or asthma) from all hospital admissions in California from 2012 to 2014. The researchers were unable to identify meaningful variation in hospital performance without broadening the metric definition and merging multiple years of data. They recommend that utilizers of pediatric-quality measures consider modifying metrics to better evaluate the quality of pediatric care at low-volume hospitals.
AHRQ-funded; HS024385; HS022835; HS024592; HS025297.
Citation: Kaiser SV, Lam R, Joseph GB .
Limitations of using pediatric respiratory illness readmissions to compare hospital performance.
J Hosp Med 2018 Nov;13(11):737-42. doi: 10.12788/jhm.2988..
Keywords: Children/Adolescents, Respiratory Conditions, Provider Performance, Hospital Readmissions, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care, Quality Improvement
Liu TL, Taylor YJ, Mahabaleshwarkar R
Shared decision making and time to exacerbation in children with asthma.
This study examined the use of shared decision making (SDM) to delay exacerbation in children with asthma. A prospective cohort of children at five primary care practices in Charlotte, North Carolina that serve vulnerable population was studied between 2011 and 2013. The cohort included 746 children, with 60.5% male and 54.2% African American with a mean age of 8.6 years. The final analysis included 100 matched pairs of children for use of SDM and normal care. There was a marginally significant difference in the time of exacerbation between the two groups.
AHRQ-funded; HS019946.
Citation: Liu TL, Taylor YJ, Mahabaleshwarkar R .
Shared decision making and time to exacerbation in children with asthma.
J Asthma 2018 Sep;55(9):949-55. doi: 10.1080/02770903.2017.1378357..
Keywords: Children/Adolescents, Shared Decision Making, Asthma, Respiratory Conditions, Chronic Conditions, Primary Care
Harris VC, Links AR, Kim JM
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
The purpose of this study was to evaluate follow-up and timing of sleep-disordered breathing diagnosis and treatment in urban children referred from primary care. Researchers found that half of the children referred for sleep-disordered breathing evaluation are lost to follow-up from primary care. Obstructive sleep apnea severity did not predict follow-up or timeliness of treatment. They conclude that these findings suggest social determinants may pose barriers to care in addition to the clinical burden of sleep-disordered breathing.
AHRQ-funded; HS022932.
Citation: Harris VC, Links AR, Kim JM .
Follow-up and time to treatment in an urban cohort of children with sleep-disordered breathing.
Otolaryngol Head Neck Surg 2018 Aug;159(2):371-78. doi: 10.1177/0194599818772035..
Keywords: Access to Care, Children/Adolescents, Disparities, Healthcare Delivery, Patient-Centered Healthcare, Quality of Care, Respiratory Conditions, Sleep Problems, Urban Health
Taylor YJ, Tapp H, Shade LE
Impact of shared decision making on asthma quality of life and asthma control among children.
This study evaluated the impact of shared decision making (SDM) on quality of life and symptom control in children with asthma. The investigators found that implementation of SDM within clinical practices using a standardized toolkit was associated with improved asthma quality of life and asthma control for low-income children with asthma when compared to usual care with decision support.
AHRQ-funded; HS019946.
Citation: Taylor YJ, Tapp H, Shade LE .
Impact of shared decision making on asthma quality of life and asthma control among children.
J Asthma 2018 Jun;55(6):675-83. doi: 10.1080/02770903.2017.1362423..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Chronic Conditions, Shared Decision Making, Quality of Life
Kojima T, Harwayne-Gidansky I, Shenoi AN
Cricoid pressure during induction for tracheal intubation in critically ill children: a report from National Emergency Airway Registry for Children.
The objective of this retrospective cohort study was to evaluate the association between cricoid pressure use and the occurrence of regurgitation during tracheal intubation for critically ill children in pediatric intensive care unit (PICU). The investigators found that cricoid pressure during induction and mask ventilation before tracheal intubation in the current ICU practice was not associated with a lower regurgitation rate after adjusting for previously reported confounders.
AHRQ-funded; HS024511.
Citation: Kojima T, Harwayne-Gidansky I, Shenoi AN .
Cricoid pressure during induction for tracheal intubation in critically ill children: a report from National Emergency Airway Registry for Children.
Pediatr Crit Care Med 2018 Jun;19(6):528-37. doi: 10.1097/pcc.0000000000001531.
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Keywords: Children/Adolescents, Critical Care, Children/Adolescents, Registries, Respiratory Conditions
Eisler L, Huang G, Lee KM
Identification of perioperative pulmonary aspiration in children using quality assurance and hospital administrative billing data.
This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source. The investigators found that International Classification of Diseases, Ninth Revision codes for aspiration used as a secondary data source were nonspecific for perioperative aspiration, but when combined with record review yielded a 30% increase in identified cases of aspiration over quality assurance data alone.
AHRQ-funded; HS022941.
Citation: Eisler L, Huang G, Lee KM .
Identification of perioperative pulmonary aspiration in children using quality assurance and hospital administrative billing data.
Paediatr Anaesth 2018 Mar;28(3):218-25. doi: 10.1111/pan.13319..
Keywords: Adverse Events, Children/Adolescents, Data, Pneumonia, Respiratory Conditions
Bavishi A, Boss E, Shah RK
Outcomes after endoscopic dilation of laryngotracheal stenosis: an analysis of ACS-NSQIP.
Endoscopic management of pediatric subglottic stenosis (SGS) is common, however no multi-institutional studies have assessed its perioperative outcomes. This study examined outcomes after endoscopic dilation of laryngotracheal stenosis. The study found that open airway reconstruction is associated with longer length of stay and increased reintubations and reoperations, suggesting a possible opportunity to improve value in healthcare in the appropriately selected patient. Reoperations and readmissions following endoscopic dilation are more prevalent in children less than one year.
AHRQ-funded; HS022932.
Citation: Bavishi A, Boss E, Shah RK .
Outcomes after endoscopic dilation of laryngotracheal stenosis: an analysis of ACS-NSQIP.
J Clin Outcomes Manag 2018 Mar;25(3):111-16..
Keywords: Children/Adolescents, Patient-Centered Outcomes Research, Quality Improvement, Respiratory Conditions, Surgery
Kojima T, Laverriere EK, Owen EB
Clinical impact of external laryngeal manipulation during laryngoscopy on tracheal intubation success in critically ill children.
In this retrospective observational study, the objective was to evaluate the association between external laryngeal manipulation use and initial tracheal intubation attempt success in pediatric ICUs. The investigators found that external laryngeal manipulation during direct laryngoscopy was associated with lower initial tracheal intubation attempt success in critically ill children, even after adjusting for underlying differences in patient factors and provider levels. They asserted that the indiscriminate use of external laryngeal manipulation cannot be recommended.
AHRQ-funded; HS024511.
Citation: Kojima T, Laverriere EK, Owen EB .
Clinical impact of external laryngeal manipulation during laryngoscopy on tracheal intubation success in critically ill children.
Pediatr Crit Care Med 2018 Feb;19(2):106-14. doi: 10.1097/pcc.0000000000001373..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Children/Adolescents, Respiratory Conditions
Goldstein E, Nguyen HH, Liu P
AHRQ Author: Steiner CA
On the relative role of different age groups during epidemics associated with respiratory syncytial virus.
This study evaluated the roles played by individuals in different age groups during respiratory syncytial virus (RSV) epidemics in the United States between 2001 and 2012, using the previously defined relative risk (RR) statistic estimated from the hospitalization data from the Healthcare Cost and Utilization Project. Its estimates suggest the prominent relative roles of children aged </=10 years (particularly among those aged 3-6 years) in propagating RSV epidemics.
AHRQ-authored.
Citation: Goldstein E, Nguyen HH, Liu P .
On the relative role of different age groups during epidemics associated with respiratory syncytial virus.
J Infect Dis 2018 Jan 4;217(2):238-44. doi: 10.1093/infdis/jix575.
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Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Respiratory Conditions
Li S, Hsieh TC, Rehder KJ
Frequency of desaturation and association with hemodynamic adverse events during tracheal intubations in PICUs.
In this retrospective cohort study, the investigators aimed to determine the occurrence and severity of desaturation during tracheal intubations and the association with adverse hemodynamic tracheal intubation-associated events. They found that moderate and severe desaturation were reported among 19% and 13% of all tracheal intubation encounters; Moderate and severe desaturations were independently associated with the occurrence of adverse hemodynamic events.
AHRQ-funded; HS024511.
Citation: Li S, Hsieh TC, Rehder KJ .
Frequency of desaturation and association with hemodynamic adverse events during tracheal intubations in PICUs.
Pediatr Crit Care Med 2018 Jan;19(1):e41-e50. doi: 10.1097/pcc.0000000000001384..
Keywords: Adverse Events, Children/Adolescents, Patient Safety, Children/Adolescents, Respiratory Conditions