National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Arthritis (1)
- Back Health and Pain (1)
- Blood Thinners (1)
- Cancer (6)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (2)
- Care Management (1)
- Children/Adolescents (1)
- Comparative Effectiveness (2)
- Complementary and Alternative Medicine (1)
- Critical Care (1)
- Disparities (2)
- Elderly (4)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (4)
- Guidelines (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Healthcare Utilization (1)
- Heart Disease and Health (3)
- Hospitals (1)
- Intensive Care Unit (ICU) (1)
- Labor and Delivery (1)
- Medicare (1)
- Medication (6)
- Mortality (1)
- Opioids (1)
- Outcomes (4)
- Pain (1)
- Palliative Care (2)
- (-) Patient-Centered Outcomes Research (17)
- Patient Safety (2)
- (-) Practice Patterns (17)
- Quality Improvement (1)
- Quality Measures (1)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Risk (1)
- Surgery (2)
- Training (1)
- 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 17 of 17 Research Studies DisplayedKim HS, Kaplan SH, McCarthy DM
A comparison of analgesic prescribing among ED back and neck pain visits receiving physical therapy versus usual care.
Researchers used a retrospective cohort study to examine whether physical therapy (PT) is associated with lower analgesic prescribing in the emergency department (ED) setting. They found that, in this single center study, ED back and neck pain visits receiving PT were no less likely to receive an opioid prescription and were more likely to receive a benzodiazepine than visits receiving usual care. They conclude that, although prior studies demonstrated that PT may reduce opioid utilization in the subsequent year, these results indicated that analgesic prescribing is not reduced at the initial ED encounter.
AHRQ-funded; HS023011.
Citation: Kim HS, Kaplan SH, McCarthy DM .
A comparison of analgesic prescribing among ED back and neck pain visits receiving physical therapy versus usual care.
Am J Emerg Med 2019 Jul;37(7):1322-26. doi: 10.1016/j.ajem.2018.10.009..
Keywords: Opioids, Medication, Practice Patterns, Emergency Department, Patient-Centered Outcomes Research, Pain, Back Health and Pain, Outcomes, Evidence-Based Practice
Schmidt B, Eapen RS, Cowan JE
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
This study investigated usage of external-beam radiation therapy (EBRT), with or without neoadjuvant androgen deprivation therapy (ADT), using data from a community-based prospective disease registry (CaPSURE). Data on 1337 men diagnosed between 1990 and 2014 with localized disease who received EBRT as primary treatment was compared. The authors conclude that use of ADT in conjunction with primary EBRT has increased in frequency and duration since 1990, and that men who received ADT have higher risk characteristics than those who receive EBRT alone.
AHRQ-funded; HS019356.
Citation: Schmidt B, Eapen RS, Cowan JE .
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
Prostate Cancer Prostatic Dis 2019 Mar;22(1):117-24. doi: 10.1038/s41391-018-0084-3..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Practice Patterns, Evidence-Based Practice, Comparative Effectiveness, Outcomes, Treatments
Lee DJ, Barocas DA, Zhao Z
Contemporary prostate cancer radiation therapy in the United States: patterns of care and compliance with quality measures.
This study measured compliance with quality measures for radiation therapy treatment of prostate cancer. The Comparative Effectiveness Analysis of Surgery and Radiation Study enrolled men who were treated for localized prostate cancer from 2011 and 2012. Medical records were reviewed, and patients completed surveys. Researchers concluded that men who received external beam radiation therapy (EBRT) were treated more appropriately than those treated with brachytherapy (BT). White men were also more likely to receive appropriate treatment than African-American and other minorities.
AHRQ-funded; HS019356; HS022640.
Citation: Lee DJ, Barocas DA, Zhao Z .
Contemporary prostate cancer radiation therapy in the United States: patterns of care and compliance with quality measures.
Pract Radiat Oncol 2018 Sep-Oct;8(5):307-16. doi: 10.1016/j.prro.2018.04.009..
Keywords: Cancer, Cancer: Prostate Cancer, Comparative Effectiveness, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Practice Patterns, Quality Measures
Spatz ES, Wang Y, Beckman AL
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
This study examined the use of traditional Chinese medicine (TCM) in patients admitted for acute myocardial infarction (AMI) in China during the first 24 hours of hospitalization. The data came from the China Patient-centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction. A chart review was done of randomly sampled patients in 2001, 2006 and 2011 in 162 Western medicine hospitals across China. Nearly all (99%) hospitals used some form of TCM, with Salvia miltiorrhiza being the most commonly prescribed. This TCM treatment (and others) was used intravenously and use has increased over the span of the study, despite lack of evidence of benefit or harm.
AHRQ-funded; HS023000.
Citation: Spatz ES, Wang Y, Beckman AL .
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
Circ Cardiovasc Qual Outcomes 2018 Mar;11(3):e004190. doi: 10.1161/circoutcomes.117.004190..
Keywords: Adverse Events, Cardiovascular Conditions, Complementary and Alternative Medicine, Heart Disease and Health, Hospitals, Mortality, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Practice Patterns, Risk
Singal AG, Tiro J, Li X
Hepatocellular carcinoma surveillance among patients with cirrhosis in a population-based integrated health care delivery system.
This study characterized guideline-concordant hepatocellular carcinoma (HCC) surveillance rates and patient-level factors associated with surveillance among a population-based cohort of patients with cirrhosis. It concluded that, although one third of patients undergo inconsistent HCC surveillance, less than 2 percent of patients receive guideline-concordant biannual HCC surveillance.
AHRQ-funded; HS022418.
Citation: Singal AG, Tiro J, Li X .
Hepatocellular carcinoma surveillance among patients with cirrhosis in a population-based integrated health care delivery system.
J Clin Gastroenterol 2017 Aug;51(7):650-55. doi: 10.1097/mcg.0000000000000708.
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Keywords: Cancer, Guidelines, Healthcare Delivery, Patient-Centered Outcomes Research, Practice Patterns
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
Lyu PF, Hockenberry JM, Gaydos LM
Impact of a sequential intervention on albumin utilization in critical care.
The authors evaluated the effect of a sequential multifaceted intervention on decreasing albumin use in the intensive care unit. They found that a sequential intervention achieved significant reductions in albumin use and cost savings without changes in patient outcomes, supporting the combination of financial and nonfinancial strategies to align providers with evidence-based practices.
AHRQ-funded; HS000055.
Citation: Lyu PF, Hockenberry JM, Gaydos LM .
Impact of a sequential intervention on albumin utilization in critical care.
Crit Care Med 2016 Jul;44(7):1307-13. doi: 10.1097/ccm.0000000000001638.
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Keywords: Critical Care, Healthcare Utilization, Intensive Care Unit (ICU), Patient-Centered Outcomes Research, Practice Patterns
Dimou FM, Adhikari D, Mehta HB
Trends in follow-up of patients presenting to the emergency department with symptomatic cholelithiasis.
To better understand underuse of cholecystectomy, the researchers examined physician follow-up patterns after emergency department (ED) visits for symptomatic gallstones. They found that fewer than half of patients were evaluated by a surgeon after an initial ED visit for symptomatic gallstones. Patients who did not have physician follow-up were most likely to require emergent cholecystectomy, suggesting inappropriate ED discharge and highlighting the need for timely follow-up.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Trends in follow-up of patients presenting to the emergency department with symptomatic cholelithiasis.
J Am Coll Surg 2016 Apr;222(4):377-84. doi: 10.1016/j.jamcollsurg.2015.12.011.
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Keywords: Elderly, Emergency Medical Services (EMS), Patient-Centered Outcomes Research, Practice Patterns
Dev S, Hoffman TK, Kavalieratos D
Barriers to adoption of mineralocorticoid receptor antagonists in patients with heart failure: A mixed-methods study.
Mineralocorticoid receptor antagonists (MRAs) are the most underutilized pharmacotherapy for heart failure. This study sought to ascertain barriers to optimal use of MRAs. It identified eight primary barriers to MRA adoption at the provider, patient, and health system levels from the prescriber perspective. These barriers can inform the creation of multilevel interventions that will be required to close the gap in MRA adoption.
AHRQ-funded; HS022989.
Citation: Dev S, Hoffman TK, Kavalieratos D .
Barriers to adoption of mineralocorticoid receptor antagonists in patients with heart failure: A mixed-methods study.
J Am Heart Assoc 2016 Mar 31;5(3). doi: 10.1161/jaha.115.002493.
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Keywords: Heart Disease and Health, Medication, Patient-Centered Outcomes Research, Practice Patterns
Wang SY, Hall J, Pollack CE
Trends in end-of-life cancer care in the Medicare program.
The researchers sought to examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. They found that the proportion of beneficiaries receiving at least one potentially aggressive end-of-life intervention increased in repeated hospitalization, repeated ED visits, ICU admissions, and late hospice enrollment but declined in in-hospital death. End-of-life chemotherapy use did not change significantly over time. They concluded that despite growing focus on providing appropriate end-of-life care, there has not been an improvement in aggressive end-of-life cancer care in the Medicare program.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Trends in end-of-life cancer care in the Medicare program.
J Geriatr Oncol 2016 Mar;7(2):116-25. doi: 10.1016/j.jgo.2015.11.007.
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Keywords: Cancer, Care Management, Elderly, Medicare, Palliative Care, Outcomes, Patient-Centered Outcomes Research, Practice Patterns
Dimou F, Sineshaw H, Parmar AD
Trends in receipt and timing of multimodality therapy in early-stage pancreatic cancer.
The researchers described treatment patterns and time trends with regard to age and treatment center in the receipt of multimodality therapy for early-stage pancreatic cancer. They concluded that despite increased use of multimodality therapy, it remains underutilized in all patients and especially in older patients. Receipt of multimodality therapy and neoadjuvant therapy is highly dependent on treatment at NCI-designated cancer centers.
AHRQ-funded; HS022134.
Citation: Dimou F, Sineshaw H, Parmar AD .
Trends in receipt and timing of multimodality therapy in early-stage pancreatic cancer.
J Gastrointest Surg 2016 Jan;20(1):93-103; discussion 03. doi: 10.1007/s11605-015-2952-7.
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Keywords: Cancer, Disparities, Practice Patterns, Elderly, Patient-Centered Outcomes Research
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
Andrews SE, Alston MJ, Allshouse AA
Does the number of forceps deliveries performed in residency predict use in practice?
The researchers aimed to determine whether a threshold number of forceps deliveries in residency predicts use of forceps in independent practice. They concluded that, although exceeding 13 forceps deliveries made it highly likely that obstetricians would use them in practice, further study is necessary to set goals for a number of resident forceps deliveries that translate into use in practice.
AHRQ-funded; HS022143.
Citation: Andrews SE, Alston MJ, Allshouse AA .
Does the number of forceps deliveries performed in residency predict use in practice?
Am J Obstet Gynecol 2015 Jul;213(1):93.e1-4. doi: 10.1016/j.ajog.2015.03.025..
Keywords: Labor and Delivery, Patient-Centered Outcomes Research, Practice Patterns, Training, Women
De Martino RR, Hoel AW, Beck AW
Participation in the Vascular Quality Initiative is associated with improved perioperative medication use, which is associated with longer patient survival.
The researchers analyzed the effect of Vascular Quality Initiative (VQI) participation on perioperative (preoperative and postoperative) medical management (MM) use over time and the effect of discharge MM on patient survival. They demonstrated that MM is associated with improved survival after a number of vascular procedures, and that VQI participation improves the use of MM, demonstrating that involvement in an organized quality effort can affect patient outcomes.
AHRQ-funded; HS021581.
Citation: De Martino RR, Hoel AW, Beck AW .
Participation in the Vascular Quality Initiative is associated with improved perioperative medication use, which is associated with longer patient survival.
J Vasc Surg 2015 Apr;61(4):1010-9. doi: 10.1016/j.jvs.2014.11.073.
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Keywords: Medication, Quality Improvement, Patient-Centered Outcomes Research, Practice Patterns
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
Mannion ML, Xie F, Curtis JR
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
The researchers investigated temporal trends in medication use among children diagnosed with juvenile idiopathic arthritis (JIA). They found that the use of tumor necrosis factor inhibitors (TNFi) in the treatment of JIA increased 2- to 3-fold from 2005 to 2012. New TNFi use was associated with decreased NSAID and oral glucocorticoids use. TNFi may be replacing, rather than complementing, methotrexate in the treatment of many patients.
AHRQ-funded; HS018517.
Citation: Mannion ML, Xie F, Curtis JR .
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
J Rheumatol 2014 Oct;41(10):2078-84. doi: 10.3899/jrheum.140012.
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Keywords: Children/Adolescents, Medication, Patient-Centered Outcomes Research, Practice Patterns, Arthritis
O'Brien EC, Holmes DN, Ansell JE
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
This study describes the frequencies of and factors associated with oral anticoagulation (OAC) contraindications in clinical practice for patients with atrial fibrillation (AF). Contraindications to OAC therapy among patients with AF are common but subjective. Many patients with reported contraindications were receiving OAC, suggesting that the perceived benefits outweighed the potential harm posed by the relative contraindication.
AHRQ-funded; HS021092
Citation: O'Brien EC, Holmes DN, Ansell JE .
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
Am Heart J. 2014 Apr;167(4):601-609.e1. doi: 10.1016/j.ahj.2013.12.014..
Keywords: Heart Disease and Health, Blood Thinners, Medication, Registries, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Practice Patterns