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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 201 Research Studies DisplayedRich NE, Oji S, Mufti AR
Racial and ethnic disparities in nonalcoholic fatty liver disease prevalence, severity, and outcomes in the United States: a systematic review and meta-analysis.
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States, affecting 75-100 million Americans. However, the disease burden may not be equally distributed among races or ethnicities. In this study, the investigators conducted a systematic review and meta-analysis to characterize racial and ethnic disparities in NAFLD prevalence, severity, and prognosis.
AHRQ-funded; HS022418.
Citation: Rich NE, Oji S, Mufti AR .
Racial and ethnic disparities in nonalcoholic fatty liver disease prevalence, severity, and outcomes in the United States: a systematic review and meta-analysis.
Clin Gastroenterol Hepatol 2018 Feb;16(2):198-210.e2. doi: 10.1016/j.cgh.2017.09.041..
Keywords: Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Armstrong MJ, Gronseth GS
Approach to assessing and using clinical practice guidelines.
Knowing when to use guidelines in clinical practice requires neurologists to assess the rigor of published guidelines. This review briefly describes guideline definitions and the American Academy of Neurology process for guideline development, outlines key elements for assessing guideline quality, and details a practical approach for incorporating guideline recommendations when partnering with patients in shared decision-making.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gronseth GS .
Approach to assessing and using clinical practice guidelines.
Neurol Clin Pract 2018 Feb;8(1):58-61. doi: 10.1212/cpj.0000000000000417.
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Keywords: Shared Decision Making, Evidence-Based Practice, Guidelines, Patient and Family Engagement, Implementation
Holmes-Rovner M, Srikanth A, Henry SG
Decision aid use during post-biopsy consultations for localized prostate cancer.
The purpose of this study was to characterize the content and communicative function of high-quality decision aids during diagnostic clinic visits for prostate cancer. Results showed that good decision aids, systematically provided to patients, appeared to function not to open up deliberations about how to balance benefits and harms of competing treatments, but rather to allow patients to ask narrow technical questions about recommended treatments.
AHRQ-funded; HS021764.
Citation: Holmes-Rovner M, Srikanth A, Henry SG .
Decision aid use during post-biopsy consultations for localized prostate cancer.
Health Expect 2018 Feb;21(1):279-87. doi: 10.1111/hex.12613..
Keywords: Cancer: Prostate Cancer, Shared Decision Making, Evidence-Based Practice, Patient and Family Engagement, Patient-Centered Healthcare, Clinician-Patient Communication
Rangachari P
Innovation implementation in the context of hospital QI: lessons learned and strategies for success.
This paper conducts an integrative review of the literature on "innovation implementation" in hospitals and health systems over the last decade, since the spotlight was cast on "innovation implementation failure" in health care organizations (HCOs). It summarizes the lessons learned from the literature, discusses the relevance of management research on innovation implementation in HCOs, and identifies future research avenues.
AHRQ-funded; HS024335.
Citation: Rangachari P .
Innovation implementation in the context of hospital QI: lessons learned and strategies for success.
Innov Entrep Health 2018;5:1-14. doi: 10.2147/ieh.s151040.
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Keywords: Evidence-Based Practice, Health Systems, Health Information Technology (HIT), Implementation, Quality Improvement, Hospitals, Quality of Care
Patel PK, Gupta A, Vaughn VM
Review of strategies to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in adult ICUs.
This systematic review was conducted back in October 2015 within PubMed and Cochrane databases on interventions to reduce central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI). The interventions were categorized by stages applicable to both CAUTI and CLABSI prevention. Stage 0: avoid catheter if possible; Stage 1: ensure aseptic placement; Stage 2: maintain awareness and proper care of catheters in place, and Stage 3: promptly remove unnecessary catheters. They also looked for effective components that the 5 stages were most successful with. The review is designed for hospitalists to use to formulate quality improvement interventions for infection reduction.
AHRQ-funded; HS018334.
Citation: Patel PK, Gupta A, Vaughn VM .
Review of strategies to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in adult ICUs.
J Hosp Med 2018 Feb;13(2):105-16. doi: 10.12788/jhm.2856..
Keywords: Care Management, Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infections (CLABSI), Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Infectious Diseases, Intensive Care Unit (ICU), Patient Safety, Urinary Tract Infection (UTI)
Ono SS, Crabtree BF, Hemler JR
Taking innovation to scale in primary care practices: the functions of health care extension.
Health care extension is an approach to providing external support to primary care practices with the aim of diffusing innovation. EvidenceNOW was launched to rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive care in the primary care setting. This article describes how cooperatives varied in their approaches to extension and provides early empirical evidence that health care extension is a feasible and potentially useful approach for providing quality improvement.
AHRQ-funded; HS023940.
Citation: Ono SS, Crabtree BF, Hemler JR .
Taking innovation to scale in primary care practices: the functions of health care extension.
Health Aff 2018 Feb;37(2):222-30. doi: 10.1377/hlthaff.2017.1100.
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Keywords: Primary Care, Implementation, Cardiovascular Conditions, Evidence-Based Practice, Healthcare Delivery, Practice Improvement, Quality Improvement, Quality of Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention
Yepes-Nunez JJ, Morgan RL, Mbuagbaw L
AHRQ Author: Chang S
Two alternatives versus the standard Grading of Recommendations Assessment, Development and Evaluation (GRADE) summary of findings (SoF) tables to improve understanding in the presentation of systematic review results: a three-arm, randomised, controlled,
The primary objective of this trial is to investigate whether an alternative Grading of Recommendations Assessment, Development and Evaluation (GRADE) SoF table or Evidence-based Practice Center SoF table is non-inferior to the current GRADE SoF table in the understanding of the information presented to systematic review users. Non-inferiority would be declared if the difference in the proportion of participants who understand the information displayed in the alternative SoF table is 10 percent or less.
AHRQ-authored.
Citation: Yepes-Nunez JJ, Morgan RL, Mbuagbaw L .
Two alternatives versus the standard Grading of Recommendations Assessment, Development and Evaluation (GRADE) summary of findings (SoF) tables to improve understanding in the presentation of systematic review results: a three-arm, randomised, controlled,
BMJ Open 2018 Jan 23;8(1):e015623. doi: 10.1136/bmjopen-2016-015623.
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Keywords: Evidence-Based Practice, Guidelines, Research Methodologies
Bravo PE, Bergmark BA, Vita T
Diagnostic and prognostic value of myocardial blood flow quantification as non-invasive indicator of cardiac allograft vasculopathy.
Cardiac allograft vasculopathy (CAV) is a leading cause of death in orthotopic heart transplant (OHT) survivors. Effective non-invasive screening methods are needed. The aim of this study was to investigate the added diagnostic and prognostic value of myocardial blood flow (MBF) to standard myocardial perfusion imaging (MPI) with positron emission tomography (PET) for CAV detection.
AHRQ-funded; HS022998.
Citation: Bravo PE, Bergmark BA, Vita T .
Diagnostic and prognostic value of myocardial blood flow quantification as non-invasive indicator of cardiac allograft vasculopathy.
Eur Heart J 2018 Jan 21;39(4):316-23. doi: 10.1093/eurheartj/ehx683..
Keywords: Adverse Events, Cardiovascular Conditions, Diagnostic Safety and Quality, Evidence-Based Practice, Heart Disease and Health, Imaging, Patient-Centered Outcomes Research, Surgery
Dunn J, Henrikson NB, Morrison CC
Screening for adolescent idiopathic scoliosis: evidence report and systematic review for the US Preventive Services Task Force.
The authors systematically reviewed evidence on benefits and harms of adolescent idiopathic scoliosis (AIS) screening for the US Preventive Services Task Force (USPSTF). They concluded that screening can detect AIS. Also, bracing and possibly exercise treatment can interrupt or slow progression of curvature in adolescence. However, there is little or no evidence on long-term outcomes for AIS treated in adolescence.
AHRQ-funded; 290201200015I357.
Citation: Dunn J, Henrikson NB, Morrison CC .
Screening for adolescent idiopathic scoliosis: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2018 Jan 9;319(2):173-87. doi: 10.1001/jama.2017.11669.
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Keywords: Children/Adolescents, Evidence-Based Practice, Guidelines, Prevention, Screening
Skolasky RL, Maggard AM, Wegener ST
Telephone-based intervention to improve rehabilitation engagement after spinal stenosis surgery: a prospective lagged controlled trial.
A prospective interventional trial was conducted, to compare the effectiveness of health behavior change counseling with usual care to improve health outcomes after lumbar spine surgical procedures. The investigators found that health behavior change counseling improved health outcomes during the first 12 months after the surgical procedure through changes in rehabilitation engagement.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Wegener ST .
Telephone-based intervention to improve rehabilitation engagement after spinal stenosis surgery: a prospective lagged controlled trial.
J Bone Joint Surg Am 2018 Jan 3;100(1):21-30. doi: 10.2106/jbjs.17.00418..
Keywords: Back Health and Pain, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Rehabilitation, Surgery
Butler M, McCreedy E, Nelson VA
Does cognitive training prevent cognitive decline?: A systematic review.
This review summarized evidence on the effects of cognitive training on cognitive performance and incident dementia outcomes for adults with normal cognition or mild cognitive impairment (MCI). It concluded that results for populations with MCI suggested no effect of training on performance (low-strength and insufficient evidence). Evidence for prevention of cognitive decline or dementia was insufficient.
AHRQ-funded; 290201500008I.
Citation: Butler M, McCreedy E, Nelson VA .
Does cognitive training prevent cognitive decline?: A systematic review.
Ann Intern Med 2018 Jan 2;168(1):63-68. doi: 10.7326/m17-1531.
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Keywords: Dementia, Evidence-Based Practice, Neurological Disorders, Prevention
Butler M, Nelson VA, Davila H
Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
This review summarizes the evidence on efficacy and harms of over-the-counter (OTC) supplements to prevent or delay cognitive decline, mild cognitive impairment (MCI), or clinical Alzheimer-type dementia in adults with normal cognition or MCI but no dementia diagnosis. It concluded that evidence is insufficient to recommend any OTC supplement for cognitive protection in adults with normal cognition or MCI.
AHRQ-funded; 290201500008I.
Citation: Butler M, Nelson VA, Davila H .
Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
Ann Intern Med 2018 Jan 2;168(1):52-62. doi: 10.7326/m17-1530.
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Keywords: Dementia, Evidence-Based Practice, Prevention, Neurological Disorders
Brasure M, Desai P, Davila H
Physical activity interventions in preventing cognitive decline and Alzheimer-type dementia: a systematic review.
This systematic review assessed the effectiveness of physical activity interventions in slowing cognitive decline and delaying the onset of cognitive impairment and dementia in adults without diagnosed cognitive impairments. Evidence was insufficient to draw conclusions about the effectiveness of aerobic training, resistance training, or tai chi for improving cognition. ALSO, Evidence regarding effects on dementia prevention was insufficient for all physical activity interventions.
AHRQ-funded; 290201500008I.
Citation: Brasure M, Desai P, Davila H .
Physical activity interventions in preventing cognitive decline and Alzheimer-type dementia: a systematic review.
Ann Intern Med 2018 Jan 2;168(1):30-38. doi: 10.7326/m17-1528.
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Keywords: Comparative Effectiveness, Dementia, Evidence-Based Practice, Lifestyle Changes, Patient-Centered Outcomes Research
Keenan GM, Lopez KD, Sousa VEC
A shovel-ready solution to fill the nursing data gap in the interdisciplinary clinical picture.
The purpose of this study was to critically evaluate the 2014 American Academy of Nursing (AAN) call-to-action plan for generating interoperable nursing data. The authors of the article present recommendations for revisions to AAN's plan as well as an evidence-based alternative to generating interoperable nursing data in the near term.
AHRQ-funded; HS015054.
Citation: Keenan GM, Lopez KD, Sousa VEC .
A shovel-ready solution to fill the nursing data gap in the interdisciplinary clinical picture.
Int J Nurs Knowl 2018 Jan;29(1):49-58. doi: 10.1111/2047-3095.12168..
Keywords: Data, Evidence-Based Practice, Nursing
Krist AH, Bibbins-Domingo K, Wolff TA
AHRQ Author: Wolff TA, Mabry-Hernandez IR
Advancing the methods of the U.S. Preventive Services Task Force.
The mission of the U.S. Preventive Services Task Force (USPSTF) is to provide evidence-based recommendations on preventive services to primary care clinicians who deliver preventive care.This editorial introduces a journal supplement issue the purpose of which is to present and discuss some of the key methodologic concepts and questions that the USPSTF is currently addressing.
AHRQ-authored.
Citation: Krist AH, Bibbins-Domingo K, Wolff TA .
Advancing the methods of the U.S. Preventive Services Task Force.
Am J Prev Med 2018 Jan;54(1s1):S1-s3. doi: 10.1016/j.amepre.2017.10.012.
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Keywords: Evidence-Based Practice, Guidelines, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Kemper AR, Krist AH, Tseng CW
AHRQ Author: Mabry-Hernandez IR, Wolff TA
Challenges in developing U.S. Preventive Services Task Force child health recommendations.
In March 2016, the USPSTF convened an expert panel to discuss its portfolio of child and adolescent recommendations and identify unique methodologic issues when evaluating evidence regarding children and adolescents. The panel identified key domains of challenges, including measuring patient-centered health outcomes; identifying intermediate outcomes predictive of important health outcomes and evaluating the long time horizon needed to assess the balance of benefits and harms.
AHRQ-authored.
Citation: Kemper AR, Krist AH, Tseng CW .
Challenges in developing U.S. Preventive Services Task Force child health recommendations.
Am J Prev Med 2018 Jan;54(1s1):S63-s69. doi: 10.1016/j.amepre.2017.08.023.
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Keywords: Children/Adolescents, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, U.S. Preventive Services Task Force (USPSTF)
Ngo-Metzger Q, Moyer V, Grossman D
AHRQ Author: Ngo-Metzger Q, Chowdhury J, Kato E
Conflicts of interest in clinical guidelines: update of U.S. Preventive Services Task Force policies and procedures.
The conflicts of interest policy is described, as is the formal process by which best practices were incorporated to update the policy. The USPSTF conflicts of interest policy includes disclosures for immediate family members, a clear non-financial conflicts of interest definition, long look-back period and application of the policy to prospective members. The conflicts of interest policy is publicly available as part of the USPSTF Procedure Manual.
AHRQ-authored.
Citation: Ngo-Metzger Q, Moyer V, Grossman D .
Conflicts of interest in clinical guidelines: update of U.S. Preventive Services Task Force policies and procedures.
Am J Prev Med 2018 Jan;54(1s1):S70-s80. doi: 10.1016/j.amepre.2017.06.034.
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Keywords: Evidence-Based Practice, Guidelines, Policy, U.S. Preventive Services Task Force (USPSTF)
Doherty JA, Crelia SJ, Smith MW
AHRQ Author: Mabry-Hernandez IR, Ngo-Metzger Q
Large health systems' prevention guideline implementation: a qualitative study.
In 2015, researchers conducted and analyzed interviews with quality leaders from eight hospital-based systems and one physician organization who explained organizational processes to adapt, adopt, disseminate, and incentivize adherence to preventive services guidelines. Nearly all have a formal process for reviewing and refining guidelines, developing clinician support, and disseminating the approved guidelines.
AHRQ-authored.
Citation: Doherty JA, Crelia SJ, Smith MW .
Large health systems' prevention guideline implementation: a qualitative study.
Am J Prev Med 2018 Jan;54(1s1):S88-s94. doi: 10.1016/j.amepre.2017.07.025.
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Keywords: Primary Care, Guidelines, Evidence-Based Practice, Prevention, Implementation, Healthcare Delivery
Phillippi JC, Danhausen K, Alliman J
Neonatal outcomes in the birth center setting: a systematic review.
This systematic review examined the effects of the birth center setting on neonatal mortality in economically developed countries. The criteria for inclusion included being in English, published after 1980 and in countries with similar guidelines to the American Association of Birth Centers Standards. The only measure used was neonatal mortality and results did not find any difference between using a birth center as opposed to a traditional hospital setting. The literature was not found to have many good quality studies, and further research is recommended.
AHRQ-funded; HS024733.
Citation: Phillippi JC, Danhausen K, Alliman J .
Neonatal outcomes in the birth center setting: a systematic review.
J Midwifery Womens Health 2018 Jan;63(1):68-89. doi: 10.1111/jmwh.12701..
Keywords: Evidence-Based Practice, Labor and Delivery, Mortality, Newborns/Infants, Outcomes, Pregnancy, Women
Aggarwal R, Brown KM, de Groen PC
AHRQ Author: Henriksen K
Simulation research in gastrointestinal and urologic care-challenges and opportunities: summary of a National Institute of Diabetes and Digestive and Kidney Diseases and National Institute of Biomedical Imaging and Bioengineering workshop.
The purpose of the workshop was to examine the extent to which simulation approaches have been used by skilled proceduralists (not trainees) caring for patients with gastrointestinal and urologic diseases. The current status of research findings in the use and effectiveness of simulation applications was reviewed, and numerous knowledge gaps and research needs were identified by the faculty and the attendees.
AHRQ-authored.
Citation: Aggarwal R, Brown KM, de Groen PC .
Simulation research in gastrointestinal and urologic care-challenges and opportunities: summary of a National Institute of Diabetes and Digestive and Kidney Diseases and National Institute of Biomedical Imaging and Bioengineering workshop.
Ann Surg 2018 Jan;267(1):26-34. doi: 10.1097/sla.0000000000002228.
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Keywords: Digestive Disease and Health, Education: Continuing Medical Education, Evidence-Based Practice, Research Methodologies
Kurth AE, Krist AH, Borsky AE
AHRQ Author: Borsky AE, Fan T, Weinstein R
U.S. Preventive Services Task Force methods to communicate and disseminate clinical preventive services recommendations.
The U.S. Preventive Services Task Force (USPSTF) issues evidence-based screening and prevention recommendations, and key to this task is dissemination and implementation of these recommendations. This paper outlines the approaches used by the USPSTF to both solicit input (e.g., public comment periods), as well as to facilitate dissemination of its recommendations to help improve the health of all Americans (e.g., web-based and mobile application tools, journal publications, and annual reports to Congress).
AHRQ-authored.
Citation: Kurth AE, Krist AH, Borsky AE .
U.S. Preventive Services Task Force methods to communicate and disseminate clinical preventive services recommendations.
Am J Prev Med 2018 Jan;54(1s1):S81-s87. doi: 10.1016/j.amepre.2017.07.004.
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Keywords: Communication, Evidence-Based Practice, Guidelines, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Mabry-Hernandez IR, Curry SJ, Phillips WR
AHRQ Author: Mabry-Hernandez IR, Ngo-Metzger Q, Bierman AS
U.S. Preventive Services Task Force priorities for prevention research.
This article describes the types of evidence gaps that the USPSTF encounters across its various recommendations and how the USPSTF identifies and communicates these gaps to researchers and policymakers, who can help generate the needed evidence. Common types of evidence gaps include limited evidence in primary care settings and populations, a lack of appropriate health outcomes, limited evidence linking behavior change to health outcomes, and a lack of evidence for effective preventive services in diverse populations.
AHRQ-authored.
Citation: Mabry-Hernandez IR, Curry SJ, Phillips WR .
U.S. Preventive Services Task Force priorities for prevention research.
Am J Prev Med 2018 Jan;54(1s1):S95-s103. doi: 10.1016/j.amepre.2017.08.014.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Prevention, U.S. Preventive Services Task Force (USPSTF)
Wolff TA, Krist AH, LeFevre M
AHRQ Author: Wolff TA
Update on the methods of the U.S. Preventive Services Task Force: linking intermediate outcomes and health outcomes in prevention.
Given the frequent lack of evidence on health outcomes, the USPSTF uses evidence on intermediate outcomes when appropriate. The ultimate goal is to determine precisely a consistent relationship between the direction and magnitude of change in an intermediate outcome with a predictable resultant direction and magnitude of change in the health outcomes. The USPSTF will exercise great caution when making a recommendation that depends on the evidence linking intermediate and health outcomes because of inherent evidence limitations.
AHRQ-authored.
Citation: Wolff TA, Krist AH, LeFevre M .
Update on the methods of the U.S. Preventive Services Task Force: linking intermediate outcomes and health outcomes in prevention.
Am J Prev Med 2018 Jan;54(1s1):S4-s10. doi: 10.1016/j.amepre.2017.08.032.
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Keywords: Evidence-Based Practice, Guidelines, Outcomes, Prevention, U.S. Preventive Services Task Force (USPSTF)
Krist AH, Wolff TA, Jonas DE
AHRQ Author: Wolff TA
Update on the methods of the U.S. Preventive Services Task Force: methods for understanding certainty and net benefit when making recommendations.
Since the 1980s, the U.S. Preventive Services Task Force (USPSTF) has developed and used rigorous methods to make evidence-based recommendations about preventive services to promote health and well-being for all Americans. This manuscript details examples of how the USPSTF uses different methods to make recommendations that truly reflect the evidence.
AHRQ-authored.
Citation: Krist AH, Wolff TA, Jonas DE .
Update on the methods of the U.S. Preventive Services Task Force: methods for understanding certainty and net benefit when making recommendations.
Am J Prev Med 2018 Jan;54(1s1):S11-s18. doi: 10.1016/j.amepre.2017.09.011.
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Keywords: Evidence-Based Practice, Guidelines, Prevention, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Hartling L, Guise JM, Kato E
AHRQ Author: Kato, E, Berliner E
A taxonomy of rapid reviews links report types and methods to specific decision-making contexts.
The researchers described characteristics of rapid reviews and examined the impact of methodological variations on their reliability and validity. They concluded that rapid products have tremendous methodological variation and that categorization based on timeframe or type of synthesis reveals patterns. The similarity across rapid products lies in the close relationship with the end user to meet time-sensitive decision-making needs.
AHRQ-authored; AHRQ-funded; 290201200013I; 290201200010I; 290201200011I; 290201200015I; 290201200007I; 290201200004C.
Citation: Hartling L, Guise JM, Kato E .
A taxonomy of rapid reviews links report types and methods to specific decision-making contexts.
J Clin Epidemiol 2015 Dec;68(12):1451-62.e3. doi: 10.1016/j.jclinepi.2015.05.036.
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Keywords: Shared Decision Making, Evidence-Based Practice, Data, Research Methodologies