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
101 to 125 of 1625 Research Studies DisplayedOlfson M, Gerhard T, Huang C
Premature mortality among adults with schizophrenia in the United States.
The objective of the study was to describe overall and cause-specific mortality rates and standardized mortality ratios for adults with schizophrenia compared with the US general population. In a US national cohort of adults with schizophrenia, excess deaths from cardiovascular and respiratory diseases implicate modifiable cardiovascular risk factors, including especially tobacco use.
AHRQ-funded; HS021112.
Citation: Olfson M, Gerhard T, Huang C .
Premature mortality among adults with schizophrenia in the United States.
JAMA Psychiatry 2015 Dec;72(12):1172-81. doi: 10.1001/jamapsychiatry.2015.1737..
Keywords: Mortality, Behavioral Health, Patient-Centered Outcomes Research, Risk
Krouse RS, You YN
Prospective comparative effectiveness trial for malignant bowel obstruction: SWOG S1316.
This paper is an update on the status of the Prospective Comparative Effectiveness Trial for Malignant Bowel Obstruction trial (S1316), the aim of which is to assess the quality of life outcome of “good days” for patients with malignant bowel obstruction (MBO) who receive surgical intervention in comparison with patients who undergo nonsurgical intervention.
AHRQ-funded; HS021491.
Citation: Krouse RS, You YN .
Prospective comparative effectiveness trial for malignant bowel obstruction: SWOG S1316.
Bull Am Coll Surg 2015 Dec;100(12):49-50.
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Keywords: Comparative Effectiveness, Digestive Disease and Health, Patient-Centered Outcomes Research, Quality of Life
McCarthy IM
Putting the patient in patient reported outcomes: a robust methodology for health outcomes assessment.
Through a series of Monte Carlo simulations, this paper illustrates that reliance solely on the summary score may lead to biased estimates of incremental effects, and proposes a novel two-stage approach that allows for unbiased estimation of incremental effects. The proposed methodology essentially reverses the order of the analysis, from one of 'aggregate, then estimate' to one of 'estimate, then aggregate'.
AHRQ-funded; HS022431.
Citation: McCarthy IM .
Putting the patient in patient reported outcomes: a robust methodology for health outcomes assessment.
Health Econ 2015 Dec;24(12):1588-603. doi: 10.1002/hec.3113.
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Keywords: Patient-Centered Outcomes Research, Outcomes, Quality of Life, Research Methodologies
Scialla JJ, Parekh RS, Eustace JA
Race, mineral homeostasis and mortality in patients with end-stage renal disease on dialysis.
In this study, the researchers determined the race-specific relationship between mineral parameters and mortality in patients initiating hemodialysis. They concluded that aberrant phosphorus homeostasis, reflected by higher phosphorus and FGF23, may be a risk factor for mortality in patients initiating hemodialysis, particularly among African Americans.
AHRQ-funded; HS08365.
Citation: Scialla JJ, Parekh RS, Eustace JA .
Race, mineral homeostasis and mortality in patients with end-stage renal disease on dialysis.
Am J Nephrol 2015;42(1):25-34. doi: 10.1159/000438999.
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Keywords: Kidney Disease and Health, Racial and Ethnic Minorities, Mortality, Kidney Disease and Health
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
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Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Lewiss RE, Chan W, Sheng AY
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
A group of radiologists, physicists, and emergency physicians convened at the 2015 Academic Emergency Medicine consensus conference to discuss and prioritize a research agenda related to education, assessment, and competency in ordering and interpreting diagnostic imaging. In this article, the authors review the supporting reliability and validity evidence and make specific recommendations for future research on the education, competency, and assessment of learning diagnostic imaging.
AHRQ-funded; HS023498.
Citation: Lewiss RE, Chan W, Sheng AY .
Research priorities in the utilization and interpretation of diagnostic imaging: Education, assessment, and competency.
Acad Emerg Med 2015 Dec;22(12):1447-54. doi: 10.1111/acem.12833.
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Keywords: Imaging, Education: Continuing Medical Education, Emergency Department, Emergency Medical Services (EMS), Healthcare Utilization, Health Services Research (HSR)
Lo Re V, 3rd, Haynes K, Forde KA
Risk of acute liver failure in patients with drug-induced liver injury: evaluation of Hy's Law and a new prognostic model.
The researchers aimed to develop a highly sensitive model to identify drug-induced liver injury (DILI) patients at increased risk of acute liver failure (ALF). negative predictive value (0.99), but low level of sensitivity (0.68) and positive predictive value (0.02). Their model, comprising data on platelet count and total bilirubin level, identified patients with ALF with a C statistic of 0.87 and enabled calculation of a risk score (Drug-Induced Liver Toxicity ALF Score).
AHRQ-funded; HS018372.
Citation: Lo Re V, 3rd, Haynes K, Forde KA .
Risk of acute liver failure in patients with drug-induced liver injury: evaluation of Hy's Law and a new prognostic model.
Clin Gastroenterol Hepatol 2015 Dec;13(13):2360-8. doi: 10.1016/j.cgh.2015.06.020.
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Keywords: Antimicrobial Stewardship, Medication, Chronic Conditions, Adverse Drug Events (ADE), Clinical Decision Support (CDS)
Bali V, Chatterjee S, Carnahan RM
Risk of dementia among elderly nursing home patients using paroxetine and other selective serotonin reuptake inhibitors.
This study evaluated the comparative risk of dementia associated with use of paroxetine and other selective serotonin reuptake inhibitors (SSRIs) among elderly nursing home patients. It found that compared with use of other SSRIs, use of paroxetine was not associated with higher risk of dementia among elderly nursing home patients with depression.
AHRQ-funded; HS021264.
Citation: Bali V, Chatterjee S, Carnahan RM .
Risk of dementia among elderly nursing home patients using paroxetine and other selective serotonin reuptake inhibitors.
Psychiatr Serv 2015 Dec;66(12):1333-40. doi: 10.1176/appi.ps.201500011.
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Keywords: Adverse Drug Events (ADE), Dementia, Elderly, Nursing Homes, Medication
Du XL, Zhang Y
Risks of venous thromboembolism, stroke, heart disease, and myelodysplastic syndrome associated with hematopoietic growth factors in a large population-based cohort of patients with colorectal cancer.
This study sought to determine the relationship between the receipt of colony-stimulating factors (CSFs) with erythropoiesis-stimulating agents (ESAs) and the risk of developing venous thromboembolism (VTE), stroke, heart disease, and myelodysplastic syndrome (MDS) in patients with colorectal cancer. It found that the use of ESAs was significantly associated with a substantially increased risk of MDS in patients with colorectal cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y .
Risks of venous thromboembolism, stroke, heart disease, and myelodysplastic syndrome associated with hematopoietic growth factors in a large population-based cohort of patients with colorectal cancer.
Clin Colorectal Cancer 2015 Dec;14(4):e21-31. doi: 10.1016/j.clcc.2015.05.007.
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Keywords: Adverse Drug Events (ADE), Cancer: Colorectal Cancer, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk
Batsis JA, Mackenzie TA, Lopez-Jimenez F
Sarcopenia, sarcopenic obesity, and functional impairments in older adults: National Health and Nutrition Examination Surveys 1999-2004.
The researchers tested the hypothesis that the prevalence of sarcopenia and sarcopenic obesity would be similar based on the different NIH criteria, increase with age, and be associated with risk of impairment limitations. They concluded that the prevalence of sarcopenia and sarcopenic obesity varies greatly, and a uniform definition is needed to identify and characterize these high-risk populations.
AHRQ-funded; HS021695.
Citation: Batsis JA, Mackenzie TA, Lopez-Jimenez F .
Sarcopenia, sarcopenic obesity, and functional impairments in older adults: National Health and Nutrition Examination Surveys 1999-2004.
Nutr Res 2015 Dec;35(12):1031-9. doi: 10.1016/j.nutres.2015.09.003.
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Keywords: Elderly, Obesity, Chronic Conditions, Health Status
Fan T, Feaginsfletcher H
AHRQ Author: Fan T
Screening for iron deficiency anemia in young children.
This case study involves a 32-year-old white woman, presenting to your office with her nine-month-old son for a routine well-child visit. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Fan T, Feaginsfletcher H .
Screening for iron deficiency anemia in young children.
Am Fam Physician 2015 Dec 15;92(12):1103-4.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Case Study, Children/Adolescents, Prevention
Vistnes J, Selden TM, Zawacki A
AHRQ Author: Vistnes J, Selden TM
Several factors responsible for the recent slowdown in premium growth in employer-sponsored insurance.
Researchers have been seeking to identify which factors behind the recent spending slowdown . This study found that the slowdown in premium growth that preceded the recession reflected declining growth rates in per policyholder premiums. For 2009-11, however, the dominant contributors to the slowdown were factors underlying declining employee enrollment: a sharp downturn in employment in 2009, followed by eroding offer and eligibility rates.
AHRQ-authored.
Citation: Vistnes J, Selden TM, Zawacki A .
Several factors responsible for the recent slowdown in premium growth in employer-sponsored insurance.
Health Aff 2015 Dec;34(12):2036-43. doi: 10.1377/hlthaff.2015.0436..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs, Health Insurance
Dicks KV, Baker AW, Durkin MJ
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
The purpose of this paper was to determine the association between shorter operative duration and surgical site infection (SSI) and also between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties. The researchers concluded that short operative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in their analysis.
AHRQ-funded; HS023866.
Citation: Dicks KV, Baker AW, Durkin MJ .
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
Infect Control Hosp Epidemiol 2015 Dec;36(12):1431-6. doi: 10.1017/ice.2015.222.
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Keywords: Healthcare-Associated Infections (HAIs), Orthopedics, Patient Safety, Adverse Events, Surgery, Injuries and Wounds
Slagle JM, Anders S, Porterfield E
Significant physiological disturbances associated with non-routine event containing and routine anesthesia cases.
The researchers sought to compare anesthesia providers' reporting of non-routine events (NREs) with the incidence of significant physiological disturbances (SPDs) detected via retrospective videotape review. They concluded that SPDs occur more often in NRE-containing cases. The incidence of approximately one NRE-independent SPD per case was similar in NRE-containing and routine case.
AHRQ-funded; HS011375.
Citation: Slagle JM, Anders S, Porterfield E .
Significant physiological disturbances associated with non-routine event containing and routine anesthesia cases.
J Patient Saf 2015 Dec;11(4):198-203. doi: 10.1097/pts.0000000000000081.
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Keywords: Patient Safety, Adverse Events, Adverse Drug Events (ADE), Medication
Lemke AA, Harris-Wai JN
Stakeholder engagement in policy development: challenges and opportunities for human genomics.
The purpose of this paper is to examine how stakeholder engagement is used to develop policies in genomics research and public health areas, as well as to identify future priorities for conducting evidence-based stakeholder engagements. It concluded that several challenges of using stakeholder engagement as a tool for genomics policy development remain, and little evidence regarding how to best incorporate stakeholder feedback into policy-making processes is currently available.
AHRQ-funded; HS023547.
Citation: Lemke AA, Harris-Wai JN .
Stakeholder engagement in policy development: challenges and opportunities for human genomics.
Genet Med 2015 Dec;17(12):949-57. doi: 10.1038/gim.2015.8.
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Keywords: Evidence-Based Practice, Genetics, Patient and Family Engagement, Policy, Public Health
Yun H, Xie F, Delzell E
The comparative effectiveness of biologics among older adults and disabled rheumatoid arthritis patients in the Medicare population.
Older and disabled rheumatoid arthritis (RA) patients are often not present in large numbers in clinical trials or registries. Using a novel, claims-based clinical effectiveness algorithm with the potential to compare the effectiveness of different biologics among this population using large administrative databases, researchers found that abatacept, adalimumab and etanercept are more effective than infliximab among RA patients initiating biologics.
AHRQ-funded; HS021694; HS023009; HS018517.
Citation: Yun H, Xie F, Delzell E .
The comparative effectiveness of biologics among older adults and disabled rheumatoid arthritis patients in the Medicare population.
Br J Clin Pharmacol 2015 Dec;80(6):1447-57. doi: 10.1111/bcp.12709.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Elderly, Arthritis, Medicare
Lipton BJ, Decker SL
AHRQ Author: Decker SL
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
The reserarchers examined the effect of vision insurance on eye care utilization and vision health outcomes by taking advantage of quasi-experimental variation in Medicaid coverage of adult vision care. They found that Medicaid beneficiaries with vision coverage are 4.4 percentage points more likely to have seen an eye doctor in the past year,and 5.3 percentage points less likely to report needing but not purchasing eyeglasses or contacts due to cost.
AHRQ-authored.
Citation: Lipton BJ, Decker SL .
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits.
J Health Econ 2015 Dec;44:320-32. doi: 10.1016/j.jhealeco.2015.10.006.
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Keywords: Medicaid, Eye Disease and Health, Healthcare Utilization, Health Services Research (HSR), Outcomes
Selden TM, Karaca Z, Keenan P
AHRQ Author: Selden TM, Karaca Z, Keenan P, Kronick R
The growing difference between public and private payment rates for inpatient hospital care.
The difference between private and public (Medicare and Medicaid) payment rates for inpatient hospital stays widened between 1996 and 2012. Medical Expenditure Panel Survey data reveal that standardized private insurer payment rates in 2012 were approximately 75 percent greater than Medicare's-a sharp increase from the differential of approximately 10 percent in the period 1996-2001.
AHRQ-authored.
Citation: Selden TM, Karaca Z, Keenan P .
The growing difference between public and private payment rates for inpatient hospital care.
Health Aff 2015 Dec;34(12):2147-50. doi: 10.1377/hlthaff.2015.0706.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Inpatient Care, Hospitalization
Graetz I, Huang J, Brand R
The impact of electronic health records and teamwork on diabetes care quality.
The researchers examined whether team cohesion among primary care team members changed the association between EHR use and changes in clinical outcomes for patients with diabetes. They found that patients cared for by higher cohesion primary care teams experienced modest but statistically significantly greater EHR-related health outcome improvements, compared with patients cared for by providers practicing in lower cohesion teams.
AHRQ-funded; HS015280; HS021082.
Citation: Graetz I, Huang J, Brand R .
The impact of electronic health records and teamwork on diabetes care quality.
Am J Manag Care 2015 Dec;21(12):878-84.
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Keywords: Diabetes, Electronic Health Records (EHRs), Quality of Care, Primary Care, Teams
Lee DC, Carr BG, Smith TE
The impact of hospital closures and hospital and population characteristics on increasing emergency department volume: a geographic analysis.
The objective of this study was to test the association of hospital and population characteristics and the effect of hospital closures with increases in emergency department volume. Emergency volume increased nearly twice as fast at tertiary referral centers (4.8 percent) and nonurban hospitals (3.7 percent versus urban at 2.1 percent) after adjusting for other characteristics. The effect of hospital closures also strongly predicted variation in growth.
AHRQ-funded; HS018362; HS010914.
Citation: Lee DC, Carr BG, Smith TE .
The impact of hospital closures and hospital and population characteristics on increasing emergency department volume: a geographic analysis.
Popul Health Manag 2015 Dec;18(6):459-66. doi: 10.1089/pop.2014.0123.
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Keywords: Emergency Medical Services (EMS), Emergency Department, Hospitals, Access to Care
Graham JL, Shahani L, Grimes RM
The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care.
The present study was designed to determine if trust in physicians and the healthcare system among persons newly diagnosed with HIV infection was predictive of patients' subsequent linkage, retention, and adherence to HIV care. No significant association was found between trust-in-physicians and linkage to care or adherence to antiretroviral therapy.
AHRQ-funded; HS016093.
Citation: Graham JL, Shahani L, Grimes RM .
The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care.
AIDS Patient Care STDS 2015 Dec;29(12):661-7. doi: 10.1089/apc.2015.0156..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Outcomes, Healthcare Utilization
O'Brien EC, Simon DN, Thomas LE
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
The researchers sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based in atrial fibrillation (AF) population. They concluded that their five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Simon DN, Thomas LE .
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
Eur Heart J 2015 Dec 7;36(46):3258-64. doi: 10.1093/eurheartj/ehv476.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events, Risk, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
Petkovic J, Epstein J, Buchbinder R
Toward ensuring health equity: Readability and cultural equivalence of OMERACT patient-reported outcome measures.
The goal of the Outcome Measures in Rheumatology (OMERACT) 12 (2014) equity working group was to determine whether and how comprehensibility of patient-reported outcome measures (PROM) should be assessed, to ensure suitability for people with low literacy and differing cultures. The results of this preconference work were presented to the equity working group participants to gain their perspectives on the importance of comprehensibility and cross-cultural adaptation for PROM.
AHRQ-funded; HS021110.
Citation: Petkovic J, Epstein J, Buchbinder R .
Toward ensuring health equity: Readability and cultural equivalence of OMERACT patient-reported outcome measures.
J Rheumatol 2015 Dec;42(12):2448-59. doi: 10.3899/jrheum.141168.
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Keywords: Patient-Centered Outcomes Research, Outcomes, Health Literacy
Kerlin MP, Cooke CR
Understanding costs when seeking value in critical care.
The authors discuss a study by Gershengorn and colleagues about daily ICU costs in five ICUs within a single medical center. They argue that although the authors should be commended on advancing the understanding of ICU costs, we should also recognize that efforts to reduce ICU length of stay will necessarily be insufficient to make a real dent in our health care economy.
AHRQ-funded; HS020672.
Citation: Kerlin MP, Cooke CR .
Understanding costs when seeking value in critical care.
Ann Am Thorac Soc 2015 Dec;12(12):1743-4. doi: 10.1513/AnnalsATS.201510-660ED.
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Keywords: Critical Care, Healthcare Costs, Intensive Care Unit (ICU)
Melnick ER, Shafer K, Rodulfo N
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
The objective was to identify nonclinical, human factors that promote or inhibit the appropriate use of computed tomography (CT) in patients presenting to the emergency department (ED) with minor head injury. Five core domains emerged from the analysis: establishing trust, anxiety (patient and provider), constraints related to ED practice, the influence of others, and patient expectations.
AHRQ-funded; HS021271.
Citation: Melnick ER, Shafer K, Rodulfo N .
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
Acad Emerg Med 2015 Dec;22(12):1474-83. doi: 10.1111/acem.12824.
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Keywords: Emergency Medical Services (EMS), Imaging, Brain Injury, Shared Decision Making, Health Services Research (HSR)