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
1 to 25 of 74 Research Studies DisplayedSolberg LI, Ziegenfuss JY, Rivard RL
Is there room for individual patient-specified preferences in the patient-reported outcome measurement revolution?
The goal of this study was to test the feasibility of collecting qualitative patient-preferred goals and its feasibility as an addition to a standardized process for collecting quantitative composite patient-reported outcome measures (PROMs) from patients undergoing knee joint replacement. The study found that joint replacement patients who responded to quantitative PROMS were willing to report on their other preferred outcomes.
AHRQ-funded; HS025618.
Citation: Solberg LI, Ziegenfuss JY, Rivard RL .
Is there room for individual patient-specified preferences in the patient-reported outcome measurement revolution?
J Patient Cent Res Rev 2023 Fall; 10(4):210-18. doi: 10.17294/2330-0698.2017..
Keywords: Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Neerland C, Slaughter-Acey J, Behrens K
An evidence map for social and structural determinants for maternal morbidity and mortality: a systematic review.
The study aimed to identify social and structural determinants of maternal morbidity and mortality during prenatal and postpartum periods in the U.S. Out of 8,378 references screened, 118 studies were included, covering domains like identity, socioeconomic factors, violence, and trauma. Findings revealed mixed patterns between risk factors and outcomes, with notable attention to depression and mental health. Advancing the field long-term should involve developing comprehensive datasets to thoroughly investigate intersections with biological and medical risk factors.
AHRQ-funded; 75Q80120D00008.
Citation: Neerland C, Slaughter-Acey J, Behrens K .
An evidence map for social and structural determinants for maternal morbidity and mortality: a systematic review.
Obstet Gynecol 2024 Mar; 143(3):383-92. doi: 10.1097/aog.0000000000005489.
Keywords: Social Determinants of Health, Maternal Care, Mortality, Evidence-Based Practice, Risk, Women, Outcomes
Wu J, Yuan CT, Moyal-Smith R
Electronic health record-supported implementation of an evidence-based pathway for perioperative surgical care.
This study examines the role of electronic health records (EHRs) in implementing enhanced recovery pathways (ERPs) for perioperative surgical care. Interviews with informaticians and clinicians from eight US hospitals revealed three thematic clusters: "EHR difficulties," "EHR enablers," and "EHR barriers." Researchers concluded that high performers and improvers successfully integrated ERPs into EHRs with dedicated multidisciplinary teams, while others faced challenges. Early involvement of informatics expertise benefited ERP implementation and sustainability.
AHRQ-funded; 2332015000201.
Citation: Wu J, Yuan CT, Moyal-Smith R .
Electronic health record-supported implementation of an evidence-based pathway for perioperative surgical care.
J Am Med Inform Assoc 2024 Feb 16; 31(3):591-99. doi: 10.1093/jamia/ocad237.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Evidence-Based Practice, Hospitals
Hernandez SE, Solomon D, Moon J
Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions.
Researchers described their fluoroquinolone restriction for the prevention of Clostridioides difficile infection (FIRST) trial, a multisite clinical study which used an electronic health record-based best-practice alert to optimize the use of fluoroquinolone antibiotics in acute care settings. Their goals were to describe the roles and responsibilities of clinical implementation coordinators within antibiotic stewardship teams and to identify facilitators and barriers coordinators experienced within the implementation process. The researchers conducted directed content analysis of semistructured interviews, implementation diaries, and check-in meetings. Their results indicated that clinical implementation coordinators facilitated the implementation process via their roles and responsibilities and acted as strategic partners in the improvement of adoption and sustainability of a fluoroquinolone preauthorization protocol.
AHRQ-funded; HS026226.
Citation: Hernandez SE, Solomon D, Moon J .
Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions.
Am J Health Syst Pharm 2024 Feb 8; 81(4):120-28. doi: 10.1093/ajhp/zxad272.
Keywords: Evidence-Based Practice, Implementation, COVID-19
Al Hussein Al Awamlh B, Wallis CJD, Penson DF
Functional outcomes after localized prostate cancer treatment.
The objective of this observational cohort study was to compare rates of adverse functional outcomes between specific treatments for localized prostate cancer. Researchers used data from five U.S. Surveillance, Epidemiology, and End Results Program registries. Participants were patients treated for localized prostate cancer in 2011-2012. The results indicated that radical prostatectomy was associated with worse urinary incontinence, but not with worse sexual function, at 10-year followup when compared with radiotherapy or surveillance. Among patients with unfavorable-prognosis disease, external beam radiotherapy with androgen deprivation therapy was associated with worse bowel and hormone function at 10-year followup compared with radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Al Hussein Al Awamlh B, Wallis CJD, Penson DF .
Functional outcomes after localized prostate cancer treatment.
JAMA 2024 Jan 23; 331(4):302-17. doi: 10.1001/jama.2023.26491.
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Keywords: Cancer: Prostate Cancer, Cancer, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Feltner C, Wallace IF, Nowell SW
Screening for speech and language delay and disorders in children 5 years or younger: evidence report and systematic review for the US Preventive Services Task Force.
This evidence report and systematic review reviewed the evidence on screening for speech and language delay or disorders in children 5 years or younger to inform the US Preventive Services Task Force. This literature review looked at English-language studies of screening test accuracy, trials or cohort studies comparing screening vs no screening; randomized clinical trials (RCTs) of interventions. Main outcomes and measures were screening test accuracy, speech and language outcomes, school performance, function, quality of life, and harms. A total of 38 studies in 41 articles were included (N = 9006). There were 21 studies (n = 7489) that assessed the accuracy of 23 different screening tools that varied with regard to whether they were designed to be completed by parents vs trained examiners, and to screen for global (any) language problems vs specific skills (e.g., expressive language). Three studies assessing parent-reported tools for expressive language skills had consistently high sensitivity (range, 88%-93%) and specificity (range, 88%-85%). Other screening tools had widely varying accuracy. Seventeen RCTs (n = 1517) evaluated interventions for speech and language delay or disorders. There were no RCTs included on the harms of interventions.
AHRQ-funded; 75Q80120D00006.
Citation: Feltner C, Wallace IF, Nowell SW .
Screening for speech and language delay and disorders in children 5 years or younger: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2024 Jan 23; 331(4):335-51. doi: 10.1001/jama.2023.24647..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Screening, Prevention, Evidence-Based Practice
Cantor AG, Jungbauer RM, Skelly AC
Respectful maternity care : a systematic review.
The purpose of this systematic review was to collect information on definitions and valid measurements of respectful maternity care (RMC), its effectiveness for improving pregnant and postpartum maternal and infant health outcomes, and strategies for implementation. Frameworks for RMC were found to be well described but varied in definition. Evidence was lacking on the effectiveness of implementing RMC to improve any maternal or infant health outcome. Tools to measure RMC demonstrated consistency but lacked a gold standard; the authors conclude that further evaluation was needed before implementation in U.S. settings.
AHRQ-funded; 75Q80120D00006
Citation: Cantor AG, Jungbauer RM, Skelly AC .
Respectful maternity care : a systematic review.
Ann Intern Med 2024 Jan; 177(1):50-64. doi: 10.7326/m23-2676..
Keywords: Maternal Care, Women, Patient-Centered Outcomes Research, Evidence-Based Practice
Peaker B, Dooley C B, Peaker B, Dooley C C
AHRQ Author: Peaker B
Screening for syphilis in nonpregnant adolescents and adults.
This case study described a 42-year-old male presenting at the clinic with low back pain that had been radiating down his right leg for one week. Case study questions related to the USPSTF recommendation on Screening for Syphilis in Nonpregnant Adolescents and Adults addressed why this patient was at increased risk, whether screening should take place, and why the USPSTF does not recommend screening for all people.
AHRQ-authored.
Citation: Peaker B, Dooley C B, Peaker B, Dooley C C .
Screening for syphilis in nonpregnant adolescents and adults.
Am Fam Physician 2024 Jan; 109(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Evidence-Based Practice, Sexual Health, Children/Adolescents
Feltner C, Grodensky C, Ebel C
Serologic screening for genital herpes: an updated evidence report and systematic review for the US Preventive Services Task Force.
This report assessed the evidence on serologic screening and preventive interventions for Genital herpes simplex virus (HSV) infection in asymptomatic adults and adolescents to support the US Preventive Services Task Force for an updated recommendation statement. It found that serologic screening for genital herpes is associated with a high rate of false-positive test results and potential psychosocial harms.
AHRQ-funded; 290201200015I.
Citation: Feltner C, Grodensky C, Ebel C .
Serologic screening for genital herpes: an updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Dec 20;316(23):2531-43. doi: 10.1001/jama.2016.17138.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Screening, Evidence-Based Practice, Prevention
Califf RM, Robb MA, Bindman AB
AHRQ Author: Bindman AB, Dymek C
Transforming evidence generation to support health and health care decisions.
Collaborations among federal health agencies involved in biomedical research and health care delivery with regard to data sharing, research infrastructure, and computational capabilities require combining expertise and resources and will entail substantial changes to the culture of clinical research, In this article, the authors propose a set of core principles for data collaboration and system organizational design that they believe will further enable research efforts by both the private sector and government agencies.
AHRQ-authored.
Citation: Califf RM, Robb MA, Bindman AB .
Transforming evidence generation to support health and health care decisions.
N Engl J Med 2016 Dec 15;375(24):2395-400. doi: 10.1056/NEJMsb1610128.
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Keywords: Healthcare Delivery, Shared Decision Making, Evidence-Based Practice, Policy
Metersky ML, Wang Y, Klompas M
Trend in ventilator-associated pneumonia rates between 2005 and 2013.
This study found that, from 2005 through 2013, Medicare Patient Safety Monitoring System (MPSMS) ventilator-associated pneumonia (VAP) rates remained stable and substantial, affecting approximately 10 percent of ventilated patients. Persistently high VAP rates bolster concerns that most interventions purported to reduce VAP are supported by limited evidence.
AHRQ-authored; AHRQ-funded; 290201200003C.
Citation: Metersky ML, Wang Y, Klompas M .
Trend in ventilator-associated pneumonia rates between 2005 and 2013.
JAMA 2016 Dec 13;316(22):2427-29. doi: 10.1001/jama.2016.16226.
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Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Evidence-Based Practice
Wasson LT, Cusmano A, Meli L
Association between learning environment interventions and medical student well-being: a systematic review.
This review sought to identify best practices for undergraduate medical education learning environment interventions that are associated with improved emotional well-being of students. Limited evidence suggested that some specific learning environment interventions were associated with improved emotional well-being among medical students. However, the overall quality of the evidence was low, highlighting the need for high-quality medical education research.
AHRQ-funded; HS024598.
Citation: Wasson LT, Cusmano A, Meli L .
Association between learning environment interventions and medical student well-being: a systematic review.
JAMA 2016 Dec 6;316(21):2237-52. doi: 10.1001/jama.2016.17573.
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Keywords: Education: Academic, Evidence-Based Practice, Behavioral Health
Wilcox HC, Kharrazi H, Wilson RF
Data linkage strategies to advance youth suicide prevention: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This review sought to identify and describe data systems that can be linked to data from prevention studies to advance youth suicide prevention research. It concluded that there is untapped potential to evaluate and enhance suicide prevention efforts by linking suicide prevention data with existing data systems. However, sparse availability of data dictionaries and lack of adherence to standard data elements limit this potential.
AHRQ-funded; 290201200007I.
Citation: Wilcox HC, Kharrazi H, Wilson RF .
Data linkage strategies to advance youth suicide prevention: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med 2016 Dec 6;165(11):779-85. doi: 10.7326/m16-1281.
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Keywords: Behavioral Health, Children/Adolescents, Data, Evidence-Based Practice, Prevention
Khatibzadeh S, Saheb Kashaf M, Micha R
A global database of food and nutrient consumption.
The authors conducted an empirical assessment of dietary intakes in order for evidence-based policy-making to address global health challenges. They derived The Global Dietary Database, which combines broad global coverage with estimates of food and nutrient consumption by age, sex and time. They believe that these data provide an empirical basis for global dietary surveillance, policy-making and priority setting to address diet-related burdens of disease.
AHRQ-funded; HS000062.
Citation: Khatibzadeh S, Saheb Kashaf M, Micha R .
A global database of food and nutrient consumption.
Bull World Health Organ 2016 Dec;94(12):931-34. doi: 10.2471/blt.15.156323.
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Keywords: Data, Evidence-Based Practice, Nutrition, Policy, Public Health
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
Patel HD, Iyoha E, Pierorazio PM
A systematic review of research gaps in the evaluation and management of localized renal masses.
The authors conducted a systematic review to summarize research gaps for the evaluation of composite models for predicting malignancy; use of percutaneous renal sampling for diagnosis; and comparative effectiveness of surgery, thermal ablation, and active surveillance. They recommended incorporation of emerging biomarkers into validated composite models, standardization of biopsy protocols, standard reporting of clinical stage, and performance of prospective studies with objective selection criteria.
AHRQ-funded; 290201200007I.
Citation: Patel HD, Iyoha E, Pierorazio PM .
A systematic review of research gaps in the evaluation and management of localized renal masses.
Urology 2016 Dec;98:14-20. doi: 10.1016/j.urology.2016.08.013.
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Keywords: Cancer, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Indicators (QIs), Research Methodologies
Kantor R, Kim A, Thyssen JP
Association of atopic dermatitis with smoking: a systematic review and meta-analysis.
The authors examined the association between atopic dermatitis (AD) and exposure to tobacco smoke. They found that a diagnosis of AD was associated with higher odds of active smoking and exposure to passive smoke but not to maternal smoking during pregnancy, and concluded that active and passive tobacco smoke exposure are associated with increased AD prevalence.
AHRQ-funded; HS023011.
Citation: Kantor R, Kim A, Thyssen JP .
Association of atopic dermatitis with smoking: a systematic review and meta-analysis.
J Am Acad Dermatol 2016 Dec;75(6):1119-25.e1. doi: 10.1016/j.jaad.2016.07.017.
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Keywords: Skin Conditions, Tobacco Use, Risk, Evidence-Based Practice
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
Quinn M, Gephart S
Evidence for implementation strategies to provide palliative care in the neonatal intensive care unit.
The authors sought to answer the clinical question: In neonatal intensive care, what evidence can be used to guide implementation of palliative care protocols? They found that successful team approaches included standardized order sets to initiate neonatal palliative care (NPC), NPC education for staff, and references to NPC guidelines or protocols.They recommended that barriers such as lack of interdisciplinary cooperation, lack of appropriate physical space, and lack of education be addressed during program development.
AHRQ-funded; HS022908.
Citation: Quinn M, Gephart S .
Evidence for implementation strategies to provide palliative care in the neonatal intensive care unit.
Adv Neonatal Care 2016 Dec;16(6):430-38. doi: 10.1097/anc.0000000000000354.
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Keywords: Evidence-Based Practice, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Palliative Care
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
Chou R, Dana T, Blazina I
Statins for prevention of cardiovascular disease in adults: Evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this report systematically reviewed benefits and harms of statins for prevention of cardiovascular disease (CVD), in order to inform the US Preventive Services Task Force. It concluded that in adults at increased CVD risk but without prior CVD events, statin therapy was associated with reduced risk of all-cause and cardiovascular mortality and CVD events, with greater absolute benefits in patients at greater baseline risk.
AHRQ-funded; 2902012000015I.
Citation: Chou R, Dana T, Blazina I .
Statins for prevention of cardiovascular disease in adults: Evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Nov 15;316(19):2008-24. doi: 10.1001/jama.2015.15629.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Cardiovascular Conditions, Medication, Evidence-Based Practice
Lee T, Thamer M, Zhang Y
Association of peritonitis with hemodialysis catheter dependence after modality switch.
This study characterized vascular access use after switch to hemodialysis and its effect on patient mortality. The researchers found that patients using a permanent vascular access 180 days after switching from peritoneal dialysis to hemodialysis had better adjusted survival during the ensuing year than those using a catheter. They concluded that among patients who switch, prior peritonitis is associated with a higher rate of persistent hemodialysis catheter use, which, in turn, is associated with lower patient survival.
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Thamer M, Zhang Y .
Association of peritonitis with hemodialysis catheter dependence after modality switch.
Clin J Am Soc Nephrol 2016 Nov 7;11(11):1999-2004. doi: 10.2215/cjn.04970516.
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Keywords: Dialysis, Kidney Disease and Health, Evidence-Based Practice, Mortality, Patient-Centered Healthcare
Jensen RE, Snyder CF, Basch E
All together now: findings from a PCORI workshop to align patient-reported outcomes in the electronic health record.
The goal of this paper was to report key findings from a 2013 Patient-Centered Outcomes Research Institute workshop on patient-reported outcomes, to report a summary of actions that followed from the workshop, and to present resulting recommendations that address patient, clinical and research/quality improvement barriers to regular use.
AHRQ-funded; HS000029.
Citation: Jensen RE, Snyder CF, Basch E .
All together now: findings from a PCORI workshop to align patient-reported outcomes in the electronic health record.
J Comp Eff Res 2016 Nov;5(6):561-67. doi: 10.2217/cer-2016-0026.
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Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Improvement
Raman G, Adam GP, Halladay CW
Comparative effectiveness of management strategies for renal artery stenosis: an updated systematic review.
This study compared benefits and harms of percutaneous transluminal renal angioplasty with stent placement (PTRAS) versus medical therapy alone in adults with atherosclerotic renal artery stenosis (ARAS). The strength of evidence regarding the relative benefits and harms of PTRAS versus medical therapy alone for patients with ARAS is low.
AHRQ-funded; 290201500002.
Citation: Raman G, Adam GP, Halladay CW .
Comparative effectiveness of management strategies for renal artery stenosis: an updated systematic review.
Ann Intern Med 2016 Nov;165(9):635-49. doi: 10.7326/m16-1053.
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Keywords: Kidney Disease and Health, Treatments, Comparative Effectiveness, Evidence-Based Practice
Brunwasser SM, Garber J
Programs for the prevention of youth depression: evaluation of efficacy, effectiveness, and readiness for dissemination.
This study used the Society for Prevention Research's Standards of Evidence to evaluate the degree to which existing depression prevention programs have established intervention efficacy, effectiveness, and readiness for dissemination. The authors concluded that although several programs have demonstrated promise in terms of efficacy, no depression prevention program for children or adolescents has garnered sufficient evidence of effectiveness under real-world conditions to warrant widespread dissemination.
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Garber J .
Programs for the prevention of youth depression: evaluation of efficacy, effectiveness, and readiness for dissemination.
J Clin Child Adolesc Psychol 2016 Nov-Dec;45(6):763-83. doi: 10.1080/15374416.2015.1020541.
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Keywords: Children/Adolescents, Depression, Evidence-Based Practice, Patient-Centered Outcomes Research