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
76 to 100 of 857 Research Studies DisplayedSanger 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
Kendall L, Eschler J, Lozano P
Engineering for reliability in at-home chronic disease management.
The researchers examined how individuals responsible for managing their own or others’ chronic conditions integrate reminders and notification systems into their daily routines. Based on the participants’ experiences, they contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance.
AHRQ-funded; HS021590.
Citation: Kendall L, Eschler J, Lozano P .
Engineering for reliability in at-home chronic disease management.
AMIA Annu Symp Proc 2014 Nov 14;2014:777-86..
Keywords: Chronic Conditions, Patient Self-Management, Home Healthcare, Patient Adherence/Compliance
Cummins MR, Crouch BI, Del Fiol G
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
The researchers analyzed audio recordings of current telephone-based communications between emergency departments (EDs) and poison control centers (PCCs) in order to describe the information requirements for health information exchange between PCCs and EDs. Their goal was to identify a focused subset of available health information, most relevant to emergency treatment of poison exposure, in order to support generalizable process re-design.
AHRQ-funded; HS018773.
Citation: Cummins MR, Crouch BI, Del Fiol G .
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
AMIA Annu Symp Proc 2014 Nov 14;2014:449-56..
Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Health Information Exchange (HIE), Health Information Technology (HIT)
Prey JE, Restaino S, Vawdrey DK
Providing hospital patients with access to their medical records.
The researchers conducted two experiments to better understand clinician and patient perceptions about giving patients access to their medical records during hospital encounters. They found that increased patient information sharing in the inpatient setting is beneficial and desirable to patients, and generally acceptable to clinicians.
AHRQ-funded; HS021816.
Citation: Prey JE, Restaino S, Vawdrey DK .
Providing hospital patients with access to their medical records.
AMIA Annu Symp Proc 2014 Nov 14;2014:1884-93.
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Keywords: Electronic Health Records (EHRs), Inpatient Care, Patient and Family Engagement, Provider, Clinician-Patient Communication
Einbinder J, Hebel E, Wright A
The number needed to remind: a measure for assessing CDS effectiveness.
The purpose of this paper is to provide a better understanding of population based clinical decision support (CDS) performance measurement, to identify best practices for designing and implementing CDS, and to introduce two new quality measures, titled Reminder Performance (RP) and the Number Needed to Remind (NNR) for evaluating the effectiveness of clinical reminders in the context of the CDS Dashboards.
AHRQ-funded; 290200810010.
Citation: Einbinder J, Hebel E, Wright A .
The number needed to remind: a measure for assessing CDS effectiveness.
AMIA Annu Symp Proc 2014 Nov 14;2014:506-15..
Keywords: Shared Decision Making, Clinical Decision Support (CDS), Quality Measures, Quality of Care
Zhang R, Pakhomov SV, Lee JT
Using language models to identify relevant new information in inpatient clinical notes.
The authors investigated the use of language models for identification of new information in inpatient notes and evaluated their methods using expert-derived reference standards. They found that the average proportion of redundant information was similar between inpatient and outpatient progress notes, and that advanced practice providers tended to have higher rates of redundancy in their notes compared to physicians.
AHRQ-funded; HS022085.
Citation: Zhang R, Pakhomov SV, Lee JT .
Using language models to identify relevant new information in inpatient clinical notes.
AMIA Annu Symp Proc 2014 Nov 14;2014:1268-76.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Inpatient Care
Garg N, Kuperman G, Onyile A
Validating health information exchange (HIE) data for quality measurement across four hospitals.
The study objective was to validate the secondary use of HIE data for two emergency department (ED) quality measures: identification of frequent ED users and early (72-hour) ED returns in four hospitals. It found that there was no significant difference in the total counts for frequent ED users or early ED returns for any of the four hospitals.
AHRQ-funded; HS021261.
Citation: Garg N, Kuperman G, Onyile A .
Validating health information exchange (HIE) data for quality measurement across four hospitals.
AMIA Annu Symp Proc 2014 Nov 14;2014:573-9..
Keywords: Electronic Health Records (EHRs), Emergency Department, Quality of Care, Health Information Exchange (HIE), Quality Measures
Merlin JS, Walcott M, Ritchie C
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
The researchers’ objective was to explore HIV-infected patients’ perspectives on psychological aspects of chronic pain using in-depth qualitative interviews. Key themes that emerged included the close relationship between mood and pain; mood and pain in the context of living with HIV; use of alcohol/drugs to self-medicate for pain; and the challenge of receiving prescription pain medications while dealing with substance use disorders.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Ritchie C .
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
PLoS One 2014 Nov 3;9(11):e111765. doi: 10.1371/journal.pone.0111765..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient-Centered Outcomes Research, Patient Self-Management
Qato DM, Daviglus ML, Wilder J
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
The authors examined whether trends in the availability of pharmacies varied across communities in Chicago with different racial or ethnic compositions and whether "pharmacy deserts," or low-access neighborhoods, were more common in segregated black and Hispanic communities than elsewhere. They found that in 2012 there were disproportionately more pharmacy deserts in segregated black communities, as well as in low-income communities and federally designated Medically Underserved Areas. These findings suggest that public policies aimed at improving access to prescription medications may need to address factors beyond insurance coverage and medication affordability.
AHRQ-funded; HS021093.
Citation: Qato DM, Daviglus ML, Wilder J .
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
Health Aff 2014 Nov;33(11):1958-65. doi: 10.1377/hlthaff.2013.1397.
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Keywords: Access to Care, Medication, Provider: Pharmacist, Racial and Ethnic Minorities, Urban Health
Aschbrenner KA, Pepin R, Mueser KT
A mixed methods exploration of family involvement in medical care for older adults with serious mental illness.
This study explored family involvement in medical care for older adults with serious mental illness (SMI). The investigators found that approximately 89% of older adults with SMI reported family involvement in at least one aspect of their medical care (e.g., medication reminders, medical decision making). However, many family members reported that they were rarely involved in their relative's medical visits, and most did not perceive a need to be involved during routine care.
AHRQ-funded; HS021695.
Citation: Aschbrenner KA, Pepin R, Mueser KT .
A mixed methods exploration of family involvement in medical care for older adults with serious mental illness.
Int J Psychiatry Med 2014;48(2):121-33. doi: 10.2190/PM.48.2.e..
Keywords: Caregiving, Elderly, Behavioral Health, Patient and Family Engagement
Bhavsar NA, Bream JH, Meeker AK
A peripheral circulating TH1 cytokine profile is inversely associated with prostate cancer risk in CLUE II.
The authors evaluated the association between peripheral-cytokine concentrations and prostate cancer. They found that men with a prediagnostic circulating TH1 profile and higher IL6 may have a lower risk of prostate cancer, including aggressive disease. They concluded that identifying specific inflammatory cytokines associated with prostate cancer may lead to improved prevention and treatment strategies.
AHRQ-funded; HS019488.
Citation: Bhavsar NA, Bream JH, Meeker AK .
A peripheral circulating TH1 cytokine profile is inversely associated with prostate cancer risk in CLUE II.
Cancer Epidemiol Biomarkers Prev 2014 Nov;23(11):2561-7. doi: 10.1158/1055-9965.epi-14-0010.
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Keywords: Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Risk
Bradford WD, Lastrapes WD
A prescription for unemployment? Recessions and the demand for mental health drugs.
The authors estimated the relationship between mental health drug prescriptions and the level of labor market activity in the USA. They found that the number of mental health drug prescriptions rises by about 10% when employment falls by 1% and when unemployment rises by 100 basis points, but only for patients in the Northeast region.
AHRQ-funded; HS011326.
Citation: Bradford WD, Lastrapes WD .
A prescription for unemployment? Recessions and the demand for mental health drugs.
Health Econ 2014 Nov;23(11):1301-25. doi: 10.1002/hec.2983.
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Keywords: Medication, Healthcare Utilization, Health Services Research (HSR), Behavioral Health
Viswanathan M, Carey TS, Belinson SE
AHRQ Author: Berliner E, Chang SM
A proposed approach may help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest.
The researchers sought to create practical guidance on ensuring adequate clinical or content expertise while maintaining independence of judgment on systematic review teams. They discussed their approach and concluded that the feasibility and utility of this approach to ensuring needed expertise on systematic reviews and minimizing bias from nonfinancial conflicts of interest must be investigated.
AHRQ-authored.
Citation: Viswanathan M, Carey TS, Belinson SE .
A proposed approach may help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest.
J Clin Epidemiol 2014 Nov;67(11):1229-38. doi: 10.1016/j.jclinepi.2014.02.023.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Research Methodologies
Haukoos JS, Lyons MS, White DA
Acute HIV infection and implications of fourth-generation HIV screening in emergency departments.
This editorial discusses a study in the same journal issue that contributes substantially to the understanding of HIV screening in EDs by reporting programmatic results of nontargeted opt-out screening in a high-volume, urban ED. This study is unique in that it reports, for the first time in an ED setting, the use of fourth-generation HIV testing which improves detection of acute HIV infection.
AHRQ-funded; HS021749.
Citation: Haukoos JS, Lyons MS, White DA .
Acute HIV infection and implications of fourth-generation HIV screening in emergency departments.
Ann Emerg Med 2014 Nov;64(5):547-51. doi: 10.1016/j.annemergmed.2014.07.004..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Emergency Department, Urban Health
Berliner E
AHRQ Author: Berliner E
Adopting medical technology.
This editorial described a study by Gold and colleagues within this issue concerning the treatment accelerated partial breast irradiation (APBI), which was incorporated into clinical practice with few data on its benefits and risks. Berliner recommends a coordinated approach to evidence generation.
AHRQ-authored.
Citation: Berliner E .
Adopting medical technology.
Med Decis Making 2014 Nov;34(8):948-50. doi: 10.1177/0272989x14546378.
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Keywords: Evidence-Based Practice, Medical Devices
Guise JM, Chang C, Viswanathan M
AHRQ Author: Chang C, Berliner E
Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions.
The purpose of this AHRQ EPC methods white paper was to outline approaches to conducting systematic reviews of complex multicomponent health care interventions. It provided a framework for synthesizing studies of multicomponent interventions and also provided an initial list of critical reporting elements for such studies in order to help systematic reviewers understand the options and tradeoffs available for such reviews.
AHRQ-authored; AHRQ-funded; 290201200010I; 290201200012I; 290201200011I; 290201200015I; 290201200008I; 290201200004C.
Citation: Guise JM, Chang C, Viswanathan M .
Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions.
J Clin Epidemiol 2014 Nov;67(11):1181-91. doi: 10.1016/j.jclinepi.2014.06.010.
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Keywords: Evidence-Based Practice, Healthcare Delivery, Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies
Segal CG, Waller DK, Tilley B
An evaluation of differences in risk factors for individual types of surgical site infections after colon surgery.
The authors developed four independent, multivariate, predictive models to assess the unique associations between risk factors and each surgical site infection (SSI) group: superficial, deep, organ space, and an aggregate of all 3 types of SSIs. They found that unique risks for superficial SSIs include diabetes, chronic obstructive pulmonary disease, and dyspnea; deep SSIs had the greatest magnitude of association with BMI and the greatest incidence of wound disruption; and organ space SSIs were often owing to anastomotic leaks and were uniquely associated with disseminated cancer, preoperative dialysis, preoperative radiation treatment, and a bleeding disorder. They concluded that more effective prevention strategies may be developed by reporting and examining each type of SSI separately.
AHRQ-funded; HS021857.
Citation: Segal CG, Waller DK, Tilley B .
An evaluation of differences in risk factors for individual types of surgical site infections after colon surgery.
Surgery 2014 Nov;156(5):1253-60. doi: 10.1016/j.surg.2014.05.010.
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Keywords: Risk, Healthcare-Associated Infections (HAIs), Adverse Events, Surgery, Patient Safety
Finnerty M, Neese-Todd S, Bilder S
Best practices: MEDNET: a multistate policy maker-researcher collaboration to improve prescribing practices.
The authors describe the Medicaid/ Mental Health Network for Evidence-Based Treatment (MEDNET), the first multistate Medicaid QI collaborative to focus on improving psychotropic prescribing. In particular, this article includes the development, infrastructure challenges, and early evidence of success of this public-academic partnership.
AHRQ-funded; HSO19937; HS021112.
Citation: Finnerty M, Neese-Todd S, Bilder S .
Best practices: MEDNET: a multistate policy maker-researcher collaboration to improve prescribing practices.
Psychiatr Serv 2014 Nov 1;65(11):1297-9. doi: 10.1176/appi.ps.201400343..
Keywords: Behavioral Health, Evidence-Based Practice, Medication, Medicaid, Practice Patterns
Fiscella K, Geiger HJ
Caring for the poor in the 21st century: enabling community health centers for a new era.
This article discusses various challenges facing community health centers (CHCs) in the 21st century. These include: potential erosion of the Medicaid prospective payment system, the failure of many States to expand Medicaid, the growth of accountable care organizations, the growth of high deductible health insurance for the privately insured, and increased competition for primary care clinicians.
AHRQ-funded; HS022440
Citation: Fiscella K, Geiger HJ .
Caring for the poor in the 21st century: enabling community health centers for a new era.
J Health Care Poor Underserved. 2014 Nov;25(4):2044-52. doi: 10.1353/hpu.2014.0182..
Keywords: Low-Income, Primary Care, Medicaid, Health Insurance
Khazanie P, Hammill BG, Qualls LG
Clinical effectiveness of cardiac resynchronization therapy versus medical therapy alone among patients with heart failure: analysis of the ICD Registry and ADHERE.
The researchers examined associations between cardiac resynchronization therapy with defibrillator (CRT-D) and mortality and readmission among patients with heart failure who received CRT-D in clinical practice, compared with those who received medical therapy alone. They found that CRT-D was associated with lower risks of mortality and readmission than medical therapy alone.
AHRQ-funded; HS021092
Citation: Khazanie P, Hammill BG, Qualls LG .
Clinical effectiveness of cardiac resynchronization therapy versus medical therapy alone among patients with heart failure: analysis of the ICD Registry and ADHERE.
Circ Heart Fail. 2014 Nov;7(6):926-34. doi: 10.1161/circheartfailure.113.000838..
Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Hospital Readmissions, Outcomes
Kruger JF, Chen AH, Rybkin A
Clinician perspectives on considering radiation exposure to patients when ordering imaging tests: a qualitative study.
The authors examined outpatient clinician attitudes towards considering radiation exposure when ordering CT scans and clinician reactions to displaying radiation exposure information for CT scans at clinician electronic order entry. They found that displaying clinically relevant radiation exposure information at order entry may improve clinician knowledge and inform patient-clinician discussions regarding risks and benefits of imaging.
AHRQ-funded; HS018090.
Citation: Kruger JF, Chen AH, Rybkin A .
Clinician perspectives on considering radiation exposure to patients when ordering imaging tests: a qualitative study.
BMJ Qual Saf 2014 Nov;23(11):893-901. doi: 10.1136/bmjqs-2013-002773.
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Keywords: Shared Decision Making, Provider: Health Personnel, Imaging, Patient Safety, Practice Patterns
Shaikh U, Nettiksimmons J, Joseph JG
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
The authors assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. They found that children who received care from clinicians who led the implementation of the intervention at their clinic showed significant improvements in nutrition and physical activity. Virtual QI learning networks in geographically dispersed clinics can significantly increase clinicians' adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children.
AHRQ-funded; HS018567.
Citation: Shaikh U, Nettiksimmons J, Joseph JG .
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
Am J Med Qual 2014 Nov-Dec;29(6):467-75. doi: 10.1177/1062860613506252.
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Keywords: Children/Adolescents, Evidence-Based Practice, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Obesity, Prevention, Quality Improvement, Rural Health, Telehealth
Fritz SA, Hogan PG, Singh LN
Contamination of environmental surfaces with Staphylococcus aureus in households with children infected with methicillin-resistant S aureus.
This study of the households of 50 children with active or recent culture-positive community-associated methicillin-resistant staphylococcus aureus (MRSA) infection found MRSA-contaminated surfaces in 23 of the 50 households, most frequently form the bed linens (18 percent), television remote control (16 percent), and bathroom hand towel (15 percent).
AHRQ-funded; HS021736
Citation: Fritz SA, Hogan PG, Singh LN .
Contamination of environmental surfaces with Staphylococcus aureus in households with children infected with methicillin-resistant S aureus.
JAMA Pediatr. 2014 Nov;168(11):1030-8. doi: 10.1001/jamapediatrics.2014.1218..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Children/Adolescents, Racial and Ethnic Minorities
Berner ES, Burkhardt JH, Panjamapirom A
Cost implications of human and automated follow-up in ambulatory care.
This study tracked costs associated with using nurse-initiated telephone calls or interactive voice response (IVR) over the first two years of followup for a practice assumed to have 4800 acute care patient visits per year. For the first two years, costs were approximately the same but, in subsequent years, IVR followup is approximately $9000 per year less expensive than nurse followup.
AHRQ-funded; HS017060
Citation: Berner ES, Burkhardt JH, Panjamapirom A .
Cost implications of human and automated follow-up in ambulatory care.
Am J Manag Care. 2014 Nov;20(11 Spec No. 17):SP531-40..
Keywords: Healthcare Costs, Primary Care, Quality of Care, Critical Care
Mullen MT, Wiebe DJ, Bowman A
Disparities in accessibility of certified primary stroke centers.
These authors examined the proportion of the U.S. population with less than 60-minute access to Primary Stroke Centers (PSCs). They found significant geographic disparities in access to the PSCs. Stroke belt States have a higher burden of stroke and more limited access to PSCs.
AHRQ-funded; HS013852; HS017960; HS010914
Citation: Mullen MT, Wiebe DJ, Bowman A .
Disparities in accessibility of certified primary stroke centers.
Stroke. 2014 Nov;45(11):3381-8. doi: 10.1161/strokeaha.114.006021..
Keywords: Stroke, Access to Care, Disparities