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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 39 Research Studies DisplayedLamplot JD, Bansal A, Nguyen JT
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
The purpose of this study using HCUP data was to determine how demographic and other patient-specific factors are associated with the risk of subsequent joint replacement in the contralateral or a different joint following an index joint replacement for osteoarthritis. Results showed a relatively high risk of subsequent replacement of the contralateral joint and a relatively low risk of subsequent replacement of a different joint within 5 to 8 years after an index total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty. Obesity was associated with a higher risk of subsequent replacement of the contralateral joint or a different joint.
AHRQ-funded; HS019455.
Citation: Lamplot JD, Bansal A, Nguyen JT .
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
J Bone Joint Surg Am 2018 Oct 17;100(20):1750-56. doi: 10.2106/jbjs.17.00948..
Keywords: Arthritis, Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Orthopedics, Healthcare Utilization
Makris UE, Alvarez CA, Mortensen EM
Association of statin use with increased risk of musculoskeletal conditions: a retrospective cohort study.
This study examined the association between statin use and the risk of being diagnosed with non-traumatic arthropathies, use-related injury, and undergoing rehabilitation in a cohort with longitudinal follow-up. Statin use was associated with a significant increased risk of non-traumatic arthropathies and use-related injury. The results provide additional data that can inform patient and clinician conversations about the benefits and risks of statin use.
AHRQ-funded; HS022418.
Citation: Makris UE, Alvarez CA, Mortensen EM .
Association of statin use with increased risk of musculoskeletal conditions: a retrospective cohort study.
Drug Saf 2018 Oct;41(10):939-50. doi: 10.1007/s40264-018-0682-y..
Keywords: Arthritis, Medication, Risk
Yazdany J, Dudley RA, Lin GA
Out-of-pocket costs for infliximab and its biosimilar for rheumatoid arthritis under Medicare Part D.
This paper discusses the out-of-pocket costs for infliximab and its biosimilar for rheumatoid arthritis under Medicare Part D. The investigators analyzed nationwide benefit design data for all Part D plans from the June 2017 Medicare Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files to calculate mean total cost and out-of-pocket cost requirements for infliximab-dyyb and infliximab assuming a standard 8-week dosing regimen.
AHRQ-funded; HS016772.
Citation: Yazdany J, Dudley RA, Lin GA .
Out-of-pocket costs for infliximab and its biosimilar for rheumatoid arthritis under Medicare Part D.
JAMA 2018 Sep 4;320(9):931-33. doi: 10.1001/jama.2018.7316..
Keywords: Healthcare Costs, Health Insurance, Medicare, Medication, Arthritis
Urish KL, Qin Y, Li BY
Predictors and cost of readmission in total knee arthroplasty.
The Comprehensive Care for Joint Replacement bundle was created to decrease total knee arthroplasty (TKA) cost. To help accomplish this, there is a focus on reducing TKA readmissions. The study’s authors used the Nationwide Readmission Database to examine national readmission rates, predictors of readmission, and associated readmission costs for elective TKA procedures.
AHRQ-funded; HS018726.
Citation: Urish KL, Qin Y, Li BY .
Predictors and cost of readmission in total knee arthroplasty.
J Arthroplasty 2018 Sep;33(9):2759-63. doi: 10.1016/j.arth.2018.04.008..
Keywords: Arthritis, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Orthopedics
Beukelman T, Xie F, Chen L
Risk of malignancy associated with paediatric use of tumour necrosis factor inhibitors.
The objective of the study was to determine whether tumour necrosis factor inhibitor (TNFi) use is associated with an increased rate of incident malignancy compared with no TNFi use in the treatment of juvenile idiopathic arthritis (JIA), paediatric inflammatory bowel disease (pIBD) and paediatric plaque psoriasis (pPsO). The authors concluded that children diagnosed with JIA, pIBD and pPsO had an increased rate of malignancy compared with the general population, but treatment with TNFi did not appear to significantly further increase the risk compared with no TNFi use.
AHRQ-funded; HS021110.
Citation: Beukelman T, Xie F, Chen L .
Risk of malignancy associated with paediatric use of tumour necrosis factor inhibitors.
Ann Rheum Dis 2018 Jul;77(7):1012-16. doi: 10.1136/annrheumdis-2017-212613..
Keywords: Children/Adolescents, Cancer, Patient-Centered Outcomes Research, Risk, Arthritis
Goodman SM, Mandi LA, Mehta B
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
The authors assessed the interaction between education and poverty on 2-year Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function. They found that having no college was associated with worse pain and function at baseline and 2 years and that living in a poor neighborhood was associated with worse 2-year pain and function. There was a strong interaction between individual education and community poverty with WOMAC scores at 2 years. Patients without college living in poor communities had pain scores that were ~10 points worse than those with some college; in wealthy communities, college was associated with a 1-point difference in pain. Function was similar. The authors recommended further study on how education protects those in impoverished communities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandi LA, Mehta B .
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
Arthritis Care Res 2018 Jun;70(6):884-91. doi: 10.1002/acr.23442..
Keywords: Arthritis, Education, Low-Income, Orthopedics, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Favier LA, Taylor J, Loiselle Rich K
Barriers to adherence in juvenile idiopathic arthritis: a multicenter collaborative experience and preliminary results.
The purpose of our study was to design and implement a standardized approach to identifying adherence barriers for youth with juvenile idiopathic arthritis (JIA) and to assess the frequency of adherence barriers in patients and their caregivers across treatment modalities. It concluded that implementing a standardized tool assessing adherence barriers in the JIA population across multiple clinical settings is feasible.
AHRQ-funded; HS021114.
Citation: Favier LA, Taylor J, Loiselle Rich K .
Barriers to adherence in juvenile idiopathic arthritis: a multicenter collaborative experience and preliminary results.
J Rheumatol 2018 May;45(5):690-96. doi: 10.3899/jrheum.171087.
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Keywords: Caregiving, Patient Adherence/Compliance, Quality Improvement, Arthritis, Children/Adolescents
Gilbert AL, Lee J, Ehrlich-Jones L
A randomized trial of a motivational interviewing intervention to increase lifestyle physical activity and improve self-reported function in adults with arthritis.
In this study, the investigators evaluated the effect of a motivational interviewing-based lifestyle physical activity intervention on self-reported physical function in adults with knee osteoarthritis (KOA) or rheumatoid arthritis (RA). They found that participants with KOA receiving the lifestyle intervention experienced modest improvement in self-reported function and a trend toward improved pain compared to controls; there was no intervention effect for RA participants.
AHRQ-funded; HS023011.
Citation: Gilbert AL, Lee J, Ehrlich-Jones L .
A randomized trial of a motivational interviewing intervention to increase lifestyle physical activity and improve self-reported function in adults with arthritis.
Semin Arthritis Rheum 2018 Apr;47(5):732-40. doi: 10.1016/j.semarthrit.2017.10.003..
Keywords: Arthritis, Health Promotion, Lifestyle Changes, Arthritis
Wright NC, Hooker ER, Nielson CM
The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study.
The goal of this study was to calculate the frequency of and to identify risk factors for wrist fracture in the Osteoporotic Fractures in Men (MrOS) study. The researchers identified incident wrist fractures in men aged 65 or older. Potential risk factors included demographics, lifestyle, bone mineral density, selected medications, biomarkers, and physical function and performance measures. The researcher confirmed that fracture history and certain medications are predictors, and also identified novel predictors such as markers of kidney function and an inability to perform the grip strength test. They did not find associations with factors commonly associated with wrist and other osteoporosis fractures such as falls, diabetes, calcium and vitamin D intake, or alcohol intake.
AHRQ-funded; HS023009.
Citation: Wright NC, Hooker ER, Nielson CM .
The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study.
Osteoporos Int 2018 Apr;29(4):859-70. doi: 10.1007/s00198-017-4349-9..
Keywords: Arthritis, Elderly, Injuries and Wounds, Men's Health, Risk
Lopez-Olivo MA, Ingleshwar A, Volk RJ
Development and pilot testing of multimedia patient education tools for patients with knee osteoarthritis, osteoporosis, and rheumatoid arthritis.
Researched developed multimedia educational tools that incorporated videos to help patients understand their chronic diseases including osteoporosis, osteoarthritis, and rheumatoid arthritis. Tools were developed in English and Spanish. A total of 60 patients (20 per disease) were recruited to see the videos and were interviewed after all. All participants gave them a favorable rating and felt it helped them understand the disease, the importance of taking their medications, and seeing their doctor regularly. They found the videos and accompanying materials easy to use and easy to understand.
AHRQ-funded; HS019354.
Citation: Lopez-Olivo MA, Ingleshwar A, Volk RJ .
Development and pilot testing of multimedia patient education tools for patients with knee osteoarthritis, osteoporosis, and rheumatoid arthritis.
Arthritis Care Res 2018 Feb;70(2):213-20. doi: 10.1002/acr.23271..
Keywords: Arthritis, Chronic Conditions, Education: Patient and Caregiver, Osteoporosis, Health Literacy
Jafri K, Ogdie A, Qasim A
Discordance of the Framingham cardiovascular risk score and the 2013 American College of Cardiology/American Heart Association risk score in systemic lupus erythematosus and rheumatoid arthritis..
The authors of this study compared Framingham and 2013 American College of Cardiology/American Heart Association (ACC/AHA) risk scores in subjects with systemic lupus erythematosus and rheumatoid arthritis and assessed demographic, cardiovascular, and rheumatologic characteristics associated with discordant scores (high-risk ACC/AHA scores but low-risk Framingham scores).
AHRQ-funded; HS024412.
Citation: Jafri K, Ogdie A, Qasim A .
Discordance of the Framingham cardiovascular risk score and the 2013 American College of Cardiology/American Heart Association risk score in systemic lupus erythematosus and rheumatoid arthritis..
Clin Rheumatol 2018 Feb;37(2):467-74. doi: 10.1007/s10067-017-3860-x..
Keywords: Cardiovascular Conditions, Arthritis, Risk
Pitta M, Esposito CI, Li Z
Failure after modern total knee arthroplasty: a prospective study of 18,065 knees.
The investigators sought to determine the mechanism of failure among primary total knee arthroplasties (TKAs) performed at a single high-volume institution. They found that the most common reasons for failure within 2 years after TKA were infection and stiffness. They suggested that the study identified preoperative risk factors for failure of primary TKAs, which may be useful information for developing strategies to improve outcomes following TKA.
AHRQ-funded; HS016075.
Citation: Pitta M, Esposito CI, Li Z .
Failure after modern total knee arthroplasty: a prospective study of 18,065 knees.
J Arthroplasty 2018 Feb;33(2):407-14. doi: 10.1016/j.arth.2017.09.041..
Keywords: Arthritis, Orthopedics
Gianfrancesco MA, Yazdany J, Schmajuk G
The impact of smoking on disease measures in rheumatoid arthritis: the need for appropriate adjustment of time-varying confounding.
In a recent publication, Quintana-Dunque et al. studied patients with early onset rheumatoid arthritis (RA) and showed that baseline smoking status was inversely associated with disease activity and disability at 36 months. This paper argues that the authors failed to highlight several limitations of study design and analysis, including time-varying confounding, which may have had a direct impact on results and corresponding conclusions.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Yazdany J, Schmajuk G .
The impact of smoking on disease measures in rheumatoid arthritis: the need for appropriate adjustment of time-varying confounding.
Rheumatol Int 2018 Feb;38(2):313-14. doi: 10.1007/s00296-017-3902-3.
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Keywords: Health Status, Lifestyle Changes, Arthritis, Tobacco Use
Palmsten K, Hulugalle A, Bandoli G
Agreement between maternal report and medical records during pregnancy: medications for rheumatoid arthritis and asthma.
This study examined the agreement between maternal report and medical records during pregnancy for rheumatoid arthritis and asthma-related medications. The investigators concluded that agreement was higher for medications typically used continuously than sporadically. Information on medication use from medical records alone may not be adequate when studying the impact of intermittently used medications during pregnancy on perinatal outcomes.
AHRQ-funded; HS018474.
Citation: Palmsten K, Hulugalle A, Bandoli G .
Agreement between maternal report and medical records during pregnancy: medications for rheumatoid arthritis and asthma.
Paediatr Perinat Epidemiol 2018 Jan;32(1):68-77. doi: 10.1111/ppe.12415..
Keywords: Asthma, Medication, Pregnancy, Arthritis
Bove AM, Smith KJ, Bise CG
Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial.
The study objective was to compare the cost-effectiveness of 4 different combinations of exercise, manual therapy, and booster sessions for individuals with knee osteoarthritis (OA). The authors found that spacing exercise-based physical therapy sessions over 12 months using periodic booster sessions was less costly and more effective over 2 years than strategies not containing booster sessions for individuals with knee OA.
AHRQ-funded; HS019642.
Citation: Bove AM, Smith KJ, Bise CG .
Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial.
Phys Ther 2018 Jan;98(1):16-27. doi: 10.1093/ptj/pzx104..
Keywords: Arthritis, Comparative Effectiveness, Healthcare Costs, Outcomes
Schmajuk G, Tonner C, Miao Y
Folic acid supplementation is suboptimal in a national cohort of older veterans receiving low dose oral methotrexate.
The authors aimed to determine the prevalence, predictors of, and persistence of folic acid use in a population-based cohort of methotrexate (MTX) users with rheumatic diseases. They found that patients who did not see a rheumatologist were 23% less likely to receive folic acid compared to patients who did have a rheumatologist visit during the baseline period, and after 20 months, only 50% of patients continued to receive folic acid. The authors recommend improving patient safety for users of MTX by standardizing workflows for folic acid supplementation.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Tonner C, Miao Y .
Folic acid supplementation is suboptimal in a national cohort of older veterans receiving low dose oral methotrexate.
PLoS One 2016 Dec 15;11(12):e0168369. doi: 10.1371/journal.pone.0168369.
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Keywords: Elderly, Healthcare Utilization, Medication, Arthritis
Herrinton LJ, Harrold L, Salman C
Population variations in rheumatoid arthritis treatment and outcomes, Northern California, 1998-2009.
This study assessed variations in rheumatoid arthritis treatment and outcomes at the community level from 1998 through 2009. It found that disease-modifying anti-rheumatic drug use increased in the typical patient from 38 to 63 percent of the time, and oral prednisone use declined from 23 to 15 percent of the time, whereas opioid use initially rose but then fell to 23 percent of the time.
AHRQ-funded; HS019912; HS010391; HS021590; HS018517; HS017919.
Citation: Herrinton LJ, Harrold L, Salman C .
Population variations in rheumatoid arthritis treatment and outcomes, Northern California, 1998-2009.
Perm J 2016 Winter;20(1):4-12. doi: 10.7812/tpp/15-028.
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Keywords: Arthritis, Medication, Comparative Effectiveness, Outcomes
Yazdany J, Bansback N, Clowse M
Rheumatology informatics system for effectiveness: a national informatics-enabled registry for quality improvement.
The authors reported on the Rheumatology Informatics System for Effectiveness (RISE) registry's architecture and initial data and demonstrated how RISE is being used to improve care quality. They concluded that RISE provides critical infrastructure for improving care quality in rheumatology and is a unique data source to generate new knowledge.
AHRQ-funded; HS024412.
Citation: Yazdany J, Bansback N, Clowse M .
Rheumatology informatics system for effectiveness: a national informatics-enabled registry for quality improvement.
Arthritis Care Res 2016 Dec;68(12):1866-73. doi: 10.1002/acr.23089.
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Keywords: Quality of Care, Health Information Technology (HIT), Quality Improvement, Registries, Arthritis
Ware JE, Jr., Gandek B, Allison J
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
The objective of this study was to evaluate the convergent and discriminant validity of QOL attributions to specific diseases among adults with multiple chronic conditions (MCC). It concluded that, collectively, convergent and discriminant test results support the construct validity of disease-specific QOL impact attributions across MCC within the eight pre-identified conditions.
AHRQ-funded; HS023117.
Citation: Ware JE, Jr., Gandek B, Allison J .
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
Int J Stat Med Res 2016;5(1):17-40..
Keywords: Quality of Life, Chronic Conditions, Arthritis, Kidney Disease and Health, Heart Disease and Health
Rolfson O, Wissig S, van Maasakkers L
Defining an international standard set of outcome measures for patients with hip or knee osteoarthritis: consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group.
The researchers defined a minimum Standard Set of outcome measures and case-mix factors for monitoring, comparing, and improving healthcare for patients with clinically diagnosed hip or knee osteoarthritis (OA) with a focus on defining the outcomes that matter most to patients. The Working Group reached consensus on a concise set of outcome measures to evaluate patients' joint pain, physical functioning, health-related quality of life, work status, mortality, reoperations, readmissions, and overall satisfaction with treatment result.
AHRQ-funded; HS018910.
Citation: Rolfson O, Wissig S, van Maasakkers L .
Defining an international standard set of outcome measures for patients with hip or knee osteoarthritis: consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group.
Arthritis Care Res 2016 Nov;68(11):1631-39. doi: 10.1002/acr.22868.
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Keywords: Arthritis, Care Management, Chronic Conditions, Patient-Centered Outcomes Research
Yazdany J, Robbins M, Schmajuk G
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
The researchers sought to develop and test electronic clinical quality measures for rheumatoid arthritis. Disease activity assessment, functional status assessment, disease-modifying antirheumatic durg use, and tuberculosis screening measures have achieved national endorsement and are recommended for use in federal quality reporting programs.
AHRQ-funded; HS024412.
Citation: Yazdany J, Robbins M, Schmajuk G .
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
Arthritis Care Res 2016 Nov;68(11):1579-90. doi: 10.1002/acr.22984.
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Keywords: Electronic Health Records (EHRs), Medication, Quality Measures, Arthritis, Outcomes
Nguyen UD, Ayers DC, Li W
Preoperative pain and function: profiles of patients selected for total knee arthroplasty.
The researchers examined patient-reported preoperative pain and function profiles to understand symptom severity at the time of total knee arthroplasty (TKA) decision. Of 6,936 patients, 77 percent had high pain and poor function (group 4), 19 percent had high pain "or" poor function (groups 2-3), and 5 percent had little pain and high function before TKA (group 1).
AHRQ-funded; HS018910.
Citation: Nguyen UD, Ayers DC, Li W .
Preoperative pain and function: profiles of patients selected for total knee arthroplasty.
J Arthroplasty 2016 Nov;31(11):2402-07.e2. doi: 10.1016/j.arth.2016.04.015.
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Keywords: Pain, Surgery, Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research
Suter LG, Barber CE, Herrin J
American College of Rheumatology white paper on performance outcome measures in rheumatology.
The objective of this study was to highlight the opportunities and challenges of developing and implementing performance outcome measures in rheumatology for accountability purposes. The authors' hypothetical outcome measure was a measure of rheumatoid arthritis disease activity intended for evaluating Accountable Care Organization performance. They provided a summary table of key take-home points for clinicians and policymakers. The authors concluded that the most effective and meaningful measures can only be created through the close collaboration of patients, providers, measure developers, and policymakers.
AHRQ-funded; HS024412.
Citation: Suter LG, Barber CE, Herrin J .
American College of Rheumatology white paper on performance outcome measures in rheumatology.
Arthritis Care Res 2016 Oct;68(10):1390-401. doi: 10.1002/acr.22936.
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Keywords: Quality of Care, Quality Measures, Outcomes, Arthritis
Mamtani R, Clark AS, Scott FI
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
The researchers examined the rates of breast cancer recurrence in patients with immune-mediated disease and treated breast cancer who received therapy with methotrexate, thiopurines, or anti-tumor necrosis factor (anti-TNF). They found that the risk of breast cancer recurrence in patients who received methotrexate, thiopurine, or anti-TNF therapy was not statistically significantly increased, although they did not rule out a 2-fold or greater increased risk in those treated with thiopurines.
AHRQ-funded; HS021110; HS018517.
Citation: Mamtani R, Clark AS, Scott FI .
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
Arthritis Rheumatol 2016 Oct;68(10):2403-11. doi: 10.1002/art.39738.
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Keywords: Cancer: Breast Cancer, Digestive Disease and Health, Medication, Patient-Centered Outcomes Research, Arthritis
Mannion ML, Xie F, Baddley J
Analysis of health care claims during the peri-transfer stage of transition from pediatric to adult care among juvenile idiopathic arthritis patients.
This study investigated the utilization of health care services before and after transfer from pediatric to adult rheumatology care in clinical practice. It found that individuals with juvenile idiopathic arthritis (JIA) who transferred to adult care were more likely receive a diagnosis of rheumatoid arthritis instead of juvenile rheumatoid arthritis and were less likely to receive NSAIDs, but had no significant immediate changes to other medication use.
AHRQ-funded; HS021110.
Citation: Mannion ML, Xie F, Baddley J .
Analysis of health care claims during the peri-transfer stage of transition from pediatric to adult care among juvenile idiopathic arthritis patients.
Pediatr Rheumatol Online J 2016 Sep 5;14(1):49. doi: 10.1186/s12969-016-0107-3.
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Keywords: Healthcare Utilization, Arthritis, Children/Adolescents