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
26 to 50 of 66 Research Studies DisplayedLozano P, Henrikson NB, Morrison CC
Lipid screening in childhood and adolescence for detection of multifactorial dyslipidemia: evidence report and systematic review for the US Preventive Services Task Force.
The researchers systematically reviewed the evidence on benefits and harms of screening adolescents and children for multifactorial dyslipidemia for the US Preventive Services Task Force (USPSTF). They concluded that diagnostic yield of lipid screening varies by age and body mass index. No direct evidence was identified for benefits or harms of childhood screening or treatment on outcomes in adulthood. Intensive dietary interventions may be safe, with modest short-term benefit of uncertain clinical significance.
AHRQ-funded.
Citation: Lozano P, Henrikson NB, Morrison CC .
Lipid screening in childhood and adolescence for detection of multifactorial dyslipidemia: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Aug 9;316(6):634-44. doi: 10.1001/jama.2016.6423.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Children/Adolescents, Screening, Evidence-Based Practice
Wernli KJ, Henrikson NB, Morrison CC
Screening for skin cancer in adults: Updated evidence report and systematic review for the US Preventive Services Task Force.
The researchers updated a systematic review for the US Preventive Services Task Force regarding clinical skin cancer screening among adults. No randomized clinical trials were identified. There was limited evidence on the association between skin cancer screening and mortality. Future research on skin cancer screening should focus on evaluating the effectiveness of targeted screening in those considered to be at higher risk for skin cancer.
AHRQ-funded.
Citation: Wernli KJ, Henrikson NB, Morrison CC .
Screening for skin cancer in adults: Updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Jul 26;316(4):436-47. doi: 10.1001/jama.2016.5415.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer, Screening, Prevention, Evidence-Based Practice
Wilt TJ, MacDonald R, Brasure M
Pharmacologic treatment of insomnia disorder: an evidence report for a clinical practice guideline by the American College of Physicians.
The researchers assessed the benefits, harms, and comparative effectiveness of pharmacologic treatments for adults with insomnia disorder. Their review concluded that eszopiclone, zolpidem, and suvorexant may improve short-term global and sleep outcomes for adults with insomnia disorder, but the comparative effectiveness and long-term efficacy of pharmacotherapies for insomnia are not known.
AHRQ-funded; 290201200016I.
Citation: Wilt TJ, MacDonald R, Brasure M .
Pharmacologic treatment of insomnia disorder: an evidence report for a clinical practice guideline by the American College of Physicians.
Ann Intern Med 2016 Jul 18;165(2):103-12. doi: 10.7326/m15-1781.
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Keywords: Sleep Problems, Comparative Effectiveness, Medication, Evidence-Based Practice
Croswell J, Owings J
Screening for breast cancer.
This case study involves a 47-year-old woman who presents to your office for a well-woman visit. She is healthy, takes no medications, and has no health concerns. She has never been diagnosed with breast cancer, nor have any of her first-degree relatives. Her digital mammography two years ago was negative, and she asks whether she should be screened again this year. The study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Croswell J, Owings J .
Screening for breast cancer.
Am Fam Physician 2016 Jul 15;94(2):143-4.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Screening, Prevention, Evidence-Based Practice, Women, Imaging, Case Study
Shelley DR, Ogedegbe G, Anane S
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
The long-term goal of the HealthyHearts NYC trial is to create a robust infrastructure for implementing and disseminating evidence-based practice guidelines in primary care practices. The authors hypothesized that practice facilitation will result in superior clinical outcomes compared to usual care and that the effects of practice facilitation will be mediated by greater adoption of system changes in accord with patient-centered medical homes and the chronic care model.
AHRQ-funded; HS023922.
Citation: Shelley DR, Ogedegbe G, Anane S .
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
Implement Sci 2016 Jul 4;11(1):88. doi: 10.1186/s13012-016-0450-2.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Primary Care
Sawinski D, Trofe-Clark J, Leas B
Calcineurin inhibitor minimization, conversion, withdrawal, and avoidance strategies in renal transplantation: a systematic review and meta-analysis.
The researchers evaluated 92 comparisons from 88 randomized controlled trials and found moderate- to high-strength evidence suggesting that minimization strategies result in better clinical outcomes compared with standard-dose regimens and moderate-strength evidence indicating that conversion to a mammalian target of rapamycin inhibitor or belatacept was associated with improved renal function but increased rejection risk.
AHRQ-funded; 290201200011I.
Citation: Sawinski D, Trofe-Clark J, Leas B .
Calcineurin inhibitor minimization, conversion, withdrawal, and avoidance strategies in renal transplantation: a systematic review and meta-analysis.
Am J Transplant 2016 Jul;16(7):2117-38. doi: 10.1111/ajt.13710.
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Keywords: Transplantation, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Medication
Linder SK, Kamath GR, Pratt GF
Citation searches are more sensitive than keyword searches to identify studies using specific measurement instruments.
This study compared the effectiveness of two search methods in identifying studies that used the Control Preferences Scale (CPS), a health care decision-making instrument commonly used in clinical settings. It found that keyword searches in bibliographic databases yielded high average precision (90%) but low average sensitivity (16%). PubMed was the most precise, followed closely by Scopus and WOS.
AHRQ-funded; HS022134.
Citation: Linder SK, Kamath GR, Pratt GF .
Citation searches are more sensitive than keyword searches to identify studies using specific measurement instruments.
J Clin Epidemiol 2015 Apr;68(4):412-7. doi: 10.1016/j.jclinepi.2014.10.008..
Keywords: Research Methodologies, Shared Decision Making, Evidence-Based Practice
Silverberg JI
Practice gaps in pruritus.
There are several practice gaps in the evaluation and management of itch. These gaps include a dearth of objective measures of itch, infrequent use of validated patient-reported outcomes for itch, non-evidence-based treatment, and lack of consensus about the ideal workup for generalized itch. The present article reviews these gaps and presents potential solutions.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Practice gaps in pruritus.
Dermatol Clin 2016 Jul;34(3):257-61. doi: 10.1016/j.det.2016.02.008.
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Keywords: Care Management, Evidence-Based Practice, Patient-Centered Outcomes Research
Bishai D, Xu J, Sherry M
Strengthening the efferent arm in public health.
The purpose of the efferent arm in public health is to convene, coordinate, and shepherd the energy and resources of a community into collectively addressing shared health problems. The authors argue that the secret of an effective efferent arm is to focus on convening and communicating clearly the public health burdens and threats as widely as possible and to speak with authority about the evidence base of proven approaches.
AHRQ-funded; HS000029.
Citation: Bishai D, Xu J, Sherry M .
Strengthening the efferent arm in public health.
Am J Public Health 2016 Jul;106(7):1196-7. doi: 10.2105/ajph.2016.303216.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Public Health
Cohen DJ, Balasubramanian BA, Gordon L
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness.
AHRQ-funded; HS022981; HS023940.
Citation: Cohen DJ, Balasubramanian BA, Gordon L .
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
Implement Sci 2016 Jun 29;11(1):86. doi: 10.1186/s13012-016-0449-8.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Primary Care, Research Methodologies
Kaplan HC, Sherman SN, Cleveland C
Reliable implementation of evidence: a qualitative study of antenatal corticosteroid administration in Ohio hospitals.
The objective of this study was to understand conditions that enable delivery of antenatal corticosteroid administration (ANCS) with high reliability among hospitals participating in an Ohio Perinatal Quality Collaborative (OPQC) ANCS project. Among the major themes supporting reliable implementation of ANCS at these hospitals that emerged were: (1) presence of a high reliability culture, (2) processes that emphasize high reliability, and (3) timely and efficient administration process.
AHRQ-funded; HS021114.
Citation: Kaplan HC, Sherman SN, Cleveland C .
Reliable implementation of evidence: a qualitative study of antenatal corticosteroid administration in Ohio hospitals.
BMJ Qual Saf 2016 Jun 8;25(3):173-81. doi: 10.1136/bmjqs-2015-003984..
Keywords: Evidence-Based Practice, Patient-Centered Outcomes Research, Maternal Care
Maruther NM, Tseng E, Huftless S
Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: A systematic review and meta-analysis.
The purpose of this study was to evaluate the comparative effectiveness and safety of monotherapy and selected metformin-based combinations in adults with type 2 diabetes. It found that the evidence supports metformin as first-line therapy for type 2 diabetes, given its relative safety and beneficial effects on hemoglobin A1c, weight, and cardiovascular mortality (compared with sulfonylureas). AHRQ-funded; 290-201-200007.
AHRQ-funded; 290201200007I.
Citation: Maruther NM, Tseng E, Huftless S .
Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes: A systematic review and meta-analysis.
Ann Intern Med 2016 Jun 7;164(11):740-51. doi: 10.7326/m15-2650.
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Keywords: Comparative Effectiveness, Medication, Diabetes, Evidence-Based Practice, Medication: Safety
Khazanie P, Greiner MA, Al-Khatib SM
Comparative effectiveness of cardiac resynchronization therapy among patients with heart failure and atrial fibrillation: Findings from the National Cardiovascular Data Registry's Implantable Cardioverter-Defibrillator Registry.
The researchers investigated the outcomes of patients with both atrial fibrillation and heart failure who receive cardiac resynchronization therapy with defibrillator (CRT-D) compared with an implantable cardioverter-defibrillator (ICD) alone. They found that CRT-D was associated with lower risks of mortality, all-cause readmission, and heart failure readmission, as well as with a similar risk of complications compared with ICD alone.
AHRQ-funded; HS021092.
Citation: Khazanie P, Greiner MA, Al-Khatib SM .
Comparative effectiveness of cardiac resynchronization therapy among patients with heart failure and atrial fibrillation: Findings from the National Cardiovascular Data Registry's Implantable Cardioverter-Defibrillator Registry.
Circ Heart Fail 2016 Jun;9(6). doi: 10.1161/circheartfailure.115.002324.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Comparative Effectiveness, Patient-Centered Outcomes Research, Registries, Evidence-Based Practice, Outcomes
Simmons SF, Schnelle JF, Sathe NA
Defining safety in the nursing home setting: Implications for future research.
AHRQ’s Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to safety in the NH setting to inform a research agenda. Thirty-six recent systematic reviews evaluated NH safety-related interventions to address these 4 adverse events and reported mostly mixed evidence about effective approaches to ameliorate them.
AHRQ-funded; 290201500003I.
Citation: Simmons SF, Schnelle JF, Sathe NA .
Defining safety in the nursing home setting: Implications for future research.
J Am Med Dir Assoc 2016 Jun;17(6):473-81. doi: 10.1016/j.jamda.2016.03.005..
Keywords: Nursing Homes, Long-Term Care, Adverse Events, Patient Safety, Evidence-Based Practice
Piccini JP, Simon DN, Steinberg BA
Differences in clinical and functional outcomes of atrial fibrillation in women and men: two-year results from the ORBIT-AF Registry.
The purpose of this paper was to determine whether symptoms, quality of life, treatment, and outcomes differ between women and men with atrial fibrillation (AF). The authors found that women with AF have more symptoms and worse quality of life, lower risk-adjusted all-cause and cardiovascular death compared with men, but higher stroke rates.
AHRQ-funded; HS021092.
Citation: Piccini JP, Simon DN, Steinberg BA .
Differences in clinical and functional outcomes of atrial fibrillation in women and men: two-year results from the ORBIT-AF Registry.
JAMA Cardiol 2016 Jun 1;1(3):282-91. doi: 10.1001/jamacardio.2016.0529.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Sex Factors, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Registries, Evidence-Based Practice
Pronovost PJ, Cleeman JI, Wright D
AHRQ Author: Cleeman JI
Fifteen years after to Err is Human: a success story to learn from.
This paper provides a historical profile of the central line-associated bloodstream infection (CLABSI) success story, comparing infection rates before and 15 years after the IOM report. It discusses the five elements essential to the national success in reducing CLABSI rates: a reliable and valid measurement system, evidence-based care practices, investment in implementation sciences, local ownership and peer learning communities, and coordination and alignment of CLABSI reduction efforts.
AHRQ-authored.
Citation: Pronovost PJ, Cleeman JI, Wright D .
Fifteen years after to Err is Human: a success story to learn from.
BMJ Qual Saf 2016 Jun;25(6):396-9. doi: 10.1136/bmjqs-2015-004720.
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Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Medical Errors, Evidence-Based Practice, Quality of Care
Dimou FM, Eckelbarger D, Riall TS
Surgeon burnout: a systematic review.
The authors sought to provide a concise review and identify studies reporting on identification, prevention, or intervention for surgeons suffering from burnout. They concluded that systematic evaluation of the structure, effectiveness, and resources required for existing programs needs to be done to better understand what does and does not work, with feedback from participants providing significant information.
AHRQ-funded; HS022134.
Citation: Dimou FM, Eckelbarger D, Riall TS .
Surgeon burnout: a systematic review.
J Am Coll Surg 2016 Jun;222(6):1230-39. doi: 10.1016/j.jamcollsurg.2016.03.022.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Provider: Health Personnel
Padula WV, Gibbons RD, Valuck RJ
Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers in US academic medical centers?
The objective of this study was to evaluate the longitudinal impact of CMS policy and quality improvement adoption on hospital-acquired pressure ulcers (HAPU) rates. It concluded that HAPU rates were significantly lower after changes in CMS reimbursement. Reductions are associated with hospital-wide implementation of evidence-based practices for HAPU prevention.
AHRQ-funded; HS023710.
Citation: Padula WV, Gibbons RD, Valuck RJ .
Are evidence-based practices associated with effective prevention of hospital-acquired pressure ulcers in US academic medical centers?
Med Care 2016 May;54(5):512-8. doi: 10.1097/mlr.0000000000000516..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Pressure Ulcers, Quality Improvement
Wysham NG, Kamal AH
Integrating palliative care in the intensive care unit. evidence gaps and quality gaps.
The authors discuss Mularski and colleagues in the same issue, stating that this study provides an important advancement in measuring palliative care quality in the ICU. They commend Mularski and colleagues for advancing the candidate measures of ICU-based palliative care and conclude that this report draws attention to important and persistent deficiencies in comprehensive, patient-centered critical care delivery that needs to be addressed in research and in practice.
AHRQ-funded; HS023681.
Citation: Wysham NG, Kamal AH .
Integrating palliative care in the intensive care unit. evidence gaps and quality gaps.
Ann Am Thorac Soc 2016 May;13(5):595-7. doi: 10.1513/AnnalsATS.201601-061ED.
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Keywords: Evidence-Based Practice, Intensive Care Unit (ICU), Palliative Care, Patient-Centered Outcomes Research, Quality of Care
Mathur MB, Epel E, Kind S
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
The researchers conducted a systematic review and meta-analysis to determine the association between self-reported, perceived psychological stress (PS) and telomere length (TL). They found that increased PS was associated with a very small decrease in TL and that this relationship was similar between sexes. They concluded that the association may be stronger with known major stressors and is similar in magnitude to that noted between obesity and TL. The authors recommended that futre research assess for potential confounders and use longitudinal, multidimensional models of stress.
AHRQ-funded; HS019816.
Citation: Mathur MB, Epel E, Kind S .
Perceived stress and telomere length: a systematic review, meta-analysis, and methodologic considerations for advancing the field.
Brain Behav Immun 2016 May;54:158-69. doi: 10.1016/j.bbi.2016.02.002.
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Keywords: Evidence-Based Practice, Genetics, Stress
Chen PG, Daubs MD, Berven S
Surgery for degenerative lumbar scoliosis: the development of appropriateness criteria.
The authors sought to evaluate the appropriateness of surgery for degenerative lumbar scoliosis (DLS), including identifying clinical characteristics that influence when surgery is inappropriate, appropriate, or necessary, and which procedures are preferable. They concluded that defining the appropriateness of surgery for patients with DLS will be useful to improve evidence-based clinical decision making as well as the consistency and quality of care for these patients.
AHRQ-funded; HS017954.
Citation: Chen PG, Daubs MD, Berven S .
Surgery for degenerative lumbar scoliosis: the development of appropriateness criteria.
Spine 2016 May;41(10):910-8. doi: 10.1097/brs.0000000000001392.
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Keywords: Shared Decision Making, Evidence-Based Practice, Surgery
Burda BU, Holmer HK, Norris SL
Limitations of A Measurement Tool to Assess Systematic Reviews (AMSTAR) and suggestions for improvement.
A Measurement Tool to Assess Systematic Reviews (AMSTAR) is a commonly used tool to assess the quality of systematic reviews; however, modifications are needed to improve its usability, reliability, and validity. In this commentary, the authors summarize their experience and the experiences of others who have used AMSTAR and provide suggestions for its improvement.
AHRQ-funded; HS018500.
Citation: Burda BU, Holmer HK, Norris SL .
Limitations of A Measurement Tool to Assess Systematic Reviews (AMSTAR) and suggestions for improvement.
Syst Rev 2016 Apr 12;5:58. doi: 10.1186/s13643-016-0237-1.
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Keywords: Research Methodologies, Data, Evidence-Based Practice, Guidelines, Quality Measures
Wyer P, Stojanovic Z, Shaffer JA
Combining training in knowledge translation with quality improvement reduced 30-day heart failure readmissions in a community hospital: a case study.
The authors linked multidisciplinary training in evidence-based practice to an initiative to decrease 30-day readmissions among patients admitted to a community teaching hospital for heart failure (HF). They discovered that training of a multidisciplinary hospital team in use of a knowledge translation model, combined with ongoing facilitation, led to implementation of a budget neutral program that decreased HF readmissions.
AHRQ-funded; HS018607.
Citation: Wyer P, Stojanovic Z, Shaffer JA .
Combining training in knowledge translation with quality improvement reduced 30-day heart failure readmissions in a community hospital: a case study.
J Eval Clin Pract 2016 Apr;22(2):171-9. doi: 10.1111/jep.12450.
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Keywords: Evidence-Based Practice, Heart Disease and Health, Quality Improvement, Hospital Readmissions, Training
Rising KL, Carr BG, Hess EP
Patient-centered outcomes research in emergency care: opportunities, challenges, and future directions.
The authors explored factors unique to patient-centered emergency care research and highlighted specific areas of potential alignment within each of the five national PCORI priorities.
AHRQ-funded; HS023901.
Citation: Rising KL, Carr BG, Hess EP .
Patient-centered outcomes research in emergency care: opportunities, challenges, and future directions.
Acad Emerg Med 2016 Apr;23(4):497-502. doi: 10.1111/acem.12944.
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Keywords: Emergency Department, Patient-Centered Outcomes Research, Patient-Centered Healthcare, Quality Improvement, Quality of Care, Evidence-Based Practice
Carman KL, Maurer M, Mangrum R
Understanding an informed public's views on the role of evidence in making health care decisions.
The Community Forum Deliberative Methods Demonstration project, sponsored by AHRQ, obtained informed public views on the role of evidence in health care decisions through seventy-six deliberative groups involving 907 people overall, in the period August-November 2012. Although participants perceived evidence as being essential to high-quality care, they also believed that personal choice or clinical judgment could trump evidence.
AHRQ-funded; 290201000005C.
Citation: Carman KL, Maurer M, Mangrum R .
Understanding an informed public's views on the role of evidence in making health care decisions.
Health Aff 2016 Apr;35(4):566-74. doi: 10.1377/hlthaff.2015.1112.
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Keywords: Healthcare Delivery, Shared Decision Making, Evidence-Based Practice, Policy