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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 54 Research Studies DisplayedLewis CC, Powell BJ, Brewer SK
Advancing mechanisms of implementation to accelerate sustainable evidence-based practice integration: protocol for generating a research agenda.
This article outlines the protocol for an AHRQ-funded initiative to: 1) establish priorities for an agenda to guide research on implementation mechanisms in health and public health, and 2) disseminate the agenda to research, policy, and practice audiences. The goal is to advance mechanisms of implementation to accelerate sustainable evidence-based practice integration. A network of scientific experts will be created to convene in “Deep Dive” meetings for 3 years. The research agenda will be generated through analysis and synthesis of information from 6 sources: (1) systematic reviews, (2) network members' approaches to studying mechanisms, (3) new proposals presented in implementation proposal feedback sessions, (4) working group sessions conducted in a leading implementation research training institute, (5) breakout sessions at the Society for Implementation Research Collaboration's (SIRC) 2019 conference and (6) SIRC conference abstracts. Mechanism-relevant text segments will be extracted by two members and a third member will generate statements as an input for concept mapping.
AHRQ-funded; HS025632.
Citation: Lewis CC, Powell BJ, Brewer SK .
Advancing mechanisms of implementation to accelerate sustainable evidence-based practice integration: protocol for generating a research agenda.
BMJ Open 2021 Oct 18;11(10):e053474. doi: 10.1136/bmjopen-2021-053474..
Keywords: Implementation, Evidence-Based Practice, Research Methodologies, Health Services Research (HSR)
Murphy DR, Savoy A, Satterly T
Dashboards for visual display of patient safety data: a systematic review.
Methods to visualize patient safety data can support effective monitoring of safety events and discovery of trends. While quality dashboards are common, use and impact of dashboards to visualize patient safety event data remains poorly understood. The objective of this study was to understand development, use and direct or indirect impacts of patient safety dashboards. The investigators conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
AHRQ-funded; HS022087; HS022901; HS027363.
Citation: Murphy DR, Savoy A, Satterly T .
Dashboards for visual display of patient safety data: a systematic review.
BMJ Health Care Inform 2021 Oct;28(1). doi: 10.1136/bmjhci-2021-100437..
Keywords: Patient Safety, Health Services Research (HSR)
Bierman AS, Wang J, O'Malley PG
AHRQ Author: Bierman AS, Wang J, O'Malley PG, Moss DK
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
This article describes issues addressing the needs of those with multiple chronic conditions and discusses the AHRQ research agenda.
AHRQ-authored.
Citation: Bierman AS, Wang J, O'Malley PG .
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
Health Serv Res 2021 Oct;56(Suppl 1):973-79. doi: 10.1111/1475-6773.13863..
Keywords: Chronic Conditions, Health Services Research (HSR), Healthcare Delivery, Quality of Care, Primary Care, Guidelines, Evidence-Based Practice
Yano EM, Resnick A, Gluck M
AHRQ Author: Kwon H, Mistry KB
Accelerating learning healthcare system development through embedded research: career trajectories, training needs, and strategies for managing and supporting embedded researchers.
Health systems and organizations seeking to achieve learning healthcare system principles are increasingly relying on embedded research teams to optimize delivery of evidence-based, high-quality care that improves patient and staff experience alike. In February 2018, 115 attendees from multiple agencies, institutions and professional societies participated in a conference to accelerate development of learning healthcare systems through embedded research. This paper describes the process.
AHRQ-authored.
Citation: Yano EM, Resnick A, Gluck M .
Accelerating learning healthcare system development through embedded research: career trajectories, training needs, and strategies for managing and supporting embedded researchers.
Healthc 2021 Jun;8(Suppl 1):100479. doi: 10.1016/j.hjdsi.2020.100479..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR)
Shortell SM, Gottlieb DJ, Martinez Camblor P
Hospital-based health systems 20 years later: a taxonomy for policy research and analysis.
Building on the original taxonomy of hospital-based health systems from 20 years ago, the investigators developed a new taxonomy to inform emerging public policy and practice developments. The study design included a cluster analysis of the 2016 AHA Annual Survey data to derive measures of differentiation, centralization, and integration to create categories or types of hospital-based health systems.
AHRQ-funded; HS024075.
Citation: Shortell SM, Gottlieb DJ, Martinez Camblor P .
Hospital-based health systems 20 years later: a taxonomy for policy research and analysis.
Health Serv Res 2021 Jun;56(3):453-63. doi: 10.1111/1475-6773.13621..
Keywords: Hospitals, Health Systems, Health Services Research (HSR), Policy
Sanghavi P, Jena AB, Newhouse JP
Identifying outlier patterns of inconsistent ambulance billing in Medicare.
The objective of this study was to illustrate a method that accounts for sampling variation in identifying suppliers and counties with outlying rates of a particular pattern of inconsistent billing for ambulance services to Medicare. The investigators concluded that health care fraud and abuse were frequently asserted but could be difficult to detect. They suggested that their data-driven approach may be a useful starting point for further investigation.
AHRQ-funded; 6HS022798; HS025720.
Citation: Sanghavi P, Jena AB, Newhouse JP .
Identifying outlier patterns of inconsistent ambulance billing in Medicare.
Health Serv Res 2021 Apr;56(2):188-92. doi: 10.1111/1475-6773.13622..
Keywords: Medicare, Payment, Health Services Research (HSR)
Sood E, Wysocki T, Alderfer MA
Topical review: crowdsourcing as a novel approach to qualitative research.
The purpose of this paper was to describe a novel, five-phase approach to collecting qualitative data from hard-to-reach populations using crowdsourcing methods. The phases of crowdsourcing methodology described were: (I) Preparing; (II) Forming Crowds; (III) Collecting Crowdsourced Data; (IV) Coding and Analyzing Crowdsourced Data; and (V) Generating and Disseminating Findings. The investigators concluded that crowdsourcing is an innovative, efficient, feasible, and timely approach to engaging hard-to-reach populations in qualitative research.
AHRQ-funded; HS026393.
Citation: Sood E, Wysocki T, Alderfer MA .
Topical review: crowdsourcing as a novel approach to qualitative research.
J Pediatr Psychol 2021 Feb 19;46(2):189-96. doi: 10.1093/jpepsy/jsaa096..
Keywords: Health Services Research (HSR), Research Methodologies
Rodriguez PJ, Ward ZJ, Long MW
Applied methods for estimating transition probabilities from electronic health record data.
This study examined the usefulness of electronic health records (EHRs) in estimating transition probabilities for state-transition models. No guidelines exist on appropriate methods. The authors used 3 potential methods to estimate transition probabilities for EHR data, using pediatric eating disorders (EDs) as a case study. They mapped diagnoses to 3 ED health states: anorexia nervous, bulimia nervosa, and other specified feeding or eating disorder using data from PEDsnet, which includes 8 US children’s hospitals. They used 3 approaches: simple first-last proportions, a multistate Markov (MSM) model, and independent survival models. The first-last proportion approach estimated higher probabilities of remaining the same health state, while the other two approaches estimated higher probabilities of transitioning to a different health state. Published literature differed substantially from these estimates. Further research is needed to improve methods for using EHR data to inform transition probabilities.
AHRQ-funded; HS013853.
Citation: Rodriguez PJ, Ward ZJ, Long MW .
Applied methods for estimating transition probabilities from electronic health record data.
Med Decis Making 2021 Feb;41(2):143-52. doi: 10.1177/0272989x20985752..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Shu D, Han P, Wang R, Toh S. D, Han P, Wang R
Estimating the marginal hazard ratio by simultaneously using a set of propensity score models: a multiply robust approach.
The inverse probability weighted Cox model is frequently used to estimate the marginal hazard ratio. Its validity requires a crucial condition that the propensity score model be correctly specified. To provide protection against misspecification of the propensity score model, the investigators proposed a weighted estimation method rooted in the empirical likelihood theory. They applied the proposed method to compare the risk of postoperative hospitalization between sleeve gastrectomy and Roux-en-Y gastric bypass using data from a large medical claims and billing database.
AHRQ-funded; HS026214.
Citation: Shu D, Han P, Wang R, Toh S. D, Han P, Wang R .
Estimating the marginal hazard ratio by simultaneously using a set of propensity score models: a multiply robust approach.
Stat Med 2021 Feb;40(5):1224-42. doi: 10.1002/sim.8837..
Keywords: Research Methodologies, Health Services Research (HSR)
Kuo YF, Lin YL, D Jupiter, et al.
How to identify team-based primary care in the United States using Medicare data.
The authors assessed whether analyses using different sets of Medicare data can produce results similar to those from analyses using 100% data from an entire state in identifying primary care teams through social network analysis. They found that, depending on specific study purposes, researchers could use either 100% data from Medicare beneficiaries in randomly selected primary care services areas or data from a 20% national sample of Medicare beneficiaries to study team-based primary care in the United States.
AHRQ-funded; HS020642.
Citation: Kuo YF, Lin YL, D Jupiter, et al..
How to identify team-based primary care in the United States using Medicare data.
Med Care 2021 Feb;59(2):118-22. doi: 10.1097/mlr.0000000000001478.
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Keywords: Teams, Primary Care: Models of Care, Primary Care, Medicare, Health Services Research (HSR), Healthcare Delivery
Thompson HM
Stakeholder experiences with gender identity data capture in electronic health records: implementation effectiveness and a visibility paradox.
Advocates have endorsed transgender visibility via gender identity (GI) data capture with the advent of the Affordable Care Act and electronic health record (EHR) requirements. Visibility in data in order to enumerate a population contrasts with ways in which other LGBT and public health scholars have deployed these concepts. This article aims to assess the effectiveness of GI data capture in EHRs and implications for trans health care quality improvements and research.
AHRQ-funded; HS026385.
Citation: Thompson HM .
Stakeholder experiences with gender identity data capture in electronic health records: implementation effectiveness and a visibility paradox.
Health Educ Behav 2021 Feb;48(1):93-101. doi: 10.1177/1090198120963102.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Vulnerable Populations, Sex Factors
Cohen GR, Jones DJ, Heeringa J
AHRQ Author: Furukawa MF, Miller D
Leveraging diverse data sources to identify and describe U.S. health care delivery systems.
Health care delivery systems are a growing presence in the U.S., yet research is hindered by the lack of universally agreed-upon criteria to denote formal systems. This study assesses available data sources to identify and describe systems, including system members and relationships among the members.
AHRQ-authored.
Citation: Cohen GR, Jones DJ, Heeringa J .
Leveraging diverse data sources to identify and describe U.S. health care delivery systems.
eGEMS 2017 Dec 15;5(3):9. doi: 10.5334/egems.200..
Keywords: Healthcare Delivery, Data, Health Services Research (HSR), System Design
Raffo JE, Lloyd C, Collier M
Defining the role of the community health worker within a federal healthy start care coordination team.
The Strong Beginnings program worked to define community health worker (CHW) interventions, a core service of the program to improve maternal and child health. The workgroup identified seven core functions and 28 maternal and child health risk topics to be addressed by the CHW. The process resulted in a detailed document of program interventions that the CHWs use to guide care.
AHRQ-funded; HS020208.
Citation: Raffo JE, Lloyd C, Collier M .
Defining the role of the community health worker within a federal healthy start care coordination team.
Matern Child Health J 2017 Dec;21(Suppl 1):93-100. doi: 10.1007/s10995-017-2379-8.
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Keywords: Care Coordination, Children/Adolescents, Health Promotion, Health Services Research (HSR), Maternal Care
Serang S, Jacobucci R, Brimhall KC
Exploratory mediation analysis via regularization.
The researchers propose a two-stage approach called exploratory mediation analysis via regularization (XMed). They demonstrate that this approach is able to correctly identify mediators more often than conventional approaches and that its estimates are unbiased. Finally, their approach is illustrated through an empirical example examining the relationship between college acceptance and enrollment.
AHRQ-funded; HS024650.
Citation: Serang S, Jacobucci R, Brimhall KC .
Exploratory mediation analysis via regularization.
Struct Equ Modeling 2017;24(5):733-44. doi: 10.1080/10705511.2017.1311775.
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Keywords: Health Services Research (HSR), Research Methodologies
Oakes AH, Garmo VS, Bone LR
Identifying and prioritizing the barriers and facilitators to the self-management of type 2 diabetes mellitus: a community-centered approach.
The researchers sought to develop and test an instrument to identify and quantify the barriers and facilitators to self-management of type 2 diabetes. The study concluded that factors impacting self-management can be quantified and categorized as barriers and facilitators. Further refinement to some factors and investigation into alternative prioritization methods is necessary.
AHRQ-funded; HS000029.
Citation: Oakes AH, Garmo VS, Bone LR .
Identifying and prioritizing the barriers and facilitators to the self-management of type 2 diabetes mellitus: a community-centered approach.
Patient 2017 Dec;10(6):773-83. doi: 10.1007/s40271-017-0248-6..
Keywords: Diabetes, Health Services Research (HSR), Patient-Centered Healthcare, Patient Self-Management
Rundell SD, Gold LS, Hansen RN
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
The purpose of this study was to assess if co-morbidity is associated with higher use of back-related care and adherence to back pain guidelines. The investigators found that co-morbidity burden and the presence of specific chronic conditions, such as musculoskeletal conditions, were associated with high long-term use of back-related care and care inconsistent with guidelines.
AHRQ-funded; HS022982.
Citation: Rundell SD, Gold LS, Hansen RN .
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
J Eval Clin Pract 2017 Dec;23(6):1218-26. doi: 10.1111/jep.12763..
Keywords: Back Health and Pain, Guidelines, Health Services Research (HSR), Healthcare Utilization, Patient Adherence/Compliance
Senathirajah Y, Wang J, Borycki E
Mapping the electronic health record: a method to study display fragmentation.
Electronic health records have often been criticized for poor interaction design. The authors describe a method for evaluating and depicting the extent of display fragmentation and discuss its potential uses in comparing systems, identifying navigation pathways and information juxtaposition, and improving EHR interaction design.
AHRQ-funded; HS023708.
Citation: Senathirajah Y, Wang J, Borycki E .
Mapping the electronic health record: a method to study display fragmentation.
Stud Health Technol Inform 2017;245:1138-42.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR)
Kumar K, Holscher CM, Luo X
Persistent regional and racial disparities in nondirected living kidney donation.
Nondirected living donors (NDLDs) are an important and growing source of kidneys to help reduce the organ shortage. The authors of this study hypothesized that the initial geographic clustering and racial disparities may have improved due to an increase in NDLDs. The authors found that despite the increased number of NDLDs, racial disparities have worsened and the center-level distribution of NDLD transplants has narrowed in recent years.
AHRQ-funded; HS024600.
Citation: Kumar K, Holscher CM, Luo X .
Persistent regional and racial disparities in nondirected living kidney donation.
Clin Transplant 2017 Dec;31(12). doi: 10.1111/ctr.13135..
Keywords: Disparities, Health Services Research (HSR), Policy, Transplantation, Racial and Ethnic Minorities
Attanasio LB, Hardeman RR, Kozhimannil KB
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
This study examined whether women's prenatal attitudes toward vaginal delivery differed by race/ethnicity or socioeconomic status, and whether attitudes were differently related to delivery mode depending on race/ethnicity or socioeconomic status. The study concluded that there are racial/ethnic differences in chances of cesarean delivery, and these differences are not explained by birth attitudes. Findings also suggested that white and high-socioeconomic status women may be more able to realize their preferences in childbirth.
AHRQ-funded; HS024215.
Citation: Attanasio LB, Hardeman RR, Kozhimannil KB .
Prenatal attitudes toward vaginal delivery and actual delivery mode: variation by race/ethnicity and socioeconomic status.
Birth 2017 Dec;44(4):306-14. doi: 10.1111/birt.12305..
Keywords: Health Services Research (HSR), Labor and Delivery, Pregnancy, Racial and Ethnic Minorities, Social Determinants of Health
Henderson ML, Thomas AG, Shaffer A
The national landscape of living kidney donor follow-up in the United States.
The purpose of this study was to understand the impact of the 2013 policy the Organ Procurement and Transplantation Network/United Network for Organ Sharing issued. The policy required that transplant centers collect data on living kidney donors (LKDs) at 6 months, 1 year, and 2 years postdonation, with policy-defined thresholds for the proportion of complete living donor follow-up data submitted in a timely manner (60 days before or after the expected visit date).
AHRQ-funded; HS024600.
Citation: Henderson ML, Thomas AG, Shaffer A .
The national landscape of living kidney donor follow-up in the United States.
Am J Transplant 2017 Dec;17(12):3131-40. doi: 10.1111/ajt.14356..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Policy, Registries, Transplantation
Ji X, Machiraju R, Ritter A
Visualizing article similarities via sparsified article network and map projection for systematic reviews.
In this study, the authors visualized article similarities to extend its utilization in practical settings for SR researchers, aiming to promote human comprehension of article distributions and hidden patterns. To prompt an effective visualization in an interpretable, intuitive, and scalable way, they implemented a graph-based network visualization with three network sparsification approaches and a distance-based map projection via dimensionality reduction.
AHRQ-funded; HS025047.
Citation: Ji X, Machiraju R, Ritter A .
Visualizing article similarities via sparsified article network and map projection for systematic reviews.
Stud Health Technol Inform 2017;245:422-26.
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Keywords: Data, Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Schaffhausen CR, Bruin MJ, Chesley D
What patients and members of their support networks ask about transplant program data.
This study used qualitative document research methods to review 678 detailed Scientific Registry of Transplant Recipients (SRTR) entries and summary counts of 55 362 United Network for Organ Sharing (UNOS) entries to provide a better understanding of what was asked and what requests were most common. Patients sought a wide range of information about outcomes, waiting times, program volumes, and willingness to perform transplants in candidates with specific diseases or demographics.
AHRQ-funded; HS024527.
Citation: Schaffhausen CR, Bruin MJ, Chesley D .
What patients and members of their support networks ask about transplant program data.
Clin Transplant 2017 Dec;31(12). doi: 10.1111/ctr.13125.
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Keywords: Education: Patient and Caregiver, Shared Decision Making, Health Services Research (HSR), Registries, Transplantation
Colla CH, Mainor AJ
Choosing Wisely Campaign: valuable for providers who knew about it, but awareness remained constant, 2014-17.
The Choosing Wisely campaign has codified recommendations of which health care services' use should be questioned and discussed with patients. The ABIM Foundation administered surveys in 2014 and 2017 to examine physicians' attitudes toward and awareness of the use of low-value care. There were no significant changes between 2014 and 2017 in awareness of the campaign among physicians or physician-reported difficulty in talking to patients about avoiding a low-value service.
AHRQ-funded; HS023812.
Citation: Colla CH, Mainor AJ .
Choosing Wisely Campaign: valuable for providers who knew about it, but awareness remained constant, 2014-17.
Health Aff 2017 Nov;36(11):2005-11. doi: 10.1377/hlthaff.2017.0945.
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Keywords: Shared Decision Making, Guidelines, Quality of Care, Health Services Research (HSR), Clinician-Patient Communication
Hessels AJ, Darby SW, Simpser E
National testing of the nursing-kids intensity of care survey for pediatric long-term care.
The purpose of this study is to test the Nursing-Kids Intensity of Care, a measure of the intensity of nursing care needs, defined as the quantity and type of direct and indirect care activities performed by caregivers in a national sample. The authors concluded that additional testing to further establish psychometric sufficiency and expanded use to quantify the intensity of nursing care needs of children with complex medical conditions in pediatric long-term care settings is recommended.
AHRQ-funded; HS021470.
AHRQ-funded; HS021470.
AHRQ-funded; HS021470.
Citation: Hessels AJ, Darby SW, Simpser E .
National testing of the nursing-kids intensity of care survey for pediatric long-term care.
J Pediatr Nurs 2017 Nov/Dec;37:86-90. doi: 10.1016/j.pedn.2017.08.026..
Keywords: Children/Adolescents, Health Services Research (HSR), Long-Term Care, Nursing, Children/Adolescents
Fairbrother G, Dougherty D, Pradhananga R
AHRQ Author: Dougherty D
Road to the future: priorities for child health services research.
The researchers sought to develop and disseminate a robust, domestically focused, policy-oriented health services research agenda. Among the six priority domains identified for future research, including both enduring and emerging emphases were: 1) framing children's health issues so that they are compelling to policy-makers; 2) addressing poverty and other social determinants of child health and wellbeing; and 3) promoting equity in population health and health care.
AHRQ-authored; AHRQ-funded.
Citation: Fairbrother G, Dougherty D, Pradhananga R .
Road to the future: priorities for child health services research.
Acad Pediatr 2017 Nov - Dec;17(8):814-24. doi: 10.1016/j.acap.2017.04.015.
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Keywords: Children/Adolescents, Health Services Research (HSR), Health Services Research (HSR), Policy