National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- (-) Cancer (54)
- Cancer: Breast Cancer (20)
- Cancer: Colorectal Cancer (4)
- Cancer: Lung Cancer (4)
- Cancer: Prostate Cancer (3)
- Caregiving (2)
- Case Study (1)
- Children/Adolescents (3)
- Chronic Conditions (1)
- Clinician-Patient Communication (8)
- Communication (5)
- Comparative Effectiveness (1)
- COVID-19 (1)
- Diagnostic Safety and Quality (4)
- Disparities (1)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (2)
- Elderly (11)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (2)
- Genetics (7)
- Guidelines (1)
- Healthcare Costs (3)
- Health Information Technology (HIT) (2)
- Imaging (2)
- Implementation (1)
- Medication (2)
- Men's Health (2)
- Mortality (1)
- Outcomes (3)
- Pain (1)
- Palliative Care (3)
- Patient-Centered Healthcare (8)
- Patient-Centered Outcomes Research (7)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (5)
- Patient Experience (2)
- Practice Patterns (2)
- Pregnancy (1)
- Prevention (6)
- Primary Care (2)
- Provider: Physician (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (3)
- Research Methodologies (1)
- Risk (4)
- Screening (14)
- (-) Shared Decision Making (54)
- Surgery (11)
- Training (1)
- Treatments (2)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Vulnerable Populations (1)
- Women (17)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
26 to 50 of 54 Research Studies DisplayedGreenzang KA, Al-Sayegh H, Ma C
Parental considerations regarding cure and late effects for children with cancer.
The purpose of this study was to learn how parents and physicians consider late-effects risks against a potential survival benefit when making treatment decisions. Parents of children with cancer and physicians at Dana-Farber/Boston Children's Cancer and Blood Disorders Center were surveyed. Investigators found that avoidance of severe neurocognitive impairment was the predominant driver of parent and physician treatment preferences, even over an increased chance of cure. They concluded that their study highlights the importance of exploring parental late-effects priorities when discussing treatment options.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Al-Sayegh H, Ma C .
Parental considerations regarding cure and late effects for children with cancer.
Pediatrics 2020 May;145(5):e20193552. doi: 10.1542/peds.2019-3552..
Keywords: Children/Adolescents, Cancer, Shared Decision Making, Caregiving, Risk
Kierkegaard P, Vale MD, Garrison S
Mechanisms of decision-making in preoperative assessment for older adult prostate cancer patients-a qualitative study.
The purpose of this study was to identify and examine the underlying mechanisms that uniquely shape preoperative surgical decision-making strategies concerning older adult prostate cancer patients. Results showed that surgeons’ personal experiences had a significant impact on the decision-making processes during preoperative assessments. However, non-patient factors such as institutional microcultures passively and actively influenced the decision-making process during preoperative assessment.
AHRQ-funded; HS025707.
Citation: Kierkegaard P, Vale MD, Garrison S .
Mechanisms of decision-making in preoperative assessment for older adult prostate cancer patients-a qualitative study.
J Surg Oncol 2020 Mar;121(3):561-69. doi: 10.1002/jso.25819..
Keywords: Shared Decision Making, Cancer: Prostate Cancer, Cancer, Surgery, Men's Health
Killelea BK, Evans SB, Mougalian SS
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
This study examined perceptions of older women with stage I estrogen-receptor-positive breast cancer who underwent lumpectomy and were considering or receiving radiotherapy. Perceptions among 63 older women was that radiotherapy would reduce their 10-year-risk of local recurrent by an average of 18.7% although the literature showed only an 8% risk reduction. Participants who had the perception of a larger benefit were more likely to receive radiotherapy treatment.
AHRQ-funded; HS023900.
Citation: Killelea BK, Evans SB, Mougalian SS .
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
Breast J 2020 Feb;26(2):231-34. doi: 10.1111/tbj.13518..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Patient-Centered Outcomes Research, Shared Decision Making
Acree ME, McNulty M, Blocker O
Shared decision-making around anal cancer screening among black bisexual and gay men in the USA.
This study focused on shared decision-making on anal cancer screening among black gay and bisexual men in the US. The researchers conducted 30 semi-structured one-on-one interviews and two focus groups in 2016-2017. Out of forty-five participants, all were black and male, with 13 identified as bisexual and 32 as gay. Barriers to screening include internalized racism, biphobia/homophobia, provider bias lead to reduced healthcare engagement and discomfort discussing sexual practices which hindered shared decision-making.
AHRQ-funded; HS023050.
Citation: Acree ME, McNulty M, Blocker O .
Shared decision-making around anal cancer screening among black bisexual and gay men in the USA.
Cult Health Sex 2020 Feb;22(2):201-16. doi: 10.1080/13691058.2019.1581897..
Keywords: Shared Decision Making, Cancer, Screening, Prevention, Racial and Ethnic Minorities, Vulnerable Populations
Kunst NR, Alarid-Escudero F, Paltiel AD
A value of information analysis of research on the 21-gene assay for breast cancer management.
The authors aimed to quantify the value of conducting further research to reduce decision uncertainty in the use of the 21-gene assay Oncotype DX (21-GA). They found that current evidence strongly supports the use of the 21-GA in intermediate- and high-risk women and recommended that further research focus on low-risk women.
AHRQ-funded; HS023900.
Citation: Kunst NR, Alarid-Escudero F, Paltiel AD .
A value of information analysis of research on the 21-gene assay for breast cancer management.
Value Health 2019 Oct;22(10):1102-10. doi: 10.1016/j.jval.2019.05.004..
Keywords: Genetics, Cancer: Breast Cancer, Cancer, Shared Decision Making, Research Methodologies
Sepucha KR, Langford AT, Belkora JK
Impact of timing on measurement of decision quality and shared decision making: longitudinal cohort study of breast cancer patients.
Med Decis Making 2019 Aug;39(6):642-50. doi: 10.1177/0272989x19862545.
AHRQ-funded; HS025718.
Citation: Sepucha KR, Langford AT, Belkora JK .
Impact of timing on measurement of decision quality and shared decision making: longitudinal cohort study of breast cancer patients.
Med Decis Making 2019 Aug;39(6):642-50. doi: 10.1177/0272989x19862545..
Keywords: Shared Decision Making, Cancer: Breast Cancer, Cancer, Surgery
Bateni SB, Davidson AJ, Arora M
Is breast-conserving therapy appropriate for male breast cancer patients? A national cancer database analysis.
The purpose of this study was to compare overall survival rates among male breast cancer patients who underwent breast-conserving therapy (BCT) versus mastectomy. A retrospective analysis identified 8445 stage I-II male breast cancer patients from the National Cancer Database and grouped them according to surgical and radiation therapy (RT). Most of the patients underwent total mastectomy, while 18.2% underwent BCT, 12.4% underwent total mastectomy with RT, and 8.2% underwent partial mastectomy alone. Partial mastectomy alone, total mastectomy alone, and total mastectomy with RT were associated with worse overall survival rates compared with BCT. The authors conclude that BCT is associated with greater survival, but the underlying mechanisms of this association warrant further study.
AHRQ-funded; HS022236.
Citation: Bateni SB, Davidson AJ, Arora M .
Is breast-conserving therapy appropriate for male breast cancer patients? A national cancer database analysis.
Ann Surg Oncol 2019 Jul;26(7):2144-53. doi: 10.1245/s10434-019-07159-4..
Keywords: Cancer, Cancer: Breast Cancer, Shared Decision Making, Mortality, Outcomes, Patient-Centered Outcomes Research
Johnston FM, Beckman M
Navigating difficult conversations.
In this paper, the authors discussed breaking bad news and navigating difficult conversations in surgical oncology practice. They note that mounting evidence supports a patient-centered communication approach and models of shared decisionmaking. Physician training in patient-centered cancer communication also continues to evolve.
AHRQ-funded; HS024736.
Citation: Johnston FM, Beckman M .
Navigating difficult conversations.
J Surg Oncol 2019 Jul;120(1):23-29. doi: 10.1002/jso.25472..
Keywords: Cancer, Clinician-Patient Communication, Communication, Shared Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Provider: Physician, Surgery
Gordon BE, Basak R, Carpenter WR
Factors influencing prostate cancer treatment decisions for African American and white men.
This prospective, population-based cohort study examined some possible reasons for mortality outcome differences for prostate cancer between African American (AA) and white patients. A cohort of 1170 men with nonmetastatic prostate cancer were enrolled from 2011 to 2013 before treatment in North Carolina. Participants were asked to rate their aggressiveness of their cancer, and also the importance of 10 factors their treatment decision-making process. Among low-risk patients, there was no difference in perception of their cancer as “not very aggressive”. Among high-risk patients, 54% of AA patients considered their cancer to be “not very aggressive” while only 24% of white patients did. For AA patients, cost, treatment time, and recovery time were considered very important more than white patients.
AHRQ-funded.
Citation: Gordon BE, Basak R, Carpenter WR .
Factors influencing prostate cancer treatment decisions for African American and white men.
Cancer 2019 May 15;125(10):1693-700. doi: 10.1002/cncr.31932..
Keywords: Shared Decision Making, Cancer, Cancer: Prostate Cancer, Disparities, Men's Health, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Matsen CB, Lyons S, Goodman MS
Decision role preferences for return of results from genome sequencing amongst young breast cancer patients.
The purpose of this study was to better understand decision role preferences in women diagnosed with breast cancer at a young age for return of results of genome sequencing in research and clinical settings. The investigators found that most women in their study preferred to share in decision making and that participants had somewhat different role preferences for clinical and research contexts, with greater preference for active roles in the research context.
AHRQ-funded; HS024784.
Citation: Matsen CB, Lyons S, Goodman MS .
Decision role preferences for return of results from genome sequencing amongst young breast cancer patients.
Patient Educ Couns 2019 Jan;102(1):155-61. doi: 10.1016/j.pec.2018.08.004..
Keywords: Cancer, Cancer: Breast Cancer, Shared Decision Making, Genetics, Women
Bateni SB, Canter RJ, Meyers FJ
Palliative care training and decision-making for patients with advanced cancer: a comparison of surgeons and medical physicians.
Surgical decision-making in patients with advanced cancer requires careful thought and deliberation to balance the high risks with the potential palliative benefits. In this study, the investigators sought to compare surgical decision-making and palliative care training among surgeons and medical physicians who commonly treat advanced cancer patients. The investigators concluded that substantial deficiencies in palliative care training persised among surgeons and were associated with more aggressive recommendations for treatment for the selected scenarios presented in patients with advanced cancer.
AHRQ-funded; HS022236.
Citation: Bateni SB, Canter RJ, Meyers FJ .
Palliative care training and decision-making for patients with advanced cancer: a comparison of surgeons and medical physicians.
Surgery 2018 Jul;164(1):77-85. doi: 10.1016/j.surg.2018.01.021..
Keywords: Shared Decision Making, Palliative Care, Cancer, Surgery, Education: Continuing Medical Education, Training
Lewis CL, Kistler CE, Dalton AF
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
The purpose of this study was to test a patient decision aid (PtDA) to promote CRC screening in older adults. The PtDA was designed to facilitate individual decision-making to help patients understand the potential risks and benefit of CRC screening. 424 patients aged 70 – 84 who were not up to date with CRC screening participated in a double-blinded randomized controlled trial, using the PtDA or an attention control. Two outcomes - appropriate CRC screening behavior at 6 months following the initial visit or appropriate screening intent immediately after the visit - were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, or no screening or intent for patients in poor health. Appropriate screening behavior at 6 months was higher in the intervention group; appropriate screening intent following the provider visit was also higher. The authors conclude that the PtDA for older adults promoted appropriate CRC screening behavior.
AHRQ-funded; HS021133.
Citation: Lewis CL, Kistler CE, Dalton AF .
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
Med Decis Making 2018 Jul;38(5):614-24. doi: 10.1177/0272989x18773713..
Keywords: Cancer, Cancer: Colorectal Cancer, Shared Decision Making, Education: Patient and Caregiver, Elderly, Prevention, Screening
Pappadis MR, Volk RJ, Krishnan S
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
The authors explored older women's perceptions about the concept of overdetection of breast cancer and its influence on future screening intentions. Semistructured interviews were conducted with 59 English-speaking women aged 70 years or older with no prior history of breast cancer. The authors found that many older women did not understand the concept of overdetection, in addition to being suspicious of or resistant to the concept. Providing older women with descriptions of overdetection may not be sufficient to influence screening intentions.
AHRQ-funded; HS022134.
Citation: Pappadis MR, Volk RJ, Krishnan S .
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
BMJ Open 2018 Jun 14;8(6):e022138. doi: 10.1136/bmjopen-2018-022138..
Keywords: Cancer: Breast Cancer, Cancer, Elderly, Screening, Shared Decision Making, Women, Prevention, Imaging
Bardach NS, Burkhart Q, Richardson LP
Hospital-based quality measures for pediatric mental health care.
The objective of this study was to develop and test medical record-based measures used to assess quality of pediatric mental health care in the emergency department (ED) and inpatient settings. The investigators drafted an evidence-based set of pediatric mental health care quality measures for the ED and inpatient settings and used them to identify sex and race disparities and substantial hospital variation.
AHRQ-funded; HS020506.
Citation: Bardach NS, Burkhart Q, Richardson LP .
Hospital-based quality measures for pediatric mental health care.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2017-3554..
Keywords: Cancer, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Shared Decision Making, Diagnostic Safety and Quality, Patient Experience, Patient and Family Engagement
Greenzang KA, Dauti A, Mack JW
Parent perspectives on information about late effects of childhood cancer treatment and their role in initial treatment decision making.
The authors’ objective was to explore how parents of children with cancer consider late effects in initial treatment decision making and during active cancer treatment. Through interviews, they found that parents desire detailed information about late effects to make informed treatment decisions and to prepare for the future. Despite the role of late effects in treatment decision making, some parents feel that late effects are either inadequately addressed or too overwhelming to process at diagnosis. They suggested that parents may benefit from early assessment of their information needs and a return to these issues over time.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Dauti A, Mack JW .
Parent perspectives on information about late effects of childhood cancer treatment and their role in initial treatment decision making.
Pediatr Blood Cancer 2018 Jun;65(6):e26978. doi: 10.1002/pbc.26978.
.
.
Keywords: Cancer, Children/Adolescents, Shared Decision Making, Education: Patient and Caregiver, Patient-Centered Healthcare
Semenkovich TR, Panni RZ, Hudson JL
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
This study examined comparative effectiveness and survival rates for upfront esophagectomy versus induction chemoradiation in patients with clinical stage T2N20 esophageal cancer. A decision analysis model was created for the two treatment strategies. Results showed comparable median survival rates for both strategies. The optimal treatment strategy depended on the accuracy of endoscopic ultrasound staging.
AHRQ-funded; HS022330.
Citation: Semenkovich TR, Panni RZ, Hudson JL .
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
J Thorac Cardiovasc Surg 2018 May;155(5):2221-30.e1. doi: 10.1016/j.jtcvs.2018.01.006..
Keywords: Treatments, Cancer, Surgery, Comparative Effectiveness, Shared Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes, Medication
Balentine CJ, Vanness DJ, Schneider DF
Cost-effectiveness of lobectomy versus genetic testing (Afirma(R)) for indeterminate thyroid nodules: considering the costs of surveillance.
This study evaluated whether diagnostic thyroidectomy for indeterminate thyroid nodules would be more cost-effective than genetic testing after including the costs of long-term surveillance. Its base case estimate suggests that diagnostic lobectomy dominates genetic testing as a strategy for ruling out malignancy of indeterminate thyroid nodules.
AHRQ-funded; HS023009.
Citation: Balentine CJ, Vanness DJ, Schneider DF .
Cost-effectiveness of lobectomy versus genetic testing (Afirma(R)) for indeterminate thyroid nodules: considering the costs of surveillance.
Surgery 2018 Jan;163(1):88-96. doi: 10.1016/j.surg.2017.10.004.
.
.
Keywords: Cancer, Shared Decision Making, Diagnostic Safety and Quality, Genetics, Healthcare Costs, Screening, Surgery
Kistler CE, Golin C, Morris C
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
This paper reports on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. The study aims to determine the ability of a patient decision aid to increase individualized and appropriate colorectal cancer screening.
AHRQ-funded; HS021133.
Citation: Kistler CE, Golin C, Morris C .
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
Clin Trials 2017 Dec;14(6):648-58. doi: 10.1177/1740774517725289..
Keywords: Cancer, Cancer: Colorectal Cancer, Shared Decision Making, Elderly, Prevention, Screening
Tamirisa NP, Goodwin JS, Kandalam A
Patient and physician views of shared decision making in cancer.
The aim of the study was to explore patient and physician perceptions of shared decision making in clinical encounters for cancer care. Among the study’s multiple conclusions was that most physicians reported providing patients with written information, however, most patients reported that written information was too detailed and felt that the physicians did not assess the level of information they wished to receive.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Goodwin JS, Kandalam A .
Patient and physician views of shared decision making in cancer.
Health Expect 2017 Dec;20(6):1248-53. doi: 10.1111/hex.12564..
Keywords: Cancer, Shared Decision Making, Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Iyer AS, Bakitas M
Early palliative care in advanced illness: do right by mama.
This letter describes a case study where the doctor and the family decided not to do aggressive treatment on their mother in her 80’s with metastatic lung cancer and pneumonia. After describing the intubation procedure and the use of mechanical ventilation, the family decided that palliative care was the best option. The doctor emphasizes the use of palliative care as the best outcome for many terminally ill patients.
AHRQ-funded; HS023009; HS013852.
Citation: Iyer AS, Bakitas M .
Early palliative care in advanced illness: do right by mama.
JAMA Intern Med 2017 Jun;177(6):761-62. doi: 10.1001/jamainternmed.2017.0764.
.
.
Keywords: Cancer, Cancer: Lung Cancer, Case Study, Shared Decision Making, Elderly, Palliative Care, Patient-Centered Outcomes Research
Perone JA, Riall TS, Olino K
Palliative care for pancreatic and periampullary cancer.
This article summarizes surgical, endoscopic, and other palliative techniques for relief of obstructive jaundice, relief of duodenal or gastric outlet obstruction, and relief of pain due to invasion of the celiac plexus. It also introduces the utility of the palliative care triangle in clarifying a patient's and family's goals to guide decision making.
AHRQ-funded; HS022134.
Citation: Perone JA, Riall TS, Olino K .
Palliative care for pancreatic and periampullary cancer.
Surg Clin North Am 2016 Dec;96(6):1415-30. doi: 10.1016/j.suc.2016.07.012.
.
.
Keywords: Cancer, Palliative Care, Pain, Shared Decision Making
Roberts MC, Bryson A, Weinberger M
Patient-centered communication for discussing oncotype DX testing.
The researchers identified patient-centered communication strategies/gaps for discussing Oncotype DX testing (ODX) results. They applied a patient-centered communication framework to analyze qualitative interviews with oncologists about how they communicate about ODX with patients. Overall, providers discussed four patient-centered communication domains: exchanging information, assessing uncertainty, making decisions and cross-cutting themes.
AHRQ-funded; HS019468; HS022189.
Citation: Roberts MC, Bryson A, Weinberger M .
Patient-centered communication for discussing oncotype DX testing.
Cancer Invest 2016 May 27;34(5):205-12. doi: 10.3109/07357907.2016.1172637.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Communication, Clinician-Patient Communication, Shared Decision Making, Genetics, Patient and Family Engagement, Patient-Centered Healthcare, Women
Pollack CE, Blackford AL, Schoenborn NL
Comparing prognostic tools for cancer screening: considerations for clinical practice and performance assessment.
The researchers compared the agreement and rates of cancer screening using four prognostic tools that require different types of clinical information. They found high agreement among the four prognostic tools. They concluded that the high rates of cancer screening of individuals with limited life expectancy suggest the importance of incorporating tools into clinical decision-making.
AHRQ-funded; HS000029.
Citation: Pollack CE, Blackford AL, Schoenborn NL .
Comparing prognostic tools for cancer screening: considerations for clinical practice and performance assessment.
J Am Geriatr Soc 2016 May;64(5):1032-8. doi: 10.1111/jgs.14089.
.
.
Keywords: Elderly, Cancer, Screening, Shared Decision Making
Patel J, Yopp A, Waljee AK
Development and internal validation of a model for early detection of hepatocellular carcinoma in patients with cirrhosis.
The authors sought to derive and validate a model to accurately distinguish cirrhotic patients with and without hepatocellular carcinoma (HCC) and compare the accuracy of the model to that of α-fetoprotein (AFP) alone. They found that models including AFP and FIB-4 can accurately discriminate cirrhotic patients with early-stage HCC from those without HCC.
AHRQ-funded; HS022418.
Citation: Patel J, Yopp A, Waljee AK .
Development and internal validation of a model for early detection of hepatocellular carcinoma in patients with cirrhosis.
J Clin Gastroenterol 2016 Feb;50(2):175-9. doi: 10.1097/mcg.0000000000000377.
.
.
Keywords: Cancer, Shared Decision Making, Diagnostic Safety and Quality
Lee SC, Marks EG, Sanders JM
Elucidating patient-perceived role in "decision-making" among African Americans receiving lung cancer care through a county safety-net system.
The researchers explored patient-perceived role in "decision-making" related to active treatment and palliation among African Americans receiving lung cancer care through a county safety-net system. They found that caregivers and patients expressed a concurrent lack of understanding of their prognosis and outcomes of treatment. Dyads did not discuss their lung cancer experience in terms of decision-making; rather, most articulated their role as following physician guidance.
AHRQ-funded; HS022418.
Citation: Lee SC, Marks EG, Sanders JM .
Elucidating patient-perceived role in "decision-making" among African Americans receiving lung cancer care through a county safety-net system.
J Cancer Surviv 2016 Feb;10(1):153-63. doi: 10.1007/s11764-015-0461-z.
.
.
Keywords: Cancer: Lung Cancer, Cancer, Racial and Ethnic Minorities, Shared Decision Making, Clinician-Patient Communication