National Healthcare Quality and Disparities Report
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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
251 to 275 of 366 Research Studies DisplayedChou R, Bougatsos C, Blazina I
Screening for celiac disease: evidence report and systematic review for the US Preventive Services Task Force.
The researchers reviewed the evidence on benefits and harms of screening for celiac disease in asymptomatic adults, adolescents, and children 3 years and older for the US Preventive Services Task Force. Although some evidence was found regarding diagnostic accuracy of tests for celiac disease, little or no evidence was identified to inform most of the key questions related to benefits and harms of screening for celiac disease in asymptomatic individuals.
AHRQ-funded; 290201200015I.
Citation: Chou R, Bougatsos C, Blazina I .
Screening for celiac disease: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Mar 28;317(12):1258-68. doi: 10.1001/jama.2016.10395.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Evidence-Based Practice, Guidelines
Armstrong MJ, Mullins CD, Gronseth GS
Recommendations for patient engagement in guideline development panels: a qualitative focus group study of guideline-naive patients.
This study investigated the perspectives of potential patient/consumer guideline representatives on topics pertaining to engagement including guideline development, group composition and barriers to and facilitators of engagement. It found that participants recommended small, diverse guideline development groups engaging multiple patient/consumer stakeholders with no prior relationships with each other or professional panel members.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Mullins CD, Gronseth GS .
Recommendations for patient engagement in guideline development panels: a qualitative focus group study of guideline-naive patients.
PLoS One 2017 Mar 20;12(3):e0174329. doi: 10.1371/journal.pone.0174329.
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Keywords: Evidence-Based Practice, Guidelines, Patient and Family Engagement
Eaton EF, Hudak K, Muzny CA
Budgetary impact of compliance with STI screening guidelines in persons living with HIV.
The study objective was to evaluate the budgetary impact of sexually transmitted infection (STI) screening. At one HIV clinic where the number of patients receiving care from August 2014 to August 2015 was 3,163, the study found that annual screening for N. gonorrhoeae, C. trachomatis, syphilis, and T. vaginalis would lead to a mean net loss of $129,416, $118,304, $72,625, and $13,523, respectively.
AHRQ-funded; HS013852; HS023009.
Citation: Eaton EF, Hudak K, Muzny CA .
Budgetary impact of compliance with STI screening guidelines in persons living with HIV.
J Acquir Immune Defic Syndr 2017 Mar;74(3):303-08. doi: 10.1097/qai.0000000000001212.
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Keywords: Human Immunodeficiency Virus (HIV), Guidelines, Screening, Sexual Health
Encinosa W, Davidoff AJ
AHRQ Author: Encinosa W
Changes in antiemetic overuse in response to Choosing Wisely recommendations.
Antiemetics are used to prevent chemotherapy-induced nausea and vomiting in patients with cancer. Newer antiemetic agents (serotonin and neurokinin-1 receptor antagonists) have increased efficacy but are expensive. This study estimating the baseline prevalence, trends, determinants, and costs of antiemetic overuse found that antiemetic overuse is prevalent and results in unnecessary spending associated with systemic chemotherapy treatment.
AHRQ-authored.
Citation: Encinosa W, Davidoff AJ .
Changes in antiemetic overuse in response to Choosing Wisely recommendations.
JAMA Oncol 2017 Mar;3(3):320-26. doi: 10.1001/jamaoncol.2016.2530.
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Keywords: Guidelines, Medication, Prevention, Shared Decision Making
Greenhawt M, Oppenheimer J, Nelson M
Sublingual immunotherapy: a focused allergen immunotherapy practice parameter update.
The primary focus of the sublingual immunotherapy (SLIT) practice parameter is to provide guidance for effective, safe, and appropriate administration of the FDA-approved SLIT formulations. The SLIT practice parameters contain systematically developed statements with recommendations intended to optimize patient care and assist physicians and/or other health care practitioners and patients to make decisions regarding this therapy.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Oppenheimer J, Nelson M .
Sublingual immunotherapy: a focused allergen immunotherapy practice parameter update.
Ann Allergy Asthma Immunol 2017 Mar;118(3):276-82.e2. doi: 10.1016/j.anai.2016.12.009.
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Keywords: Evidence-Based Practice, Guidelines, Treatments
Curtis JR, Chen L, Greenberg JD
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Treat to target guidelines recommend achieving remission or low disease activity in rheumatoid arthritis (RA). However, the reduction in adverse events and costs associated with lower disease activity is unclear. This study found that leveraging the benefits of linking registry and administrative data together, lower disease activity in RA was associated with incrementally reduced risks of all-cause hospitalization, ED visits, mortality, and medical costs in a dose-dependent fashion.
AHRQ-funded; HS021694.
Citation: Curtis JR, Chen L, Greenberg JD .
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Pharmacoepidemiol Drug Saf 2017 Mar;26(3):310-19. doi: 10.1002/pds.4126.
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Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Healthcare Costs, Guidelines
Romagnoli KM, Nelson SD, Hines L
Information needs for making clinical recommendations about potential drug-drug interactions: a synthesis of literature review and interviews.
To better understand the information needs and work practices of specialists who search and synthesize potential drug-drug interactions (PDDIs) evidence for drug information resources, the researchers conducted an inquiry that combined a thematic analysis of published literature with unstructured interviews. Their review of 92 papers and 10 interviews identified 56 categories of information needs related to the interpretation of PDDI information including drug and interaction information, study design and evidence including clinical details.
AHRQ-funded; HS019461.
Citation: Romagnoli KM, Nelson SD, Hines L .
Information needs for making clinical recommendations about potential drug-drug interactions: a synthesis of literature review and interviews.
BMC Med Inform Decis Mak 2017 Feb 22;17(1):21. doi: 10.1186/s12911-017-0419-3.
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Keywords: Guidelines, Clinical Decision Support (CDS), Medication, Adverse Drug Events (ADE)
Armstrong MJ, Rueda JD, Gronseth GS
Framework for enhancing clinical practice guidelines through continuous patient engagement.
The authors propose a ten-step framework outlining steps and options for patient engagement in guideline development with the goal of highlighting steps for patient engagement and methods by which this can be achieved. This framework can serve as a resource for guideline developers desiring to increase patient engagement and reference for researchers investigating engagement methodology at different steps of the clinical practice guideline lifecycle.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Rueda JD, Gronseth GS .
Framework for enhancing clinical practice guidelines through continuous patient engagement.
Health Expect 2017 Feb;20(1):3-10. doi: 10.1111/hex.12467.
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Keywords: Evidence-Based Practice, Guidelines, Patient and Family Engagement, Patient-Centered Outcomes Research, Quality Improvement
Nace DA, Archbald-Pannone LR, Ashraf MS
Pneumococcal vaccination guidance for post-acute and long-term care settings: recommendations from AMDA's infection advisory committee.
Sorting out the indications and timing for 13 pneumococcal serotypes and 23 pneumococcal serotypes administration is complex. The authors discuss the importance of pneumococcal vaccination for older adults, detail AMDA-The Society for Post-Acute and Long-Term Care Medicine (The Society)'s recommendations for pneumococcal vaccination practice and procedures, and offer guidance to postacute and long-term care providers supporting the development and effective implementation of pneumococcal vaccine policies.
AHRQ-funded; HS023779.
Citation: Nace DA, Archbald-Pannone LR, Ashraf MS .
Pneumococcal vaccination guidance for post-acute and long-term care settings: recommendations from AMDA's infection advisory committee.
J Am Med Dir Assoc 2017 Feb;18(2):99-104. doi: 10.1016/j.jamda.2016.11.010.
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Keywords: Elderly, Guidelines, Nursing Homes, Pneumonia, Vaccination
Hamilton JG, Lillie SE, Alden DL
What is a good medical decision? A research agenda guided by perspectives from multiple stakeholders.
This position paper, informed by conference sessions featuring diverse stakeholders held at the 2015 Society of Behavioral Medicine and Society for Medical Decision Making annual meetings, describes key concepts that influence the decision making process itself and that may change what it means to make a good decision: interpersonal factors, structural constraints, affective influences, and values clarification methods.
AHRQ-funded; HS022418.
Citation: Hamilton JG, Lillie SE, Alden DL .
What is a good medical decision? A research agenda guided by perspectives from multiple stakeholders.
J Behav Med 2017 Feb;40(1):52-68. doi: 10.1007/s10865-016-9785-z.
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Keywords: Shared Decision Making, Guidelines, Patient-Centered Healthcare
Dhruva SS, Desai NR, Karaca-Mandic P
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
This letter describes a study which examined the use of statins and non-statin medications at Medicare formularies before and after the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guideline was released. The study found that while many formularies did restrict nonstatin medications as per the new guidelines, many others did not.
AHRQ-funded; HS023000.
Citation: Dhruva SS, Desai NR, Karaca-Mandic P .
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
J Am Coll Cardiol 2017 Jan 17;69(2):244-46. doi: 10.1016/j.jacc.2016.10.053..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Guidelines, Medicare, Medication
Newberry SJ, FitzGerald JD, Motala A
Diagnosis of gout: a systematic review in support of an American College of Physicians clinical practice guideline.
This review summarized evidence regarding the accuracy of clinical tests and classification algorithms compared with that of a reference standard of monosodium urate crystals in joint aspirate for diagnosing gout. It concluded that multidimensional algorithms, which must be validated in primary and urgent care settings, may help clinicians make a provisional diagnosis of gout. Although dual-energy computed tomography and ultrasonography also show promise for gout diagnosis, accessibility to these methods may be limited.
AHRQ-funded; 290201200006I.
Citation: Newberry SJ, FitzGerald JD, Motala A .
Diagnosis of gout: a systematic review in support of an American College of Physicians clinical practice guideline.
Ann Intern Med 2017 Jan 3;166(1):27-36. doi: 10.7326/m16-0462.
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Keywords: Guidelines, Diagnostic Safety and Quality, Evidence-Based Practice
Shekelle PG, Newberry SJ, FitzGerald JD
Management of gout: a systematic review in support of an American College of Physicians clinical practice guideline.
The authors reviewed evidence about treatment of acute gout attacks, management of hyperuricemia to prevent attacks, and discontinuation of medications for chronic gout in adults. They concluded that colchicine, NSAIDs, and corticosteroids relieve pain in adults with acute gout. Urate-lowering therapy decreases serum urate levels and reduces risk for acute gout attacks.
AHRQ-funded; 290201200006I.
Citation: Shekelle PG, Newberry SJ, FitzGerald JD .
Management of gout: a systematic review in support of an American College of Physicians clinical practice guideline.
Ann Intern Med 2017 Jan 3;166(1):37-51. doi: 10.7326/m16-0461.
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Keywords: Evidence-Based Practice, Guidelines, Prevention, Medication, Comparative Effectiveness
Togias A, Cooper SF, Acebal ML
Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel.
Along with 25 professional organizations, federal agencies, and patient advocacy groups, the National Institute of Allergy and Infectious Diseases facilitated development of addendum guidelines to specifically address the prevention of peanut allergy. This addendum provides 3 separate guidelines for infants at various risk levels for the development of peanut allergy and is intended for use by a wide variety of health care providers.
AHRQ-funded; HS024599.
Citation: Togias A, Cooper SF, Acebal ML .
Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel.
J Allergy Clin Immunol 2017 Jan;139(1):29-44. doi: 10.1016/j.jaci.2016.10.010.
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Keywords: Guidelines, Prevention, Skin Conditions
Rocque GB, Williams CP, Jackson BE
Choosing Wisely: opportunities for improving value in cancer care delivery?
The researchers conducted a retrospective analysis of Medicare claims data to examine concordance with Choosing Wisely recommendations across 12 cancer centers in the southeastern United States. Significant variability was noted across centers for all recommendations. The researchers concluded that if concordance were to increase to 95 percent for all measures, an estimated $19 million difference in total cost of care per quarter would be saved.
AHRQ-funded; HS023009.
Citation: Rocque GB, Williams CP, Jackson BE .
Choosing Wisely: opportunities for improving value in cancer care delivery?
J Oncol Pract 2017 Jan;13(1):e11-e21. doi: 10.1200/jop.2016.015396.
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Keywords: Cancer, Guidelines, Healthcare Delivery, Medicare
Nuckols T, Conlon C, Robbins M
Quality of care for work-associated carpal tunnel syndrome.
This study evaluated the quality of care provided to individuals with workers' compensation claims related to carpal tunnel syndrome and identified patient characteristics associated with receiving better care. Overall, 81.6 percent of care adhered to recommended standards. Patients with classic/probable Katz diagrams, positive electrodiagnostic tests, and higher incomes received better care. However, age, sex, and race/ethnicity were not associated with quality.
AHRQ-funded; HS018982.
Citation: Nuckols T, Conlon C, Robbins M .
Quality of care for work-associated carpal tunnel syndrome.
J Occup Environ Med 2017 Jan;59(1):47-53. doi: 10.1097/jom.0000000000000916.
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Keywords: Guidelines, Quality of Care, Neurological Disorders, Patient-Centered Healthcare, Quality Indicators (QIs)
Manojlovich M, Ratz D, Miller MA
AHRQ Author: Miller MA
Use of daily interruption of sedation and early mobility in US hospitals.
Although the Awakening and Breathing Coordination, Delirium assessment, and Early exercise/mobility (ABCDE) bundle may be effective, individual components of ABCDE may not be implemented as intended. The researchers examined the use of daily interruption of sedation and early mobility, looking for an association between these bundle elements.
AHRQ-authored.
Citation: Manojlovich M, Ratz D, Miller MA .
Use of daily interruption of sedation and early mobility in US hospitals.
J Nurs Care Qual 2017 Jan/Mar;32(1):71-76. doi: 10.1097/ncq.0000000000000222.
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Keywords: Evidence-Based Practice, Guidelines, Medication, Patient Safety, Healthcare Delivery
Bierman AS, Tinetti ME
AHRQ Author: Bierman AS
Precision medicine to precision care: managing multimorbidity.
Multimorbidity is the most common condition managed in practice. The authors argue that health-care delivery must be transformed to provide precision care to people with multimorbidity. Accomplishing this transition will require a change in practice, research, and policy from disease-specific to patient-centered models of care delivery.
AHRQ-authored.
Citation: Bierman AS, Tinetti ME .
Precision medicine to precision care: managing multimorbidity.
Lancet 2016 Dec 3;388(10061):2721-23. doi: 10.1016/s0140-6736(16)32232-2.
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Keywords: Healthcare Delivery, Chronic Conditions, Guidelines, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care
Meisel ZF, Metlay JP, Sinnenberg L
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
The authors compared whether narrative vignettes embedded in the American College of Emergency Physicians (ACEP) daily e-newsletter improved dissemination of the clinical policy to ACEP members, and engagement of members with the clinical policy, compared with traditional summary text. They found that the vignettes outperformed traditional guideline text in promoting engagement with an evidence-based clinical guideline related to opioid prescriptions.
AHRQ-funded; HS021956.
Citation: Meisel ZF, Metlay JP, Sinnenberg L .
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
Ann Emerg Med 2016 Dec;68(6):719-28. doi: 10.1016/j.annemergmed.2016.03.007.
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Keywords: Communication, Evidence-Based Practice, Guidelines, Opioids, Medication, Medication: Safety, Policy, Provider
Burstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Cram P, Wolinsky FD, Lou Y
Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial.
In a clinical trial of 7749 patients, the researchers tested whether usual care augmented by a tailored patient-activation DXA result letter accompanied by an educational brochure would improve guideline-concordant pharmacological treatment compared to usual care only. They found that treatment rates did not improve.
AHRQ-funded; HS023009.
Citation: Cram P, Wolinsky FD, Lou Y .
Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial.
Osteoporos Int 2016 Dec;27(12):3513-24. doi: 10.1007/s00198-016-3681-9.
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Keywords: Education: Patient and Caregiver, Guidelines, Medication, Osteoporosis, Patient and Family Engagement
Lee KC, Ngo-Metzger Q, Wolff T
AHRQ Author: Lee KC, Ngo-Metzger Q, Wolff T, Chowdhury J, Meyers DS
Sexually transmitted infections: recommendations from the U.S. Preventive Services Task Force.
The USPSTF recommends intensive behavioral counseling for all sexually active adolescents and for adults whose history indicates an increased risk of STIs. These interventions can reduce STI acquisition and risky sexual behaviors, and increase condom use and other protective behaviors. The USPSTF also recommends screening for chlamydia and gonorrhea in all sexually active women 24 years and younger, and in older women at increased risk.
AHRQ-authored.
Citation: Lee KC, Ngo-Metzger Q, Wolff T .
Sexually transmitted infections: recommendations from the U.S. Preventive Services Task Force.
Am Fam Physician 2016 Dec 1;94(11):907-15.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Guidelines, Screening
Musuuza JS, Hundt AS, Zimbric M
Standardizing direct observation for assessing compliance to a daily chlorhexidine bathing protocol among hospitalized patients.
This paper describes the authors' experience training observers to conduct chlorhexidine gluconate bathing observations, and they present findings from pilot observations.
AHRQ-funded; HS024039.
Citation: Musuuza JS, Hundt AS, Zimbric M .
Standardizing direct observation for assessing compliance to a daily chlorhexidine bathing protocol among hospitalized patients.
Infect Control Hosp Epidemiol 2016 Dec;37(12):1516-18. doi: 10.1017/ice.2016.214.
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Keywords: Guidelines, Quality of Care, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Beckman MG, Abe K, Barnes K
AHRQ Author: Brady PJ
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
This issue of the Journal of Hospital Medicine showcases the initiatives of several of the CDC’s healthcare-associated venous thromboembolism (HA-VTE) prevention champions. The CDC and AHRQ are partnering to disseminate and promote these best practices. In addition to this challenge, the CDC, AHRQ and the Joint Commission Center for Transforming Healthcare are working on activities and programs dedicated to improving prevention of HA-VTE. They are summarized in the article.
AHRQ-authored.
Citation: Beckman MG, Abe K, Barnes K .
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
J Hosp Med 2016 Dec;11 Suppl 2:S5-s7. doi: 10.1002/jhm.2659.
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Keywords: Prevention, Blood Clots, Quality Improvement, Guidelines, Adverse Events
Hand RK, Kenne D, Wolfram TM
Assessing the viability of social media for disseminating evidence-based nutrition practice guideline through content analysis of twitter messages and health professional interviews: an observational study.
This study explored the potential for social media dissemination of the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline (EBNPG) for Heart Failure (HF). ). It found that interview participants believed that social media was a useful way to gather professional information. They did not believe that social media was useful for communicating with patients.
AHRQ-funded; HS021953.
Citation: Hand RK, Kenne D, Wolfram TM .
Assessing the viability of social media for disseminating evidence-based nutrition practice guideline through content analysis of twitter messages and health professional interviews: an observational study.
J Med Internet Res 2016 Nov 15;18(11):e295. doi: 10.2196/jmir.5811.
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Keywords: Social Media, Evidence-Based Practice, Guidelines, Heart Disease and Health, Nutrition