National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- (-) Arthritis (18)
- Back Health and Pain (1)
- Behavioral Health (1)
- Chronic Conditions (5)
- Clinical Decision Support (CDS) (1)
- Depression (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (4)
- Guidelines (1)
- Health Information Technology (HIT) (3)
- Health Literacy (1)
- Health Status (1)
- Injuries and Wounds (1)
- Medication (1)
- Mortality (1)
- Opioids (1)
- Orthopedics (4)
- Outcomes (5)
- Pain (3)
- Patient-Centered Outcomes Research (6)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (2)
- Quality of Life (1)
- Racial and Ethnic Minorities (2)
- Registries (3)
- Sex Factors (1)
- Sexual Health (1)
- Shared Decision Making (2)
- Social Determinants of Health (1)
- Surgery (3)
- Telehealth (1)
- Tobacco Use (1)
- Women (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 18 of 18 Research Studies DisplayedMcQuillan J, Andersen JA, Berdahl TA
AHRQ Author: Berdahl TA
Associations of rheumatoid arthritis and depressive symptoms over time: are there differences by education, race/ethnicity, and gender?
The objective of this study was to examine associations between changes in Rheumatoid Arthritis symptoms and depressive symptoms and to test if these associations differed by education, or gender, or race/ethnicity. Data was taken from the National Rheumatoid Arthritis Study, 1988-98. The results indicated that people with Rheumatoid Arthritis experienced increases in depressive symptoms as well as pain, functional disability, and household work disability over the study period. There was no difference noted in the rate of change in depressive symptoms by education, gender, nor race/ethnicity, but the association of functional disability with depressive symptoms was stronger for men than women. The researchers concluded that it is important to monitor and treat both mental and physical health symptoms, and that future research should focus on the collection of data that reflects the educational, gender, and racial/ethnic diversity of people with Rheumatoid Arthritis.
AHRQ-authored.
Citation: McQuillan J, Andersen JA, Berdahl TA .
Associations of rheumatoid arthritis and depressive symptoms over time: are there differences by education, race/ethnicity, and gender?
Arthritis Care Res 2022 Dec;74(12):2050-58. doi: 10.1002/acr.24730..
Keywords: Arthritis, Depression, Behavioral Health, Racial and Ethnic Minorities, Sex Factors, Chronic Conditions
Ferucci ED, Day GM, Choromanski TL
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
This study’s objective was to evaluate outcomes and quality of care for rheumatoid arthritis (RA) in patients seen by video telemedicine compared to in-person only. Individuals in the Alaska Tribal Health System who were diagnosed with RA were recruited when seeing a rheumatologist either in person or by video telemedicine. Participants completed a Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire and a telephone medicine perception survey at the start of the survey. They also agreed to medical record review. The authors repeated the surveys by telephone and at 6 and 12 months, and medical record abstraction was performed at 12 months for quality measures. By the end of the 12-month period, about half of the 122 RA participants (52%) had ever used telemedicine for RA. Higher RAPID3 score and functional status were associated with the telemedicine group, with no statistically significant change over the 12-month period. The only quality measure that differed between the two groups at 12 months was the proportion of visits in which disease activity was documented, but it was not significantly after multivariate analysis.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Day GM, Choromanski TL .
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
Arthritis Care Res 2022 Mar;74(3):484-92. doi: 10.1002/acr.24485..
Keywords: Arthritis, Chronic Conditions, Telehealth, Health Information Technology (HIT), Quality of Care, Outcomes
Lin E, Uhler LM, Finley EP
Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol.
This article describes a US-based 2-year, two-site hybrid type 1 study to assess clinical effectiveness and implementation of a machine learning-based patient decision aid integrating patient-reported outcomes and clinical variables to support shared decision-making for patients with knee osteoarthritis considering total knee replacement. Study results will be disseminated through conference presentations, publications and professional societies.
AHRQ-funded; HS027037.
Citation: Lin E, Uhler LM, Finley EP .
Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol.
BMJ Open 2022 Feb 21;12(2):e055933. doi: 10.1136/bmjopen-2021-055933..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Arthritis, Patient-Centered Outcomes Research, Orthopedics, Health Information Technology (HIT), Evidence-Based Practice
Izadi Z, Schmajuk G, Gianfrancesco M
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
This study examined performance on rheumatoid arthritis (RA) quality measures and assessed the association between practice characteristics and changes in performance over time among participating practices. The authors analyzed data from practices enrolled in the American College of Rheumatology Rheumatology Informatics System for Effectiveness (RISE) registry from 2015 to 2017. Eight quality measures in the areas of RA disease management, cardiovascular risk reduction, and patient safety were analyzed. Data from 59,986 patients from 54 practices were examined. Cohort characteristics were a mean age of 62 years, 77% female, 69% Caucasian, and most patients (46%) were seen in a single-specialty group practice. Measures related to RA functional status and disease activity assessment improved over time, with single-specialty group practices having the fastest rates of improvement across all measures.
AHRQ-funded; HS025638; HS024412.
Citation: Izadi Z, Schmajuk G, Gianfrancesco M .
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
Arthritis Care Res 2022 Feb;74(2):219-28. doi: 10.1002/acr.24444..
Keywords: Arthritis, Chronic Conditions, Quality Measures, Quality Indicators (QIs), Registries, Quality of Care
Barber CEH, Zell J, Yazdany J
2019 American College of Rheumatology recommended patient-reported functional status assessment measures in rheumatoid arthritis.
This study’s objective was to develop American College of Rheumatology (ACR) Functional Status Assessment Measures (FSAMs) for patient reporting in most clinic settings. The authors convened a workgroup to conduct a systematic literature review through March 2017. They focused on the following FSAMs: the Health Assessment Questionnaire (HAQ) and derived measures from the Patient-Reported Outcomes Measurement Information System (PROMIS) tool. Out of 11,835 articles identified in the search, 56 were included in the review. A modified Delphi process identified 7 measures which fulfilled the minimum standard for regular use, and 3 measures were recommended: the PROMIS 10-item short form, the HAQ-II, and the Multidimensional HAQ.
AHRQ-funded; HS025638.
Citation: Barber CEH, Zell J, Yazdany J .
2019 American College of Rheumatology recommended patient-reported functional status assessment measures in rheumatoid arthritis.
Arthritis Care Res 2019 Dec;71(12):1531-39. doi: 10.1002/acr.24040..
Keywords: Arthritis, Health Status, Guidelines, Evidence-Based Practice
Brodney S, Fowler FJ, Barry MJ
Comparison of three measures of shared decision making: SDM Process_4, CollaboRATE, and SURE scales.
This study compared 3 different shared decision making (SDM) aids for patients facing surgery for hip or knee osteoarthritis, lumbar herniated disc or lumber spinal stenosis (backs). Patients were surveys after they used one of the following patient decision aids (PDAs): SMD Process_4, CollaboRATE, or SURE. The sample size was 649 with a mean age of 63.3 years, 51% female, and 60% were college educated. Most patients (69%) were facing hip or knee surgery. Results showed that the PDAs did aid patients – especially for hips/knees and were different for each PDA.
AHRQ-funded; HS025718.
Citation: Brodney S, Fowler FJ, Barry MJ .
Comparison of three measures of shared decision making: SDM Process_4, CollaboRATE, and SURE scales.
Med Decis Making 2019 Aug;39(6):673-80. doi: 10.1177/0272989x19855951..
Keywords: Shared Decision Making, Surgery, Arthritis, Back Health and Pain
Birru Talabi M, Cllowse MEB, Blalock SJ
Contraception use among reproductive-age women with rheumatic diseases.
The purpose of this study was to determine contraception use among a cohort of reproductive-age women with rheumatic diseases. Women who had one of 21 possible rheumatic disease diagnoses, and had at least two outpatient rheumatology visits, were included. Findings revealed low use of prescription contraception, and the authors recommended urgent efforts to improve contraceptive care and access for some women with rheumatic diseases.
AHRQ-funded; HS022989.
Citation: Birru Talabi M, Cllowse MEB, Blalock SJ .
Contraception use among reproductive-age women with rheumatic diseases.
Arthritis Care Res 2019 Aug;71(8):1132-40. doi: 10.1002/acr.23724..
Keywords: Arthritis, Chronic Conditions, Women, Sexual Health
Kim SC, Jin Y, Lee YC
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
The purpose of this study was to determine the association of preoperative opioid use among patients 65 years and older with mortality and other complications at 30 days post-total knee replacement (TKR). Findings show that continuous opioid users had a higher risk of revision operations, vertebral fractures, and opioid overdose at 30 days post-TKR but not of in-hospital or 30-day mortality, compared with opioid-naive patients. Highlights include the need for better understanding of patient characteristics associated with chronic opioid use to optimize preoperative assessment of overall risk after TKR.
AHRQ-funded; HS018910.
Citation: Kim SC, Jin Y, Lee YC .
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
JAMA Netw Open 2019 Jul 3;2(7):e198061. doi: 10.1001/jamanetworkopen.2019.8061..
Keywords: Opioids, Medication, Surgery, Orthopedics, Elderly, Patient-Centered Outcomes Research, Mortality, Outcomes, Arthritis, Evidence-Based Practice
Gandek B, Roos EM, Franklin PD
A 12-item short form of the Hip disability and Osteoarthritis Outcome Score (HOOS-12): tests of reliability, validity and responsiveness.
The goal of this study was to measure validity, reliability and responsiveness of the 12-item version of the 40-item Hip disability and Osteoarthritis Outcome Score (HOOS) surveys that measure joint-specific pain, function and quality of life (QOL) for patients. The shorter forms were given to 1,281 hip OA patients from the FORCE-TJR cohort who had previously completed the HOOS surveys before and after total joint replacement surgery. The HOOS-12 survey was compared to the full-length HOOS, HOOS-PS, and HOOS, JR surveys. Internal consistency reliability was above 0.70 for all HOOS-12 scales and above 0.90 for the Summary score. Validity and responsiveness were also found to be comparable to full-length HOOS scales.
AHRQ-funded; HS024632; HS018910.
Citation: Gandek B, Roos EM, Franklin PD .
A 12-item short form of the Hip disability and Osteoarthritis Outcome Score (HOOS-12): tests of reliability, validity and responsiveness.
Osteoarthritis Cartilage 2019 May;27(5):754-61. doi: 10.1016/j.joca.2018.09.017..
Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Orthopedics
Gandek B, Roos EM, Franklin PD
Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12).
The goal of this study was to develop 12-item versions of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) and 40-item Hip disability and Osteoarthritis Outcome Score (HOOS) surveys that measure joint-specific pain, function and quality of life (QOL) for patients. The shorter forms were given to 1,395 knee osteoarthritis (OA) and 1,281 hip OA patients from the FORCE-TJR cohort who had previously completed the KOOS and HOOS surveys before and after total joint replacement surgery. The KOOS-12 and HOOS-12 surveys were found to successfully measure pain and function items of the patients as well as the 42-item versions.
AHRQ-funded; HS024632; HS018910.
Citation: Gandek B, Roos EM, Franklin PD .
Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12).
Osteoarthritis Cartilage 2019 May;27(5):746-53. doi: 10.1016/j.joca.2018.11.011..
Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Orthopedics
Gandek B, Roos EM, Franklin PD
A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness.
The purpose of this study was to evaluate reliability, validity and responsiveness of KOOS-12, a 12-item short form of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) that provides Pain, Function and Quality of Life (QOL) scale scores and a summary knee impact score. Results showed that KOOS-12 was a reliable and valid alternative to KOOS in total knee replacement patients with moderate to severe knee osteoarthritis and provided three domain-specific and summary knee impact scores with substantially reduced respondent burden.
AHRQ-funded; HS024632; HS018910.
Citation: Gandek B, Roos EM, Franklin PD .
A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness.
Osteoarthritis Cartilage 2019 May;27(5):762-70. doi: 10.1016/j.joca.2019.01.011..
Keywords: Arthritis, Evidence-Based Practice, Injuries and Wounds, Outcomes, Pain, Patient-Centered Outcomes Research, Quality of Life
Hirsh J, Wood P, Keniston A
Limited health literacy and patient confusion about rheumatoid arthritis patient global assessments and model disease states.
The objective of this study was to understand the perspectives of vulnerable patients regarding patient global assessment visual analog scales (PGA-VAS) and model disease states. The investigators found that vulnerable patients perceived difficulty with PGA-VAS and did not reliably rate a model disease state VAS. The authors suggest that these patients are potentially at risk for disease activity misclassification because of literacy and other barriers in completing VAS.
AHRQ-funded.
Citation: Hirsh J, Wood P, Keniston A .
Limited health literacy and patient confusion about rheumatoid arthritis patient global assessments and model disease states.
Arthritis Care Res 2019 May;71(5):611-19. doi: 10.1002/acr.23692..
Keywords: Arthritis, Health Literacy
Gianfrancesco MA, Trupin L, Shiboski S
Smoking is associated with higher disease activity in rheumatoid arthritis: a longitudinal study controlling for time-varying covariates.
Prior studies around the relationship between smoking and rheumatoid arthritis (RA) disease activity have reported inconsistent findings, which may be ascribed to heterogeneous study designs or biases in statistical analyses. In this study, the investigators examined the association between smoking and RA outcomes using statistical methods that account for time-varying confounding and loss to followup. They found that smoking was associated with higher levels of disease activity in RA.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Trupin L, Shiboski S .
Smoking is associated with higher disease activity in rheumatoid arthritis: a longitudinal study controlling for time-varying covariates.
J Rheumatol 2019 Apr;46(4):370-75. doi: 10.3899/jrheum.180262..
Keywords: Arthritis, Tobacco Use
Dannecker EA, Warne-Griggs MD, Royse LA
Listening to patients' voices: workarounds patients use to construct pain intensity ratings.
This study analyzed patients’ perspectives on constructing pain intensity ratings and workarounds used. Focus groups were conducted with thirty-one patients with osteoarthritis. Three emerging themes were found: 1) many factors affected patients’ perceptions and ratings of intensity, 2) patients used different approaches to evaluate pain, and 3) patients interpreted maximal response anchors differently. Activity items also helped patients to remember pain.
AHRQ-funded; HS022140.
Citation: Dannecker EA, Warne-Griggs MD, Royse LA .
Listening to patients' voices: workarounds patients use to construct pain intensity ratings.
Qual Health Res 2019 Mar 1;29(4):484-97. doi: 10.1177/1049732318773714..
Keywords: Pain, Arthritis
Norgeot B, Glicksberg BS, Trupin L
Assessment of a deep learning model based on electronic health record data to forecast clinical outcomes in patients with rheumatoid arthritis.
This study researched the use of artificial intelligence learning models to predict clinical outcomes in patients with rheumatoid arthritis (RA). Patients from a university hospital (UH) and a public safety-net hospital (SNH). The populations were quite different from each other. A total of 578 UH patients and 242 SNH patients were included in the study. Patients at the UH were seen more frequently than the SNH patients and were often prescribed high-class medications (63% vs. 28.9%). The model that was used showed a statistically random performance based on each patients’ most recent disease activity score.
AHRQ-funded; HS024412.
Citation: Norgeot B, Glicksberg BS, Trupin L .
Assessment of a deep learning model based on electronic health record data to forecast clinical outcomes in patients with rheumatoid arthritis.
JAMA Netw Open 2019 Mar;2(3):e190606. doi: 10.1001/jamanetworkopen.2019.0606..
Keywords: Arthritis, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes
Curtis JR, Xie F, Yang S
Uptake and clinical utility of multibiomarker disease activity testing in the United States.
The purpose of this study was to examine the clinical utility of the multibiomarker disease activity (MBDA) test for rheumatoid arthritis management (RA) in routine care in the United States. Using Medicare data for 2011-15, researchers linked each patient with RA to their MBDA test result. Initiation of a biologic or Janus kinase inhibitor during the 6 months after MBDA testing was described. The researchers found that the MBDA score was associated with both biologic and Janus kinase inhibitor medication addition/switching and subsequent treatment outcomes.
AHRQ-funded; HS013852.
Citation: Curtis JR, Xie F, Yang S .
Uptake and clinical utility of multibiomarker disease activity testing in the United States.
J Rheumatol 2019 Mar;46(3):237-44. doi: 10.3899/jrheum.180071..
Keywords: Arthritis
Mehta B, Szymonifka J, Dey S
Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
The objective of this study was to assess the relationship of neighborhood immigrant proportion (IP) to preoperative and 2-year postoperative pain and function after elective total knee arthroplasty (TKA) using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patients in a high-volume institutional TKA registry were analyzed retrospectively, and demographics, pre-op and 2-year post-op WOMAC pain and function scores, and addresses obtained. Patient-level variables were linked to Census Bureau tract data. Researchers conclude that patients living in high IP neighborhoods do not have worse pre-op or 2-year post-op pain and function outcomes after TKA compared to those living in lower IP neighborhoods.
AHRQ-funded; HS016075.
Citation: Mehta B, Szymonifka J, Dey S .
Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
BMC Musculoskelet Disord 2019 Feb 9;20(1):67. doi: 10.1186/s12891-019-2446-y..
Keywords: Arthritis, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Social Determinants of Health, Surgery
Pinto D, Bockenholt U, Lee J
Preferences for physical activity: a conjoint analysis involving people with chronic knee pain.
The goals of this study were to investigate individual preferences for physical activity attributes in adults with chronic knee pain, to identify clusters of individuals with similar preferences, and to identify whether these individuals differ by demographic or health characteristics. Researchers conducted an adaptive conjoint analysis (ACA) using the Potentially All Pairwise RanKings of all possible Alternatives (PAPRIKA) method to determine preference weights representing the relative importance of six physical activity attributes: health benefit, enjoyment, convenience, financial cost, effort, and time cost. The study sample included 146 participants. The authors conclude that patients with chronic knee pain have preferences for physical activities which are effectively distinguished by using ACA methods, and that adults with chronic knee pain, as clustered by their preferences, share distinguishing characteristics.
AHRQ-funded; HS023011.
Citation: Pinto D, Bockenholt U, Lee J .
Preferences for physical activity: a conjoint analysis involving people with chronic knee pain.
Osteoarthritis Cartilage 2019 Feb;27(2):240-47. doi: 10.1016/j.joca.2018.10.002..
Keywords: Arthritis, Chronic Conditions, Pain