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- Adverse Events (2)
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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
1 to 13 of 13 Research Studies DisplayedSchumacher JR, Zahrieh D, Chow S
Increasing socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making through a shared decision-making intervention (A231701CD): protocol for a cluster randomised clinical trial.
This paper describes the protocol for a multisite randomized trial to test the impact of a newly developed decision aid to increase socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making. The study will be conducted through 10 surgical clinics within the National Cancer Institute Community Oncology Research Program (NCORP). A stepped-wedge design with clinics will be randomized to the time of transition from usual care to the decision aid arm. Study participants will be female, aged ≥18 years, with newly diagnosed stage 0-III breast cancer who are planning breast surgery. Data collection will include a baseline surgeon survey, baseline patient survey, audio-recording of the surgeon-patient consultation, a follow-up patient survey and medical record data review. A subset of patients, surgeons, and clinic stakeholders will participate in interviews and focus groups.
AHRQ-funded; HS025194.
Citation: Schumacher JR, Zahrieh D, Chow S .
Increasing socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making through a shared decision-making intervention (A231701CD): protocol for a cluster randomised clinical trial.
BMJ Open 2022 Nov 17;12(11):e063895. doi: 10.1136/bmjopen-2022-063895..
Keywords: Cancer: Breast Cancer, Cancer, Patient and Family Engagement, Shared Decision Making, Patient-Centered Healthcare, Surgery, Women
Graber J, Kittelson A, Juarez-Colunga E
Comparing "people-like-me" and linear mixed model predictions of functional recovery following knee arthroplasty.
This study compared the relative strengths and weaknesses of 2 prediction model approaches for predicting functional recovery after knee arthroplasty: a neighbors-based "people-like-me" (PLM) approach and a linear mixed model (LMM) approach. The authors used 2 distinct datasets to train and then test PLM and LMM prediction approaches. They used the Timed Up and Go (TUG)-a common test of mobility-to operationalize physical function. Both approaches use patient characteristics and baseline postoperative TUG values to predict TUG recovery from days 1-425 following surgery. They then compared the accuracy and precision of the two approaches. A total of 317 patient records with 1379 TUG observations were used to train approaches, and 456 patient records with 1244 TUG observations were used to test the predictions. Both approaches performed similarly in terms of mean squared error and bias, but the PLM approach provided more accurate and precise estimates of prediction uncertainty.
AHRQ-funded; HS025692.
Citation: Graber J, Kittelson A, Juarez-Colunga E .
Comparing "people-like-me" and linear mixed model predictions of functional recovery following knee arthroplasty.
J Am Med Inform Assoc 2022 Oct 7;29(11):1899-907. doi: 10.1093/jamia/ocac123..
Keywords: Orthopedics, Surgery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes
Graber J, Lockhart S, Matlock DD
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
In this qualitative study, researchers sought to understand patients' and physical therapists' perspectives related to decision making during outpatient rehabilitation after total knee arthroplasty (TKA) and further to describe potential barriers and opportunities for shared decision making (SDM) in this setting. They found that physical therapists described using decision-making strategies with varying levels of patient involvement, while both patients and physical therapists described barriers to routine use of SDM in the outpatient setting. They also presented actionable strategies for overcoming these barriers for providers and organizations seeking consistently to use SDM in outpatient TKA rehabilitation.
AHRQ-funded; HS025692.
Citation: Graber J, Lockhart S, Matlock DD .
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
J Eval Clin Pract 2022 Feb;28(1):99-107. doi: 10.1111/jep.13591..
Keywords: Shared Decision Making, Rehabilitation, Orthopedics, Surgery, Patient-Centered Healthcare
Kittelson AJ, Hoogeboom TJ, Schenkman M
Person-centered care and physical therapy: a "people-like-me" approach.
In this article the authors propose developing "people-like-me" reference charts, generated with historical outcomes data, to provide real-time information on an individual's status relative to similar people, using as an example people rehabilitating after total knee arthroplasty. The authors propose this framework as a practical mechanism to advance person-centered decisions in physical therapy according to the ideals of evidence-based practice.
AHRQ-funded; HS024316; HS025692.
Citation: Kittelson AJ, Hoogeboom TJ, Schenkman M .
Person-centered care and physical therapy: a "people-like-me" approach.
Phys Ther 2020 Jan 23;100(1):99-106. doi: 10.1093/ptj/pzz139..
Keywords: Patient-Centered Healthcare, Surgery, Orthopedics
Smith AB, Mueller D, Garren B
Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.
This study examined the need for qualitative research on meaningful patient-reported outcomes (PROs) to prevent complications and readmissions after cystectomy. The investigators looked at the potential use of mobile communication devices (mHealth) to capture patients’ experiences and to improve outcomes. Interviews were conducted with 15 readmitted patients and 10 of their partners over 45 semi-structured in-depth interviews. The most common perspectives were that patients and their caregivers were overloaded with cystectomy education; they need to know what are normal post-operative symptoms; and that using mHealth would help with patient and caregiver education.
AHRQ-funded; HS024134.
Citation: Smith AB, Mueller D, Garren B .
Using qualitative research to reduce readmissions and optimize perioperative cystectomy care.
Cancer 2019 Oct 15;125(20):3545-53. doi: 10.1002/cncr.32362..
Keywords: Hospital Readmissions, Surgery, Health Information Technology (HIT), Quality Improvement, Quality of Care, Hospitals, Patient-Centered Healthcare
Johnston FM, Beckman M
Navigating difficult conversations.
In this paper, the authors discussed breaking bad news and navigating difficult conversations in surgical oncology practice. They note that mounting evidence supports a patient-centered communication approach and models of shared decisionmaking. Physician training in patient-centered cancer communication also continues to evolve.
AHRQ-funded; HS024736.
Citation: Johnston FM, Beckman M .
Navigating difficult conversations.
J Surg Oncol 2019 Jul;120(1):23-29. doi: 10.1002/jso.25472..
Keywords: Cancer, Clinician-Patient Communication, Communication, Shared Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Provider: Physician, Surgery
Pellegrini CA, Chang RW, Dunlop DD
Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: a pilot study.
This article reports the results of a randomized pilot study that assessed changes in weight during a Patient Centered Weight Loss Program (PACE) initiated either before or after knee replacement. The feasibility of recruiting and retaining participants over 26 weeks was also examined. Recruitment outreach was extended to patients scheduled for knee replacement. Sixteen participants were randomly assigned to a 14-session weight loss program that started either at least 6 weeks before surgery or at 12 weeks following surgery. The authors conclude that behavioral intervention is challenging but feasible in a knee replacement population. Preliminary evidence suggests that initiating a program 12 weeks after surgery produces greater weight losses at 26 weeks when compared to a program that begins before knee replacement.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Chang RW, Dunlop DD .
Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: a pilot study.
Obes Res Clin Pract 2018 Sep - Oct;12(5):472-78. doi: 10.1016/j.orcp.2018.06.009..
Keywords: Orthopedics, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Obesity: Weight Management, Surgery, Obesity, Outcomes
Bossick AS, Sangha R, Olden H
Identifying what matters to hysterectomy patients: postsurgery perceptions, beliefs, and experiences.
This study collected data through structured focus groups with 24 post-hysterectomy women in order to identify Patient Centered Outcomes to employ in a subsequent cohort study of hysterectomy surgical approaches. According to the authors, the data suggested a need for increased education and empowerment in the decision making process, while expanding on information given for post-operative expectations and somatic changes that occur post-hysterectomy.
AHRQ-funded; HS022417.
Citation: Bossick AS, Sangha R, Olden H .
Identifying what matters to hysterectomy patients: postsurgery perceptions, beliefs, and experiences.
J Patient Cent Res Rev 2018;5(2):167-75. doi: 10.17294/2330-0698.1581..
Keywords: Patient Experience, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Surgery, Women
Acher AW, Campbell-Flohr SA, Brenny-Fitzpatrick M
Improving patient-centered transitional care after complex abdominal surgery.
Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are still lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. The investigators concluded that a phone-based transitional care protocol for surgical patients is feasible, with <1% refusals and 95% engagement.
patients is feasible, with <1% refusals and 95% engagement.
AHRQ-funded; HS022446.
AHRQ-funded; HS022446.
Citation: Acher AW, Campbell-Flohr SA, Brenny-Fitzpatrick M .
Improving patient-centered transitional care after complex abdominal surgery.
J Am Coll Surg 2017 Aug;225(2):259-65. doi: 10.1016/j.jamcollsurg.2017.04.008..
Keywords: Patient-Centered Healthcare, Quality of Care, Quality Improvement, Surgery, Transitions of Care
Pellegrini CA, Ledford G, Hoffman SA
Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention.
The purpose of this study was to identify knee replacement patient preferences for weight loss programs and qualitatively understand previous motives for weight loss attempts as well as strategies used to facilitate behavior changes. It provides a preliminary examination into the motives for weight loss, strategies utilized during past weight loss attempts, and preferences for future weight loss programs as described by knee replacement patients.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Ledford G, Hoffman SA .
Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention.
BMC Musculoskelet Disord 2017 Aug 1;18(1):327. doi: 10.1186/s12891-017-1687-x.
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Keywords: Patient-Centered Healthcare, Surgery, Obesity, Obesity: Weight Management
Lee DJ, Najari BB, Davison WL
Trends in the utilization of penile prostheses in the treatment of erectile dysfunction in the United States.
This study assessed the national temporal trends in the surgical management of ED utilizing penile prosthesis (PP). It found that the surgical management of ED with PP changed significantly between 2001 and 2010. Also, the overall utilization of PP decreased, but its use in patients with significant medical comorbidities increased.
AHRQ-funded; HS000066.
Citation: Lee DJ, Najari BB, Davison WL .
Trends in the utilization of penile prostheses in the treatment of erectile dysfunction in the United States.
J Sex Med 2015 Jul;12(7):1638-45. doi: 10.1111/jsm.12921..
Keywords: Healthcare Utilization, Men's Health, Patient-Centered Healthcare, Sexual Health, Surgery
Holcomb CN, Graham LA, Richman JS
The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.
The investigators sought to determine the incremental risk of noncardiac surgery on myocardial infarction (MI) and coronary revascularization following coronary stenting. They found that the incremental risk of noncardiac surgery on adverse cardiac events among post-stent patients is highest in the initial 6 months following stent implantation and stabilizes at 1.0% after 6 months.
AHRQ-funded; HS013852.
Citation: Holcomb CN, Graham LA, Richman JS .
The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.
J Am Coll Cardiol 2014 Dec 30;64(25):2730-9. doi: 10.1016/j.jacc.2014.09.072.
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Keywords: Adverse Events, Cardiovascular Conditions, Patient-Centered Healthcare, Risk, Surgery
Sanger 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