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AHRQ Research Studies Date
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- Children/Adolescents (1)
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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 18 of 18 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 The authors intended to use their findings to develop draft guidance checklists and assess agreement with each item through an international survey.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)
Lewis 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