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
101 to 125 of 936 Research Studies DisplayedKuzel AJ, Cuellar A, Nichols L
The EvidenceNOW practice support initiative: the Heart of Virginia Healthcare.
The purpose of this study was for The Heart of Virginia Health care (HVH) collaborative (one of the Agency for Healthcare Research and Quality's (AHRQ) Evidence Now project’s 7 collaboratives) to test different ways to improve performance and outcomes on ABCS clinical quality measures (appropriate Aspirin use, Blood pressure control, Cholesterol control, and Smoking cessation counseling) within small primary care practices. The researchers recruited 264 eligible practices and randomized them to 3 cohorts in a stepped wedge design, with 173, utilizing 16 different EHRs, participated through the entire initiative. Trained coaches delivered the practice support curriculum to improve performance on the ABCS measures. The program included an initial kickoff meeting, 3 months of focused support, 9 months of continued support, and access to online materials and faculty. The intervention phase was shortened due to difficulty in recruiting a sufficient number of practices. The study found that the short HVH intervention had a small but statistically significant positive average effects on appropriate use of aspirin and other anti-thrombotics, small negative effects on blood pressure control, except for those practices which did not attend the kickoff, and small negative effects on smoking cessation counseling. The researchers concluded that the truncation of the intervention contributed to the lack of substantial improvements in the ABCS.
AHRQ-funded; HS023913.
Citation: Kuzel AJ, Cuellar A, Nichols L .
The EvidenceNOW practice support initiative: the Heart of Virginia Healthcare.
J Am Board Fam Med 2022 Oct 18;35(5):979-89. doi: 10.3122/jabfm.2022.05.210021..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Primary Care, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care, Healthcare Delivery
Viswanathan M, Wallace IF, Cook Middleton J
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this paper was to review the evidence on screening for anxiety in children and adolescents to inform the US Preventive Services Task Force. Indirect evidence of findings suggested that some screening instruments were reasonably accurate. Cognitive behavioral therapy and pharmacotherapy were associated with benefits; no statistically significant association with harms was reported.
AHRQ-funded; 290201500011I, 75Q80120D00007.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 11;328(14):1445-55. doi: 10.1001/jama.2022.16303..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Anxiety, Behavioral Health, Primary Care, Screening, Guidelines, Evidence-Based Practice, Prevention
Scott Scott, Kempe A, Bajaj L
"These are our kids": qualitative interviews with clinical leaders in general emergency departments on motivations, processes, and guidelines in pediatric sepsis care.
Researchers sought to identify barriers and facilitators to pediatric sepsis care in general emergency departments (EDs), including care processes, the role of guidelines, and incentivized metrics. They interviewed medical directors, nurse managers, and quality coordinators. They found that leaders in general EDs were motivated to provide high-quality pediatric sepsis care but disagreed on whether reportable metrics would drive improvements. Leaders universally sought direct support from their nearest children's hospitals and actionable guidelines.
AHRQ-funded; HS025696.
Citation: Scott Scott, Kempe A, Bajaj L .
"These are our kids": qualitative interviews with clinical leaders in general emergency departments on motivations, processes, and guidelines in pediatric sepsis care.
Ann Emerg Med 2022 Oct;80(4):347-57. doi: 10.1016/j.annemergmed.2022.05.030..
Keywords: Children/Adolescents, Emergency Department, Sepsis, Guidelines, Evidence-Based Practice
Adam GP, Pappas D, Papageorgiou H
A novel tool that allows interactive screening of PubMed citations showed promise for the semi-automation of identification of biomedical literature.
This study looked at a novel tool named Pythia that allows interactive screening of PubMed citations to provide semi-automation of identification of biomedical literature for use with systematic reviews. Pythia incorporates a set of natural-language questions with machine-learning algorithms to rank all PubMed citations based on relevance, returning the 100 top-ranked citations. Of the seven systematic reviews conducted, the number of abstracts reviewed per relevant abstract number needed to read was lower than in the manually screened project in four reviews, higher in two, and had mixed results in one. The reviews that had greater overall sensitivity retrieved more relevant citations in early batches, but retrieval was generally unaffected by other aspects, such as study design, study size, and specific key question.
AHRQ-funded; HS027247.
Citation: Adam GP, Pappas D, Papageorgiou H .
A novel tool that allows interactive screening of PubMed citations showed promise for the semi-automation of identification of biomedical literature.
J Clin Epidemiol 2022 Oct;150:63-71. doi: 10.1016/j.jclinepi.2022.06.007..
Keywords: Research Methodologies, Evidence-Based Practice
Adhia AH, Feinglass JM, Schlick CJR
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
This study developed quality measures for management of stage III esophageal cancer including: utilization of neoadjuvant therapy, surgical sampling of at least 15 lymph nodes, resection within 60 days of chemotherapy or radiation, and completeness of resection to determine whether hospital volume varies measure adherence of published guidelines. A total of 1345 hospitals participating in the National Cancer Database from 2004 to 2016 were included. The authors examined association of volume, program accreditation, safety net status, geographic region, and patient travel distance on adequate adherence (≥85% of patients are adherent) using logistic regression modeling. The rate of adequate adherence was worst in nodal staging at 12.6% and highest for utilization of neoadjuvant therapy at 84.8%. Academic programs had the highest rate of adequate adherence for induction therapy (77.2%), timing of surgery (56.6%), and completeness of resection (78.5%) but lowest for nodal staging at only 4.4%. Every additional esophagectomy performed per year increased the odds of adequate adherence for induction therapy and completeness of resection but decreased for nodal staging.
AHRQ-funded; HS026385.
Citation: Adhia AH, Feinglass JM, Schlick CJR .
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
Ann Thorac Surg 2022 Oct;114(4):1176-82. doi: 10.1016/j.athoracsur.2021.07.092..
Keywords: Hospitals, Cancer, Guidelines, Evidence-Based Practice
Leland NE, Lekovitch C, Martínez J
Optimizing post-acute care patient safety: a scoping review of multifactorial fall prevention interventions for older adults.
The purpose of this scoping review was to describe the evidence for multifactorial post-acute care (PAC) fall prevention interventions for older patients. The researchers included 33 studies and characterized common intervention domains including: evaluating patient-specific fall risk factors, developing an individualized risk profile and treatment plan that targets each patient's fall risk factors, and implementing facility-based strategies such as staff education. There was not consensus across studies in how the domains were addressed and to what extent. The researchers concluded that health system efforts to prevent accidental falls in PAC should consider a patient-centered multifactorial approach.
AHRQ-funded; HS022907.
Citation: Leland NE, Lekovitch C, Martínez J .
Optimizing post-acute care patient safety: a scoping review of multifactorial fall prevention interventions for older adults.
J Appl Gerontol 2022 Oct;41(10):2187-96. doi: 10.1177/07334648221104375..
Keywords: Elderly, Falls, Prevention, Patient Safety, Evidence-Based Practice
Holcomb J, Ferguson GM, Sun J
Stakeholder engagement in adoption, implementation, and sustainment of an evidence-based intervention to increase mammography adherence among low-income women.
The purpose of this document review study was to create a conceptual framework to guide stakeholder engagement in an evidence-based intervention to increase mammography appointment adherence in underserved and low-income women. The document review results were aligned with the constructs of the conceptual framework and an application of stakeholder engagement in an evidence-based mammography intervention. The researchers concluded that both the conceptual framework constructs and the stakeholder engagement strategies can be utilized across a range of organizations, programs, and settings.
AHRQ-funded; HS023255.
Citation: Holcomb J, Ferguson GM, Sun J .
Stakeholder engagement in adoption, implementation, and sustainment of an evidence-based intervention to increase mammography adherence among low-income women.
J Cancer Educ 2022 Oct;37(5):1486-95. doi: 10.1007/s13187-021-01988-2..
Keywords: Evidence-Based Practice, Screening, Imaging, Women, Low-Income, Patient Adherence/Compliance
Lozano PM, Lane-Fall M, Franklin PD
AHRQ Author: Chesley FD
Training the next generation of learning health system scientists.
The purpose of this paper was to describe the approaches developed by 11 Agency for Healthcare Research and Quality (AHRQ)- and Patient-Centered Outcomes Research Institute- funded Centers of Excellence (COEs) to grow the number of learning health systems (LHS) scientists. Program directors for each COE have provided descriptive program data since 2018. The authors found that since the program began, the 11 COEs have partnered with health systems to train 110 scholars. Nine programs partner with a Veterans Affairs health system and 9 partner with safety net providers. Clinically trained scholars include 70 physicians and 17 scholars in other clinical disciplines. Non-clinicians represent diverse fields, with most representing population health sciences. Challenges include guiding scholars through issues that can disrupt or delay projects during already-limited program time, such as delays in accessing data, organizational changes, pandemic impacts and others. The researchers concluded that the program documentation provides evidence of scholars' academic accomplishments and career-trajectory achievements.
AHRQ-authored; AHRQ-funded; HS026369; HS026370; HS026372; HS026379; HS026383; HS026385; HS026390; HS026393; HS026395; HS026396; HS026407
Citation: Lozano PM, Lane-Fall M, Franklin PD .
Training the next generation of learning health system scientists.
Learn Health Syst 2022 Oct;6(4):e10342. doi: 10.1002/lrh2.10342..
Keywords: Learning Health Systems, Health Systems, Patient-Centered Outcomes Research, Evidence-Based Practice, Training, Workforce
Henninger ML, Bean SI, Lin JS
Screening for syphilis infection in nonpregnant adults and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this systematic review was to summarize the available published evidence on the potential benefits and harms of screening for syphilis infection in non-pregnant, asymptomatic adults and adolescents at increased risk for syphilis infection, for the purpose of supporting the 2022 United States Prevention Services Task Force recommendations statement on screening for syphilis infection.
AHRQ-funded; 75Q80120D00004.
Citation: Henninger ML, Bean SI, Lin JS .
Screening for syphilis infection in nonpregnant adults and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 27;328(12):1250-52. doi: 10.1001/jama.2022.8612..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Sexual Health, Infectious Diseases, Evidence-Based Practice
Jonas DE, Vander Schaaf EB, Riley S
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to explore the evidence on the benefits and harms of screening children and adolescents for prediabetes and type 2 diabetes to inform the US Preventive Services Task Force (USPSTF). The researchers utilized references; experts; literature surveillance, and PubMed/MEDLINE, Cochrane Library, and trial registries. The final review included 8 publications with 856 participants with a mean age of 14 years. The researchers found that none of the eligible studies directly assessed the benefits or harms of preventive screening. The limited eligible clinical trials reported few health outcomes and found no difference between groups.
AHRQ-funded; 290201500007I.
Citation: Jonas DE, Vander Schaaf EB, Riley S .
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 13;328(10):968-79. doi: 10.1001/jama.2022.7957..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Prevention, Evidence-Based Practice, Guidelines
Tracer H, Newhouse CN
AHRQ Author: Tracer H
Aspirin use to prevent cardiovascular disease.
This Putting Prevention into Practice case study involves a 56-year-old man, a wellness visit, and aspirin usage to prevent cardiovascular disease. Three questions based on U.S. Preventative Serices Task Force recommendations are presented, followed by the answers.
AHRQ-authored.
Citation: Tracer H, Newhouse CN .
Aspirin use to prevent cardiovascular disease.
Am Fam Physician 2022 Sep;106(3):327-28..
Keywords: Medication, Cardiovascular Conditions, Prevention, Guidelines, Evidence-Based Practice
Oatis CA, Konnyu KJ, Franklin PD
Generating consistent longitudinal real-world data to support research: lessons from physical therapists.
The purpose of this study was to evaluate whether clinicians can generate consistent and standardized real-world data (RWD) to enhance data quality in the course of routine patient care. The researchers collaborated with PT clinicians and experts to generate a web-based comprehensive system to quantify the total dose of PT interventions with type of modality, quantity, intensity, and progressions over time. The system was designed to be implemented in outpatient PT clinics capable of residing alongside or within a clinic’s existing EHR. The study goal was to collect routine clinical data in a format useable by the general population of outpatient physical therapists treating patients post Total Knee Replacement (TKR) and in a structure that would allow easy quantification and analysis across patients, therapists, and sites. Uniform and efficient documentation of real-world PT practice following TKR is essential for the necessary comparative effectiveness research demanded by the currently unexplained practice variation. Over a period of 2 years, physical therapists and PT assistants located in three US states entered data for a total of 161 patients post TKR with 2615 patient visits. No technical problems with the data capture system were reported, and physical therapists noted that data entry was efficient and simple. The researchers concluded that the results demonstrate that routine PT interventions can be captured thoroughly in an efficient, systematic, and consistent manner across real-world therapists and sites.
AHRQ-funded; 75Q80120D00001.
Citation: Oatis CA, Konnyu KJ, Franklin PD .
Generating consistent longitudinal real-world data to support research: lessons from physical therapists.
ACR Open Rheumatol 2022 Sep;4(9):771-74. doi: 10.1002/acr2.11465..
Keywords: Research Methodologies, Patient-Centered Outcomes Research, Evidence-Based Practice
Calcaterra SL, Martin M, Bottner R
Management of opioid use disorder and associated conditions among hospitalized adults: a consensus statement from the Society of Hospital Medicine.
This paper discusses the findings of a Society of Hospital Medicine working group convened to develop a Consensus Statement on the management of opioid use disorder (OUD) and associated conditions among hospitalized adults. The statement is intended for clinicians practicing medicine in the inpatient setting (e.g., hospitalists, primary care physicians, family physicians, advanced practice nurses, and physician assistants) and is intended to apply to hospitalized adults at risk for, or diagnosed with, OUD. The first step of the working group to develop the statement was to conduct a systematic review of relevant guidelines and compose a draft statement based on extracted recommendations. In the next step the working group obtained feedback on the draft statement from external experts in addiction medicine, SHM members, professional societies, harm reduction organizations and advocacy groups, and peer reviewers. This iterative development process resulted in a final Consensus Statement consisting of 18 recommendations covering the following topics: (1) identification and treatment of OUD and opioid withdrawal, (2) perioperative and acute pain management in patients with OUD, and (3) methods to optimize care transitions at hospital discharge for patients with OUD.
AHRQ-funded; HS026215.
Citation: Calcaterra SL, Martin M, Bottner R .
Management of opioid use disorder and associated conditions among hospitalized adults: a consensus statement from the Society of Hospital Medicine.
J Hosp Med 2022 Sep;17(9):744-56. doi: 10.1002/jhm.12893..
Keywords: Opioids, Substance Abuse, Behavioral Health, Evidence-Based Practice, Guidelines, Inpatient Care
Calcaterras SL, Bottner R, Martin M
Management of opioid use disorder, opioid withdrawal, and opioid overdose prevention in hospitalized adults: a systematic review of existing guidelines.
This study evaluated the quality and content of existing guidelines for in-hospital opioid use disorder (OUD) treatment and management. A literature search was done on several databases, websites of relevant societies and advocacy organizations, and selected international search engines. Nineteen guidelines published between January 2010 and June 2020 met the selection criteria. The majority of guidelines were based on observational studies or expert consensus. They recommended the use of nonstigmatizing language among patients with OUD; to assess patients with unhealthy opioid use for OUD using the Diagnostic Statistical Manual of Diseases-5th Edition criteria; use of methadone or buprenorphine to treat OUD and opioid withdrawal; use of multimodal, nonopioid therapy, and when needed, short-acting opioid analgesics in addition to buprenorphine or methadone, for acute pain management; ensuring linkage to ongoing methadone or buprenorphine treatment; referring patients to psychosocial treatment; and ensuring access to naloxone for opioid overdose reversal.
AHRQ-funded; HS026215.
Citation: Calcaterras SL, Bottner R, Martin M .
Management of opioid use disorder, opioid withdrawal, and opioid overdose prevention in hospitalized adults: a systematic review of existing guidelines.
J Hosp Med 2022 Sep;17(9):679-92. doi: 10.1002/jhm.12908..
Keywords: Opioids, Substance Abuse, Behavioral Health, Evidence-Based Practice, Guidelines, Inpatient Care
Gupta N, Patel HD, Taylor J
Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes.
The objective of this study was to perform a systematic review of plant-based diets and prostate cancer. Findings showed that interventional studies displayed generally favorable results of lifestyle modifications incorporating a plant-based diet with prostate cancer outcomes as well as improvements in nutrition and general health. Further, observational studies demonstrated either a lower risk of prostate cancer or no significant difference.
AHRQ-funded; HS026120.
Citation: Gupta N, Patel HD, Taylor J .
Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes.
Prostate Cancer Prostatic Dis 2022 Sep;25(3):444-52. doi: 10.1038/s41391-022-00553-2..
Keywords: Cancer: Prostate Cancer, Cancer, Evidence-Based Practice, Nutrition, Outcomes
Chou R, Cantor A, Dana T
Statin use for the primary prevention of cardiovascular disease in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to update the 2016 review on statins for the primary prevention of cardiovascular disease to inform the US Preventive Services Task Force (USPSTF). The researchers utilized the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews (to November 2021), Ovid, and MEDLINE, and selected 26 randomized clinical trials on statins vs placebo or no statin and statin intensity in adults without prior cardiovascular events. The researchers found that statins were significantly associated with decreased risk of all-cause mortality absolute risk difference [ARD], stroke, myocardial infarction, and composite cardiovascular outcomes. The association with cardiovascular mortality was determined not to be statistically significant. Statin therapy was not significantly associated with increased risk of serious adverse events, myalgias, or elevated alanine aminotransferase level. Statin therapy was not significantly associated with increased diabetes risk overall, although 1 trial found high-intensity statin therapy was significantly associated with increased risk. The researchers concluded that statin therapy for primary prevention of CVD was associated with reduced risk of all-cause mortality and CVD events for adults with increased of risk of CVD, but without prior CVD events.
AHRQ-funded; 290201500007I.
Citation: Chou R, Cantor A, Dana T .
Statin use for the primary prevention of cardiovascular disease in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Aug 23;328(8):754-71. doi: 10.1001/jama.2022.12138..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Medication, Prevention, Evidence-Based Practice
McDonagh MS, Morasco BJ, Wagner J
Cannabis-based products for chronic pain : a systematic review.
Researchers sought to evaluate the benefits and harms of cannabinoids for chronic pain. They found that oral, synthetic cannabis products with high THC-to-CBD ratios and sublingual, extracted cannabis products with comparable THC-to-CBD ratios may be associated with short-term improvements in chronic pain and increased risk for dizziness and sedation.
AHRQ-funded; 75Q80120D00006.
Citation: McDonagh MS, Morasco BJ, Wagner J .
Cannabis-based products for chronic pain : a systematic review.
Ann Intern Med 2022 Aug;175(8):1143-53. doi: 10.7326/m21-4520.
AHRQ-funded; 75Q80120D00006..
AHRQ-funded; 75Q80120D00006..
Keywords: Pain, Chronic Conditions, Complementary and Alternative Medicine, Treatments, Evidence-Based Practice
Israni AK, Schladt D, Bruin MJ
Deconstructing silos of knowledge around lung transplantation to support patients: a patient-specific search of scientific registry of transplant recipients data.
This article describes the development of the web site www.transplantcentersearch.org intended to support lung transplant patients by providing program-level data from the Scientific Registry of Transplant Recipients (SRTR) on each program in the United States. There is a high level of variation in selection criteria and although nearly half of recipients reside within 50 miles of their transplant program, >30% travel 100 miles or more. The web site allows patients to search for programs in the area of their choosing and receive information on the number of transplants and program factors that are most predictive of recipient survival after listing. Patients can also review information on recipients and donors at each program to further differentiate program options. This feature is patient-specific, allowing the patient to enter information about their clinical background and indicate general preferences for their treatment before receiving counts on recipients and donors matching their entries. The development of the site involved 2 phases. In Phase I the authors examined variations between programs using data on waitlist and transplant outcomes from the SRTR. Phase II involved interviews and focus groups with transplant candidates, recipients, and family members to gain insight into the decision-making process, barriers, and knowledge groups. In the future randomized trials will be conducted to evaluate the efficacy of the web site.
AHRQ-funded; HS026379.
Citation: Israni AK, Schladt D, Bruin MJ .
Deconstructing silos of knowledge around lung transplantation to support patients: a patient-specific search of scientific registry of transplant recipients data.
Transplantation 2022 Aug;106(8):1517-19. doi: 10.1097/tp.0000000000004051..
Keywords: Transplantation, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
Kumamaru H, Jalbert JJ, Nguyen LL
Utility of automated data-adaptive propensity score method for confounding by indication in comparative effectiveness study in real world Medicare and registry data.
The authors assessed the utility of an automated data-adaptive analytic approach for confounding adjustment when both claims and clinical registry data are available. Using a comparative study example of carotid artery stenting vs. carotid endarterectomy with strong confounding by indication, they found that the automated data-adaptive propensity score performed better than the investigator-specified propensity score in general, but both claims and registry data were needed to adequately control for bias.
AHRQ-funded; 29020050016I.
Citation: Kumamaru H, Jalbert JJ, Nguyen LL .
Utility of automated data-adaptive propensity score method for confounding by indication in comparative effectiveness study in real world Medicare and registry data.
PLoS One 2022 Aug;17(8):e0272975. doi: 10.1371/journal.pone.0272975..
Keywords: Registries, Comparative Effectiveness, Research Methodologies, Patient-Centered Outcomes Research, Evidence-Based Practice
Tyler A, Dempsey A, Spencer S
Do the guidelines apply?-A multisite, combined stakeholder qualitative case study to understand care decisions in bronchiolitis.
Researchers sought an improved understanding of factors that influence care decisions across multiple stakeholders and diverse settings in order to develop effective strategies to de-implement unnecessary testing and treatment for bronchiolitis. A qualitative case study was conducted across two geographically distinct university affiliated children's hospitals, including semistructured interviews and focus groups with patient participants. The researchers found that, incongruent with provider and care team perceptions, parents reported that they desire an evidence-based, less-is-more approach to bronchiolitis care.
AHRQ-funded; HS026512.
Citation: Tyler A, Dempsey A, Spencer S .
Do the guidelines apply?-A multisite, combined stakeholder qualitative case study to understand care decisions in bronchiolitis.
Acad Pediatr 2022 Jul;22(5):806-17. doi: 10.1016/j.acap.2021.08.003..
Keywords: Children/Adolescents, Respiratory Conditions, Shared Decision Making, Guidelines, Evidence-Based Practice
Korthuis PT, Cook RR, Lum PJ
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Opioid Use Disorder (OUD) treatment medications can improve outcomes for human immunodeficiency virus (HIV) and also reduce opioid use. The purpose of the study was to determine if outpatient naltrexone treatment could also reduce opioid use and improve outcomes for HIV. The researchers reported that enrollment was stopped early because of slower than expected recruitment, resulting in 114 final participants with untreated OUD and HIV, with 62% positive for fentanyl, 60% positive for cocaine, and 47% positive for other opioids at the baseline. The intervention compared treatment as usual (TAU) of methadone or buprenorphine with extended-release naltrexone (XR-NTX) on group differences in viral suppression at 24 weeks and past 30-day use of opioids at 24 weeks. The study reported that at 24 weeks the outcome of viral suppression was similar for TAU and XR-NTX, and that fewer XR-NTX participants initiated medication than TAU participants. The outcome of previous 30-day use of opioids was similar for TAU as compared to XR-NTX. Of those participants who did initiate medication, those administered XR-NTX experienced less days of opioid use when compared with TAU in the prior 30 days. The researchers reported that the study evidence was not conclusive but did support that XR-NTX is not inferior to TAU for HIV viral suppression, and that study participants who started XR-NTX used less opioids at 24 weeks than participants who were administered TAU.
AHRQ-funded; HS026370.
Citation: Korthuis PT, Cook RR, Lum PJ .
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Addiction 2022 Jul;117(7):1961-71. doi: 10.1111/add.15836..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Behavioral Health, Medication, Treatments, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Ivlev I, Beil TL, Haynes JS
Rapid evidence review of digital cognitive-behavioral therapy for adolescents with depression.
This rapid evidence review was conducted to explore the benefits and harms of digital cognitive-behavioral therapy (dCBT) and the barriers to and facilitators of implementing dCBT for adolescents. An extensive literature review was done through December 6, 2021 for controlled trials conducted in settings highly applicable to the US. Additionally, the authors searched relevant systematic reviews for eligible studies. They identified 12 trials that examined the effects of nine dCBT programs. Overall, dCBT was slightly superior to other therapies in improving depression symptoms immediately, but not at a longer follow-up. There did not appear to be an increased risk for suicidal attempts or ideation with dCBT, however the number of events was very small. Potential barriers to implementing and maintaining dCBT included challenges engaging/retaining patients, developing infrastructure, and training therapists to facilitate dCBT. No data on harms or unintended negative consequences were reported in the included studies.
AHRQ-funded; HS026370.
Citation: Ivlev I, Beil TL, Haynes JS .
Rapid evidence review of digital cognitive-behavioral therapy for adolescents with depression.
J Adolesc Health 2022 Jul;71(1):14-19. doi: 10.1016/j.jadohealth.2022.01.220..
Keywords: Children/Adolescents, Depression, Behavioral Health, Evidence-Based Practice, Patient-Centered Outcomes Research
Rastogi V, Kim NH, Marcaccio CL
Retroperitoneal versus transperitoneal approach for open repair of complex abdominal aortic aneurysms.
This retrospective analysis compared the outcomes of a transperitoneal approach (TP) versus the retroperitoneal approach (RP) for infrarenal abdominal aortic aneurysm (AAA) repair. Several studies have found an advantage for the RP approach. Among a cohort of 1,195 patients identified 729 (61%) underwent cAAA repair via a TP approach and 39% via an RP approach. After adjustment, the RP approach was associated with lower odds of peri-operative death (4.0% versus 7.2%) and lower odds of any major, cardiac, or wound complications and post-operative sepsis. Despite this, the proportion of repairs using an RP approach decreased between 2011 to 2015 and 2016 to 2019.
AHRQ-funded; HS027285.
Citation: Rastogi V, Kim NH, Marcaccio CL .
Retroperitoneal versus transperitoneal approach for open repair of complex abdominal aortic aneurysms.
Eur J Vasc Endovasc Surg 2022 Jul;64(1):23-31. doi: 10.1016/j.ejvs.2022.05.030..
Keywords: Cardiovascular Conditions, Surgery, Comparative Effectiveness, Evidence-Based Practice
Saldanha IJ, Cao W, Bhuma MR
Systematic reviews can guide clinical practice and new research on primary headaches in pregnancy: an editorial on the 2022 American Headache Society Members' Choice Award paper.
This article describes the systematic review paper that was done on management of primary headaches during pregnancy, postpartum, and breastfeeding, which won the 2021 American Headache Society’s Member’s Choice Award. The findings are summarized in this paper, which discusses different pharmacologic interventions and their possible effects on the fetus/child and mother. Evidence was summarized for prevention and treatment of primary headache. The authors did not find a lot of evidence for harms or benefits but called for more studies to be done.
AHRQ-funded; 290201500002I.
Citation: Saldanha IJ, Cao W, Bhuma MR .
Systematic reviews can guide clinical practice and new research on primary headaches in pregnancy: an editorial on the 2022 American Headache Society Members' Choice Award paper.
Headache 2022 Jul;62(7):774-76. doi: 10.1111/head.14332..
Keywords: Neurological Disorders, Pregnancy, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research
O'Connor EA, Evans CV, Ivlev I
Vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
This evidence report and systematic review updated the 2013 USPSTF final recommendation to assess benefits and harms of using vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer. After an extensive literature review, 84 studies were included. While multivitamin use was significantly associated with a lower incidence of any cancer and lung cancer, the evidence had serious limitations. Beta carotene was significantly associated with an increased risk of lung cancer and cardiovascular mortality. Vitamins D and E were not significantly associated with all-cause mortality, cardiovascular disease events, or cancer incidence. Evidence for the benefit of other supplements was equivocal, minimal, or absent. There was limited evidence that suggested some supplements may be associated with higher risk of serious harms (hip fracture [vitamin A], hemorrhagic stroke [vitamin E], and kidney stones [vitamin C, calcium]).
AHRQ-funded; 290201500007I.
Citation: O'Connor EA, Evans CV, Ivlev I .
Vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Jun 21;327(23):2334-47. doi: 10.1001/jama.2021.15650..
Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Cardiovascular Conditions, Cancer, Evidence-Based Practice, Guidelines