National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (3)
- Adverse Drug Events (ADE) (1)
- Adverse Events (4)
- Cancer (3)
- Caregiving (1)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (2)
- Clostridium difficile Infections (1)
- Communication (1)
- Comparative Effectiveness (2)
- Disparities (2)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Delivery (1)
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- Health Information Technology (HIT) (2)
- Health Promotion (1)
- Health Services Research (HSR) (4)
- Hospitalization (1)
- Hospital Readmissions (1)
- Hospitals (1)
- Injuries and Wounds (1)
- Kidney Disease and Health (3)
- Medical Errors (1)
- Medication (2)
- Mortality (5)
- Outcomes (5)
- Patient-Centered Outcomes Research (3)
- Patient and Family Engagement (1)
- Patient Safety (1)
- Policy (3)
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- Quality of Care (1)
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- Risk (4)
- Sepsis (1)
- Shared Decision Making (2)
- Social Determinants of Health (1)
- Surgery (2)
- (-) Transplantation (25)
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 25 of 25 Research Studies DisplayedKasiske BL, Salkowski N, Wey A
Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States.
The authors reviewed the details and implications of changes in transplant program oversight.
AHRQ-funded; HS024527.
Citation: Kasiske BL, Salkowski N, Wey A .
Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States.
Am J Transplant 2016 Dec;16(12):3371-77. doi: 10.1111/ajt.13955.
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Keywords: Health Services Research (HSR), Policy, Registries, Policy, Transplantation
Rosenberg AS, Ruthazer R, Paulus JK
Survival analyses and prognosis of plasma-cell myeloma and plasmacytoma-like posttransplantation lymphoproliferative disorders.
Multiple myeloma/plasmacytoma-like posttransplantation lymphoproliferative disorder (PTLD-MM) is a rare complication of solid organ transplantation. Case series have shown variable outcomes, and survival data in the modern era are lacking. This study found that age at diagnosis, elevated creatinine, and white race were associated with inferior survival in patients with PTLD-MM.
AHRQ-funded; HS000060.
Citation: Rosenberg AS, Ruthazer R, Paulus JK .
Survival analyses and prognosis of plasma-cell myeloma and plasmacytoma-like posttransplantation lymphoproliferative disorders.
Clin Lymphoma Myeloma Leuk 2016 Dec;16(12):684-92.e3. doi: 10.1016/j.clml.2016.09.002.
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Keywords: Adverse Events, Cancer, Mortality, Transplantation, Outcomes
Dimou FM, Mehta HB, Adhikari D
The role of extended criteria donors in liver transplantation for nonalcoholic steatohepatitis.
The authors' objective was to determine the use of extended criteria donors (ECD) in patients with nonalcoholic steatohepatitis undergoing liver transplantation to stimulate a liver-specific predictive model for ECD use. They found that ECDs in nonalcoholic steatohepatitis were associated with similar overall survival but increased risk of graft failure. The authors concluded that creation of an easily calculated, liver-specific model similar to the Kidney Donor Profile Index may help risk stratify patients and improve organ allocation.
AHRQ-funded; HS022134.
Citation: Dimou FM, Mehta HB, Adhikari D .
The role of extended criteria donors in liver transplantation for nonalcoholic steatohepatitis.
Surgery 2016 Dec;160(6):1533-43. doi: 10.1016/j.surg.2016.06.051.
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Keywords: Transplantation, Patient-Centered Outcomes Research, Risk, Mortality, Outcomes
Donnelly JP, Locke JE, MacLennan PA
Inpatient mortality among solid organ transplant recipients hospitalized for sepsis and severe sepsis.
The researchers investigated the impact of solid organ transplant (SOT) on outcomes following sepsis. They found that among patients hospitalized for severe sepsis or sepsis, those with SOT had lower inpatient mortality than those without SOT.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Locke JE, MacLennan PA .
Inpatient mortality among solid organ transplant recipients hospitalized for sepsis and severe sepsis.
Clin Infect Dis 2016 Jul 15;63(2):186-94. doi: 10.1093/cid/ciw295.
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Keywords: Transplantation, Mortality, Sepsis, Hospitalization, Patient-Centered Outcomes Research
Sawinski D, Trofe-Clark J, Leas B
Calcineurin inhibitor minimization, conversion, withdrawal, and avoidance strategies in renal transplantation: a systematic review and meta-analysis.
The researchers evaluated 92 comparisons from 88 randomized controlled trials and found moderate- to high-strength evidence suggesting that minimization strategies result in better clinical outcomes compared with standard-dose regimens and moderate-strength evidence indicating that conversion to a mammalian target of rapamycin inhibitor or belatacept was associated with improved renal function but increased rejection risk.
AHRQ-funded; 290201200011I.
Citation: Sawinski D, Trofe-Clark J, Leas B .
Calcineurin inhibitor minimization, conversion, withdrawal, and avoidance strategies in renal transplantation: a systematic review and meta-analysis.
Am J Transplant 2016 Jul;16(7):2117-38. doi: 10.1111/ajt.13710.
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Keywords: Transplantation, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Medication
Platt J, Thiel DB, Kardia SL
Innovating consent for pediatric HCT patients.
The authors discussed hematopoietic cell transplantation (HCT) and informed consent for pediatric patients.
AHRQ-funded; HS023613.
Citation: Platt J, Thiel DB, Kardia SL .
Innovating consent for pediatric HCT patients.
Bone Marrow Transplant 2016 Jun;51(6):885-8. doi: 10.1038/bmt.2016.10.
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Keywords: Children/Adolescents, Transplantation
Melcher ML, Roberts JP, Leichtman AB
Utilization of deceased donor kidneys to initiate living donor chains.
The authors proposed that some deceased donor kidneys be allocated to initiate nonsimultaneous extended altruistic donor chains of living donor kidney transplants. They hypothesized that a pilot program would show a positive impact on patients of all ethnicities and blood types.
AHRQ-funded; HS020610.
Citation: Melcher ML, Roberts JP, Leichtman AB .
Utilization of deceased donor kidneys to initiate living donor chains.
Am J Transplant 2016 May;16(5):1367-70. doi: 10.1111/ajt.13740.
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Keywords: Healthcare Delivery, Kidney Disease and Health, Policy, Transplantation
McElroy LM, Woods DM, Yanes AF
Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.
The researchers aimed to test the applicability of the International Classification for Patient Safety to a surgical population by developing a codebook for future use by researchers. They found that the most common severity classification was 'reportable circumstance' and that the most common incident type was 'resources/organizational management.' They noted that several aspects of surgical care were encompassed by more than one classification, including operating room scheduling, delays in care, trainee-related incidents, interruptions, and handoffs. They concluded that a framework for patient safety can be applied to facilitate the organization and analysis of surgical safety data.
AHRQ-funded; HS000078.
Citation: McElroy LM, Woods DM, Yanes AF .
Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.
Int J Qual Health Care 2016 Apr;28(2):166-74. doi: 10.1093/intqhc/mzw001.
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Keywords: Surgery, Patient Safety, Transplantation, Adverse Events, Medical Errors
Santos CA, Brennan DC, Saeed MJ
Pharmacoepidemiology of cytomegalovirus prophylaxis in a large retrospective cohort of kidney transplant recipients with Medicare Part D coverage.
The researchers sought to determine real-world use of cytomegalovirus (CMV) prophylaxis. They found that variability in usage of prophylaxis among transplant centers was greater than variability within transplant centers. They concluded that limiting unnecessary use of CMV prophylaxis may decrease healthcare costs and drug-related harms.
AHRQ-funded; HS019455.
Citation: Santos CA, Brennan DC, Saeed MJ .
Pharmacoepidemiology of cytomegalovirus prophylaxis in a large retrospective cohort of kidney transplant recipients with Medicare Part D coverage.
Clin Transplant 2016 Apr;30(4):435-44. doi: 10.1111/ctr.12706.
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Keywords: Adverse Drug Events (ADE), Kidney Disease and Health, Medication, Prevention, Transplantation
Traino HM, Nonterah CW, Gupta G
Living kidney donors' information needs and preferences.
The purpose of this study was to assess donors' perceptions of the information provided while considering living donation. The study revealed limited usefulness of certain CMS-mandated topics and a desire for additional information about donation. Efforts to standardize the informed consent process should incorporate donors' perspectives as to the specific topics, quantity of information, and the mode of communication found most useful when considering living donation.
AHRQ-funded; HS018113; HS021312.
Citation: Traino HM, Nonterah CW, Gupta G .
Living kidney donors' information needs and preferences.
Prog Transplant 2016 Mar;26(1):47-54. doi: 10.1177/1526924816633943.
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Keywords: Communication, Shared Decision Making, Transplantation
Kaziunas E, Hanauer DA, Ackerman MS
Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation.
The researchers conducted field observations and semi-structured interviews of pediatric hematopoietic stem cell transplantation (HSCT) caregivers and patients to identify informational challenges in the inpatient hospital setting. Theyn concluded that pediatric HSCT caregivers and patients have multiple informational needs that could be met with a health information technology system that integrates data from several sources, including electronic health records. Meeting these needs could reduce patients' and caregivers' anxiety surrounding the care process.
AHRQ-funded; HS023613.
Citation: Kaziunas E, Hanauer DA, Ackerman MS .
Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation.
J Am Med Inform Assoc 2016 Jan;23(1):94-104. doi: 10.1093/jamia/ocv116.
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Keywords: Caregiving, Children/Adolescents, Electronic Health Records (EHRs), Patient and Family Engagement, Transplantation
Rodrigue JR, Fleishman A, Fitzpatrick S
Organ donation video messaging in motor vehicle offices: results of a randomized trial.
Since nearly all registered organ donors in the United States signed up via a driver's license transaction, motor vehicle (MV) offices represent an important venue for organ donation education. The researchers evaluated the impact of organ donation video messaging in MV offices. There was a relatively low uptake of the video intervention by customers that most likely contributed to the negative trial finding.
HS022061; HS024204
Citation: Rodrigue JR, Fleishman A, Fitzpatrick S .
Organ donation video messaging in motor vehicle offices: results of a randomized trial.
Prog Transplant 2015 Dec;25(4):332-8. doi: 10.7182/pit2015166..
Keywords: Transplantation, Health Promotion, Education: Patient and Caregiver
Donnelly JP, Wang HE, Locke JE
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
The researchers examined hospital-onset Clostridium difficile infection (CDI) from 2012 to 2014 among transplant recipients in the University HealthSystem Consortium, which includes academic medical center-affiliated hospitals in the United States. They found that factors associated with CDI among transplant recipients included transplant type, risk of mortality, comorbidities, and inpatient complications.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Wang HE, Locke JE .
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
Am J Transplant 2015 Nov;15(11):2970-7. doi: 10.1111/ajt.13491.
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Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Transplantation, Adverse Events, Mortality
Fumo DE, Kapoor V, Reece LJ
Historical matching strategies in kidney paired donation: the 7-year evolution of a web-based virtual matching system.
Failure to convert computer-identified possible kidney paired donation (KPD) exchanges into transplants has prohibited KPD from reaching its full potential. This study analyzes the progress of exchanges in moving from "offers" to completed transplants. The "offer" and 1-way success rates were 21.9 and 15.5 percent, respectively. Three reasons for failure were found that could be prospectively prevented by changes in protocol or software.
AHRQ-funded; HS020610.
Citation: Fumo DE, Kapoor V, Reece LJ .
Historical matching strategies in kidney paired donation: the 7-year evolution of a web-based virtual matching system.
Am J Transplant 2015 Oct;15(10):2646-54. doi: 10.1111/ajt.13337.
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Keywords: Health Information Technology (HIT), Transplantation, Shared Decision Making, Clinical Decision Support (CDS)
Bray M, Wang W, Song PX
Planning for uncertainty and fallbacks can increase the number of transplants in a kidney-paired donation program.
The researchers outlined and examined, through example and by simulation, four schemes for selecting potential matches in a realistic model of a kidney-paired donation system. Their proposed schemes take account of probabilities that chosen transplants may not be completed as well as allowing for contingency plans when the optimal solution fails.
AHRQ-funded; HS020610.
Citation: Bray M, Wang W, Song PX .
Planning for uncertainty and fallbacks can increase the number of transplants in a kidney-paired donation program.
Am J Transplant 2015 Oct;15(10):2636-45. doi: 10.1111/ajt.13413.
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Keywords: Transplantation, Clinical Decision Support (CDS), Health Information Technology (HIT)
Traino HM, Nonterah CW, Cyrus JW
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
This review will catalogue disparities in the steps to transplantation as well as the barriers and facilitators to completion of each step identified in the extant literature. The results of the review will be used to generate recommendations for future research to improve equity in access to kidney transplantation.
AHRQ-funded; HS018113.
Citation: Traino HM, Nonterah CW, Cyrus JW .
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
BMJ Open 2015 Sep 08;5(9):e008677. doi: 10.1136/bmjopen-2015-008677.
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Keywords: Disparities, Transplantation, Kidney Disease and Health, Access to Care, Guidelines
Parikh ND, Waljee AK, Singal AG
Downstaging hepatocellular carcinoma: a systematic review and pooled analysis.
The researchers aimed to characterize rates of successful downstaging to within Milan criteria and post-liver transplantation recurrence and survival among patients who underwent downstaging. They concluded that the success rate of downstaging hepatocellular carcinoma to within Milan criteria exceeds 40 percent; however, posttransplant HCC recurrence rates are high at 16 percent.
AHRQ-funded; HS022418.
Citation: Parikh ND, Waljee AK, Singal AG .
Downstaging hepatocellular carcinoma: a systematic review and pooled analysis.
Liver Transpl 2015 Sep;21(9):1142-52. doi: 10.1002/lt.24169..
Keywords: Cancer, Risk, Transplantation
Orman ES, Mayorga ME, Wheeler SB
Declining liver graft quality threatens the future of liver transplantation in the United States.
This study used the United Network for Organ Sharing (UNOS) database to inform a 20-year discrete event simulation estimating liver transplantation (LT) volume from 2010 to 2030. It found that if donor liver utilization practices remain constant, utilization will fall from 78 percent to 44 percent by 2030, resulting in 2,230 fewer LTs.
AHRQ-funded; HS019468.
Citation: Orman ES, Mayorga ME, Wheeler SB .
Declining liver graft quality threatens the future of liver transplantation in the United States.
Liver Transpl 2015 Aug;21(8):1040-50. doi: 10.1002/lt.24160..
Keywords: Healthcare Utilization, Health Services Research (HSR), Transplantation
McElroy LM, Schmidt KA, Richards CT
Early postoperative emergency department care of abdominal transplant recipients.
The goal of this study was to describe early postoperative ED care of transplant recipients. It found that transplant recipients have a high frequency of ED visits in the first post transplantation year and high rates of subsequent hospital admission.
AHRQ-funded; HS000078.
Citation: McElroy LM, Schmidt KA, Richards CT .
Early postoperative emergency department care of abdominal transplant recipients.
Transplantation 2015 Aug;99(8):1652-7. doi: 10.1097/tp.0000000000000781..
Keywords: Emergency Department, Transplantation, Hospital Readmissions, Hospitals
Davis AE, Mehrotra S, Friedewald JJ
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
The authors analyzed current kidney allocation and developed an alternative kidney sharing strategy using a multiperiod linear optimization model, KSHARE, which aims to improve geographic equity in kidney transplantation while also respecting transplant system constraints and priorities. They used Organ Procurement and Transplant Network data to determine that enhancing the practice of sharing kidneys by the KSHARE model may increase geographic equity in kidney transplantation.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Friedewald JJ .
Improving geographic equity in kidney transplantation using alternative kidney sharing and optimization modeling.
Med Decis Making 2015 Aug;35(6):797-807. doi: 10.1177/0272989x14557696.
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Keywords: Access to Care, Disparities, Health Services Research (HSR), Social Determinants of Health, Transplantation
Toro-Diaz H, Mayorga ME, Barritt AS
Predicting liver transplant capacity using discrete event simulation.
The researchers constructed a discrete event simulation model informed by current donor characteristics to predict future liver transplant trends through the year 2030. They found that by altering assumptions about the future donor pool, their model can be used to develop policy interventions to prevent a further decline in this lifesaving therapy.
AHRQ-funded; HS019468.
Citation: Toro-Diaz H, Mayorga ME, Barritt AS .
Predicting liver transplant capacity using discrete event simulation.
Med Decis Making 2015 Aug;35(6):784-96. doi: 10.1177/0272989x14559055.
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Keywords: Access to Care, Health Services Research (HSR), Policy, Transplantation
Santos CA, Brennan DC, Chapman WC
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
The researchers sought to determine the risk factors and outcomes of delayed-onset CMV disease among a representative cohort of liver transplant recipients from multiple centers. They found that delayed-onset CMV disease coded during hospital readmission occurred more commonly than early-onset CMV disease and that prior transplant failure or rejection was a risk factor for delayed-onset CMV disease.
AHRQ-funded; HS019455.
Citation: Santos CA, Brennan DC, Chapman WC .
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
Liver Transpl 2015 May;21(5):581-90. doi: 10.1002/lt.24089..
Keywords: Healthcare Cost and Utilization Project (HCUP), Risk, Transplantation, Outcomes
Santos CA, Brennan DC, Chapman WC
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
The researchers sought to determine the risk factors and outcomes associated with delayed-onset cytomegalovirus (CMV) disease among liver transplant recipients. Data from a group of 7,229 adult liver transplant recipients showed that delayed onset CMV disease was twice as likely as early onset CMV disease, with transplant failure or rejection being a risk factor.
AHRQ-funded; HS019455
Citation: Santos CA, Brennan DC, Chapman WC .
Delayed-onset cytomegalovirus disease coded during hospital readmission in a multicenter, retrospective cohort of liver transplant recipients.
Liver Transpl. 2015 May;21(5):581-90. doi: 10.1002/lt.24089..
Keywords: Outcomes, Transplantation, Quality of Care, Chronic Conditions
Harris AD, Fleming B, Bromberg JS
Surgical site infection after renal transplantation.
The researchers sought to identify factors associated with the development of surgical site infection (SSI) among adult patients undergoing renal transplantation. They found that BMI was a risk factor for the development of SSI following renal transplantation. Somewhat surprisingly, they did not find other biologically plausible or transplant-specific risk factors such as presence of comorbid conditions or receipt of appropriate (type and dose) antibiotic prophylaxis.
AHRQ-funded; HS022291.
Citation: Harris AD, Fleming B, Bromberg JS .
Surgical site infection after renal transplantation.
Infect Control Hosp Epidemiol 2015 Apr;36(4):417-23. doi: 10.1017/ice.2014.77..
Keywords: Transplantation, Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Risk, Adverse Events
Cauley RP, Potanos K, Fullington N
The effect of graft type on mortality in liver transplantation for hepatocellular carcinoma.
The researchers aimed to: (1) examine the risk of mortality in liver transplantation for hepatocellular carcinoma (HCC), (2) to establish if this risk is affected by partial graft use, and (3) to determine if this effect is mitigated by improved tumor-associated risk stratification. They found that the risk of mortality following LT does not differ by the type of graft used in recipients with favorable-risk HCC or those without HCC.
AHRQ-funded; HS019485.
Citation: Cauley RP, Potanos K, Fullington N .
The effect of graft type on mortality in liver transplantation for hepatocellular carcinoma.
Ann Transplant 2015 Mar 30;20:175-85. doi: 10.12659/aot.892613..
Keywords: Mortality, Cancer, Transplantation, Comparative Effectiveness, Outcomes