National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Asthma (1)
- Autism (1)
- Behavioral Health (3)
- Cancer (2)
- Cancer: Cervical Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (2)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (1)
- Care Management (2)
- Children/Adolescents (7)
- Chronic Conditions (6)
- Clinical Decision Support (CDS) (6)
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- Communication (1)
- Community-Based Practice (1)
- Comparative Effectiveness (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Depression (3)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Elderly (3)
- Electronic Health Records (EHRs) (3)
- Emergency Department (1)
- Evidence-Based Practice (2)
- Falls (1)
- Guidelines (1)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (6)
- Health Insurance (1)
- Imaging (1)
- Implementation (1)
- Medication (5)
- Obesity (1)
- Obesity: Weight Management (1)
- Opioids (1)
- Pain (1)
- Patient-Centered Healthcare (5)
- Patient-Centered Outcomes Research (1)
- Practice Patterns (3)
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- (-) Primary Care (29)
- Primary Care: Models of Care (2)
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- Provider: Clinician (1)
- Provider: Physician (2)
- Public Reporting (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (2)
- Risk (1)
- Screening (8)
- (-) Shared Decision Making (29)
- Sickle Cell Disease (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 29 Research Studies DisplayedKukhareva PV, Li H, Caverly TJ
Implementation of lung cancer screening in primary care and pulmonary clinics: pragmatic clinical trial of electronic health record-integrated everyday shared decision-making tool and clinician-facing prompts.
The authors conducted pre- and post-intervention analysis in primary care and pulmonary clinics to explore whether clinician-facing electronic health record (EHR) prompts and an EHR-integrated shared decision-making (SDM) tool designed to support incorporation of SDM into primary care could improve low-dose computer tomography scan imaging ordering and completion. Subjects were patients who met US Preventive Services Task Force criteria for lung cancer screening (LCS). The results indicated that EHR prompts and the EHR-integrated SDM tool were promising approaches to improving LCS in the primary care setting. The authors noted that further research is warranted.
AHRQ-funded; HS026198; HS028791.
Citation: Kukhareva PV, Li H, Caverly TJ .
Implementation of lung cancer screening in primary care and pulmonary clinics: pragmatic clinical trial of electronic health record-integrated everyday shared decision-making tool and clinician-facing prompts.
Chest 2023 Nov; 164(5):1325-38. doi: 10.1016/j.chest.2023.04.040..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Shared Decision Making
Shear K, Rice H, Garabedian PM
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
The purpose of this study was to conduct usability testing of the ASPIRE fall risk management tool for use in divergent primary care clinics. Participants recruited from two sites with different electronic health records and clinical organizations used ASPIRE across two clinical scenarios; they rated ASPIRE usability as above average, based on usability benchmarks. Time spent on tasks decreased significantly between the first and second scenarios, indicating ease of learnability. The authors conclude that ASPIRE could be integrated into diverse organizations, since it allows a tailored implementation without the need to build a new system for each organization. ASPIRE is therefore well positioned to impact the challenge of falls at scale.
AHRQ-funded; HS027557.
Citation: Shear K, Rice H, Garabedian PM .
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
Appl Clin Inform 2023 Mar;14(2):212-26. doi: 10.1055/a-2006-4936.
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Falls, Primary Care, Risk, Prevention
Tierney WM, Henning JM, Altillo BS
User-centered design of a clinical tool for shared decision-making about diet in primary care.
This study described how the authors engaged primary care clinicians and their patients in an iterative design process for a software application to enhance clinician-patient diet discussions. The goal is to help prevent clinician burnout and career dissatisfaction brought on by poorly designed health information technology. Individual clinician and patient interviews were conducted to detail the desired informational content of the screens displayed followed by iterative reviews of intermediate and final versions of the program and its outputs. Participants were primary care clinicians practicing in an urban federally qualified health center and two academic primary care clinics, and their patients who were overweight or obese with diet-sensitive conditions. Three iterations of design and review were conducted with substantial evolution of the program’s content, format, and flow of information. The amount of information was fine-tuned so it would be just the right amount displayed to facilitate shared dietary goal setting.
AHRQ-funded; HS027660.
Citation: Tierney WM, Henning JM, Altillo BS .
User-centered design of a clinical tool for shared decision-making about diet in primary care.
J Gen Intern Med 2023 Feb; 38(3):715-26. doi: 10.1007/s11606-022-07804-x..
Keywords: Patient-Centered Healthcare, Shared Decision Making, Primary Care
Schuttner L, Lee JR, Hockett Sherlock S
Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: a qualitative study.
The purpose of this study was to explore primary care physician (PCP) perspectives on the influence of patients' values, health priorities and goals, and preferences on clinical decisions for patients with multimorbidity and higher psychosocial complexity. Between May and July 2020 the researchers utilized semi-structured telephone interviews with 23 PCPs in patient-centered medical home teams in a nationally integrated health system in the United States. The study found three major themes: (1) The personal values of patients were rarely directly discussed in routine clinical encounters but informed more typically discussed constructs of patient preferences, goals, and priorities; (2) Patient preferences, goals, and priorities were sources of conflicting perspectives about care plans between healthcare teams, patients, and families; (3) Physicians used direct strategies to communicate and negotiate about patient preferences, goals, and priorities when developing care plans. The researchers concluded that during clinical decision-making for complex patients with multimorbidity, primary care physicians perceive patient values, preferences, health priorities and goals as influential.
AHRQ-funded; HS026369.
Citation: Schuttner L, Lee JR, Hockett Sherlock S .
Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: a qualitative study.
Risk Manag Healthc Policy 2022 Nov 16; 15:2135-46. doi: 10.2147/rmhp.S380021..
Keywords: Primary Care, Provider: Physician, Shared Decision Making, Chronic Conditions
Reese TJ, Schlechter CR, Kramer H
Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.
This study explored the implementation of lung cancer screening with low-dose computed tomography (CT) in primary care. The study’s two goals included exploring the implementation of lung cancer screening primary care in the context of integrating a decision aid into the electronic health record and a designing of implementation strategies that target hypothesized mechanics of change and context-specific barriers. The two phases included a Qualitative Analysis phase including semi-structured interviews with primary care physicians to elicit key task behaviors, and an Implementation Strategy Design phase consisting of defining implementation strategies and hypothesizing causal pathways to improve screening with a decision aid. Fourteen interviews were conducted and out of that 3 key task behaviors and four behavioral determinants emerged. Strategies included increasing provider self-efficacy toward performing shared decision making and using the decision aid, improving provider performance expectancy, increasing social influence, and addressing key facilitators to using the decision aid.
AHRQ-funded; HS026198.
Citation: Reese TJ, Schlechter CR, Kramer H .
Implementing lung cancer screening in primary care: needs assessment and implementation strategy design.
Transl Behav Med 2022 Feb 16;12(2):187-97. doi: 10.1093/tbm/ibab115..
Keywords: Cancer: Lung Cancer, Cancer, Primary Care, Screening, Implementation, Shared Decision Making
Schuttner L, Hockett Sherlock S, Simons C
Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.
Researchers sought to describe factors affecting physician decision-making when care planning for complex patients with multimorbidity within the team-based, patient-centered medical home setting in the integrated healthcare system of the U.S. Department of Veterans Affairs, the Veterans Health Administration (VHA). They found that primary care physicians described internal, external, and relationship-based factors that affected their care planning for high-risk and complex patients with multimorbidity in the VHA.
AHRQ-funded; HS026369.
Citation: Schuttner L, Hockett Sherlock S, Simons C .
Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.
BMC Prim Care 2022 Feb 5;23(1):25. doi: 10.1186/s12875-022-01633-x..
Keywords: Primary Care, Shared Decision Making, Chronic Conditions, Patient-Centered Healthcare
Ibemere SO, Tanabe P, Bonnabeau E
Awareness and use of the sickle cell disease toolbox by primary care providers in North Carolina.
The authors developed a decision support tool for sickle cell disease (SCD) for SCD management (SCD Toolbox) based on the National Heart, Lung, and Blood Institute's SCD guidelines. Using data from primary care providers (PCPs) in North Carolina, they found that PCPs rarely co-managed with a specialist, had low awareness and use of the SCD Toolbox, and requested multiple formats for the toolbox.
AHRQ-funded; HS024501.
Citation: Ibemere SO, Tanabe P, Bonnabeau E .
Awareness and use of the sickle cell disease toolbox by primary care providers in North Carolina.
J Prim Care Community Health 2021 Jan-Dec;12:21501327211049050. doi: 10.1177/21501327211049050..
Keywords: Sickle Cell Disease, Primary Care, Chronic Conditions, Shared Decision Making, Evidence-Based Practice
Campbell NL, Holden RJ, Tang Q
Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.
This study tested the effectiveness of a multicomponent behavioral intervention to reduce the use of high-risk anticholinergic medications in primary care older adults. Ten primary care clinics within Eskenazi Health in Indianapolis were selected to test the intervention. The intervention included provider- and patient-focused components. The provider-focused component was a computerized decision support system alerting the presence of a high-risk anticholinergic and offering dose- and indication-specific alternatives; while the patient-focused component was a story-based video providing education and modeling an interaction with a healthcare provider. The intervention occurred from April 2019 through March 2020. A total of 552 older adults had primary care visits during the study period. Only 3 out of 259 provider-focused alerts led to a medication change. Of the 276 staff alerts, 4.7% were confirmed to activate the patient-focused intervention.
AHRQ-funded; P30HS024384.
Citation: Campbell NL, Holden RJ, Tang Q .
Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.
J Am Geriatr Soc 2021 Jun;69(6):1490-99. doi: 10.1111/jgs.17121..
Keywords: Elderly, Medication, Primary Care, Clinical Decision Support (CDS), Shared Decision Making
Downs SM, Bauer NS, Saha C
Effect of a computer-based decision support intervention on autism spectrum disorder screening in pediatric primary care clinics: a cluster randomized clinical trial.
This study examined outcomes for implementation of a decision support system called CHICA (Child Health Improvement Through Computer Automation) to improve screening rates for autism in children aged 18 to 24 months. A random sample of 274 children in four urban clinics was used. Two clinics participated in the intervention, and two served as controls. Because participating clinics requested intervention be discontinued for children aged 18 months, only results for those aged 24 months was analyzed. Of the 263 children with reviewed results, 92% were enrolled in Medicaid, 52.5% were African American, and 36.5% were Hispanic. Screening rates increased from 0% at baseline to 100% in 24 months during the study period of November 2010 to November 2012. Screening results were positive for 265 of 980 children screened by CHICA in the time period, with 2 children from the intervention group positively diagnosed in the time frame of the study.
AHRQ-funded; HS018453.
Citation: Downs SM, Bauer NS, Saha C .
Effect of a computer-based decision support intervention on autism spectrum disorder screening in pediatric primary care clinics: a cluster randomized clinical trial.
JAMA Netw Open 2019 Dec 2;2(12):e1917676. doi: 10.1001/jamanetworkopen.2019.17676..
Keywords: Autism, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Primary Care, Children/Adolescents, Screening
Vogel JA, Rising KL, Jones J
Reasons patients choose the emergency department over primary care: a qualitative metasynthesis.
To enhance the acute care delivery system, a comprehensive understanding of the patient's perspectives for seeking care in the emergency department (ED) versus primary care (PC) is necessary. In this study, the investigators conducted a qualitative metasynthesis on reasons patients sought care in the ED instead of PC. The investigators concluded that reasons included: (1) urgency of the medical condition, (2) barriers to accessing primary care, (3) advantages of the ED, and (4) fulfillment of medical needs and quality of care in the ED.
AHRQ-funded; HS023901.
Citation: Vogel JA, Rising KL, Jones J .
Reasons patients choose the emergency department over primary care: a qualitative metasynthesis.
J Gen Intern Med 2019 Nov;34(11):2610-19. doi: 10.1007/s11606-019-05128-x..
Keywords: Emergency Department, Primary Care, Shared Decision Making, Healthcare Delivery
Ronis SD, Kleinman LC, Stange KC
A learning loop model of collaborative decision-making in chronic illness.
In this article, the authors discuss their learning loop model, which posits the relationship between pediatric patients, their parents, and their clinicians as central to the collaborative decision-making process in the setting of chronic illness. The model incorporates the evolution of both context and developmental capacity over time. It suggests that "meta-learning" from the experience of and outcomes from iterative decision is a key factor that may influence relationships and thus continued engagement in collaboration by patients, their parents, and their clinicians.
AHRQ-funded; HS024433.
Citation: Ronis SD, Kleinman LC, Stange KC .
A learning loop model of collaborative decision-making in chronic illness.
Acad Pediatr 2019 Jul;19(5):497-503. doi: 10.1016/j.acap.2019.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Shared Decision Making, Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Clinician-Patient Communication, Communication
Militello LG, Anders S, Downs SM
Understanding how primary care clinicians make sense of chronic pain.
This research explored how primary care clinicians manage their patients with chronic noncancer pain. They conducted Critical Decision Method interviews with 10 clinicians about 30 individual patients. Findings suggested that clinicians should focus on supporting sensemaking in the content of clinical evidence rather than trying to provide them with rules.
AHRQ-funded; HS023306.
Citation: Militello LG, Anders S, Downs SM .
Understanding how primary care clinicians make sense of chronic pain.
Cogn Technol Work 2018 Nov;20(4):575-84. doi: 10.1007/s10111-018-0491-1..
Keywords: Pain, Chronic Conditions, Opioids, Medication, Shared Decision Making, Primary Care, Care Management
Liu TL, Taylor YJ, Mahabaleshwarkar R
Shared decision making and time to exacerbation in children with asthma.
This study examined the use of shared decision making (SDM) to delay exacerbation in children with asthma. A prospective cohort of children at five primary care practices in Charlotte, North Carolina that serve vulnerable population was studied between 2011 and 2013. The cohort included 746 children, with 60.5% male and 54.2% African American with a mean age of 8.6 years. The final analysis included 100 matched pairs of children for use of SDM and normal care. There was a marginally significant difference in the time of exacerbation between the two groups.
AHRQ-funded; HS019946.
Citation: Liu TL, Taylor YJ, Mahabaleshwarkar R .
Shared decision making and time to exacerbation in children with asthma.
J Asthma 2018 Sep;55(9):949-55. doi: 10.1080/02770903.2017.1378357..
Keywords: Children/Adolescents, Shared Decision Making, Asthma, Respiratory Conditions, Chronic Conditions, Primary Care
Kim JJ, Burger EA, Regan C
Screening for cervical cancer in primary care: a decision analysis for the US Preventive Services Task Force.
The purpose of this study was to inform the US Preventive Services Task Force by modeling the benefits and harms of various cervical cancer screening strategies. In this microsimulation modeling study, it was estimated that primary hrHPV screening may represent a reasonable balance of harms and benefits when performed every 5 years. Switching from cytology to hrHPV testing at age 30 years yielded the most efficient harm to benefit ratio when using colposcopy as a proxy for harms.
AHRQ-funded; 290-2012-00015-I.
Citation: Kim JJ, Burger EA, Regan C .
Screening for cervical cancer in primary care: a decision analysis for the US Preventive Services Task Force.
JAMA 2018 Aug 21;320(7):706-14. doi: 10.1001/jama.2017.19872..
Keywords: Cancer: Cervical Cancer, Shared Decision Making, Primary Care, Screening, U.S. Preventive Services Task Force (USPSTF)
Higuera L, Carlin CS, Dowd B
Narrow provider networks and willingness to pay for continuity of care and network breadth.
This study examined choices of health plans in a private health insurance exchange where consumers choose among one broad network and four narrow network plans. The willingness to pay for a network that covers consumers' usual source of care was between $84 and $275/month (for primary care) and between $0 and $115/month (for specialists). The investigators also found that, given that a network covers their usual source of care, consumers show aversion only to the narrowest networks.
AHRQ-funded; HS022881.
Citation: Higuera L, Carlin CS, Dowd B .
Narrow provider networks and willingness to pay for continuity of care and network breadth.
J Health Econ 2018 Jul;60:90-97. doi: 10.1016/j.jhealeco.2018.06.006..
Keywords: Access to Care, Shared Decision Making, Health Insurance, Primary Care
Misra-Hebert AD, Hom G, Klein EA
Testing of a tool for prostate cancer screening discussions in primary care.
As prostate cancer (PCa) screening decisions often occur in outpatient primary care, a brief tool to help the PCa screening conversation in busy clinic settings is needed. This paper discusses a previously-created 9-item tool to aid (PCa) screening discussions. The study found that the brief conversation tool was well received in busy primary-care settings and improved patients' knowledge about the screening decision.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hom G, Klein EA .
Testing of a tool for prostate cancer screening discussions in primary care.
Front Oncol 2018 Jun 28;8:238. doi: 10.3389/fonc.2018.00238..
Keywords: Cancer: Prostate Cancer, Shared Decision Making, Patient-Centered Outcomes Research, Primary Care, Screening
McCreedy EM, Kane RL, Gollust SE
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explored how patient characteristics associated with a high risk-to-benefit ratio with hypoglycemia medications affected decision making by primary care clinicians. The investigators found that primary care clinicians often chose to intensify glycemic control despite individual patient factors that warranted higher glycemic targets based on existing guidelines.
AHRQ-funded; HS000011.
Citation: McCreedy EM, Kane RL, Gollust SE .
Patient-centered guidelines for geriatric diabetes care: potential missed opportunities to avoid harm.
J Am Board Fam Med 2018 Mar-Apr;31(2):192-200. doi: 10.3122/jabfm.2018.02.170141..
Keywords: Diabetes, Elderly, Patient-Centered Healthcare, Guidelines, Evidence-Based Practice, Shared Decision Making, Medication, Primary Care, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Aalsma MC, Zerr AM, Etter DJ
Physician intervention to positive depression screens among adolescents in primary care.
The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care. The investigators found that when a computer-based decision support system algorithm focused on adolescent depression and was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Zerr AM, Etter DJ .
Physician intervention to positive depression screens among adolescents in primary care.
J Adolesc Health 2018 Feb;62(2):212-18. doi: 10.1016/j.jadohealth.2017.08.023..
Keywords: Care Management, Children/Adolescents, Shared Decision Making, Depression, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Screening
Etter DJ, McCord A, Ouyang F
Suicide screening in primary care: use of an electronic screener to assess suicidality and improve provider follow-up for adolescents.
The purpose of this study was to assess the feasibility of using an existing computer decision support system to screen adolescent patients for suicidality and provide follow-up guidance to clinicians in a primary care setting. The authors concluded that incorporating adolescent suicide screening and provider follow-up guidance into an existing computer decision support system in primary care was feasible and well utilized by providers.
AHRQ-funded; HS022681.
Citation: Etter DJ, McCord A, Ouyang F .
Suicide screening in primary care: use of an electronic screener to assess suicidality and improve provider follow-up for adolescents.
J Adolesc Health 2018 Feb;62(2):191-97. doi: 10.1016/j.jadohealth.2017.08.026..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Depression, Behavioral Health, Primary Care, Screening
Hines AL, Roter D, Ghods Dinoso BK
Informed and patient-centered decision-making in the primary care visits of African Americans with depression.
This study examined the prevalence and extent of informed decision-making (IDM) and patient-centered decision-making (PCDM) in primary care visits of African Americans with depression. It concluded that the associations between IDM and PCDM with interpersonal ratings were moderated by overall patient-centeredness of the visit, which may be indicative of broader cross-cultural communication issues. Strengthening partnerships between depressed African Americans and their clinicians may improve patient-engaged decision-making.
AHRQ-funded; HS013645.
Citation: Hines AL, Roter D, Ghods Dinoso BK .
Informed and patient-centered decision-making in the primary care visits of African Americans with depression.
Patient Educ Couns 2018 Feb;101(2):233-40. doi: 10.1016/j.pec.2017.07.027.
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Keywords: Shared Decision Making, Depression, Patient-Centered Healthcare, Primary Care, Racial and Ethnic Minorities
Kistler CE, Golin C, Sundaram A
Individualized colorectal cancer screening discussions between older adults and their primary care providers: a cross-sectional study.
The aim of this study was to describe colorectal cancer (CRC) screening discussions and explore their associations with patient characteristics and screening intentions. The investigators found that CRC screening discussions varied by type of participant and content. They assert that future work is needed to determine if interventions focused on specific domains alters the appropriateness of participants' colorectal cancer screening intentions.
AHRQ-funded; HS021133.
Citation: Kistler CE, Golin C, Sundaram A .
Individualized colorectal cancer screening discussions between older adults and their primary care providers: a cross-sectional study.
MDM Policy Pract 2018 Jan-Jun;3(1):2381468318765172. doi: 10.1177/2381468318765172..
Keywords: Cancer: Colorectal Cancer, Shared Decision Making, Elderly, Primary Care, Screening
Halbert CH, Jefferson M, Melvin CL
Provider advice about weight loss in a primary care sample of obese and overweight patients.
In this study the investigators examined receipt of provider advice to lose weight among primary care patients who were overweight and obese. The investigators found that patient beliefs about their weight status and perceptions about shared decision-making are important to receiving provider advice about weight loss/management among primary care patients.
AHRQ-funded; HS023047.
Citation: Halbert CH, Jefferson M, Melvin CL .
Provider advice about weight loss in a primary care sample of obese and overweight patients.
J Prim Care Community Health 2017 Oct;8(4):239-46. doi: 10.1177/2150131917715336..
Keywords: Shared Decision Making, Obesity, Obesity: Weight Management, Practice Patterns, Primary Care
Renati S, Linder JA
Necessity of office visits for acute respiratory infections in primary care.
The researchers measured the proportion of primary care acute respiratory infection (ARI) visits that may not require an office visit. They concluded that about two-thirds of primary care ARI visits may not be necessary for appropriate antibiotic management.
AHRQ-funded; HS018419.
Citation: Renati S, Linder JA .
Necessity of office visits for acute respiratory infections in primary care.
Fam Pract 2016 Jun;33(3):312-7. doi: 10.1093/fampra/cmw019.
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Keywords: Shared Decision Making, Medication, Primary Care, Practice Patterns, Respiratory Conditions
Ladapo JA, Blecker S, Douglas PS
Appropriateness of cardiac stress test use among primary care physicians and cardiologists in the United States.
In this study, the researchers used nationally-representative data to examine differences in appropriate use of cardiac stress testing between cardiologists and primary care physicians (PCPs) in the US. Using permissive criteria to determine appropriateness, they found that primary care physicians are more likely to order or perform a rarely appropriate cardiac stress test than cardiologists.
AHRQ-funded; HS023683.
Citation: Ladapo JA, Blecker S, Douglas PS .
Appropriateness of cardiac stress test use among primary care physicians and cardiologists in the United States.
Int J Cardiol 2016 Jan 15;203:584-6. doi: 10.1016/j.ijcard.2015.10.238.
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Keywords: Cardiovascular Conditions, Diagnostic Safety and Quality, Imaging, Primary Care, Shared Decision Making
LeBlanc A, Herrin J, Williams MD
Shared decision making for antidepressants in primary care: a cluster randomized trial.
The researchers estimated the effect of the Depression Medication Choice (DMC) encounter decision aid on quality of the decision‐making process and depression outcomes. They found that the DMC decision aid helped primary care clinicians and patients with moderate to severe depression select antidepressants together, improving the decision-making process without extending the visit.
AHRQ-funded; HS019214.
Citation: LeBlanc A, Herrin J, Williams MD .
Shared decision making for antidepressants in primary care: a cluster randomized trial.
JAMA Intern Med 2015 Nov;175(11):1761-70. doi: 10.1001/jamainternmed.2015.5214..
Keywords: Medication, Comparative Effectiveness, Shared Decision Making, Primary Care