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
151 to 171 of 171 Research Studies DisplayedHuo J, Du XL, Lairson DR
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
The authors examined the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end-of-life care for patients diagnosed with metastatic melanoma. They found that surgery and hospice care use increased over the 8 years of this study, whereas the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.
AHRQ-funded; HS018956.
Citation: Huo J, Du XL, Lairson DR .
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
Am J Clin Oncol 2015 Jun;38(3):235-41. doi: 10.1097/COC.0b013e31829378f9.
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Keywords: Cancer, Cancer: Skin Cancer, Treatments, Elderly, Healthcare Utilization, Palliative Care, Patient-Centered Outcomes Research, Surgery
Kumamaru H, Jalbert JJ, Nguyen LL
Surgeon case volume and 30-day mortality after carotid endarterectomy among contemporary medicare beneficiaries: before and after national coverage determination for carotid artery stenting.
The objective of this study is to examine the decline in past-year case-volumes of surgeons performing carotid endarterectomy (CEA) before and after the National Coverage Determination (NCD) for carotid artery stenting (CAS) and to assess its effect on 30-day post-CEA mortality. It found that the rate of CEA procedures decreased substantially during 2001 to 2008. The postprocedural mortality in Medicare beneficiaries was high compared with trial patients.
AHRQ-funded; 29020050016I.
Citation: Kumamaru H, Jalbert JJ, Nguyen LL .
Surgeon case volume and 30-day mortality after carotid endarterectomy among contemporary medicare beneficiaries: before and after national coverage determination for carotid artery stenting.
Stroke 2015 May;46(5):1288-94. doi: 10.1161/strokeaha.114.006276..
Keywords: Surgery, Mortality, Patient-Centered Outcomes Research, Outcomes, Elderly
Martin BI, Lurie JD, Tosteson AN
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
The authors examined whether published concerns about the safety of bone morphogenetic protein (BMP) altered clinical practice. They found that use of BMP in spinal fusion surgery declined subsequent to published safety concerns and revelations of financial conflicts of interest for investigators involved in the pivotal clinical trials.
AHRQ-funded; HS021695.
Citation: Martin BI, Lurie JD, Tosteson AN .
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
Spine J 2015 Apr;15(4):692-9. doi: 10.1016/j.spinee.2014.12.010.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Patient-Centered Outcomes Research, Practice Patterns, Surgery
Hartzler AL, Chaudhuri S
Integrating patient-reported outcomes into spine surgical care through visual dashboards: lessons learned from human-centered design.
The researchers share lessons learned from engaging health care professionals to inform design of visual dashboards, an emerging type of health information technology (HIT). Their work illustrates a range of engagement methods guided by human-centered principles and design recommendations for optimizing PRO Dashboards for patient care and quality improvement.
AHRQ-funded; HS020025.
Citation: Hartzler AL, Chaudhuri S .
Integrating patient-reported outcomes into spine surgical care through visual dashboards: lessons learned from human-centered design.
eGEMS 2015 Mar 13;3(2):1133. doi: 10.13063/2327-9214.1133..
Keywords: Comparative Effectiveness, Health Information Technology (HIT), Surgery, Patient-Centered Outcomes Research
Gidengil CA, Predmore Z, Mattke S
Breast implant-associated anaplastic large cell lymphoma: a systematic review.
The purpose of this study was to identify and analyze recently published cases of breast implant-associated anaplastic large cell lymphoma (ALCL), with an emphasis on diagnosis, staging, treatment, and outcomes. The researchers found that, of 54 cases, most patients presented with a seroma, approximately half were associated with the capsule, most presented as stage IE, and all but one case were ALK-negative. Most patients received chemotherapy and radiation therapy, and 11 percent received stem cell transplants. Approximately one-quarter recurred, and 9 percent died.
AHRQ-funded; HS000029.
Citation: Gidengil CA, Predmore Z, Mattke S .
Breast implant-associated anaplastic large cell lymphoma: a systematic review.
Plast Reconstr Surg 2015 Mar;135(3):713-20. doi: 10.1097/prs.0000000000001037.
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Keywords: Adverse Events, Cancer: Breast Cancer, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Surgery
Lynch TS, Parker RD, Patel RM
The Impact of the Multicenter Orthopaedic Outcomes Network (MOON) research on anterior cruciate ligament reconstruction and orthopaedic practice.
The Multicenter Orthopaedic Outcomes Network consortium was created in 2002 to enroll and longitudinally follow a large population cohort of anterior cruciate ligament reconstructions. The group has helped to establish a new benchmark for conducting multicenter, multisurgeon orthopaedic research. The changes in anterior cruciate ligament reconstruction practice resulting from the group include the use of autograft for high school, college, and competitive athletes.
AHRQ-funded; HS016075.
Citation: Lynch TS, Parker RD, Patel RM .
The Impact of the Multicenter Orthopaedic Outcomes Network (MOON) research on anterior cruciate ligament reconstruction and orthopaedic practice.
J Am Acad Orthop Surg 2015 Mar;23(3):154-63. doi: 10.5435/jaaos-d-14-00005..
Keywords: Surgery, Comparative Effectiveness, Patient-Centered Outcomes Research
Kaplan RM, Sun Q, Ries AL
AHRQ Author: Kaplan RM
Quality of well-being outcomes in the National Emphysema Treatment Trial.
The purpose of this article is to report outcomes from the National Emphysema Treatment Trial (NETT) using an index that combines quality and quantity of life. Results showed that, compared with maximal medical therapy alone, patients undergoing maximal medical therapy plus lung volume reduction surgery experienced improved health-related quality of life and gained more quality-adjusted life years.
AHRQ-authored.
Citation: Kaplan RM, Sun Q, Ries AL .
Quality of well-being outcomes in the National Emphysema Treatment Trial.
Chest 2015 Feb;147(2):377-87. doi: 10.1378/chest.14-0528.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Quality of Life, Respiratory Conditions, Surgery
Cooper AB, Parmar AD, Riall TS
Does the use of neoadjuvant therapy for pancreatic adenocarcinoma increase postoperative morbidity and mortality rates?
The researchers used data from the NSQIP Pancreatectomy Demonstration Project (11/2011 to 12/2012) to identify patients with pancreatic adenocarcinoma who did and did not receive neoadjuvant therapy. They found that despite evidence for more extensive disease, patients receiving neoadjuvant therapy did not experience more complications. Neoadjuvant radiation was associated with lower pancreatic fistula rates.
AHRQ-funded; HS022134.
Citation: Cooper AB, Parmar AD, Riall TS .
Does the use of neoadjuvant therapy for pancreatic adenocarcinoma increase postoperative morbidity and mortality rates?
J Gastrointest Surg 2015 Jan;19(1):80-6; discussion 86-7. doi: 10.1007/s11605-014-2620-3..
Keywords: Cancer, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery, Mortality
Singh JA, Lewallen DG
Are outcomes after total knee arthroplasty worsening over time? A time-trends study of activity limitation and pain outcomes.
The authors examined whether function and pain outcomes of patients undergoing primary total knee arthroplasty (TKA) are changing over time. Using Mayo Clinic Total Joint Registry data, they found that patient-reported function and pain outcomes after primary TKA have worsened over the study period 1993-95 to 2002-05; this time-trend is independent of changes in preoperative pain/limitation and certain patient characteristics.
AHRQ-funded; HS021110.
Citation: Singh JA, Lewallen DG .
Are outcomes after total knee arthroplasty worsening over time? A time-trends study of activity limitation and pain outcomes.
BMC Musculoskelet Disord 2014 Dec 17;15:440. doi: 10.1186/1471-2474-15-440.
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Keywords: Centers for Education and Research on Therapeutics (CERTs), Orthopedics, Pain, Patient-Centered Outcomes Research, Surgery
Franklin PD, Lewallen D, Bozic K
Implementation of patient-reported outcome measures in U.S. total joint replacement registries: rationale, status, and plans.
The authors report on the status of patient-reported outcomes (PRO) implementation as well as perceived barriers and facilitators of PRO use among five U.S. total joint replacement registries. They find that the current stage of implementation of patient-reported outcomes measures varies widely among U.S. registries.
AHRQ-funded; HS018910.
Citation: Franklin PD, Lewallen D, Bozic K .
Implementation of patient-reported outcome measures in U.S. total joint replacement registries: rationale, status, and plans.
J Bone Joint Surg Am 2014 Dec 17;96 Suppl 1:104-9. doi: 10.2106/jbjs.n.00328..
Keywords: Registries, Surgery, Comparative Effectiveness, Patient-Centered Outcomes Research
Sanger P, Hartzler A, Lober WB
Design considerations for post-acute care mHealth: patient perspectives.
The authors are developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Their key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. In this article, they illustrated their application of these guiding design considerations and proposed a new framework for mHealth design based on illness duration and intensity.
AHRQ-funded; HS019482.
Citation: Sanger P, Hartzler A, Lober WB .
Design considerations for post-acute care mHealth: patient perspectives.
AMIA Annu Symp Proc 2014 Nov 14;2014:1920-9.
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Keywords: Telehealth, Patient Self-Management, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Adverse Events
Du DT, McKean SJ, Kelman JA, et al.
AHRQ Author: Encinosa W
Early mortality after aortic valve replacement with mechanical prosthetic vs bioprosthetic valves among Medicare beneficiaries: a population-based cohort study.
The researchers compared early mortality after aortic valve replacement (AVR) between the recipients of mechanical and bioprosthetic aortic valves. Among 66,453 Medicare beneficiaries who received AVRs, use of mechanical valves was associated with a higher risk for death on the date of surgery and within 30 days compared with the bioprosthetic aortic valves. However, this applied only to those who underwent concurrent AVR and coronary artery bypass graft but not isolated AVR.
AHRQ-authored
Citation: Du DT, McKean SJ, Kelman JA, et al..
Early mortality after aortic valve replacement with mechanical prosthetic vs bioprosthetic valves among Medicare beneficiaries: a population-based cohort study.
JAMA Intern Med. 2014 Nov;174(11):1788-95. doi: 10.1001/jamainternmed.2014.4300..
Keywords: Cardiovascular Conditions, Medicare, Mortality, Patient-Centered Outcomes Research, Surgery
Shah RK, Stey AM, Jantana KR
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
This study evaluated perioperative outcomes in pediatric otolaryngology through analysis of records residing in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS-NSQIP) database. It found that although the overall rate of major postoperative morbidity in pediatric otolaryngology is low, the following areas may be targeted for targeted quality-improvement interventions: tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage.
AHRQ-funded; HS022932
Citation: Shah RK, Stey AM, Jantana KR .
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
JAMA Otolaryngol Head Neck Surg. 2014 Nov;140(11):1019-26. doi: 10.1001/jamaoto.2014.2067..
Keywords: Surgery, Children/Adolescents, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Ayers DC, Franklin PD
Joint replacement registries in the United States: a new paradigm.
This commentary serves as an introduction to an upcoming series of articles about orthopaedic registries, in general, with an emphasis on lessons learned from the evolving U.S. and international total joint replacement registries. Specifically, this paper provides an overview of total joint replacement registries and the current expansion of data collection beyond implant attributes and survival to include postoperative complications and patient-reported outcomes.
AHRQ-funded; HS018910.
Citation: Ayers DC, Franklin PD .
Joint replacement registries in the United States: a new paradigm.
J Bone Joint Surg Am 2014 Sep 17;96(18):1567-9. doi: 10.2106/jbjs.n.00641..
Keywords: Arthritis, Chronic Conditions, Patient-Centered Outcomes Research, Registries, Surgery
Ayers DC, Franklin PD
Joint replacement registries in the United States: a new paradigm.
This commentary serves as an introduction to an upcoming series of articles about orthopaedic registries, in general, with an emphasis on lessons learned from the evolving U.S. and international total joint replacement registries. Specifically, this paper provides an overview of total joint replacement registries and the current expansion of data collection beyond implant attributes and survival to include postoperative complications and patient-reported outcomes.
AHRQ-funded; HS018910.
Citation: Ayers DC, Franklin PD .
Joint replacement registries in the United States: a new paradigm.
J Bone Joint Surg Am 2014 Sep 17;96(18):1567-9. doi: 10.2106/jbjs.n.00641.
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Keywords: Arthritis, Chronic Conditions, Patient-Centered Outcomes Research, Registries, Surgery
Goode AP, Richardson WJ, Schectman RM
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
The authors sought to determine the 1-year risk of complications, cervical revision fusions, hospital readmissions, and health care services utilization after bone morphogenetic protein (BMP) use with cervical spine fusions. They found that patients receiving BMP were 29% more likely to have a complication and a nervous system complication; cervical revision fusions were more likely among patients receiving BMP; the risk of 30-day readmission was greater with BMP use; and readmission occurred 27.4% sooner on an average. Additionally, patients receiving BMP were more likely to receive computed tomography scans and epidurals with anterior surgical approaches.
AHRQ-funded; HS019479.
Citation: Goode AP, Richardson WJ, Schectman RM .
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
Spine J 2014 Sep;14(9):2051-9. doi: 10.1016/j.spinee.2013.11.042.
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Keywords: Adverse Events, Hospital Readmissions, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Surgery, Treatments
Vargas GM, Parmar AD, Sheffield KM
Impact of liver-directed therapy in colorectal cancer liver metastases.
This study evaluated the use of liver resection, ablation, and chemoembolization (LDT) in older patients presenting with metastatic colorectal cancer in the setting of improved chemotherapy. It found that many older patients deemed to be appropriate candidates for resection of the primary tumor and receipt of systemic chemotherapy did not receive LDT.
AHRQ-funded; HS022134
Citation: Vargas GM, Parmar AD, Sheffield KM .
Impact of liver-directed therapy in colorectal cancer liver metastases.
J Surg Res. 2014 Sep;191(1):42-50. doi: 10.1016/j.jss.2014.05.070..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Elderly, Surgery
Maggard-Gibbons M
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
This review summarized the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and described the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety.
AHRQ-funded; 2902007100621.
Citation: Maggard-Gibbons M .
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
BMJ Qual Saf 2014 Jul;23(7):589-99. doi: 10.1136/bmjqs-2013-002223..
Keywords: Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Surgery, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Bilimoria KY, Cella D, Butt Z
Current challenges in using patient-reported outcomes for surgical care and performance measurement: everybody wants to hear from the patient, but are we ready to listen?
This viewpoint article discussed patient-reported outcomes (PROs). It concludes that PROs undoubtedly capture some of the most important aspects of how successful an operation is, and PRO scores may be the best measure of patient-centered care, but considerable logistical and methodological issues must be addressed before PROs are ready for widespread national implementation.
AHRQ-funded; HS021857.
Citation: Bilimoria KY, Cella D, Butt Z .
Current challenges in using patient-reported outcomes for surgical care and performance measurement: everybody wants to hear from the patient, but are we ready to listen?
JAMA Surg 2014 Jun;149(6):505-6. doi: 10.1001/jamasurg.2013.5285.
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Keywords: Patient-Centered Outcomes Research, Quality Measures, Surgery
Mariscalco MW, Flanigan DC, Mitchell J
The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study.
The purpose of this study was to evaluate the effect of graft size on patient-reported outcomes and revision risk after anterior cruciate ligament (ACL) reconstruction. It found that smaller hamstring autograft size is a predictor of poorer Knee Injury and Osteoarthritis Outcome Score (sport/recreation subscale function) 2 years after primary ACL reconstruction.
AHRQ-funded; HS016075.
Citation: Mariscalco MW, Flanigan DC, Mitchell J .
The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study.
Arthroscopy 2013 Dec;29(12):1948-53. doi: 10.1016/j.arthro.2013.08.025.
Keywords: Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Surgery
Suskind AM, Clemens JQ, Dunn RL
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
This study assessed the effectiveness of mesh compared to nonmesh slings in the surgical treatment of female incontinence. It found that overall rates of complications were similar for patients undergoing either mesh or nonmesh sling procedures. However, patients undergoing the nonmesh procedure were more likely to require a subsequent intervention for bladder outlet obstruction.
AHRQ-funded; HS018726.
Citation: Suskind AM, Clemens JQ, Dunn RL .
Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.
Obstet Gynecol. 2013 Sep;122(3):546-52. doi: 10.1097/AOG.0b013e31829e8543..
Keywords: Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research, Surgery, Women, Outcomes, Medicare, Evidence-Based Practice