National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Antibiotics (1)
- Anxiety (1)
- Asthma (1)
- Behavioral Health (7)
- Cancer (6)
- Cancer: Colorectal Cancer (1)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (3)
- Care Management (1)
- Children/Adolescents (1)
- Community-Acquired Infections (1)
- (-) Comparative Effectiveness (34)
- Data (1)
- Depression (3)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Dialysis (1)
- Domestic Violence (1)
- Evidence-Based Practice (24)
- Family Health and History (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (1)
- Hospitalization (3)
- Hospital Readmissions (1)
- Hospitals (1)
- Imaging (1)
- Infectious Diseases (1)
- Inpatient Care (3)
- Kidney Disease and Health (2)
- Low-Income (1)
- Maternal Care (2)
- Medication (10)
- Mortality (1)
- Neurological Disorders (2)
- Newborns/Infants (2)
- Orthopedics (2)
- Outcomes (17)
- Pain (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (27)
- Patient Safety (1)
- Practice Patterns (1)
- Prevention (4)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality of Care (1)
- Quality of Life (3)
- Racial and Ethnic Minorities (2)
- Research Methodologies (5)
- Respiratory Conditions (1)
- Risk (2)
- Screening (1)
- Sexual Health (2)
- Shared Decision Making (1)
- Substance Abuse (2)
- Surgery (10)
- Telehealth (1)
- Training (1)
- Treatments (5)
- Urinary Tract Infection (UTI) (1)
- Vulnerable Populations (1)
- Women (5)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 34 Research Studies DisplayedKrouse RS, Anderson GL, Arnold KB
Surgical versus non-surgical management for patients with malignant bowel obstruction (S1316): a pragmatic comparative effectiveness trial.
The purpose of this study was to compare surgical versus non-surgical management with the goal of determining the optimal approach for managing malignant bowel obstruction. From May 11, 2015, to April 27, 2020, 221 patients were enrolled, with 199 evaluable participants. The study found no variation between surgery and non-surgery for the primary outcome of good days: mean 42·6 days in the randomized surgery group, 43·9 days (29·5) in the randomized non-surgery group, 54·8 days (27·0) in the patient choice surgery group, and 52·7 days (30·7) in the patient choice non-surgery group. During their initial hospital stay, six participants died, five due to cancer progression and one due to malignant bowel obstruction treatment complications The most common grade 3-4 malignant bowel obstruction treatment complication was anemia.
AHRQ-funded; HS021491.
Citation: Krouse RS, Anderson GL, Arnold KB .
Surgical versus non-surgical management for patients with malignant bowel obstruction (S1316): a pragmatic comparative effectiveness trial.
Lancet Gastroenterol Hepatol 2023 Oct; 8(10):908-18. doi: 10.1016/s2468-1253(23)00191-7..
Keywords: Cancer, Surgery, Treatments, Comparative Effectiveness, Evidence-Based Practice
Ayers DC, Yousef M, Yang W
Age-related differences in pain, function, and quality of life following primary total knee arthroplasty: results from a FORCE-TJR (Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement) cohort.
The purpose of this prospective, multicenter cohort study was to evaluate the differences in pain, function, and quality of life (QoL) reported 1 year after total knee arthroplasty (TKA) across varying age groups. The researchers preoperatively assessed 11,602 unilateral primary TKA patients, and collected demographic data, comorbid conditions, and patient-reported outcome measures including the knee injury and osteoarthritis outcome score (KOOS), KOOS-12, KOOS Joint Replacement, and Short-Form health survey (12-item) and then collected again at 1-year postoperatively. The study found that prior to surgery, patients less than 55 years reported worse KOOS pain (39), function (50), and QoL (18) scores with poor mental health score (47) than other older patient groups. At 1 year after TKA, patients less than 55 years reported lower KOOS pain, function, and QoL scores when compared to patients 75 years or older. The differences in score changes among the age groups were statistically significant but clinically irrelevant. Further statistical analyses revealed that age was a significant predictor for pain, but not for function at 1 year where KOOS pain score was predicted to be higher in patients 75 years or older when compared to patients less than 55 years of age.
AHRQ-funded; HS018910.
Citation: Ayers DC, Yousef M, Yang W .
Age-related differences in pain, function, and quality of life following primary total knee arthroplasty: results from a FORCE-TJR (Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement) cohort.
J Arthroplasty 2023 Jul; 38(7 Suppl 2):S169-S76. doi: 10.1016/j.arth.2023.04.005..
Keywords: Orthopedics, Surgery, Quality of Life, Outcomes, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Pain
Balk EM, Danilack VA, Bhuma MR
Reduced compared with traditional schedules for routine antenatal visits: a systematic review.
This systematic review’s objective was to assess differences in maternal and child outcomes in studies comparing reduced routine antenatal visit schedules with traditional schedules. The search was conducted in multiple databases searching for antenatal (prenatal) care, pregnancy, obstetrics, telemedicine, remote care, smartphones, telemonitoring, and related terms. Abstrackr was used for double independent screening for studies comparing televisits and in person routine antenatal care visits for maternal, child, health care utilization, and harm outcomes. The authors found five randomized controlled trials and five nonrandomized comparative studies that compared reduced routine antenatal visit schedules with traditional schedules. The studies did not find differences between schedules in gestational age at birth, likelihood of being small for gestational age, likelihood of a low Apgar score, likelihood of neonatal intensive care unit admission, maternal anxiety, likelihood of preterm birth, and likelihood of low birth weight. There was also insufficient evidence for numerous prioritized outcomes of interest, including completion of the American College of Obstetricians and Gynecologists-recommended services and patient experience measures.
AHRQ-funded; 75Q80120D00001.
Citation: Balk EM, Danilack VA, Bhuma MR .
Reduced compared with traditional schedules for routine antenatal visits: a systematic review.
Obstet Gynecol 2023 Jul 1; 142(1):8-18. doi: 10.1097/aog.0000000000005193..
Keywords: Maternal Care, Newborns/Infants, Women, Patient-Centered Outcomes Research, Outcomes, Comparative Effectiveness, Evidence-Based Practice
Cantor AG, Nelson HD, Pappas M
Telehealth for women's preventive services for reproductive health and intimate partner violence: a comparative effectiveness review.
This comparative effectiveness review was conducted on the effectiveness and harms of telehealth interventions for women's reproductive health and intimate partner violence (IPV) services. A literature search was conducted for randomized controlled trials (RCTs) and observational studies of telehealth strategies for women's reproductive health and IPV versus usual care for the period July 2016 to May 2022. Eight RCTs, 1 nonrandomized trial, and 7 observational studies were included (7 studies of contraceptive care and 9 of IPV services). Telehealth services demonstrated similar care as usual care for contraceptive use, sexually transmitted infections, and pregnancy (low strength of evidence [SOE]). Evidence on abortion was insufficient. Outcomes were also similar between telehealth and usual care interventions to replace or supplement IPV services and comparators for repeat IPV, depression, posttraumatic stress disorder, fear of partner, coercive control, self-efficacy, and safety behaviors (low SOE). Telehealth barriers identified included limited internet access, digital literacy, technical challenges, and confidentiality concerns. Safety strategies increased telehealth use for IPV services. Evidence lacked on access, health equity, or harms.
AHRQ-funded; 75Q80120D00006.
Citation: Cantor AG, Nelson HD, Pappas M .
Telehealth for women's preventive services for reproductive health and intimate partner violence: a comparative effectiveness review.
J Gen Intern Med 2023 May; 38(7):1735-43. doi: 10.1007/s11606-023-08033-6..
Keywords: Telehealth, Health Information Technology (HIT), Women, Prevention, Domestic Violence, Evidence-Based Practice, Maternal Care, Sexual Health, Patient-Centered Outcomes Research, Comparative Effectiveness
Kahwati LC, Kelly BJ, Johnson M
End-user understanding of qualitative comparative analysis used within evidence synthesis: a mixed-methods study.
This study’s purpose was to identify effective approaches to communicating results from a qualitative comparative analysis (QCA) within a systematic review. Interviews with 11 end-users followed by a randomized experiment with 254 participants provided QCA results for a hypothetical review presented through three formats (text, table, and figure). The authors observed a significant different in subjective comprehension across three presentation formats, with figure and text formats scoring higher compared to the table. Overall, there were no significant different for objective comprehension. However, interpretation (a unique component of QCA results) scores among participants that received the figure format were significantly higher than scores for participants who received the text or table. No significant differences were observed in objective comprehension for configuration interpretation.
AHRQ-funded; HS026258.
Citation: Kahwati LC, Kelly BJ, Johnson M .
End-user understanding of qualitative comparative analysis used within evidence synthesis: a mixed-methods study.
Res Synth Methods 2023 Mar;14(2):180-92. doi: 10.1002/jrsm.1602.
Keywords: Comparative Effectiveness, Evidence-Based Practice, Research Methodologies
Rastogi V, Marcaccio CL, Kim NH
The effect of supraceliac versus infraceliac landing zone on outcomes following fenestrated endovascular repair of juxta-/pararenal aortic aneurysms.
The purpose of this study was to assess perioperative outcomes in patients in the Vascular Quality Initiative who underwent juxta-/pararenal FEVAR with supraceliac vs infraceliac sealing. 1,486 Patients who received an elective FEVAR for juxta-/pararenal aortic aneurysms in the Vascular Quality Initiative between 2014 and 2021were identified and included.
The researchers defined supraceliac sealing as proximal sealing in aortic zone 5, or zone 6 with a celiac scallop/fenestration/branch or celiac occlusion. The study’s primary outcomes were perioperative and 3-year mortality, and secondary outcomes were completion endoleaks, in-hospital complications, and variables related with 3-year mortality. The study found that of the included patients, 84% underwent infraceliac sealing, and 16% underwent supraceliac sealing. Of the supraceliac patients, 60% had a celiac fenestration/branch, 31% had a celiac scallop, and 9.2% had a celiac occlusion (intentional or unintentional). Compared with infraceliac sealing, there were no differences after risk-adjusted analysis in perioperative mortality following supraceliac sealing. Supraceliac sealing was associated with lower odds of type-IA completion endoleaks, but higher odds of any complication including cardiac complications, lower extremity ischemia and acute kidney injury when compared with infraceliac sealing. The researchers concluded that supraceliac sealing was associated with lower risk of type IA endoleaks and similar mortality compared with sealing at an infraceliac level. The researchers advise that providers should be aware that supraceliac sealing was related with higher perioperative morbidity.
The researchers defined supraceliac sealing as proximal sealing in aortic zone 5, or zone 6 with a celiac scallop/fenestration/branch or celiac occlusion. The study’s primary outcomes were perioperative and 3-year mortality, and secondary outcomes were completion endoleaks, in-hospital complications, and variables related with 3-year mortality. The study found that of the included patients, 84% underwent infraceliac sealing, and 16% underwent supraceliac sealing. Of the supraceliac patients, 60% had a celiac fenestration/branch, 31% had a celiac scallop, and 9.2% had a celiac occlusion (intentional or unintentional). Compared with infraceliac sealing, there were no differences after risk-adjusted analysis in perioperative mortality following supraceliac sealing. Supraceliac sealing was associated with lower odds of type-IA completion endoleaks, but higher odds of any complication including cardiac complications, lower extremity ischemia and acute kidney injury when compared with infraceliac sealing. The researchers concluded that supraceliac sealing was associated with lower risk of type IA endoleaks and similar mortality compared with sealing at an infraceliac level. The researchers advise that providers should be aware that supraceliac sealing was related with higher perioperative morbidity.
AHRQ-funded; HS027285.
Citation: Rastogi V, Marcaccio CL, Kim NH .
The effect of supraceliac versus infraceliac landing zone on outcomes following fenestrated endovascular repair of juxta-/pararenal aortic aneurysms.
J Vasc Surg 2023 Jan;77(1):9-19.e2. doi: 10.1016/j.jvs.2022.08.007..
Keywords: Cardiovascular Conditions, Surgery, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes, Comparative Effectiveness, Treatments
Chan B, Kondo K, Freeman M
Pharmacotherapy for cocaine use disorder-a systematic review and meta-analysis.
The authors sought a better understanding of the effectiveness of pharmacotherapy for cocaine use disorder. Their search included multiple data sources for systematic reviews and randomized controlled trials of pharmacological interventions in adults with cocaine use disorder. They found that most of the pharmacotherapies studied, including antidepressants, were not effective for treating cocaine use disorder. Bupropion, psychostimulants, and topiramate may improve abstinence, and antipsychotics may improve treatment retention. They recommend further study of contingency management and behavioral interventions along with pharmacotherapy.
AHRQ-funded; HS022981.
Citation: Chan B, Kondo K, Freeman M .
Pharmacotherapy for cocaine use disorder-a systematic review and meta-analysis.
J Gen Intern Med 2019 Dec;34(12):2858-73. doi: 10.1007/s11606-019-05074-8..
Keywords: Medication, Substance Abuse, Comparative Effectiveness, Treatments, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Chan B, Freeman M, Kondo K
Pharmacotherapy for methamphetamine/amphetamine use disorder-a systematic review and meta-analysis.
The authors reviewed the effectiveness of pharmacotherapy for methamphetamine/amphetamine (MA/A) use disorder to assess the quality, publication bias, and overall strength of the evidence. They found that, on the basis of low- to moderate-strength evidence, most medications evaluated for methamphetamine/amphetamine use disorder have not shown a statistically significant benefit; however, there is low-strength evidence that methylphenidate may reduce use.
AHRQ-funded; HS022981.
Citation: Chan B, Freeman M, Kondo K .
Pharmacotherapy for methamphetamine/amphetamine use disorder-a systematic review and meta-analysis.
Addiction 2019 Dec;114(12):2122-36. doi: 10.1111/add.14755..
Keywords: Medication, Substance Abuse, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research
Gates A, Guitard S, Pillay J
Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools.
Researchers explored the performance of three machine learning tools designed to facilitate title and abstract screening in systematic reviews (SRs) when used to eliminate irrelevant records and complement the work of a single reviewer. Using Abstrackr, DistillerSR, and RobotAnalyst, they found that the workload savings afforded in the automated simulation came with increased risk of missing relevant records. Supplementing a single reviewer's decisions with relevance predictions sometimes reduced the proportion missed, but performance varied by tool and SR. They recommend designing tools based on reviewers' self-identified preferences to improve compatibility with present workflows.
AHRQ-funded; 290201500001I.
Citation: Gates A, Guitard S, Pillay J .
Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools.
Syst Rev 2019 Nov 15;8(1):278. doi: 10.1186/s13643-019-1222-2..
Keywords: Patient-Centered Outcomes Research, Health Services Research (HSR), Research Methodologies, Evidence-Based Practice, Comparative Effectiveness
Lee T, Qian JZ, Zhang Y
Long-term outcomes of arteriovenous fistulas with unassisted versus assisted maturation: a retrospective national hemodialysis cohort study.
The authors retrospectively compared patients with assisted versus unassisted arteriovenous fistula (AVF) maturation for post-maturation AVF outcomes, including functional primary patency loss, AVF abandonment, and frequency of interventions. For the studied group of patients undergoing assisted AVF maturation, they observed a positive association between the number of pre-maturation AVF interventions and the likelihood of functional primary patency loss and frequency of post-maturation interventions.
AHRQ-funded; HS022931.
Citation: Lee T, Qian JZ, Zhang Y .
Long-term outcomes of arteriovenous fistulas with unassisted versus assisted maturation: a retrospective national hemodialysis cohort study.
J Am Soc Nephrol 2019 Nov;30(11):2209-18. doi: 10.1681/asn.2019030318..
Keywords: Kidney Disease and Health, Comparative Effectiveness, Surgery, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research
Mullins BT, Basak R, Broughman JR
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
This study compares the effects of different types of radical prostatectomy and radiotherapy on sexual function. A population-based cohort of 835 men with newly diagnosed prostate cancer from 2011 through 2013 was recruited in collaboration with the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry. They were enrolled prior to treatment and followed retrospectively using the validated Prostate Cancer Symptom Indices (PCSI) instrument. The sexual function scores were compared among patients who received the following treatment types: external-beam RT (EBRT), EBRT with androgen deprivation therapy (ADT), brachytherapy, nerve-sparing radical prostatectomy (RP), and non-nerve-sparing RP. The cohort was surveyed at 24 months post-therapy, and RT alone was found to result in the best preservation of sexual function with brachytherapy, RT with ADT, and nerve-sparing RP yielding similar outcomes. Patients treated with non-nerve-sparing RP experienced the worst sexual function outcome.
AHRQ-funded.
Citation: Mullins BT, Basak R, Broughman JR .
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
Cancer 2019 Oct 15;125(20):3657-65. doi: 10.1002/cncr.32288..
Keywords: Quality of Life, Sexual Health, Surgery, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Cancer: Prostate Cancer, Cancer, Evidence-Based Practice
Oh ES, Needham DM, Nikooie R
Antipsychotics for preventing delirium in hospitalized adults: a systematic review.
The purpose of this study was to conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Results showed that there was little evidence demonstrating neurologic harms associated with short-term use of antipsychotics for treating delirium in adult inpatients, but potentially harmful cardiac effects tended to occur more frequently. Current evidence does not support routine use of haloperidol or second-generation antipsychotics to treat delirium in adult inpatients.
AHRQ-funded; 290201500006I.
Citation: Oh ES, Needham DM, Nikooie R .
Antipsychotics for preventing delirium in hospitalized adults: a systematic review.
Ann Intern Med 2019 Oct 1;171(7):474-84. doi: 10.7326/m19-1859..
Keywords: Neurological Disorders, Medication, Hospitalization, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness, Behavioral Health, Prevention
Nikooie R, Neufeld KJ, Oh ES
Antipsychotics for treating delirium in hospitalized adults: a systematic review.
The purpose of this study was to conduct a systematic review evaluating the benefits and harms of antipsychotics to treat delirium in adults. Results showed that there was little evidence demonstrating neurologic harms associated with short-term use of antipsychotics for treating delirium in adult inpatients, but potentially harmful cardiac effects tended to occur more frequently. Current evidence does not support routine use of haloperidol or second-generation antipsychotics to treat delirium in adult inpatients.
AHRQ-funded; 290201500006I.
Citation: Nikooie R, Neufeld KJ, Oh ES .
Antipsychotics for treating delirium in hospitalized adults: a systematic review.
Ann Intern Med 2019 Oct 1;171(7):485-95. doi: 10.7326/m19-1860.
.
.
Keywords: Neurological Disorders, Medication, Hospitalization, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness, Behavioral Health
Adrian M, McCauley E, Berk MS
Predictors and moderators of recurring self-harm in adolescents participating in a comparative treatment trial of psychological interventions.
This study compared outcomes for treatment of adolescents who have engaged in self-harm including suicide attempts and nonsuicidal self-injury. This randomized controlled tiral compared results with dialectical behavior therapy (DBT) to treatment with individual/group supportive therapy (IGST). 173 adolescents were randomized to receive 6 months of DBT or IGST. Assessments were made at baseline, midtreatment (3 months), and end of treatment at 6 months using the Suicide Attempt and Self –Injury Interview. Overall, DBT showed better rates of improvement than IGST. These was especially true of adolescents with higher levels of emotion dysregulation and parental psychopathology.
AHRQ-funded; HS022982.
Citation: Adrian M, McCauley E, Berk MS .
Predictors and moderators of recurring self-harm in adolescents participating in a comparative treatment trial of psychological interventions.
J Child Psychol Psychiatry 2019 Oct;60(10):1123-32. doi: 10.1111/jcpp.13099..
Keywords: Children/Adolescents, Behavioral Health, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Family Health and History, Outcomes
McGinn T, Cohen S, Khan S
The high cost of low value care.
The main focus of this study was bridging the "evidence gap" between frontline decision-making in health care and the actual evidence, with the hope of reducing unnecessary diagnostic testing and treatments. From their work in pulmonary embolism (PE) and over ordering of computed tomography pulmonary angiography, the investigators integrated the highly validated Wells' criteria into the electronic health record at two of their major academic tertiary hospitals.
AHRQ-funded; HS022061.
Citation: McGinn T, Cohen S, Khan S .
The high cost of low value care.
Trans Am Clin Climatol Assoc 2019;130:60-70..
Keywords: Healthcare Costs, Evidence-Based Practice, Patient-Centered Outcomes Research, Shared Decision Making, Comparative Effectiveness
Niu X, Amendola LM, Hart R
Clinical exome sequencing vs. usual care for hereditary colorectal cancer diagnosis: a pilot comparative effectiveness study.
The purpose of this study was to evaluate clinical exome sequencing (CES) compared to usual care (UC) in the diagnostic work-up of inherited colorectal cancer/polyposis (CRCP) in a randomized controlled trial (RCT). The investigators indicate that their results suggest that CES provides similar clinical benefits to multi-gene panels in the diagnosis of hereditary CRCP.
AHRQ-funded; HS021686.
Citation: Niu X, Amendola LM, Hart R .
Clinical exome sequencing vs. usual care for hereditary colorectal cancer diagnosis: a pilot comparative effectiveness study.
Contemp Clin Trials 2019 Sep;84:105820. doi: 10.1016/j.cct.2019.105820..
Keywords: Cancer: Colorectal Cancer, Cancer, Diagnostic Safety and Quality, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Desai S, Aronson PL, Shabanova V
Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections.
This study compared rates of recurring bacteremic urinary tract infections (UTIs) among hospitalized infants who received parenteral antibiotics 7 days or less compared with infants who received long-term treatment defined as greater than 7 days. Among 115 infants with bactermic UTI, half received short-course parenteral antibiotics and no difference in 30-day UTI recurrence was found.
AHRQ-funded; HS026006.
Citation: Desai S, Aronson PL, Shabanova V .
Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections.
Pediatrics 2019 Sep;144(3). doi: 10.1542/peds.2018-3844..
Keywords: Newborns/Infants, Antibiotics, Urinary Tract Infection (UTI), Medication, Inpatient Care, Hospitalization, Outcomes, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Nicholson WK, Wegienka G, Zhang S
Short-term health-related quality of life after hysterectomy compared with myomectomy for symptomatic leiomyomas.
The objective of this study was to compare short-term health-related quality of life (HRQOL) 6-12 weeks after hysterectomy or myomectomy for the treatment of symptomatic leiomyomas. The investigators conducted a prospective comparative effectiveness analysis of data. They concluded that both hysterectomy and myomectomy were associated with substantial improvement in HRQOL at short-term follow-up, with small but statistically significant differences in symptom severity and certain subscales.
AHRQ-funded; HS023418.
Citation: Nicholson WK, Wegienka G, Zhang S .
Short-term health-related quality of life after hysterectomy compared with myomectomy for symptomatic leiomyomas.
Obstet Gynecol 2019 Aug;134(2):261-69. doi: 10.1097/aog.0000000000003354..
Keywords: Quality of Life, Surgery, Women, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Burnett-Zeigler I, Hong S, Waldron EM
A mindfulness-based intervention for low-income African American women with depressive symptoms delivered by an experienced instructor versus a novice instructor.
The authors piloted a streamlined mindfulness teacher training protocol for Federally Qualified Health Center (FQHC) staff. They also examined the distribution and variability of psychologic outcomes for participants in groups led by an experienced instructor compared to a FQHC staff instructor who received the streamlined training. They concluded that preliminary data indicate that health care staff who receive streamlined training to deliver mindfulness-based interventions have comparable outcomes as experienced instructors.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler I, Hong S, Waldron EM .
A mindfulness-based intervention for low-income African American women with depressive symptoms delivered by an experienced instructor versus a novice instructor.
J Altern Complement Med 2019 Jul;25(7):699-708. doi: 10.1089/acm.2018.0393..
Keywords: Behavioral Health, Comparative Effectiveness, Depression, Low-Income, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Vulnerable Populations, Training, Women
Wilkinson ST, Farmer C, Ballard E
Impact of midazolam vs. saline on effect size estimates in controlled trials of ketamine as a rapid-acting antidepressant.
The article describes a study on the effectiveness of midazolam as a comparator in preserving the blind in ketamine studies for mood disorders. Four groups -- ketamine (midazolam-controlled), ketamine (saline-controlled), midazolam, and saline -- were compared with regard to clinical outcomes. The effect of ketamine was larger in saline-controlled studies than in midazolam-controlled studies, relative to control, but there was no difference between ketamine (midazolam-controlled) and ketamine (saline-controlled). The response rate for ketamine was higher than the control condition for both saline and midazolam.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Farmer C, Ballard E .
Impact of midazolam vs. saline on effect size estimates in controlled trials of ketamine as a rapid-acting antidepressant.
Neuropsychopharmacology 2019 Jun;44(7):1233-38. doi: 10.1038/s41386-019-0317-8.
.
.
Keywords: Medication, Comparative Effectiveness, Depression, Behavioral Health, Patient-Centered Outcomes Research
Bath J, Smith JB, Kruse RL
Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair.
This retrospective cohort study examined 30-day readmission rates for patients who had abdominal aortic aneurysm (AAA) repair comparing two different procedures,. The cohort was selected from inpatients (2009-2016) who had undergone elective AAA repair using the multicenter Cerner Health Facts(R) database and were identified ICD-9 procedure codes. The two procedures compared were 3,101 endovascular aneurysm repairs (EVAR) and 1,622 open procedures. Patients who had EVAR were less likely to be readmitted. Risk factors for readmission included surgical site infection, age, receipt of bronchodilators or steroids, serum potassium > 5.2 mEq/L, and higher Charlson co-morbidity scores. The most common infections causing readmission were pneumonia and urinary tract infection after EVAR.
AHRQ-funded; HS022140.
Citation: Bath J, Smith JB, Kruse RL .
Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair.
Vasa 2019 May;48(3):251-61. doi: 10.1024/0301-1526/a000767..
Keywords: Risk, Hospital Readmissions, Surgery, Outcomes, Comparative Effectiveness, Patient-Centered Outcomes Research
Randad PR, Dillen CA, Ortines RV
Comparison of livestock-associated and community-associated Staphylococcus aureus pathogenicity in a mouse model of skin and soft tissue infection.
The goal of this study was to determine the degree to which livestock-associated (LA) Staphylococcus aureus strains contracted by industrial hog-operation (IHO) workers cause disease relative to a representative CA-MRSA strain in a mouse model of skin and soft tissue infection (SSTI). Mice infected with LA-S. aureus strains developed larger lesions with a higher bacterial burden than the CA-MRSA infected mice; the largest lesion size and bacterial burden were observed with a CC398 LA-S. aureus strain which had produced a recurrent SSTI in an IHO worker. The researchers conclude that more attention should be placed on the prevention of spreading LA-S. aureus into human populations.
AHRQ-funded; HS019966.
Citation: Randad PR, Dillen CA, Ortines RV .
Comparison of livestock-associated and community-associated Staphylococcus aureus pathogenicity in a mouse model of skin and soft tissue infection.
Sci Rep 2019 May 1;9(1):6774. doi: 10.1038/s41598-019-42919-y..
Keywords: Community-Acquired Infections, Comparative Effectiveness, Infectious Diseases
Perez FA, Quinet S, Jarvik JG
Lumbar spinal stenosis severity by CT or MRI does not predict response to epidural corticosteroid versus lidocaine injections.
This study compared the results of patients with lumbar spinal stenosis injected epidurally with corticosteroids and lidocaine, or lidocaine alone. A prospective, double-blind study was conducted on 350 patients who were then evaluated for qualitative or quantitative MR imaging or CT measures of lumbar spinal stenosis. There were no differences in improvement of disability or leg pain scores at 3 weeks between the two subgroups.
AHRQ-funded; HS019222; HS022972.
Citation: Perez FA, Quinet S, Jarvik JG .
Lumbar spinal stenosis severity by CT or MRI does not predict response to epidural corticosteroid versus lidocaine injections.
AJNR Am J Neuroradiol 2019 May;40(5):908-15. doi: 10.3174/ajnr.A6050..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Imaging, Medication, Orthopedics, Outcomes, Patient-Centered Outcomes Research
Wheatley LM, Wood R, Nadeau K
Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy-an NIAID/AHRQ workshop.
A joint AHRQ and National Institute of Allergy and Infectious Diseases (NIAAD) workshop was held to develop trial concepts that could improve the use and effectiveness of aeroallergen immunotherapy (AAIT). Four different expert groups were formed to propose different study designs. These study designs would create clinical trials of long duration and would need highly characterized patient populations.
AHRQ-funded; 290200710061I.
Citation: Wheatley LM, Wood R, Nadeau K .
Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy-an NIAID/AHRQ workshop.
J Allergy Clin Immunol 2019 May;143(5):1711-26. doi: 10.1016/j.jaci.2019.01.032..
Keywords: Asthma, Comparative Effectiveness, Evidence-Based Practice, Prevention, Research Methodologies, Respiratory Conditions
Balk EM, Rofeberg VN, Adam GP
Pharmacologic and nonpharmacologic treatments for urinary incontinence in women: a systematic review and network meta-analysis of clinical outcomes.
The purpose of this study was to compare the effectiveness of pharmacologic and nonpharmacologic interventions to improve or cure stress, urgency, or mixed UI in nonpregnant women. The investigators concluded that most nonpharmacologic and pharmacologic interventions were more likely than no treatment to improve UI outcomes. They also concluded that behavioral therapy, alone or in combination with other interventions, was generally more effective than pharmacologic therapies alone in treating both stress and urgency UI.
AHRQ-funded; 290201500002I.
Citation: Balk EM, Rofeberg VN, Adam GP .
Pharmacologic and nonpharmacologic treatments for urinary incontinence in women: a systematic review and network meta-analysis of clinical outcomes.
Ann Intern Med 2019 Apr 2;170(7):465-79. doi: 10.7326/m18-3227..
Keywords: Care Management, Comparative Effectiveness, Evidence-Based Practice, Medication, Outcomes, Patient-Centered Outcomes Research, Women