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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Blood Pressure (1)
- Children/Adolescents (3)
- (-) Clinical Decision Support (CDS) (18)
- Communication (1)
- Comparative Effectiveness (1)
- Data (2)
- Elderly (1)
- Electronic Health Records (EHRs) (4)
- Electronic Prescribing (E-Prescribing) (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (3)
- Evidence-Based Practice (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (9)
- Hospitalization (1)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (2)
- Infectious Diseases (1)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Medicaid (1)
- Medication (3)
- Medication: Safety (1)
- Mortality (1)
- Patient Safety (4)
- Provider: Health Personnel (1)
- Public Health (1)
- Quality of Care (2)
- Respiratory Conditions (2)
- Risk (1)
- Sepsis (1)
- Shared Decision Making (5)
- Web-Based (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 18 of 18 Research Studies DisplayedPress A, Khan S, McCullagh L
Avoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates.'
The authors developed a new and innovative usability process named 'sensitivity and specificity trigger analysis' (SSTA) as part of a larger project around a pulmonary embolism decision support tool. They explored a unique methodology, SSTA, used to limit inaccurate triggering of a clinical decision support tool prior to integration into the electronic health record. They concluded that their methodology can be applied to other studies aiming to decrease triggering rates and increase adoption rates of previously validated clinical decision support system tools.
AHRQ-funded; HS022061.
Citation: Press A, Khan S, McCullagh L .
Avoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates.'
Evid Based Med 2016 Dec;21(6):203-07. doi: 10.1136/ebmed-2016-110440.
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Keywords: Clinical Decision Support (CDS), Respiratory Conditions, Electronic Health Records (EHRs), Provider: Health Personnel, Patient Safety
Roosan D, Samore M, Jones M
Big-data based decision-support systems to improve clinicians' cognition.
This study focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. It found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians' cognition to deal with complex problems. These cognitive strategies all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records.
AHRQ-funded; HS023349.
Citation: Roosan D, Samore M, Jones M .
Big-data based decision-support systems to improve clinicians' cognition.
IEEE Int Conf Healthc Inform 2016;2016:285-88. doi: 10.1109/ichi.2016.39.
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Keywords: Clinical Decision Support (CDS), Shared Decision Making, Data, Electronic Health Records (EHRs)
Islam R, Weir C, Del Fiol G
Clinical complexity in medicine: a measurement model of task and patient complexity.
The objective of this paper is to develop an integrated approach to understand and measure clinical complexity by incorporating both task and patient complexity components focusing on the infectious disease domain. The proposed clinical complexity model consists of two separate components:1) a clinical task complexity model with 13 clinical complexity-contributing factors and 7 dimensions and 2) a patient complexity model with 11 complexity-contributing factors and 5 dimensions.
AHRQ-funded; HS023349.
Citation: Islam R, Weir C, Del Fiol G .
Clinical complexity in medicine: a measurement model of task and patient complexity.
Methods Inf Med 2016;55(1):14-22. doi: 10.3414/me15-01-0031.
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Keywords: Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT)
Her QL, Amato MG, Seger DL
The frequency of inappropriate nonformulary medication alert overrides in the inpatient setting.
The purpose of this study was to quantify the frequency of inappropriate nonformulary medication (NFM) alert overrides in the inpatient setting and provide insight on how the design of formulary alerts could be improved. The study found that approximately 1 in 5 NFM alert overrides are overridden inappropriately.
AHRQ-funded; HS021094.
Citation: Her QL, Amato MG, Seger DL .
The frequency of inappropriate nonformulary medication alert overrides in the inpatient setting.
J Am Med Inform Assoc 2016 Sep;23(5):924-33. doi: 10.1093/jamia/ocv181..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Inpatient Care, Medication, Patient Safety
Moore CL, Daniels B, Singh D
Ureteral stones: implementation of a reduced-dose CT protocol in patients in the emergency department with moderate to high likelihood of calculi on the basis of STONE score.
The purpose of this paper was to determine if a reduced-dose computed tomography (CT) protocol could effectively help to identify patients in the emergency department (ED) with moderate to high likelihood of calculi who would require urologic intervention within 90 days. The authors found that a CT protocol with over 85% dose reduction can be used in patients with moderate to high likelihood of ureteral stone to safely and effectively identify patients in the ED who will require urologic intervention.
AHRQ-funded; HS018322.
Citation: Moore CL, Daniels B, Singh D .
Ureteral stones: implementation of a reduced-dose CT protocol in patients in the emergency department with moderate to high likelihood of calculi on the basis of STONE score.
Radiology 2016 Sep;280(3):743-51. doi: 10.1148/radiol.2016151691.
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Keywords: Clinical Decision Support (CDS), Emergency Department, Imaging, Patient Safety
Yin MT, Shiau S, Rimland D
Fracture prediction with modified-FRAX in older HIV-infected and uninfected men.
The authors investigated considering HIV as a cause of secondary osteoporosis when calculating FRAX, a clinical fracture risk calculator, in HIV-infected individuals. They found that modified-FRAX underestimated the fracture rates more in older HIV-infected than in otherwise similar uninfected men. and they recommend further studies to determine how to risk stratify for screening and treatment in older HIV-infected individuals.
AHRQ-funded; HS018372.
Citation: Yin MT, Shiau S, Rimland D .
Fracture prediction with modified-FRAX in older HIV-infected and uninfected men.
J Acquir Immune Defic Syndr 2016 Aug 15;72(5):513-20. doi: 10.1097/qai.0000000000000998.
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Keywords: Clinical Decision Support (CDS), Elderly, Injuries and Wounds, Human Immunodeficiency Virus (HIV), Risk
Bonafide CP, Roland D, Brady PW
Rapid response systems 20 years later: new approaches, old challenges.
In this article, the authors propose a set of recommendations for a research agenda aimed at pursuing the work of optimizing the identification of deteriorating children. They recommend that the second generation of pediatric rapid response systems continue to build on past achievements while further optimizing use of the data, tools, and people available at the bedside to take the next leap forward.
AHRQ-funded; HS023827.
Citation: Bonafide CP, Roland D, Brady PW .
Rapid response systems 20 years later: new approaches, old challenges.
JAMA Pediatr 2016 Aug;170(8):729-30. doi: 10.1001/jamapediatrics.2016.0398.
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Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Emergency Medical Services (EMS), Hospitals
Roosan D, Del Fiol G, Butler J
Feasibility of population health analytics and data visualization for decision support in the infectious diseases domain: a pilot study.
The objectives of this study were: 1) to explore the feasibility of extracting and displaying population-based information from an actual clinical population's database records, 2) to explore specific design features for improving population display, 3) to explore perceptions of population information displays, and 4) to explore the impact of population information display on cognitive outcomes. It concluded that a population database has great potential for reducing complexity and uncertainty in medicine to improve clinical care.
AHRQ-funded; HS023349.
Citation: Roosan D, Del Fiol G, Butler J .
Feasibility of population health analytics and data visualization for decision support in the infectious diseases domain: a pilot study.
Appl Clin Inform 2016 Jun 29;7(2):604-23. doi: 10.4338/aci-2015-12-ra-0182.
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Keywords: Clinical Decision Support (CDS), Data, Shared Decision Making, Infectious Diseases, Public Health
Wang RC, Bent S, Weber E
The impact of clinical decision rules on computed tomography use and yield for pulmonary embolism: a systematic review and meta-analysis.
The researchers performed a systematic review of impact analyses on clinical decision rules for pulmonary embolism. They found that among participants with suspected pulmonary embolism, implementation of the Wells criteria was associated with a modest increase in CT angiography yield. They concluded that there is a lack of cluster-randomized trials to confirm the efficacy of clinical decision rules for the diagnosis of pulmonary embolism.
AHRQ-funded; HS021281.
Citation: Wang RC, Bent S, Weber E .
The impact of clinical decision rules on computed tomography use and yield for pulmonary embolism: a systematic review and meta-analysis.
Ann Emerg Med 2016 Jun;67(6):693-701.e3. doi: 10.1016/j.annemergmed.2015.11.005.
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Keywords: Clinical Decision Support (CDS), Shared Decision Making, Imaging, Respiratory Conditions
Forster CS, Jerardi KE, Herbst L
Right test, wrong patient: biomarkers and value.
A 2-year-old girl with Pierre Robin sequence, a gastric tube, and a tracheostomy and ventilator was admitted to the hospital medicine service. The care delivered to this patient was not unsafe, and she did well. However, the value of care was almost certainly suboptimal. The continued emphasis on a single laboratory value (the procalcitonin test) rather than her clinical picture was the true driver behind the lower value of care delivered to this patient.
AHRQ-funded; HS023827.
Citation: Forster CS, Jerardi KE, Herbst L .
Right test, wrong patient: biomarkers and value.
Hosp Pediatr 2016 May;6(5):315-7. doi: 10.1542/hpeds.2015-0199.
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Keywords: Quality of Care, Children/Adolescents, Hospitalization, Clinical Decision Support (CDS), Healthcare Delivery
Tilson H, Hines LE, McEvoy G
AHRQ Author: Helwig AL
Recommendations for selecting drug-drug interactions for clinical decision support.
A work group consisting of 20 experts in pharmacology, drug information, and clinical decision support (CDS) from academia, government agencies, health information vendors, and healthcare organizations was convened. It recommended a transparent, systematic, and evidence-driven process with graded recommendations by a consensus panel of experts and oversight by a national organization.
AHRQ-authored.
Citation: Tilson H, Hines LE, McEvoy G .
Recommendations for selecting drug-drug interactions for clinical decision support.
Am J Health Syst Pharm 2016 Apr 15;73(8):576-85. doi: 10.2146/ajhp150565.
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Keywords: Clinical Decision Support (CDS), Adverse Drug Events (ADE), Medication: Safety, Medication, Health Information Technology (HIT)
Bauer NS, Carroll AE, Saha C
Experience with decision support system and comfort with topic predict clinicians' responses to alerts and reminders.
The researchers examined factors associated with clinician response to computer decision support system (CDSS) prompts as part of a larger, ongoing quality improvement effort to optimize CDSS use. They found that clinicians were more likely to respond to topics rated as "easy" to discuss. The position of the prompt on the page, clinician gender, and the patient's age, race/ethnicity, and preferred language were also predictive of prompt response rate.
AHRQ-funded; HS017939; HS020640; HS022681.
Citation: Bauer NS, Carroll AE, Saha C .
Experience with decision support system and comfort with topic predict clinicians' responses to alerts and reminders.
J Am Med Inform Assoc 2016 Apr;23(e1):e125-30. doi: 10.1093/jamia/ocv148.
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Keywords: Clinical Decision Support (CDS), Patient Safety, Children/Adolescents, Health Information Technology (HIT), Children/Adolescents
Taylor RA, Pare JR, Venkatesh AK
Prediction of in-hospital mortality in emergency department patients with sepsis: A local big data-driven, machine learning approach.
In this proof-of-concept study, a local, big data-driven, machine learning approach is compared to existing clinical decision rules (CDRs) and traditional analytic methods using the prediction of sepsis in-hospital mortality as the use case. It concluded that this approach outperformed existing CDRs as well as traditional analytic techniques for predicting in-hospital mortality of ED patients with sepsis.
AHRQ-funded; HS021271.
Citation: Taylor RA, Pare JR, Venkatesh AK .
Prediction of in-hospital mortality in emergency department patients with sepsis: A local big data-driven, machine learning approach.
Acad Emerg Med 2016 Mar;23(3):269-78. doi: 10.1111/acem.12876.
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Keywords: Emergency Medical Services (EMS), Mortality, Clinical Decision Support (CDS), Sepsis, Health Information Technology (HIT)
Khan S, McCullagh L, Press A
Formative assessment and design of a complex clinical decision support tool for pulmonary embolism.
This study sought to determine the general attitude towards clinical decision support (CDS) tool integration and the ideal integration point into the clinical workflow. It highlighted: (1) formative assessment of EHR functionality and clinical environment workflow, (2) focus groups and key informative interviews to incorporate providers' perceptions of CDS and workflow integration and/or (3) the demonstration of proposed workflows through wireframes to help providers visualise design concepts.
AHRQ-funded; HS022061.
Citation: Khan S, McCullagh L, Press A .
Formative assessment and design of a complex clinical decision support tool for pulmonary embolism.
Evid Based Med 2016 Feb;21(1):7-13. doi: 10.1136/ebmed-2015-110214.
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Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT)
Falck S, Adimadhyam S, Meltzer DO
A trial of indication based prescribing of antihypertensive medications during computerized order entry to improve problem list documentation.
The authors measured the accuracy and completeness of electronic problem list additions using indication-based prescribing of antihypertensives. They found that clinical decision support using indication-based prescribing of antihypertensives produced accurate problem placement roughly two-thirds of the time with fewer than 5% inaccurate problems placed; performance of alerts was sensitive to the number of potential indications of the medication and attendings vs. other clinicians prescribing.
AHRQ-funded; HS016967.
Citation: Falck S, Adimadhyam S, Meltzer DO .
A trial of indication based prescribing of antihypertensive medications during computerized order entry to improve problem list documentation.
Int J Med Inform 2013 Oct;82(10):996-1003. doi: 10.1016/j.ijmedinf.2013.07.003.
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Keywords: Blood Pressure, Medication, Clinical Decision Support (CDS), Electronic Prescribing (E-Prescribing), Health Information Technology (HIT)
Del Fiol G, Curtis C, Cimino JJ
Disseminating context-specific access to online knowledge resources within electronic health record systems.
This paper describes OpenInfobutton (www.openinfobutton.org): a standards-based, open source Web service that was designed to disseminate infobutton capabilities in multiple electronic health record systems and healthcare organizations. Included in this overview are the OpenInfobutton architecture, knowledge resource integration, and experiences at five large healthcare organizations.
AHRQ-funded; HS018352.
Citation: Del Fiol G, Curtis C, Cimino JJ .
Disseminating context-specific access to online knowledge resources within electronic health record systems.
Stud Health Technol Inform 2013;192:672-6..
Keywords: Clinical Decision Support (CDS), Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Web-Based
Lobach DF, Kawamoto K, Anstrom KJ
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
This study tested the impact of 3 clinical decision support modalities (emails to care managers, printed reports to clinic administrators, and letters to patients) on the use and cost of medical services for Medicaid patients. It found that some modalities can significantly reduce emergency department use and medical costs, while other interventions may have had detrimental consequences.
AHRQ-funded; HS015057
Citation: Lobach DF, Kawamoto K, Anstrom KJ .
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
J Med Syst. 2013 Feb;37(1):9922. doi: 10.1007/s10916-012-9922-3..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Medicaid, Emergency Medical Services (EMS), Quality of Care
Zhang M, Del Fiol G, Grout RW
Automatic identification of comparative effectiveness research from Medline citations to support clinicians' treatment information needs.
The goal of this study was to design and assess an algorithm for automatically identifying comparative effectiveness studies on the treatment of a given condition and extracting the interventions investigated in these studies. A total of 86% of the interventions extracted perfectly or partially matched the gold standard. The researchers concluded that, overall, the algorithm achieved reasonable performance.
AHRQ-funded; HS018352.
Citation: Zhang M, Del Fiol G, Grout RW .
Automatic identification of comparative effectiveness research from Medline citations to support clinicians' treatment information needs.
Stud Health Technol Inform 2013;192:846-50..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Clinical Decision Support (CDS)