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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 25 of 90 Research Studies DisplayedTyler A, Jolles M
Methodological progress note: implementation science contributions to healthcare research and practice.
Existing research reflects that specific populations such as senior citizens, minorities, and rural Americans have proportionally less access to telehealth when compared to the average American. The purpose of this study was to explore specific strategies for overcoming barriers to telehealth access through an evaluation of data collected by a medical student-run telehealth education program. During the study period the researchers contacted 47 patients by telephone through the GET (Geriatric Education On Telehealth) Access Program. The study found 4 main themes during the discussions with patients, including: completion of registration steps, familiarity with accessing and using video conferencing software, attainment of proxy access for parents of a pediatric patient, and resolution of miscellaneous technical queries.
AHRQ-funded; HS026512.
Citation: Tyler A, Jolles M .
Methodological progress note: implementation science contributions to healthcare research and practice.
J Hosp Med 2023 Oct; 18(10):920-25. doi: 10.1002/jhm.13147..
Keywords: Implementation, Health Services Research (HSR), Evidence-Based Practice
Tugwell P, Welch V, Magwood O
AHRQ Author: Chang C
Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses.
The objectives of this protocol were to: Identify, map, and synthesize findings related to engagement in evidence syntheses; Explore how engagement in evidence synthesis promotes health equity; Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement. The authors intended to use their findings to develop draft guidance checklists and assess agreement with each item through an international survey. The guidance checklists will be co-produced and after being finalized at a consensus meeting, an international team will develop guidance for collaborators and partner engagement. The authors concluded that incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.
AHRQ-authored.
Citation: Tugwell P, Welch V, Magwood O .
Protocol for the development of guidance for collaborator and partner engagement in health care evidence syntheses.
Syst Rev 2023 Aug 2; 12(1):134. doi: 10.1186/s13643-023-02279-1..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Healthcare Delivery
Markham JL, Richardson T, Stephens JR
Essential concepts for reducing bias in observational studies.
This study discussed ways to reduce bias in pediatric observational studies, which may be used instead of randomized controlled trials (RCTs) due to barriers within pediatric populations, including lower disease prevalence, high costs, inadequate funding, and additional regulatory requirements. Observational studies do not involve randomization and thus have more potential for bias when compared with RCTs because of imbalances that can exist between comparison groups. The authors describe techniques to minimize bias by controlling for important measurable covariates within observational studies and discuss the challenges and opportunities in addressing specific variables.
AHRQ-funded; HS028845.
Citation: Markham JL, Richardson T, Stephens JR .
Essential concepts for reducing bias in observational studies.
Hosp Pediatr 2023 Aug; 13(8):e234-e39. doi: 10.1542/hpeds.2023-007116..
Keywords: Research Methodologies, Health Services Research (HSR)
Strayer TE, Hollingsworth EK, Shah AS
Why do older adults decline participation in research? Results from two deprescribing clinical trials.
The objective of this study was to examine reasons why hospitalized older adults declined participation in two deprescribing clinical trials, Shed-MEDS (non-Veterans) and VA DROP (Veterans). The reasons given by participating patients were condensed into three themes: feeling overwhelmed by current health status; lack of interest or mistrust; hesitancy to participate. A greater proportion of Veterans expressed a lack of interest or, while more non-Veterans expressed feeling overwhelmed by their current health status. The authors concluded that understanding the reasons why older adults decline participation can inform future strategies to engage this multimorbid population.
AHRQ-funded; HS026122.
Citation: Strayer TE, Hollingsworth EK, Shah AS .
Why do older adults decline participation in research? Results from two deprescribing clinical trials.
Trials 2023 Jul 18; 24(1):456. doi: 10.1186/s13063-023-07506-7..
Keywords: Elderly, Research Methodologies, Health Services Research (HSR)
Rees CA, Stewart AM, Portillo EN
Reporting of important social determinants of health in pediatric clinical trials.
The purpose of this study was to assess the rates and trends in the reporting of sexual orientation, gender identity, preferred language, and socioeconomic factors in published pediatric clinical trials. The researchers conducted a cross-sectional study of pediatric clinical trials in the United States published from January 1, 2011 through December 31, 2020 in 5 general pediatric and 5 general medical journals with the highest impact factor in their respective fields. Outcomes included reporting of sexual orientation, gender identity, socioeconomic factors, and preferred language. The study found that in 612 trials, 29.6% reported preferred language. Among these, 64.6% exclusively enrolled participants whose preferred language was English. From 2011 to 2020, there was a relative increase in the reporting of preferred language. Socioeconomic factors were reported in 47.9% of trials. There was no significant change in the reporting of socioeconomic factors of published trial results among adolescent participants reported any measure of sexual orientation, and 1.1% reported gender identity. The researchers concluded that despite sexual orientation, gender identity, preferred language, and socioeconomic factors being increasingly recognized as social determinants of health these variables were infrequently included in pediatric clinical trial results reporting.
AHRQ-funded; HS026503.
Citation: Rees CA, Stewart AM, Portillo EN .
Reporting of important social determinants of health in pediatric clinical trials.
Am J Prev Med 2023 Jun; 64(6):918-26. doi: 10.1016/j.amepre.2022.12.004..
Keywords: Children/Adolescents, Social Determinants of Health, Health Services Research (HSR)
Huo T, Glueck DH, Shenkman EA
Stratified split sampling of electronic health records
Data extracted from electronic health records may require very different approaches for model building and analysis than data from clinical research. Because electronic health record data is designed for clinical use, researchers need to engage in the iterative process of defining and provide clear definitions of outcome and predictor variables and assessing associations. This process can increase Type I error rates and decrease the chance of replicability. Failure to consider subgroups may mask heterogeneous relationships between predictor and outcome by subgroups, thus decreasing the generalizability of the findings. To improve the likelihood of both replicability and generalizability, the researchers recommended utilizing a stratified split sample approach for studies using electronic health records. The researchers illustrate the approach through an electronic health record study of the relationships between socio-demographic factors and uptake of hepatic cancer screening, and potential heterogeneity of association in subgroups defined by gender, self-identified race and ethnicity, census-tract level poverty and insurance type.
AHRQ-funded; HS028283.
Citation: Huo T, Glueck DH, Shenkman EA .
Stratified split sampling of electronic health records
BMC Med Res Methodol 2023 May 25; 23(1):128. doi: 10.1186/s12874-023-01938-0..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, Health Services Research (HSR)
Jaramillo ET, Willging CE, Saldana L
Barriers and facilitators to implementing evidence-based interventions in the context of a randomized clinical trial in the United States: a qualitative study.
This study examined factors that facilitate or impede success in the implementation of evidence-based interventions in a clinical trial. This study utilized the clinical trial SafeCare®, a child maltreatment intervention. Qualitative data were obtained between May and October 2017 as part of a larger mixed-methods study involving a cluster randomized trial comparing SafeCare to usual services for caregivers within nine child welfare agencies across four states. Individual interviews were conducted with a purposive sample of 21 child welfare administrators and 24 supervisors, and 19 focus groups were conducted with 84 providers. Facilitators and barriers were determined with facilitators including: 1) Benefits afforded through RCT participation; (2) Shared vision and sustained buy-in across system and organizational levels; and (3) Ongoing leadership support for SafeCare and the RCT. The three barriers identified that hindered SafeCare were: (1) Insufficient preparation to incorporate SafeCare into services; (2) Perceived lack of fit, leading to mixed support for SafeCare and the RCT; and (3) Requirements of RCT participation at the provider level.
AHRQ-funded; HS023370.
Citation: Jaramillo ET, Willging CE, Saldana L .
Barriers and facilitators to implementing evidence-based interventions in the context of a randomized clinical trial in the United States: a qualitative study.
BMC Health Serv Res 2023 Jan 26; 23(1):88. doi: 10.1186/s12913-023-09079-2..
Keywords: Evidence-Based Practice, Health Services Research (HSR)
Klig JE, Fang A, Fox SM
2018 Academic Emergency Medicine Consensus Conference: Advancing Pediatric Emergency Medicine Education Through Research and Scholarship.
To achieve high-quality emergency care for pediatric patients nationwide, it is necessary to define the key elements for pediatric emergency medicine (PEM) education and scholarship. A working group of medical educators was formed to review the literature, develop a framework for consensus discussion at the breakout session, and then translate their findings into recommendations for future research and scholarship.
AHRQ-funded; HS026101.
Citation: Klig JE, Fang A, Fox SM .
2018 Academic Emergency Medicine Consensus Conference: Advancing Pediatric Emergency Medicine Education Through Research and Scholarship.
Acad Emerg Med 2018 Dec;25(12):1327-35. doi: 10.1111/acem.13632..
Keywords: Emergency Department, Children/Adolescents, Health Services Research (HSR)
I Auerbach, M Badaki-Makun, O
AHRQ Author: Barata
A research agenda to advance pediatric emergency care through enhanced collaboration across emergency departments.
In 2018, the Society for Academic Emergency Medicine and the journal Academic Emergency Medicine (AEM) convened a consensus conference entitled, "Academic Emergency Medicine Consensus Conference: Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps." This article is the product of the breakout session, "Emergency Department Collaboration-Pediatric Emergency Medicine in Non-Children's Hospital."
AHRQ-funded; HS026101.
Citation: I Auerbach, M Badaki-Makun, O .
A research agenda to advance pediatric emergency care through enhanced collaboration across emergency departments.
Acad Emerg Med 2018 Dec;25(12):1415-26. doi: 10.1111/acem.13642..
Keywords: Care Coordination, Children/Adolescents, Emergency Department, Evidence-Based Practice, Health Services Research (HSR), Outcomes, Quality of Care, Quality Improvement
Burgette JM, Preisser JS, Rozier RG
Access to preventive services after the integration of oral health care into early childhood education and medical care.
The authors compared children enrolled in North Carolina Early Head Start (EHS) programs with similar children enrolled in Medicaid but not EHS on the use of POHS. They analyzed 4 dependent variables (oral assessment by medical health care provider, oral assessment by oral health care provider, fluoride application by medical health care provider, fluoride application by oral health care provider) by using multivariate logistic regression that controlled for covariates.
AHRQ-funded; HS000032.
Citation: Burgette JM, Preisser JS, Rozier RG .
Access to preventive services after the integration of oral health care into early childhood education and medical care.
J Am Dent Assoc 2018 Dec;149(12):1024-31.e2. doi: 10.1016/j.adaj.2018.07.019..
Keywords: Access to Care, Children/Adolescents, Dental and Oral Health, Health Services Research (HSR), Medicaid, Patient-Centered Healthcare, Prevention
Adelgais KM, Hansen M, Lerner EB
Establishing the key outcomes for pediatric emergency medical services research.
The evidence supporting best practices when treating children in the prehospital setting or even the effect emergency medical services (EMS) has on patient outcomes is limited. This article describes a consensus process among stakeholders in the pediatric emergency medicine and EMS community that identified the critical outcomes for EMS care in five clinical areas (traumatic brain injury, general injury, respiratory disease/failure, sepsis, and seizures).
AHRQ-funded; HS026101.
Citation: Adelgais KM, Hansen M, Lerner EB .
Establishing the key outcomes for pediatric emergency medical services research.
Acad Emerg Med 2018 Dec;25(12):1345-54. doi: 10.1111/acem.13637..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Evidence-Based Practice, Health Services Research (HSR), Outcomes, Patient-Centered Outcomes Research
Marshall IJ, Noel-Storr A, Kuiper J
Machine learning for identifying randomized controlled trials: an evaluation and practitioner's guide.
The purpose of this study was to evaluate machine learning models for RCT classification. Models were evaluated on an external dataset. The authors demonstrate that machine learning approaches are better able to discriminate between RCTs and non-RCTs than traditional database search filters, and also provide practical guidance on the role of machine learning in systematic reviews, and rapid reviews and clinical question answering as well as an open-source software.
AHRQ-funded; HS025024.
Citation: Marshall IJ, Noel-Storr A, Kuiper J .
Machine learning for identifying randomized controlled trials: an evaluation and practitioner's guide.
Res Synth Methods 2018 Dec;9(4):602-14. doi: 10.1002/jrsm.1287..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Van Domelen DR, Mitchell EM, Perkins NJ
AHRQ Author: Mitchell EM
Logistic regression with a continuous exposure measured in pools and subject to errors.
A logistic regression model for poolwise data is available, but validity requires that the assay yields the precise mean exposure for members of each pool. To account for errors, the authors assume the assay returns the true mean exposure plus a measurement error (ME) and/or a processing error (PE). They describe their process in this paper.
AHRQ-authored.
Citation: Van Domelen DR, Mitchell EM, Perkins NJ .
Logistic regression with a continuous exposure measured in pools and subject to errors.
Stat Med 2018 Nov 30;37(27):4007-21. doi: 10.1002/sim.7891.
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Keywords: Health Services Research (HSR)
Simpson LA, Koechlein L, Menachemi N
Show me the money! Trends in funding for health services research.
This paper presents longitudinal data representing federal funding for health services research and discusses the observed trends in the larger context of overall funding for research and development in the United States.
AHRQ-funded; 233201600155P.
Citation: Simpson LA, Koechlein L, Menachemi N .
Show me the money! Trends in funding for health services research.
Health Serv Res 2018 Oct;53 Suppl 2:3967-75. doi: 10.1111/1475-6773.13040..
Keywords: Health Services Research (HSR)
Brennan-Cook J, Bonnabeau E, Aponte R
Barriers to care for persons with sickle cell disease: the case manager's opportunity to improve patient outcomes.
The purpose of this paper was to review the barriers to care for patients with sickle cell disease (SCD). Chronic pain and the perception of addiction, implicit bias, frequent hospitalizations and emergency department visits, clinician and patient knowledge deficits, and SCD stigma all impede the ability to provide evidence-based care for patients with SCD. The authors assert that case managers can coordinate and advocate for appropriate care that improves patient outcomes.
AHRQ-funded; HS024501.
Citation: Brennan-Cook J, Bonnabeau E, Aponte R .
Barriers to care for persons with sickle cell disease: the case manager's opportunity to improve patient outcomes.
Prof Case Manag 2018 Jul/Aug;23(4):213-19. doi: 10.1097/ncm.0000000000000260..
Keywords: Access to Care, Healthcare Delivery, Health Services Research (HSR), Patient-Centered Outcomes Research, Sickle Cell Disease
Vemulakonda VM, Bush RA, Kahn MG
"Minimally invasive research?" Use of the electronic health record to facilitate research in pediatric urology.
This literature study examined the use of electronic health records (EHRs) to facilitate research in pediatric urology. The use of EHRs has been strongly encouraged by US federal agencies, including AHRQ. The researchers found that EHR use for research has strengths and weaknesses and more collaboration is needed to identify the method that best suits incorporation of research-oriented data collection into routine pediatric urologic clinical practice.
AHRQ-funded; HS024597; HS022404.
Citation: Vemulakonda VM, Bush RA, Kahn MG .
"Minimally invasive research?" Use of the electronic health record to facilitate research in pediatric urology.
J Pediatr Urol 2018 Oct;14(5):374-81. doi: 10.1016/j.jpurol.2018.04.033..
Keywords: Electronic Health Records (EHRs), Children/Adolescents, Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Rich E, Collins A
Current and future demand for health services researchers: perspectives from diverse research organizations.
This study investigated employers' perceptions of demand for individuals to conduct health services research (HSR), the competencies required for success, and implications for HSR training programs using semi-structure qualitative telephone interviews. The investigators found that current and future demand for health services researchers is strong.
AHRQ-funded; 233201600155P.
Citation: Rich E, Collins A .
Current and future demand for health services researchers: perspectives from diverse research organizations.
Health Serv Res 2018 Oct;53 Suppl 2:3927-44. doi: 10.1111/1475-6773.12999..
Keywords: Health Services Research (HSR)
Mor V, Wallace P
Funding the training of future health services researchers.
This article describes the trends in funding for training health service researches in the United States. The government funds some training through grants by NIH and AHRQ through the National Research Service Award (NRSA) mechanism. However, most of the AHRQ grant programs have reduced their funding levels from 2010 to 2015 by almost half, with only the dissertation grants program (R36) experiencing an increase. Other federal mechanisms to fund training come through postdoctoral or post-MD programs with HRSA or the Veterans Administration. Private funding is also available through the Robert Wood Johnson Foundation. Lastly, AcademyHealth started a Delivery System Science Fellowship (DSSF) program to provide a paid post-doctoral learning experience for early-career researchers. Out of 118 applicants, 25 fellows, six trained as physicians have been accepted. Twenty-one researchers have completed the fellowship, and four are current fellows. There has been a wide background in those fellows. The writers believe more stable funding sources need to be established with a close collaboration between HSR researchers and users.
AHRQ-funded; 233201600155P.
Citation: Mor V, Wallace P .
Funding the training of future health services researchers.
Health Serv Res 2018 Oct;53 Suppl 2:3976-84. doi: 10.1111/1475-6773.12844..
Keywords: Health Services Research (HSR), Workforce
Jeffery MM, Wolfson J, Meier SK
Health care service use among elderly seasonal migrators.
Little research is available to guide providers and payers on the service use of seasonal migrators. The authors use claims data on fee-for-service (FFS) Medicare beneficiaries' locations throughout the year to (1) identify seasonal migrators and (2) describe the care they receive in each seasonal home, focusing on primary care and emergency department (ED) visits and the relationships between the two.
AHRQ-funded.
Citation: Jeffery MM, Wolfson J, Meier SK .
Health care service use among elderly seasonal migrators.
Popul Health Manag 2018 Oct;21(5):415-21. doi: 10.1089/pop.2017.0155..
Keywords: Access to Care, Elderly, Healthcare Utilization, Health Services Research (HSR)
Menachemi N, Simpson LA, Wolfe MJ
Positioning the health services research workforce for continued success: recommendations from AcademyHealth stakeholders.
This paper describes the Workforce Initiative Task Force established by AcademyHealth, in 2016, to conduct an assessment of the state of the health services research workforce and develop recommendations for its future in the context of the changing health care and research ecosystems.
AHRQ-funded; 233201600155P.
Citation: Menachemi N, Simpson LA, Wolfe MJ .
Positioning the health services research workforce for continued success: recommendations from AcademyHealth stakeholders.
Health Serv Res 2018 Oct;53 Suppl 2:4041-50. doi: 10.1111/1475-6773.13039..
Keywords: Health Services Research (HSR)
Burgess JF, Menachemi N, Maciejewski ML
Update on the health services research doctoral core competencies.
The purpose of this study was to present revised core competencies for doctoral programs in health services research (HSR), modalities to deliver these competencies, and suggested methods for assessing mastery of these competencies. The study concluded that core competencies in HSR are a continually evolving work in progress because new research questions arise, new methods are developed, and the trans-disciplinary nature of the field leads to new multidisciplinary and team building needs.
AHRQ-funded.
Citation: Burgess JF, Menachemi N, Maciejewski ML .
Update on the health services research doctoral core competencies.
Health Serv Res 2018 Oct;53(Suppl 2):3985-4003. doi: 10.1111/1475-6773.12851..
Keywords: Education: Academic, Education: Continuing Medical Education, Health Services Research (HSR), Training
Frogner BK
Update on the stock and supply of health services researchers in the United States.
This study examines the stock and supply including educational pipeline of health services researchers (HSRers) in the United States. The study found that the average annual growth rate of HSRers appeared to be within range of national recommendations. The authors asserted that additional work is needed to assess whether supply of HSRers is meeting demand and to ensure a competent and diverse educational pipeline that meets the needs of an evolving health system.
AHRQ-funded; 233201600155.
Citation: Frogner BK .
Update on the stock and supply of health services researchers in the United States.
Health Serv Res 2018 Oct;53(Suppl 2):3945-66. doi: 10.1111/1475-6773.12988..
Keywords: Education: Academic, Health Services Research (HSR), Research Methodologies
Sterling MR, Shaw AL, Leung PB
Home care workers in heart failure: a systematic review.
This systematic review aimed to 1) describe utilization patterns of home care workers (HCWs) by adults with heart failure (HF), 2) examine the effect of HCWs on HF outcomes, and 3) review HF interventions that involve HCWs. The investigators concluded that the literature on these HCWs in HF is limited. They suggest that additional research is warranted on the potential role of HCWs in HF self-care and on outcomes among adults with HF.
AHRQ-funded; HS024569; T32 HS000066.
Citation: Sterling MR, Shaw AL, Leung PB .
Home care workers in heart failure: a systematic review.
J Multidiscip Healthc 2018 Sep 25;11:481-92. doi: 10.2147/jmdh.s175512..
Keywords: Health Services Research (HSR), Heart Disease and Health, Home Healthcare
Lin L
Bias caused by sampling error in meta-analysis with small sample sizes.
This study investigated bias due to small sample sizes in meta-analyses. Researchers conducted simulation studies to assess the biased caused by sampling error. Standardized mean difference, odds ratio, and risk ratio all had noticeable bias in the simulations although mean difference did not.
AHRQ-funded; HS024743.
Citation: Lin L .
Bias caused by sampling error in meta-analysis with small sample sizes.
PLoS One 2018 Sep 13;13(9):e0204056. doi: 10.1371/journal.pone.0204056..
Keywords: Health Services Research (HSR), Research Methodologies
Thorlacius L, Ingram JR, Villumsen B
A core domain set for hidradenitis suppurativa trial outcomes: an international Delphi process.
This article describes the outcome of six stakeholder groups participating in a Delphi process to create a core outcomes set (COS) for hidradenitis suppurative (HS) research. Five anonymous e-Delphi rounds and four face-to-face consensus meetings were conducted. A total of 41 patients and 52 healthcare professionals (HCPs) from 19 countries and 4 continents participated. The consensus adopted included five domains were approved: disease course, physical signs, HS-specific quality of life, pain, and global assessments.
AHRQ-funded; HS024585.
Citation: Thorlacius L, Ingram JR, Villumsen B .
A core domain set for hidradenitis suppurativa trial outcomes: an international Delphi process.
Br J Dermatol 2018 Sep;179(3):642-50. doi: 10.1111/bjd.16672..
Keywords: Skin Conditions, Health Services Research (HSR), Research Methodologies, Quality of Life