National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Blood Pressure (1)
- Blood Thinners (1)
- Brain Injury (3)
- Caregiving (1)
- Children/Adolescents (3)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (8)
- Clinician-Patient Communication (1)
- Communication (1)
- Electronic Health Records (EHRs) (3)
- Emergency Department (2)
- Evidence-Based Practice (3)
- Guidelines (1)
- Healthcare Delivery (1)
- (-) Health Information Technology (HIT) (12)
- Health Systems (1)
- Imaging (1)
- Medication (2)
- Medication: Safety (1)
- Newborns/Infants (1)
- Patient-Centered Healthcare (2)
- Patient and Family Engagement (1)
- Patient Safety (1)
- (-) Shared Decision Making (12)
- Transplantation (1)
- Vaccination (1)
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 DisplayedGreenberg JK, Ahluwalia R, Hill M
Development and external validation of the KIIDS-TBI tool for managing children with mild traumatic brain injury and intracranial injuries.
This study's objectives were to develop a new risk model with improved sensitivity compared to the CHIIDA model for the post-neuroimaging management of children with mild traumatic brain injuries (mTBI) and intracranial injuries and further to validate externally the new model and CHIIDA model in a multicenter data set. Findings showed that the KIIDS-TBI model had high sensitivity and moderate specificity for risk stratifying children with mTBI and intracranial injuries. The researchers concluded that the use of their clinical decision support tool may help improve the safe, resource-efficient management of this important patient population.
AHRQ-funded; HS027075.
Citation: Greenberg JK, Ahluwalia R, Hill M .
Development and external validation of the KIIDS-TBI tool for managing children with mild traumatic brain injury and intracranial injuries.
Acad Emerg Med 2021 Dec;28(12):1409-20. doi: 10.1111/acem.14333..
Keywords: Children/Adolescents, Brain Injury, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT)
Chartash D, Sharifi M, Emerson B
Documentation of shared decisionmaking in the emergency department.
Patient-centered communication and shared decision making is a vital element of clinical practice, but little is known about its impact or value in the emergency department (ED) setting. The researchers of this study developed a natural language processing tool using regular expressions to identify shared decision making, patient-centered communications, and to describe visit-, site-, and temporal-level patterns within a large health system. The study took place in two parts: part 1 was the development and validation of the natural language processing tool, and part 2 was a retrospective analysis of shared decision making and patient discussion using the processing tool to assess ED physician and advanced practitioner documentation from 2013 to 2020. Compared to chart review of 600 ED notes, the accuracy rates of the natural language processing tool were 96.7% and 88.9% respectively. Between 2013 to 2020 the researchers observed greater likelihood of shared decision-making documentation among physicians vs advanced practice providers, higher likelihood among female vs male patients, and lower likelihood of shared decision-making in Black patients compared with White patients. The researchers also found that patient discussion and shared decision-making were associated with higher levels of commercial insurance status and level of triage. The study concluded that a natural language processing tool was developed, validated, and utilized to identify incidences of shared decision making from ED documentation, with the researchers finding multiple possible factors which contribute to variation in shared decision making.
AHRQ-funded; HS025701.
Citation: Chartash D, Sharifi M, Emerson B .
Documentation of shared decisionmaking in the emergency department.
Ann Emerg Med 2021 Nov;78(5):637-49. doi: 10.1016/j.annemergmed.2021.04.038..
Keywords: Shared Decision Making, Emergency Department, Patient-Centered Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT)
Reese TJ, Del Fiol G, Morgan K
A shared decision-making tool for drug interactions between warfarin and nonsteroidal anti-inflammatory drugs: design and usability study.
Exposure to life-threatening drug-drug interactions (DDIs) occurs despite the widespread use of clinical decision support. The DDI between warfarin and nonsteroidal anti-inflammatory drugs is common and potentially life-threatening. Patients can play a substantial role in preventing harm from DDIs; however, the current model for DDI decision-making is clinician centric. This study aimed to design and examine the usability of DDInteract, a tool to support shared decision-making (SDM) between a patient and provider for the DDI between warfarin and nonsteroidal anti-inflammatory drugs.
AHRQ-funded; HS026198.
Citation: Reese TJ, Del Fiol G, Morgan K .
A shared decision-making tool for drug interactions between warfarin and nonsteroidal anti-inflammatory drugs: design and usability study.
JMIR Hum Factors 2021 Oct 26;8(4):e28618. doi: 10.2196/28618..
Keywords: Blood Thinners, Medication: Safety, Medication, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Patient Safety
Samal L, Fu HN, Camara DS
AHRQ Author: Camara DS, Wang J, Bierman AS
Health information technology to improve care for people with multiple chronic conditions.
The objective of this study was to review evidence regarding the use of Health Information Technology (health IT) interventions aimed at improving care for people living with multiple chronic conditions (PLWMCC) in order to identify critical knowledge gaps. The investigators concluded that the body of literature included in this review provides critical information on the state of the science as well as the many gaps that need to be filled for digital health to fulfill its promise in supporting care delivery that meets the needs of PLWMCC.
AHRQ-authored; AHRQ-funded; HS026849; 290201600001B.
Citation: Samal L, Fu HN, Camara DS .
Health information technology to improve care for people with multiple chronic conditions.
Health Serv Res 2021 Oct;56(Suppl 1):1006-36. doi: 10.1111/1475-6773.13860..
Keywords: Chronic Conditions, Health Information Technology (HIT), Evidence-Based Practice, Shared Decision Making, Healthcare Delivery
Dutta S, McEvoy DS, Stump T
Clinical decision support reduces unnecessary tetanus vaccinations in the emergency department.
The authors implemented a clinical decision support alert in the electronic health record that warned providers when ordering a tetanus vaccine if a prior one had been given within 10 years and studied its efficacy to reduce potentially unnecessary vaccines in the ED. They found that a clinical decision support alert that warns ED clinicians that a patient may have an up-to-date tetanus vaccination status reduced potentially unnecessary vaccinations.
AHRQ-funded; HS027170.
Citation: Dutta S, McEvoy DS, Stump T .
Clinical decision support reduces unnecessary tetanus vaccinations in the emergency department.
Ann Emerg Med 2021 Sep;78(3):370-80. doi: 10.1016/j.annemergmed.2021.02.021..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Vaccination, Health Information Technology (HIT)
Dorr DA, D'Autremont C, Pizzimenti C
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
This study examined guideline-based high blood pressure (HBP) and hypertension recommendations and evaluated the suitability and adequacy of the data and logic required for a Fast Healthcare Interoperable Resources-based, patient-facing clinical decision support HBP application. Findings showed that data quality from the electronic health record required to implement recommendations for HBP was highly inconsistent, reflecting a fragmented health care system and incomplete implementation of standard terminologies and workflows. Although imperfect, data were deemed adequate for two test use cases.
AHRQ-funded; HS026849.
Citation: Dorr DA, D'Autremont C, Pizzimenti C .
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
Appl Clin Inform 2021 Aug;12(4):710-20. doi: 10.1055/s-0041-1732401..
Keywords: Blood Pressure, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Information Technology (HIT)
Marin JR, Rodean J, Mannix RC
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
The objective of this study was to examine whether the presence of clinical guidelines and clinical decision support (CDS) for mild traumatic brain injury (mTBI) were associated with lower head computed tomography (CT) use. The investigators concluded that clinical guidelines for mTBI, and particularly CDS, were associated with lower rates of head CT use without adverse clinical outcomes.
AHRQ-funded; HS026006.
Citation: Marin JR, Rodean J, Mannix RC .
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
J Pediatr 2021 Aug;235:178-83.e1. doi: 10.1016/j.jpeds.2021.04.026..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Brain Injury, Guidelines, Evidence-Based Practice, Imaging
Shi Y, Amill-Rosario A, Rudin RS
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
In this study, the investigators quantified the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examined whether CDS utilization and barriers differed based on clinics' affiliation with health systems, providing a benchmark for future empirical research and policies related to this topic.
AHRQ-funded; HS024067.
Citation: Shi Y, Amill-Rosario A, Rudin RS .
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
J Am Med Inform Assoc 2021 Jul 30;28(8):1667-75. doi: 10.1093/jamia/ocab064..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Ambulatory Care and Surgery, Health Information Technology (HIT), Health Systems
Greenberg JK, Otun A, Nasraddin A
Electronic clinical decision support for children with minor head trauma and intracranial injuries: a sociotechnical analysis.
This paper discusses the development of an evidence-based clinical decision support (CDS) for management of children with minor head trauma (MHT) and evaluates the sociotechnical environment impacting the implementation of electronic CDS, including workflow and communication, institutional culture, and hardware and software infrastructure. Semi-structured qualitative focus group interviews were conducted with 28 physicians and four information technology specialists between March and May 2020. Five primary themes were identified through inductive thematic analysis: 1) clinical impact; 2) stakeholders and users; 3) tool content; 4) clinical practice integration; and 5) post-implementation evaluation measures. Participants generally supported CDS use to determine an appropriate level-of-care. However, some had mixed feelings regarding how the tool could best be used by neurosurgeons versus non-neurosurgeons. Feedback helped refine the tool content and highlighted potential technical and workflow barriers to address prior to implementation.
AHRQ-funded; HS027075.
Citation: Greenberg JK, Otun A, Nasraddin A .
Electronic clinical decision support for children with minor head trauma and intracranial injuries: a sociotechnical analysis.
BMC Med Inform Decis Mak 2021 May 19;21(1):161. doi: 10.1186/s12911-021-01522-w.
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Keywords: Children/Adolescents, Clinical Decision Support (CDS), Brain Injury, Health Information Technology (HIT), Evidence-Based Practice, Shared Decision Making
Chu S, Bruin MJ, McKinney WT
Design of a patient-centered decision support tool when selecting an organ transplant center.
Patients in the US in need of a life-saving organ transplant must complete a long process of medical decisions, and a first step is to identify a transplant center to complete an evaluation. This study described a patient-centered process of testing and refinement of a new website (www.transplantcentersearch.org) that was developed to provide data to patients who are seeking a transplant center.
AHRQ-funded; HS026379; HS024527.
Citation: Chu S, Bruin MJ, McKinney WT .
Design of a patient-centered decision support tool when selecting an organ transplant center.
PLoS One 2021 May 17;16(5):e0251102. doi: 10.1371/journal.pone.0251102..
Keywords: Transplantation, Patient-Centered Healthcare, Shared Decision Making, Health Information Technology (HIT)
Ridgway JP, Robicsek A, Shah N
A randomized controlled trial of an electronic clinical decision support tool for inpatient antimicrobial stewardship.
The weighted incidence syndromic combination antibiogram (WISCA) is an antimicrobial stewardship tool that utilizes electronic medical record data to provide real-time clinical decision support regarding empiric antibiotic prescription in the hospital setting. The aim of this study was to determine the impact of WISCA utilization for empiric antibiotic prescription on hospital length of stay (LOS).
AHRQ-funded; HS022283.
Citation: Ridgway JP, Robicsek A, Shah N .
A randomized controlled trial of an electronic clinical decision support tool for inpatient antimicrobial stewardship.
Clin Infect Dis 2021 May 4;72(9):e265-e71. doi: 10.1093/cid/ciaa1048..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT)
Aronson PL, Politi MC, Schaeffer P
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
This study’s aim was to develop and test a tool to engage parents of febrile infants 60 days or less of age evaluated in the emergency department (ED). The tool was designed to improve communication between parents and healthcare providers and to support shared decision-making (SDM) about whether to perform a lumbar puncture (LP) for infants 29 to 60 days of age. The authors conducted a multi-phase development and testing process including individual, semi-structured interviews with parents and clinicians; design of a “storyboard” of the tool with design impression testing; development of a software application prototype called e-Care; and usability testing of e-Care using qualitative assessment and the System Usability Scale (SUS). The authors interviewed 27 parents and 23 clinicians. After the interviews, they developed separate versions of e-Care for infants aged 28 days or less and 29 to 60 days of age in both English and Spanish. e-Care is divided into 4 sections: 1) homepage; 2) why testing is done; 3) what tests are done; and 4) what happens after testing. The mean SUS score given by parents and clinicians was 90.3 representing “excellent” usability.
AHRQ-funded; HS026006.
Citation: Aronson PL, Politi MC, Schaeffer P .
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
Acad Emerg Med 2021 Jan;28(1):46-59. doi: 10.1111/acem.14082..
Keywords: Clinician-Patient Communication, Communication, Newborns/Infants, Caregiving, Shared Decision Making, Patient and Family Engagement, Emergency Department, Health Information Technology (HIT)