National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (6)
- Cardiovascular Conditions (8)
- Chronic Conditions (1)
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- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Heart Disease and Health (6)
- Hospitalization (1)
- Injuries and Wounds (1)
- (-) Medical Devices (10)
- Mortality (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (2)
- Patient Safety (3)
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- Risk (1)
- (-) Surgery (10)
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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
1 to 10 of 10 Research Studies DisplayedMao J, Sedrakyan A, Sun T
Assessing adverse event reports of hysteroscopic sterilization device removal using natural language processing.
This study’s objective was to develop an annotation model to develop natural language processing (NLP) to device adverse event reports and to implement the model to evaluate the most frequently experienced events among women reporting a sterilization device removal. Adverse event reports from the Manufacturer and User Facility Device Experience database from January 2005 to June 2018 were included. The authors used an iterative process to develop an annotation model that extracts six categories of desired information and applied the annotation model to train an NLP algorithm. A total of 16,535 reports of device removal were analyzed with the most frequently reported patient and device events being abdominal/pelvic/genital pain (79.6%) and device dislocation/migration (19.2%), respectively. A total of 7,932 patients reported an additional sterilization procedure of a hysterectomy or salpingectomy. One-fifth of the cases that had device removal timing specified reported a removal 7 years after original insertion.
AHRQ-funded; HS026291.
Citation: Mao J, Sedrakyan A, Sun T .
Assessing adverse event reports of hysteroscopic sterilization device removal using natural language processing.
Pharmacoepidemiol Drug Saf 2022 Apr;31(4):442-51. doi: 10.1002/pds.5402..
Keywords: Adverse Events, Surgery, Medical Devices, Patient Safety
Shore S, Pienta MJ, Watt TMF
Non-patient factors associated with infections in LVAD recipients: a scoping review.
Infections are the most common complication in recipients of durable left ventricular assist devices (LVAD) and are associated with increased morbidity, mortality, and expenditures. The existing literature examining factors associated with infection in LVAD recipients is limited and principally comprises single-center studies. This scoping review synthesized all available evidence related to identifying modifiable, non-patient factors associated with infections among LVAD recipients.
AHRQ-funded; HS026003.
Citation: Shore S, Pienta MJ, Watt TMF .
Non-patient factors associated with infections in LVAD recipients: a scoping review.
J Heart Lung Transplant 2022 Jan;41(1):1-16. doi: 10.1016/j.healun.2021.10.006..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Medical Devices
Mentias A, Briasoulis A, Vaughan Sarrazin MS
Trends, perioperative adverse events, and survival of patients with left ventricular assist devices undergoing noncardiac surgery.
This longitudinal cohort study examined outcomes of noncardiac surgery (NCS) in patients with left ventricular assist devices (LVADs). This study examined patients enrolled in Medicare who had undergone durable LVAD implantation from January 2012 to November 2017 with follow-up through December 2017. Primary outcome after NCS was major adverse cardiovascular events (MACEs), defined as in-hospital or 30-day all-cause mortality, ischemic stroke, or intracerebral hemorrhage. Of the 8118 patients with LVAD, 1326 underwent NCS with 75.4% emergent or urgent, and 24.6% elective. Both elective and urgent or emergent NCS was associated with higher mortality early and late compared with patients with LVAD who did not undergo NCS.
AHRQ-funded; HS023104.
Citation: Mentias A, Briasoulis A, Vaughan Sarrazin MS .
Trends, perioperative adverse events, and survival of patients with left ventricular assist devices undergoing noncardiac surgery.
JAMA Netw Open 2020 Nov 2;3(11):e2025118. doi: 10.1001/jamanetworkopen.2020.25118..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Medical Devices, Chronic Conditions, Outcomes, Adverse Events
Chandanabhumma PP, Fetters MD, Pagani FD
Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study.
This paper discusses an ongoing AHRQ-funded study to understand and address variation in health care-associated infections (HAIs) after durable ventricular assist device (VAD) implantation surgery. This procedure is used only on patients with advanced heart failure who have a poor 1-year estimated survival rate. This is a sequential mixed methods study which is conducting a systematic review of HAI prevention studies, and an in-depth quantitative analyses using administration claims, in-depth clinical data, and organizational surveys of VAD centers. The last aim is to develop and disseminate a best practices toolkit for HAI prevention. Data analysis is currently underway.
AHRQ-funded; HS026003.
Citation: Chandanabhumma PP, Fetters MD, Pagani FD .
Understanding and addressing variation in health care-associated infections after durable ventricular assist device therapy: protocol for a mixed methods study.
JMIR Res Protoc 2020 Jan 7;9(1):e14701. doi: 10.2196/14701..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Medical Devices, Prevention, Heart Disease and Health, Cardiovascular Conditions, Adverse Events
Song J, Tark A, Larson EL
The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: an integrative review.
Pocket hematoma is a common adverse event following the insertion of cardiovascular implantable electronic devices (CIEDs), but the risk of wound infections associated with a pocket hematoma is unclear. The objective of this integrative review was to examine the relationship between pocket hematoma and risk of wound infection in a CIED population.
AHRQ-funded; HS024915.
Citation: Song J, Tark A, Larson EL .
The relationship between pocket hematoma and risk of wound infection among patients with a cardiovascular implantable electronic device: an integrative review.
Heart Lung 2020 Jan-Feb;49(1):92-98. doi: 10.1016/j.hrtlng.2019.09.009..
Keywords: Medical Devices, Cardiovascular Conditions, Surgery, Adverse Events, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk
Bates J, Parzynski CS, Dhruva SS
Quantifying the utilization of medical devices necessary to detect postmarket safety differences: a case study of implantable cardioverter defibrillators.
The purpose of this study was to estimate medical device utilization needed to detect safety differences among implantable cardioverter defibrillators (ICDs) generator models and compare these estimates to utilization in practice. The investigators concluded that small safety differences among ICD generator models are unlikely to be detected through routine surveillance given current ICD utilization in practice, but large safety differences can be detected for most patients at anticipated average adverse event rates.
AHRQ-funded; HS022882.
Citation: Bates J, Parzynski CS, Dhruva SS .
Quantifying the utilization of medical devices necessary to detect postmarket safety differences: a case study of implantable cardioverter defibrillators.
Pharmacoepidemiol Drug Saf 2018 Aug;27(8):848-56. doi: 10.1002/pds.4565..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Medical Devices, Patient Safety, Registries, Surgery
Patel S, Poorjary P, Pawar S
National landscape of unplanned 30-day readmissions in patients with left ventricular assist device implantation.
This study tracked unplanned 30-day readmissions in patients who had undergone left ventricular assist device (LVAD) implantation during 2013. Data from the Healthcare Cost and Utilization Project (HCUP) National Readmission Database was used. Out of 2,235 patients who had an LVAD implantation, 29.7% had at least 1 unplanned readmission within 30 days. The top reasons for readmission were implant complications (14.9%), congestive heart failure (11.7%), and gastrointestinal bleeding (8.4%). Predictors of readmission included a prolonged length stay during the primary admission, Medicare insurance, and discharge to a short-term facility.
AHRQ-funded; HS023000.
Citation: Patel S, Poorjary P, Pawar S .
National landscape of unplanned 30-day readmissions in patients with left ventricular assist device implantation.
Am J Cardiol 2018 Jul 15;122(2):261-67. doi: 10.1016/j.amjcard.2018.03.363..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Cardiovascular Conditions, Surgery, Medical Devices, Adverse Events
Bachmann JM, Duncan MS, Shah AS
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
This study examined whether outcomes of cardiac patients who had received ventricular assist device (VAD) implementation had decreased hospitalization and mortality with cardiac rehabilitation (CR). Medicare beneficiaries enrolled for disability or aged 65 years and older in 2014 were included. The investigators identified VAD recipients by diagnosis codes. It was found that each 5-year increase in age was associated with attending an additional 1.6 CR sessions and there was a 23% lower 1-year hospitalization risk and a 47% lower 1-year mortality risk.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Duncan MS, Shah AS .
Association of cardiac rehabilitation with decreased hospitalizations and mortality after ventricular assist device implantation.
JACC Heart Fail 2018 Feb;6(2):130-39. doi: 10.1016/j.jchf.2017.11.002..
Keywords: Cardiovascular Conditions, Rehabilitation, Heart Disease and Health, Medical Devices, Surgery, Patient-Centered Outcomes Research, Outcomes, Mortality, Evidence-Based Practice, Hospitalization
Goldstone AB, Chiu P, Baiocchi M
Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement.
This study compared long-term mortality and rates of reoperation, stroke, and bleeding between cohorts of patients who underwent primary aortic-valve replacement or mitral-valve replacement with a mechanical or biologic prosthesis. The long-term mortality benefit associated with a mechanical prosthesis, as compared with a biologic prosthesis, persisted until 70 years of age among patients undergoing mitral-valve replacement and until 55 years of age among those undergoing aortic-valve replacement.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement.
N Engl J Med 2017 Nov 9;377(19):1847-57. doi: 10.1056/NEJMoa1613792.
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Keywords: Adverse Events, Cardiovascular Conditions, Medical Devices, Patient-Centered Outcomes Research, Surgery
Branzetti JB, Adedipe AA, Gittinger MJ
Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.
The purpose of this study was to evaluate the impact of a novel Just-in-Time (JIT) intervention on transvenous pacemaker (TVP) placement during a simulated patient event. The authors concluded that a JIT intervention improved procedure performance, suggesting a role for JIT interventions in rarely performed procedures.
AHRQ-funded; HS020295
Citation: Branzetti JB, Adedipe AA, Gittinger MJ .
Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.
BMJ Qual Saf 2017 Nov;26(11):881-91. doi: 10.1136/bmjqs-2017-006656..
Keywords: Medical Devices, Patient Safety, Surgery, Training, Emergency Medical Services (EMS)