National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (8)
- Antibiotics (1)
- Arthritis (4)
- Cancer (3)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Prostate Cancer (3)
- Cardiovascular Conditions (2)
- Care Management (1)
- Children/Adolescents (4)
- Comparative Effectiveness (8)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- Evidence-Based Practice (4)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Health Insurance (1)
- Hospital Readmissions (2)
- Injuries and Wounds (4)
- Medicaid (1)
- Medical Devices (1)
- Medication (3)
- Obesity (1)
- Obesity: Weight Management (1)
- Opioids (1)
- Orthopedics (1)
- Osteoporosis (1)
- Outcomes (7)
- Pain (4)
- (-) Patient-Centered Outcomes Research (29)
- Patient Experience (3)
- Patient Safety (3)
- Policy (1)
- Practice Patterns (1)
- Prevention (1)
- Provider (1)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (2)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Sleep Problems (1)
- (-) Surgery (29)
- Treatments (1)
- Women (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 25 of 29 Research Studies DisplayedGoldstone 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
Borah BJ, Yao X, Laughlin-Tommaso SK
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
The objective of this retrospective analysis of administrative claims from a large U.S. commercial insurance database, was to compare risk of reintervention, long-term clinical outcomes, and health care utilization among women who have bulk symptoms from leiomyoma and who underwent the following procedures: hysterectomy, myomectomy, uterine artery embolization, and magnetic resonance-guided, focused ultrasound surgery.
AHRQ-funded; HS023418.
Citation: Borah BJ, Yao X, Laughlin-Tommaso SK .
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
Obstet Gynecol 2017 Nov;130(5):1047-56. doi: 10.1097/AOG.0000000000002331..
Keywords: Cancer, Comparative Effectiveness, Health Insurance, Outcomes, Patient-Centered Outcomes Research, Surgery, Women
Balentine CJ, Xie R, Kirklin JK
Failure to diagnose hyperparathyroidism in 10,432 patients with hypercalcemia: opportunities for system-level intervention to increase surgical referrals and cure.
Researchers sought to determine whether a significant number of patients with hyperparathyroidism remain undiagnosed and untreated. After reviewing administrative data on 682,704 patients from a tertiary referral center between 2011 and 2015 and identifying hypercalcemia (>10.5 mg/dL) in 10,432 patients, they concluded that a significant proportion of patients with hyperparathyroidism do not undergo appropriate evaluation and surgical referral.
AHRQ-funded; HS023009.
Citation: Balentine CJ, Xie R, Kirklin JK .
Failure to diagnose hyperparathyroidism in 10,432 patients with hypercalcemia: opportunities for system-level intervention to increase surgical referrals and cure.
Ann Surg 2017 Oct;266(4):632-40. doi: 10.1097/sla.0000000000002370.
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Keywords: Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Surgery
Charles EJ, Johnston LE, Herbert MA
Impact of Medicaid expansion on cardiac surgery volume and outcomes.
The objective of this study was to evaluate the effect of Medicaid expansion on cardiac surgery volume and outcomes comparing one state that expanded to one that did not. It concluded that Medicaid expansion was associated with fewer uninsured cardiac surgery patients and improved predicted risk scores and morbidity rates. In addition to improving health care financing, Medicaid expansion may positively affect patient care and outcomes.
AHRQ-funded; HS022535.
Citation: Charles EJ, Johnston LE, Herbert MA .
Impact of Medicaid expansion on cardiac surgery volume and outcomes.
Ann Thorac Surg 2017 Oct;104(4):1251-58. doi: 10.1016/j.athoracsur.2017.03.079.
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Keywords: Patient-Centered Outcomes Research, Medicaid, Surgery, Cardiovascular Conditions, Policy
Pellegrini CA, Song J, Semanik PA
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
The purpose of this study was to examine weight change patterns preoperatively and postoperatively among overweight/obese knee replacement patients. Overweight and obese patients initially lost weight during the interval including knee replacement; however, they were less likely to lose more than 2.5% of their weight in the 1 to 2 years immediately after the surgery.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Song J, Semanik PA .
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
J Clin Rheumatol 2017 Oct;23(7):355-60. doi: 10.1097/rhu.0000000000000579..
Keywords: Obesity: Weight Management, Arthritis, Patient-Centered Outcomes Research, Surgery
Ehlers AP, Khor S, Cizik AM
Use of patient-reported outcomes and satisfaction for quality assessments.
This study investigated the relationship between PROs and satisfaction among spine surgery patients. The authors hypothesized that there would be significant disparities between patient satisfaction and PROs at the 1-year postoperative time point. The study found that overall, patients undergoing elective lumbar spine surgery reported being satisfied with outcomes, but the reported responses in PROs were much more variable.
AHRQ-funded; HS020025.
Citation: Ehlers AP, Khor S, Cizik AM .
Use of patient-reported outcomes and satisfaction for quality assessments.
Am J Manag Care 2017 Oct;23(10):618-22..
Keywords: Patient-Centered Outcomes Research, Patient Experience, Quality of Care, Surgery, Outcomes, Orthopedics
Waljee JF, Dimick JB
Do patient-reported outcomes correlate with clinical outcomes following surgery?
This study examines whether patient-reported outcomes (PROs) correlate with clinical outcomes following surgery. PROs are distinct from clinical outcomes and represent a potential indicator of performance that can be targeted to improve quality of care. Future studies that examine the influence of measurement techniques, case mix, and disease characteristics on PROs will inform efforts to routinely and efficiently integrate these critical outcomes into existing strategies to capture treatment effectiveness and quality of care for surgical conditions.
AHRQ-funded; HS023313.
Citation: Waljee JF, Dimick JB .
Do patient-reported outcomes correlate with clinical outcomes following surgery?
Adv Surg 2017 Sep;51(1):141-50. doi: 10.1016/j.yasu.2017.03.011..
Keywords: Quality of Care, Outcomes, Patient-Centered Outcomes Research, Surgery, Patient Experience, Quality Measures
Sears ED, Momoh AO, Chung KC
A national study of the impact of delayed flap timing for treatment of patients with deep sternal wound infection.
This study aimed to evaluate the impact of delayed flap closure on mortality and resource use for treatment of deep sternal wound infection. The timing of flap closure was delayed more than 7 days after diagnosis in 39 percent of patients. The study concluded that delay in flap closure was associated with greater mortality and resource use.
AHRQ-funded; HS023313.
Citation: Sears ED, Momoh AO, Chung KC .
A national study of the impact of delayed flap timing for treatment of patients with deep sternal wound infection.
Plast Reconstr Surg 2017 Aug;140(2):390-400. doi: 10.1097/prs.0000000000003514.
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Keywords: Injuries and Wounds, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Patient-Centered Outcomes Research
Varghese TK, Jr., Ghaferi AA
Cutting-edge efforts in surgical patient safety.
In October, 2015, the Surgical Outcomes Club convened a patient safety panel in Chicago, Illinois. The goal was to emphasize that patient safety efforts require a uniform, systematic, evidence-based approach. This article incorporates the major themes of the session—developing reliable measures of surgeon performance, real-world methods for continuous improvement and learning, and opportunities for incorporating the principles of implementation science into patient safety efforts.
AHRQ-funded; HS023621; HS024403.
Citation: Varghese TK, Jr., Ghaferi AA .
Cutting-edge efforts in surgical patient safety.
JAMA Surg 2017 Aug;152(8):719-20. doi: 10.1001/jamasurg.2017.0858.
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Keywords: Patient-Centered Outcomes Research, Surgery, Patient Safety, Evidence-Based Practice, Provider: Physician, Provider
Tyson MD, Alvarez J, Koyama T
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
This study tested the hypothesis that treatment-related changes in urinary, bowel, sexual, and hormonal function vary by race/ethnicity. It concluded that the effect of treatment for prostate cancer on patient-reported function did not vary dramatically by race/ethnicity. Compared to white men, African-American men experienced a somewhat more pronounced decline in urinary continence after radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Alvarez J, Koyama T .
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
Eur Urol 2017 Aug;72(2):307-14. doi: 10.1016/j.eururo.2016.10.036.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Racial and Ethnic Minorities, Surgery
Li W, Ayers DC, Lewis CG
Functional gain and pain relief after total joint replacement according to obesity status.
The researchers examined the changes between preoperative and postoperative function and pain in a large representative U.S. cohort to determine if there was a relationship to obesity status. They found that six months after total joint replacement, severely or morbidly obese patients reported excellent pain relief and substantial functional gain that was similar to the findings in other patients.
AHRQ-funded; HS018910.
Citation: Li W, Ayers DC, Lewis CG .
Functional gain and pain relief after total joint replacement according to obesity status.
J Bone Joint Surg Am 2017 Jul 19;99(14):1183-89. doi: 10.2106/jbjs.16.00960.
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Keywords: Obesity, Surgery, Pain, Arthritis, Patient-Centered Outcomes Research
Lou I, Chennell TB, Schaefer SC
Optimizing outpatient pain management after thyroid and parathyroid surgery: a two-institution experience.
This study aimed to describe the outpatient narcotic medication needs for patients undergoing thyroid and parathyroid surgery, and to identify predictors of higher requirement. It concluded that overall, 93 percent of patients undergoing thyroidectomy and parathyroidectomy require 20 or fewer oral morphine equivalents by their postoperative visit.
AHRQ-funded; HS023009.
Citation: Lou I, Chennell TB, Schaefer SC .
Optimizing outpatient pain management after thyroid and parathyroid surgery: a two-institution experience.
Ann Surg Oncol 2017 Jul;24(7):1951-57. doi: 10.1245/s10434-017-5781-y.
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Keywords: Cancer, Medication, Pain, Patient-Centered Outcomes Research, Surgery
Brummett CM, Waljee JF, Goesling J
New persistent opioid use after minor and major surgical procedures in US adults.
The authors sought to determine the incidence of new persistent opioid use after minor and major surgical procedures. They found that risk factors independently associated with new persistent opioid use included preoperative tobacco use, alcohol and substance abuse disorders, mood disorders, anxiety, and preoperative pain disorders. They concluded that new persistent opioid use after surgery is not significantly different between minor and major surgical procedures but rather associated with behavioral and pain disorders.
AHRQ-funded; HS023313.
Citation: Brummett CM, Waljee JF, Goesling J .
New persistent opioid use after minor and major surgical procedures in US adults.
JAMA Surg 2017 Jun 21;152(6):e170504. doi: 10.1001/jamasurg.2017.0504.
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Keywords: Medication, Opioids, Pain, Patient-Centered Outcomes Research, Surgery
Mehta HB, Vargas GM, Adhikari D
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
The objectives were to determine trends in the use of chemotherapy as the initial treatment and to evaluate the comparative effectiveness of initial chemotherapy vs resection of the primary tumor on survival (intention-to-treat analysis) in Stage IV colorectal cancer (CRC). Instrumental variable analysis found that, compared with resection, chemotherapy as the initial treatment offers similar or better 2-year survival in patients with Stage IV CRC.
AHRQ-funded; HS022134.
Citation: Mehta HB, Vargas GM, Adhikari D .
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
Colorectal Dis 2017 Jun;19(6):O210-o18. doi: 10.1111/codi.13659.
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Keywords: Cancer: Colorectal Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery
Gandek B, Ware JE, Jr.
Validity and responsiveness of the knee injury and osteoarthritis outcome score: a comparative study among total knee replacement patients.
The researchers evaluated validity and responsiveness of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in relation to other patient-reported outcome measures before and after total knee replacement (TKR). They concluded that KOOS scales were valid and responsive in a cohort of 1,143 US TKR patients. KOOS QOL performed particularly well in capturing aggregate knee-specific outcomes.
AHRQ-funded; HS018910; HS024632.
Citation: Gandek B, Ware JE, Jr. .
Validity and responsiveness of the knee injury and osteoarthritis outcome score: a comparative study among total knee replacement patients.
Arthritis Care Res 2017 Jun;69(6):817-25. doi: 10.1002/acr.23193.
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Keywords: Arthritis, Surgery, Patient-Centered Outcomes Research, Outcomes, Injuries and Wounds
O'Toole RV, Gary JL, Reider L
A prospective randomized trial to assess fixation strategies for severe open tibia fractures: modern ring external fixators versus internal fixation (FIXIT study).
The FIXIT study is a prospective, multicenter randomized trial comparing 1-year outcomes after treatment of severe open tibial shaft fractures with modern external ring fixation versus internal fixation among men and women of ages 18-64. The primary outcome is rehospitalization for major limb complications. One-year treatment costs and patient satisfaction will be compared between the 2 groups.
AHRQ-funded; HS000029.
Citation: O'Toole RV, Gary JL, Reider L .
A prospective randomized trial to assess fixation strategies for severe open tibia fractures: modern ring external fixators versus internal fixation (FIXIT study).
J Orthop Trauma 2017 Apr;31 Suppl 1:S10-s17. doi: 10.1097/bot.0000000000000804.
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Keywords: Injuries and Wounds, Surgery, Patient-Centered Outcomes Research, Comparative Effectiveness, Outcomes, Evidence-Based Practice
Obremskey WT, Schmidt AH, O'Toole RV
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
The POvIV study is a prospective, multicenter, randomized trial to compare oral (PO) with intravenous (IV) antibiotic therapy in patients with postoperative wound infections after extremity fractures. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.
AHRQ-funded; HS000029.
Citation: Obremskey WT, Schmidt AH, O'Toole RV .
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
J Orthop Trauma 2017 Apr;31 Suppl 1:S32-s38. doi: 10.1097/bot.0000000000000802.
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Keywords: Antibiotics, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Medication, Patient Safety, Adverse Events, Prevention, Patient-Centered Outcomes Research, Outcomes
Dimou FM, Adhikari D, Mehta HB
Outcomes in older patients with grade III cholecystitis and cholecystostomy tube placement: a propensity score analysis.
The Tokyo Guidelines recommend initial cholecystostomy tube drainage, antibiotics, and delayed cholecystectomy in patients with grade III cholecystitis. The researchers compared mortality, readmission, and complication rates with and without cholecystostomy tube placement in a cohort of patients with grade III cholecystitis. Cholecystostomy tube placement was associated with lower rates of definitive treatment with cholecystectomy, higher mortality, and higher readmission rates.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Outcomes in older patients with grade III cholecystitis and cholecystostomy tube placement: a propensity score analysis.
J Am Coll Surg 2017 Apr;224(4):502-11.e1. doi: 10.1016/j.jamcollsurg.2016.12.021.
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Keywords: Elderly, Patient-Centered Outcomes Research, Surgery, Guidelines, Practice Patterns
Chetta MD, Aliu O, Zhong L
Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity.
This study aims to assess the morbidity associated with various breast reconstruction techniques in irradiated patients. It found that overall complication rates were 45.3 percent and 30.8 percent for patients with implant and autologous reconstruction, respectively. Failure of reconstruction occurred in 29.4 percent of patients with implant reconstruction compared with 4.3 percent of patients with autologous reconstruction.
AHRQ-funded; HS023313.
Citation: Chetta MD, Aliu O, Zhong L .
Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity.
Plast Reconstr Surg 2017 Apr;139(4):783-92. doi: 10.1097/prs.0000000000003168.
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Keywords: Cancer, Cancer: Breast Cancer, Surgery, Adverse Events, Patient-Centered Outcomes Research
Chen RC, Basak R, Meyer AM
Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer.
This study compared quality of life after radical prostatectomy, external beam radiotherapy, and brachytherapy vs active surveillance. By 24 months, mean scores between treatment groups vs active surveillance were not significantly different in most domains. However, each treatment strategy was associated with distinct patterns of adverse effects over 2 years.
AHRQ-funded; AHRQ contract (no number given).
Citation: Chen RC, Basak R, Meyer AM .
Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer.
JAMA 2017 Mar 21;317(11):1141-50. doi: 10.1001/jama.2017.1652.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Surgery, Quality of Life
Barocas DA, Alvarez J, Resnick MJ
Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years.
This study compares functional outcomes and adverse effects associated with radical prostatectomy, external beam radiation therapy (EBRT), and active surveillance. It concluded that radical prostatectomy was associated with a greater decrease in sexual function and urinary incontinence than either EBRT or active surveillance after 3 years and was associated with fewer urinary irritative symptoms than active surveillance.
AHRQ-funded; HS019356; HS022640.
Citation: Barocas DA, Alvarez J, Resnick MJ .
Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years.
JAMA 2017 Mar 21;317(11):1126-40. doi: 10.1001/jama.2017.1704.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Adverse Events, Cancer: Prostate Cancer, Surgery
Sathe N, Chinnadurai S, McPheeters M
Comparative effectiveness of partial versus total tonsillectomy in children.
This review assessed the effectiveness of partial versus total tonsillectomy in children. Data did not allow firm conclusions regarding the comparative benefit of partial versus total removal; however, neither surgical technique nor extent of surgery appeared to affect outcomes markedly. Partial tonsillectomy conferred moderate advantages in return to normal diet/activity but was also associated with tonsillar regrowth and symptom recurrence.
AHRQ-funded; 290201500003I.
Citation: Sathe N, Chinnadurai S, McPheeters M .
Comparative effectiveness of partial versus total tonsillectomy in children.
Otolaryngol Head Neck Surg 2017 Mar;156(3):456-63. doi: 10.1177/0194599816683916.
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Keywords: Comparative Effectiveness, Children/Adolescents, Surgery, Patient-Centered Outcomes Research, Children/Adolescents
Francis DO, Fonnesbeck C, Sathe N
Postoperative bleeding and associated utilization following tonsillectomy in children.
This review assessed posttonsillectomy hemorrhage (PTH), associated nonoperative readmissions/revisits, and reoperations in children. It concluded that PTH occurred in roughly 4 percent of tonsillectomies. Although studies typically did not report bleeding severity or amount, relatively few episodes of PTH necessitated reoperation for hemostasis. Frequency of PTH across techniques was similar; thus, it cannot be concluded that a given technique is superior.
AHRQ-funded; 290201500003I.
Citation: Francis DO, Fonnesbeck C, Sathe N .
Postoperative bleeding and associated utilization following tonsillectomy in children.
Otolaryngol Head Neck Surg 2017 Mar;156(3):442-55. doi: 10.1177/0194599816683915.
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Keywords: Children/Adolescents, Surgery, Adverse Events, Hospital Readmissions, Patient-Centered Outcomes Research
Fish DR, Mancuso CA, Garcia-Aguilar JE
Readmission after ileostomy creation: retrospective review of a common and significant event.
This study evaluated the causes and predictors of readmission after new ileostomy creation. It concluded that Readmissions are most commonly caused by dehydration, and are predicted by serious complications, comorbidity burden, loop stoma, shorter length of stay, and age. Readmissions in older patients are easier to predict, representing an important target for improvement.
AHRQ-funded; HS000066.
Citation: Fish DR, Mancuso CA, Garcia-Aguilar JE .
Readmission after ileostomy creation: retrospective review of a common and significant event.
Ann Surg 2017 Feb;265(2):379-87. doi: 10.1097/sla.0000000000001683.
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Keywords: Patient-Centered Outcomes Research, Surgery, Hospital Readmissions, Adverse Events
Franklin PD
Research priorities for optimal use of patient-reported outcomes in quality and outcome improvement for total knee arthroplasty.
This paper uses the traditional quality management's framework of inputs (patients), processes (clinical care), and outcomes to outline priority research questions to learn how clinicians, hospital managers, and patients can interpret patient-reported outcomes to improve total knee arthroplasty care and outcomes. It concludes that research should identify best practices to minimize variation in a patient's health status before surgery.
AHRQ-funded; HS018910.
Citation: Franklin PD .
Research priorities for optimal use of patient-reported outcomes in quality and outcome improvement for total knee arthroplasty.
J Am Acad Orthop Surg 2017 Feb;25 Suppl 1:S51-s54. doi: 10.5435/jaaos-d-16-00632.
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Keywords: Patient-Centered Outcomes Research, Surgery, Quality Improvement, Patient Experience, Evidence-Based Practice