National Healthcare Quality and Disparities Report
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- Adverse Drug Events (ADE) (2)
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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
51 to 65 of 65 Research Studies DisplayedLiyanage-Don N, Fung D, Phillips E
Implementing home blood pressure monitoring into clinical practice.
The purpose of this study was to review data that supports the use of home blood pressure monitoring (HBPM) and to provide practical guidance to clinicians who wish to incorporate HBPM into their practice. Home blood pressure monitoring more accurately reflects the risk of cardiovascular events than office blood pressure measurements, and evidence supports the hypothesis that HBPM combined with clinical support improves blood pressure control. In spite of this, HBPM use remains low due to barriers between patients, clinicians, and healthcare system levels; understanding these barriers is crucial for the development of strategies to implement HBPM. This article considers how recommended best practices can facilitate the successful and effective implementation of HBPM.
AHRQ-funded; HS024262.
Citation: Liyanage-Don N, Fung D, Phillips E .
Implementing home blood pressure monitoring into clinical practice.
Curr Hypertens Rep 2019 Feb 12;21(2):14. doi: 10.1007/s11906-019-0916-0..
Keywords: Blood Pressure, Diagnostic Safety and Quality, Primary Care, Screening
Murphy DR, Meyer AN, Sittig DF
Application of electronic trigger tools to identify targets for improving diagnostic safety.
This article discusses the use of electronic trigger tools to reduce diagnostic errors and improve patient safety. The authors present a framework called Safer Dx Trigger Tools Framework that will enable health systems to develop and implement e-trigger tools. It identifies and measures diagnostic errors using comprehensive electronic health record (EHR) data. The application of the algorithms used will require a diverse team of specialists to implement. Future research is also outlined.
AHRQ-funded; HS022901; HS022087; HS017820.
Citation: Murphy DR, Meyer AN, Sittig DF .
Application of electronic trigger tools to identify targets for improving diagnostic safety.
BMJ Qual Saf 2019 Feb;28(2):151-59. doi: 10.1136/bmjqs-2018-008086..
Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Goldberg EM, Wilson T, Jambhekar B
Emergency department-provided home blood pressure devices can help detect undiagnosed hypertension.
This study researched the value of giving home blood pressure devices to patients in emergency departments (EDs) with a triage blood pressure (BP) of >= 120/80 mmHg and no history of hypertension. About 68% of the participants used the device at least 4 times. Those participants with elevated BP had follow-up with their primary care doctor 46% of the time.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Wilson T, Jambhekar B .
Emergency department-provided home blood pressure devices can help detect undiagnosed hypertension.
High Blood Press Cardiovasc Prev 2019 Feb;26(1):45-53. doi: 10.1007/s40292-019-00300-0..
Keywords: Blood Pressure, Emergency Department, Diagnostic Safety and Quality
Faye AS, Polubriaginof F, Green PHR
Low rates of screening for celiac disease among family members.
This study determined how many family members of patients diagnosed with celiac disease were screened. Even among those patients with a family history, nearly 30% of symptomatic first-degree relatives were not tested. These tests are recommended in guidelines for all relatives with a documented family history.
AHRQ-funded; HS021816.
Citation: Faye AS, Polubriaginof F, Green PHR .
Low rates of screening for celiac disease among family members.
Clin Gastroenterol Hepatol 2019 Feb;17(3):463-68. doi: 10.1016/j.cgh.2018.06.016..
Keywords: Diagnostic Safety and Quality, Digestive Disease and Health, Family Health and History, Screening
Hanmer J, Yu L, Li J
The diagnosis of asymptomatic disease is associated with fewer healthy days: a cross sectional analysis from the national health and nutrition examination survey.
This study measured the effect of asymptomatic disease on health-related quality of life (HRQoL). The health conditions focused on were glucose intolerance, hyperlipidaemia and hypertension. A secondary analysis was done of data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES). Patients who knew about their diagnosis but did not receive treatment reported lower QoL scores than those who did not know about their disease. Conversely, those without the condition reported about the same scores as those who did not know about their disease.
AHRQ-funded; HS022989.
Citation: Hanmer J, Yu L, Li J .
The diagnosis of asymptomatic disease is associated with fewer healthy days: a cross sectional analysis from the national health and nutrition examination survey.
Br J Health Psychol 2019 Feb;24(1):88-101. doi: 10.1111/bjhp.12341..
Keywords: Diagnostic Safety and Quality, Health Status, Quality of Life
Haymart MR, Miller DC, Hawley ST
Active surveillance for low-risk cancers - a viable solution to overtreatment?
In this paper, the authors discuss the overtreatment of low-risk cancers. They describe active surveillance and indicate that despite benefits such as lower costs and the elimination of surgery- and radiation-related risks, adoption of this approach has been inconsistent. They indicate that successful uptake of active surveillance for low-risk cancers will require overcoming perceived challenges to implementation.
AHRQ-funded; HS024512.
Citation: Haymart MR, Miller DC, Hawley ST .
Active surveillance for low-risk cancers - a viable solution to overtreatment?
N Engl J Med 2017 Jul 20;377(3):203-06. doi: 10.1056/NEJMp1703787..
Keywords: Cancer, Diagnostic Safety and Quality
Mills J, Thomas A
AHRQ Author: Mills J
Risk assessment for cardiovascular disease with nontraditional risk factors.
This case study considers a 46-year-old Asian American woman who is concerned about risk of cardiovascular disease because of her new, less active working conditions. She has no personal history of hypertension or hypercholesterolemia, but does have a family history. The case study questions are based on USPSTF recommendations for nontraditional cardiovascular risk factors for CVD in asymptomatic adults.
AHRQ-authored.
Citation: Mills J, Thomas A .
Risk assessment for cardiovascular disease with nontraditional risk factors.
Am Fam Physician 2019 Jan 15;99(2):123-24.
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Keywords: Cardiovascular Conditions, Case Study, Diagnostic Safety and Quality, Risk, U.S. Preventive Services Task Force (USPSTF)
Payan DD, Derose KP, Fulcar MA
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. In this study, the investigators conducted in-depth interviews with 30 women living with HIV in the Dominican Republic to explore the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings.
AHRQ-funded; HS000046.
Citation: Payan DD, Derose KP, Fulcar MA .
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
J Int Assoc Provid AIDS Care 2019 Jan-Dec;18. doi: 10.1177/2325958219849042..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Women, Social Stigma, Depression, Behavioral Health
Fogler J, Kuhn J, Prock L
Diagnostic uncertainty in a complex young man: autism versus psychosis.
This paper provides a case study of boy, diagnosed with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) who was born in Vietnam to a mother with mental illness.
AHRQ-funded; HS022242.
Citation: Fogler J, Kuhn J, Prock L .
Diagnostic uncertainty in a complex young man: autism versus psychosis.
J Dev Behav Pediatr 2019 Jan;40(1):72-74. doi: 10.1097/dbp.0000000000000635..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Autism, Behavioral Health, Case Study
Saff RR, Li Y, Santhanakrishnan N
Identification of inpatient allergic drug reactions using ICD-9-CM codes.
The study of allergic drug reactions has been limited because of challenges in identifying and confirming cases. The objective of this study was to determine the utility of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for identifying inpatient allergic drug reactions and to compare findings with previous data in the emergency department.
AHRQ-funded; HS022728; HS025375.
Citation: Saff RR, Li Y, Santhanakrishnan N .
Identification of inpatient allergic drug reactions using ICD-9-CM codes.
J Allergy Clin Immunol Pract 2019 Jan;7(1):259-64.e1. doi: 10.1016/j.jaip.2018.07.022..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Medication, Diagnostic Safety and Quality, Patient Safety
Payan DD, Florez KR, Bogart LM
Promoting health from the pulpit: a process evaluation of HIV sermons to reduce HIV stigma and promote testing in African American and Latino churches.
This study explored implementation of an HIV sermon as part of a multi-component intervention in three churches (Latino Catholic, Latino Pentecostal, and African American Baptist) in high HIV prevalence areas of Los Angeles County, California. The investigators found large variation in fidelity to communicating key HIV messages from the sermon guide. They concluded that structured training of clergy may be necessary to implement the more theoretically driven stigma reduction cues included in the sermon guide.
AHRQ-funded; HS000046.
Citation: Payan DD, Florez KR, Bogart LM .
Promoting health from the pulpit: a process evaluation of HIV sermons to reduce HIV stigma and promote testing in African American and Latino churches.
Health Commun 2019 Jan;34(1):11-20. doi: 10.1080/10410236.2017.1384352..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Racial and Ethnic Minorities, Diagnostic Safety and Quality, Health Promotion, Education: Patient and Caregiver, Communication, Prevention
Schneider JG, Wood JB, Schmitt BH
Susceptibility Provision Enhances Effective De-escalation (SPEED): utilizing rapid phenotypic susceptibility testing in Gram-negative bloodstream infections and its potential clinical impact.
In this study, the investigators evaluated the performance and time to result for pathogen identification (ID) and antimicrobial susceptibility testing (AST) of the Accelerate Pheno system (AXDX) compared with standard of care (SOC) methods. They also assessed the hypothetical improvement in antibiotic utilization if AXDX had been implemented. The authors indicated that by providing fast and reliable ID and AST results, AXDX has the potential to improve antimicrobial utilization and enhance antimicrobial stewardship.
AHRQ-funded; HS026390.
Citation: Schneider JG, Wood JB, Schmitt BH .
Susceptibility Provision Enhances Effective De-escalation (SPEED): utilizing rapid phenotypic susceptibility testing in Gram-negative bloodstream infections and its potential clinical impact.
J Antimicrob Chemother 2019 Jan;74(Suppl 1):i16-i23. doi: 10.1093/jac/dky531..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Antibiotics, Medication, Diagnostic Safety and Quality
Ishihara M, Harel D, Levis B
Shortening self-report mental health symptom measures through optimal test assembly methods: development and validation of the Patient Health Questionnaire-Depression-4.
Researchers developed and validated a short form of the Patient Health Questionnaire-9 (PHQ-9) which assesses depression symptoms. This form was tested on 7,850 English-speaking patients enrolled in 20 diagnostic accuracy studies. The questions were optimized using Optimal test assembly (OTA) methods. Questionnaires from one to eight items were tried, with four questions found to be the optimal number with minimal loss of information compared to a full-length PHQ-9.
AHRQ-funded; HS018246.
Citation: Ishihara M, Harel D, Levis B .
Shortening self-report mental health symptom measures through optimal test assembly methods: development and validation of the Patient Health Questionnaire-Depression-4.
Depress Anxiety 2019 Jan;36(1):82-92. doi: 10.1002/da.22841..
Keywords: Depression, Diagnostic Safety and Quality, Behavioral Health
Wang S, Allen D, Perkins A
Validation of a new clinical tool for post-intensive care syndrome.
The objective of this study was to validate the self-report version of the Healthy Aging Brain Care Monitor as a clinical tool for detecting post-intensive care syndrome. 142 patients who survived stays in intensive care units (ICUs) following a critical illness completed the self-report and standardized assessments of their cognition, their psychological symptoms, and physical functioning. Patients who had post-ICU syndrome were compared with a sample of primary care patients. Based on their findings, the researchers conclude that the self-report version is a valid clinical tool for the assessment of symptoms of post-ICU syndrome.
AHRQ-funded; HS024384.
Citation: Wang S, Allen D, Perkins A .
Validation of a new clinical tool for post-intensive care syndrome.
Am J Crit Care 2019 Jan;28(1):10-18. doi: 10.4037/ajcc2019639..
Keywords: Diagnostic Safety and Quality, Intensive Care Unit (ICU), Neurological Disorders, Patient Safety
Graham AK, Minc A, Staab E
Validation of the computerized adaptive test for mental health in primary care.
This study compared the use of a computerized assessment tool with paper questionnaires to diagnose major depressive disorder (MDD) and general anxiety disorder (GAD). It was found that the majority of patients in the study preferred the computerized adaptive testing tool. Diagnostic accuracy of the tool was similar or higher than many of the traditional screening methods.
AHRQ-funded; HS000078.
Citation: Graham AK, Minc A, Staab E .
Validation of the computerized adaptive test for mental health in primary care.
Ann Fam Med 2019 Jan;17(1):23-30. doi: 10.1370/afm.2316..
Keywords: Anxiety, Depression, Diagnostic Safety and Quality, Behavioral Health, Primary Care, Screening