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 796 Research Studies DisplayedWeinstein R, Brohinsky J, Meltzer A
AHRQ Author: Weinstein R
Establishing and maintaining trust: how the U.S. Preventive Services Task Force uses strategic communications to build confidence in and disseminate its evidence-based recommendations.
This article examined ways in which strategic communications support for the United States Preventive Services Task Force helped to fulfill its mission to improve the health of people nationwide through evidence-based preventive services recommendations. Communications challenges specific to the USPSTF are described, and two case examples of strategic communications approaches provided.
AHRQ-authored.
Citation: Weinstein R, Brohinsky J, Meltzer A .
Establishing and maintaining trust: how the U.S. Preventive Services Task Force uses strategic communications to build confidence in and disseminate its evidence-based recommendations.
J Health Commun 2023 Jun 3; 28(6):344-48. doi: 10.1080/10810730.2023.2208532..
Keywords: U.S. Preventive Services Task Force (USPSTF), Communication, Evidence-Based Practice, Guidelines, Prevention
Lee SJC, Lee J, Zhu H
Assessing barriers and facilitators to lung cancer screening: initial findings from a patient navigation intervention.
This study’s objective was to examine the challenges to providing lung cancer screening using low-dose computed tomography for patients, particularly minority, under-, and uninsured populations. The authors conducted a pragmatic randomized controlled trial of telephone-based navigation for lung cancer screening in an integrated, urban safety-net health care system. They used bilingual navigators (Spanish and English) to make systematic contact with patients, recording standardized call characteristics in a study-specific database. A total of 225 patients (mean age 63 years, 46% female, 70% racial/ethnic minority) were assigned navigators, with a total of 559 barriers to screening identified during 806 telephone calls. The most common barrier types were personal (46%), provider (30%), and practical (17%). System (6%) and psychosocial (1%) barriers were described by English-speaking patients, but not by Spanish-speaking patients. Provider-related barriers decreased by 80% over the course of the lung cancer screening process.
AHRQ-funded; HS022418.
Citation: Lee SJC, Lee J, Zhu H .
Assessing barriers and facilitators to lung cancer screening: initial findings from a patient navigation intervention.
Popul Health Manag 2023 Jun; 26(3):177-84. doi: 10.1089/pop.2023.0053..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Prevention, Imaging
Jenkins JL, Hsu EB, Zhang A
Current evidence for infection prevention and control interventions in emergency medical services: a scoping review.
This study’s aim was to summarize current evidence from the United States on the effectiveness of practices and interventions for preventing, recognizing, and controlling occupationally acquired infectious diseases in Emergency Medical Service (EMS) clinicians. A database search was conducted for literature published January 2006 through March 15, 2022 to search for studies in the United States that involved EMS clinicians and firefighters, reported on one or more workplace practices or interventions that prevented or controlled infectious diseases, and included outcome measures. Eleven observational studies reported on infection prevention and control (IPC) practices providing evidence that hand hygiene, standard precautions, mandatory vaccine policies, and on-site vaccine clinics are effective. Less frequent handwashing and less frequent hand hygiene after glove use were positively correlated with nasal colonization of Methicillin-resistant Staphylococcus aureus (MRSA). Lack of personal protective equipment (PPE) or PPE breach were correlated with higher severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity and virus 2 (SARS-CoV-2) seropositivity. Workers were more likely to be vaccinated against influenza if their employer offered the vaccine. Vaccination rates for H1N1 influenza increased with the use of active, targeted education modules.
AHRQ-funded; 75Q80120D00003.
Citation: Jenkins JL, Hsu EB, Zhang A .
Current evidence for infection prevention and control interventions in emergency medical services: a scoping review.
Prehosp Disaster Med 2023 Jun; 38(3):371-77. doi: 10.1017/s1049023x23000389..
Keywords: COVID-19, Emergency Department, Evidence-Based Practice, Prevention, Public Health, Infectious Diseases
Tracer H, Haselby C
AHRQ Author: Tracer H
Hormone therapy for the primary prevention of chronic conditions in postmenopausal people.
This case study described a 50-year-old woman whose last menstrual cycle was more than a year previous. Case study questions related to the USPSTF recommendation on hormone therapy addressed whether this patient would benefit from hormone therapy to prevent the onset of chronic conditions that become more common after menopause.
AHRQ-authored.
Citation: Tracer H, Haselby C .
Hormone therapy for the primary prevention of chronic conditions in postmenopausal people.
Am Fam Physician 2023 Jun; 107(6):645-46..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Prevention, Chronic Conditions, Women
Jonas DE, Riley SR, Lee LC
Screening for latent tuberculosis infection in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
This systematic review and evidence report analyzed the benefits and harms of screening for latent tuberculosis infection (LTBI) of adults, which was used to inform the U.S. Preventive Services Task Force for their final recommendation. A systematic review was conducted of English-language studies of LTBI screening, LTBI treatment, or accuracy of the tuberculin skin test (TST) or interferon-gamma release assays (IGRAs). A total of 113 publications were identified, with no studies directly evaluating the benefits and harms of screening. For treatment of LTBI, a large (n = 27,830), good-quality randomized clinical trial found a relative risk (RR) for progression to active tuberculosis at 5 years of 0.35 for 24 weeks of isoniazid compared with placebo (number needed to treat, 112) and an increase in hepatotoxicity (RR, 4.59; number needed to harm, 279). Meta-analysis found greater risk for hepatotoxicity with isoniazid than with rifampin (pooled RR, 4.22; n = 7339).
AHRQ-funded; 75Q80120D00007.
Citation: Jonas DE, Riley SR, Lee LC .
Screening for latent tuberculosis infection in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 May 2; 329(17):1495-509. doi: 10.1001/jama.2023.3954..
Keywords: U.S. Preventive Services Task Force (USPSTF), Infectious Diseases, Screening, Prevention, Evidence-Based Practice
Ahmad FA, Chan P, McGovern C
Adapting an electronic STI risk assessment program for use in pediatric primary care.
This study’s goal was to evaluate the usability of an electronic risk assessment tool to support sexually transmitted disease (STI) testing in the authors’ pediatric emergency department that they had previously designed and implemented. They conducted qualitative interviews of pediatricians, clinic staff, and adolescents from 4 pediatric practices as part of a study whose goal is to ultimately implement STI screening in pediatric primary care. The goal of the interviews was (1) to understand contextual factors related to STI screening in primary care, which they reported previously, and (2) to obtain feedback on their electronic platform, the questionnaire content, and their perspective on implementing it in primary care settings. They received quantitative feedback using the System Usability Scale (SUS). The SUS is a validated, reliable tool to measure the usability of hardware, software, websites, and applications, with a score of 68 (range 0-100) being average usability. They recruited 14 physicians, 9 clinic staff, and 12 adolescents. Participants rated the tool with a median score of 92.5, which shows a high level of usability.
AHRQ-funded; HS026704.
Citation: Ahmad FA, Chan P, McGovern C .
Adapting an electronic STI risk assessment program for use in pediatric primary care.
J Prim Care Community Health 2023 Jan-Dec; 14:21501319231172900. doi: 10.1177/21501319231172900..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Health Information Technology (HIT), Screening, Prevention
Lee CI, Abraham L, Miglioretti DL
National performance benchmarks for screening digital breast tomosynthesis: update from the Breast Cancer Surveillance Consortium.
The purpose of this study was to develop performance benchmarks for digital breast tomosynthesis (DBT) screening and assess longitudinal performance patterns in United States community practice. Between 2011 and 2018 the researchers collected DBT screening examinations from five Breast Cancer Surveillance Consortium (BCSC) registries. Measures of performance were calculated based on the American College of Radiology Breast Imaging Reporting and Data System, fifth edition and included abnormal interpretation rate (AIR), cancer detection rate (CDR), sensitivity, specificity, and false-negative rate (FNR). These rates were compared with previously published BCSC and National Mammography Database benchmarks, concurrent BCSC DM screening examinations, and expert opinion acceptable performance ranges. The study included a total of 896,101 women undergoing 2,301,766 screening examinations and 1,843,591 DM examinations were included in this study. All performance measures were higher for DBT except sensitivity and FNR, when compared with BCSC DM screening examinations from the same time period and previously published BCSC and National Mammography Database performance benchmarks. The following rates of radiologists received acceptable performance ranges with DBT: 97.6% for CDR, 91.8% for sensitivity, 75.0% for AIR, and 74.0% for specificity.
AHRQ-funded; HS018366.
Citation: Lee CI, Abraham L, Miglioretti DL .
National performance benchmarks for screening digital breast tomosynthesis: update from the Breast Cancer Surveillance Consortium.
Radiology 2023 May; 307(4):e222499. doi: 10.1148/radiol.222499..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Imaging, Prevention, Women
Cantor AG, Nelson HD, Pappas M
Telehealth for women's preventive services for reproductive health and intimate partner violence: a comparative effectiveness review.
This comparative effectiveness review was conducted on the effectiveness and harms of telehealth interventions for women's reproductive health and intimate partner violence (IPV) services. A literature search was conducted for randomized controlled trials (RCTs) and observational studies of telehealth strategies for women's reproductive health and IPV versus usual care for the period July 2016 to May 2022. Eight RCTs, 1 nonrandomized trial, and 7 observational studies were included (7 studies of contraceptive care and 9 of IPV services). Telehealth services demonstrated similar care as usual care for contraceptive use, sexually transmitted infections, and pregnancy (low strength of evidence [SOE]). Evidence on abortion was insufficient. Outcomes were also similar between telehealth and usual care interventions to replace or supplement IPV services and comparators for repeat IPV, depression, posttraumatic stress disorder, fear of partner, coercive control, self-efficacy, and safety behaviors (low SOE). Telehealth barriers identified included limited internet access, digital literacy, technical challenges, and confidentiality concerns. Safety strategies increased telehealth use for IPV services. Evidence lacked on access, health equity, or harms.
AHRQ-funded; 75Q80120D00006.
Citation: Cantor AG, Nelson HD, Pappas M .
Telehealth for women's preventive services for reproductive health and intimate partner violence: a comparative effectiveness review.
J Gen Intern Med 2023 May; 38(7):1735-43. doi: 10.1007/s11606-023-08033-6..
Keywords: Telehealth, Health Information Technology (HIT), Women, Prevention, Domestic Violence, Evidence-Based Practice, Maternal Care, Sexual Health, Patient-Centered Outcomes Research, Comparative Effectiveness
Oladapo-Shittu O, Hannum SM, Salinas AB
The need to expand the infection prevention workforce in home infusion therapy.
This study looked at the prevalence of formal surveillance and infection prevention training for home infusion staff. The authors interviewed home infusion staff who perform surveillance activities about barriers to and facilitators for central line-associated bloodstream infection (CLABSI) surveillance and identified barriers to training in CLABSI surveillance. Their findings showed a lack of formal surveillance training which can be addressed by by adapting existing training resources to the home infusion setting.
AHRQ-funded; HS027819.
Citation: Oladapo-Shittu O, Hannum SM, Salinas AB .
The need to expand the infection prevention workforce in home infusion therapy.
Am J Infect Control 2023 May; 51(5):594-96. doi: 10.1016/j.ajic.2022.11.008.AHRQ-funded; HS027819..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Home Healthcare, Central Line-Associated Bloodstream Infections (CLABSI)
Henrikson NB, Ivlev I, Blasi PR
Skin cancer screening: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to investigate the advantages and potential risks of skin cancer screening to assist the decision-making of the US Preventive Services Task Force. The researchers utilized the data sources MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials, dated between June 1, 2015, and January 7, 2022. Two independent reviewers evaluated the articles and extracted pertinent data from studies of fair or good quality; the findings were summarized narratively. The primary outcomes and indicators were morbidity; mortality; stage, precursor lesions, or lesion thickness of skin cancer at detection; potential harms of screening. Twenty studies from 29 articles were included (N = 6,053,411). Direct evidence on the effectiveness of screening was obtained from 3 nonrandomized analyses of 2 population-based skin cancer screening initiatives in Germany (n = 1,791,615), indicating no significant reduction in melanoma mortality benefit at the population level over a period of 4 to 10 years of follow up activities. Six studies (n = 2,935,513) offered inconclusive evidence on the relationship between physician-conducted skin examination and lesion thickness or stage at diagnosis. Usual care vs. routine physician-conducted skin examination was not associated with increased detection of skin cancer or precursor lesions (5 studies) or stage at melanoma detection (3 studies). The correlation between physician-conducted skin examination and lesion thickness at detection was inconsistent (3 studies). Nine studies (n = 1 326 051) found a consistent positive association between more advanced stage at melanoma detection and increasing risk of melanoma-associated and all-cause mortality. Two studies (n = 232) found negligible enduring cosmetic or psychosocial harms related to screening.
AHRQ-funded; 75Q80120D00004.
Citation: Henrikson NB, Ivlev I, Blasi PR .
Skin cancer screening: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Apr 18; 329(15):1296-307. doi: 10.1001/jama.2023.3262..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Skin Cancer, Cancer, Screening, Prevention, Evidence-Based Practice, Guidelines
Katz AJ, Chen RC, Usinger DS
Cardiovascular disease prevention and management of pre-existent cardiovascular disease in a cohort of prostate cancer survivors.
This study examined receipt of preventive care and management of pre-existing cardiovascular disease (CVD) in a prospective cohort of men newly diagnosed with prostate cancer between 2011 and 2013 throughout North Carolina linked to Medicare and private insurance claims and clinical data from the Veterans Affairs (VA). Primary outcome for patients with pre-existent CVD was a composite measure of annual preventive care (blood glucose screening, cholesterol level testing, and ≥ 1 primary care provider visit). The sample comprised 492 patients successfully linked to insurance claims and/or VA data, among whom 103 (20.9%) had pre-existent CVD. Receipt of preventive care declined from 52.7% during the first year after prostate cancer diagnosis to 40.8% during the third year. Among patients with pre-existent CVD, only 23.4% saw a cardiologist in all 3 years. Black men were more likely than White men to visit a cardiologist during the first year after diagnosis.
AHRQ-funded; 29020050040I.
Citation: Katz AJ, Chen RC, Usinger DS .
Cardiovascular disease prevention and management of pre-existent cardiovascular disease in a cohort of prostate cancer survivors.
J Cancer Surviv 2023 Apr;17(2):351-59. doi: 10.1007/s11764-022-01229-5.
Keywords: Cardiovascular Conditions, Cancer: Prostate Cancer, Cancer, Prevention
Ho TH, Bissell MCS, Lee CI
Prioritizing screening mammograms for immediate interpretation and diagnostic evaluation on the basis of risk for recall.
The purpose of this study was to establish a prioritization method for immediate interpretation of screening mammograms and potential diagnostic assessment. A cohort based on the population, comprising screening mammograms conducted from 2012 to 2020 at 126 radiology centers from 7 Breast Cancer Surveillance Consortium registries, was examined. Classification trees were used to identify combinations of clinical history (age, BI-RADS density, time elapsed since the previous mammogram, history of false-positive recall or biopsy outcome), screening technique (digital mammography, digital breast tomosynthesis), and facility features (profit status, location, screening volume, practice type, academic affiliation) that grouped screening mammograms by recall rate, with ≥12/100 classified as high and ≥16/100 as very high. The efficiency ratio was calculated as the percentage of recalls divided by the percentage of mammograms. The research cohort consisted of 2,674,051 screening mammograms in 925,777 women, with 235,569 recalls. The study found that the primary predictor of recall was the time interval since the last mammogram, followed by age, history of false-positive recall, breast density, history of benign biopsy, and screening method. Recall rates were extremely high for baseline mammograms and high for women with ≥5 years since their previous mammogram. The 9.2% of mammograms in subgroups with very high and high recall rates represented 19.2% of recalls, yielding an efficiency ratio of 2.1 compared to a random strategy. Including women under 50 with dense breasts accounted for 20.3% of mammograms and 33.9% of recalls (efficiency ratio = 1.7). Findings incorporating facility-level characteristics were analogous.
AHRQ-funded; HS018366
Citation: Ho TH, Bissell MCS, Lee CI .
Prioritizing screening mammograms for immediate interpretation and diagnostic evaluation on the basis of risk for recall.
J Am Coll Radiol 2023 Mar;20(3):299-310. doi: 10.1016/j.jacr.2022.09.030.
Keywords: Cancer: Breast Cancer, Cancer, Screening, Imaging, Women, Prevention, Diagnostic Safety and Quality
Barry MJ, Wolff TA, Pbert L
AHRQ Author: Wolff TA, Fan TM, Mabry-Hernandez IR, Mills J
Putting evidence into practice: an update on the US Preventive Services Task Force methods for developing recommendations for preventive services
The purpose of this study was to outline the current methodologies employed by the US Preventive Services Task Force (USPSTF) evidence-based recommendations regarding preventive services to improve health for people nationwide, discuss the evolution of these methods to address health equity in preventive care, and identify areas requiring further research. The researchers found that the USPSTF selects subjects based on disease impact, the availability of novel evidence, and the feasibility of implementing the service within primary care settings. In the future, health equity will be increasingly taken into account. Analytical frameworks delineate the crucial questions and associations linking preventive measures to health outcomes. Contextual inquiries offer insights into the natural course of diseases, prevailing practices, health outcomes in vulnerable populations, and health equity considerations. The USPSTF allocates a certainty level to the net benefit estimation of a preventive service (high, moderate, or low) and assesses the net benefit magnitude (considerable, moderate, minimal, or none/negative). Utilizing these evaluations, the USPSTF assigns an alphabetic grade ranging from A (endorse) to D (advise against). When evidence is inadequate, an "I" statement is issued. The USPSTF aims to further refine its simulation modeling techniques and apply evidence to address conditions with limited data in populations disproportionately affected by disease. The authors concluded that exploratory efforts are in progress to gain a deeper understanding of the relationships between social constructs such as race, ethnicity, and gender and their impact on health outcomes, ultimately informing the creation of a USPSTF health equity framework.
Citation: Barry MJ, Wolff TA, Pbert L .
Putting evidence into practice: an update on the US Preventive Services Task Force methods for developing recommendations for preventive services
Ann Fam Med 2023 Mar-Apr;21(2):165-71. doi: 10.1370/afm.2946.
Keywords: U.S. Preventive Services Task Force (USPSTF), Evidence-Based Practice, Guidelines, Prevention, Screening
Mills J, Harding MC
AHRQ Author: Mills J
Screening for obstructive sleep apnea in adults.
This Putting Prevention into Practice case study was created to increase understanding of the USPSTF final recommendation on screening for obstructive sleep apnea (OSA) in adults. A case study was presented using a 41-year-old man with a history of class 1 obesity but was otherwise feeling well. The patient has an uncle who was recently diagnosed with OSA, and the patient has some questions. Three multiple-choice questions are presented regarding USPSTF recommendations whether to screen for OSA for that patient.
AHRQ-authored.
Citation: Mills J, Harding MC .
Screening for obstructive sleep apnea in adults.
Am Fam Physician 2023 Mar;107(3):297-98.
Keywords: U.S. Preventive Services Task Force (USPSTF), Sleep Problems, Guidelines, Prevention, Evidence-Based Practice, Case Study
Shear K, Rice H, Garabedian PM
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
The purpose of this study was to conduct usability testing of the ASPIRE fall risk management tool for use in divergent primary care clinics. Participants recruited from two sites with different electronic health records and clinical organizations used ASPIRE across two clinical scenarios; they rated ASPIRE usability as above average, based on usability benchmarks. Time spent on tasks decreased significantly between the first and second scenarios, indicating ease of learnability. The authors conclude that ASPIRE could be integrated into diverse organizations, since it allows a tailored implementation without the need to build a new system for each organization. ASPIRE is therefore well positioned to impact the challenge of falls at scale.
AHRQ-funded; HS027557.
Citation: Shear K, Rice H, Garabedian PM .
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
Appl Clin Inform 2023 Mar;14(2):212-26. doi: 10.1055/a-2006-4936.
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Falls, Primary Care, Risk, Prevention
Asher GN, Feltner C, Harrison WN
Serologic screening for genital herpes: updated evidence report and systematic review for the US Preventive Services Task Force.
Genital herpes, a viral sexually transmitted infection (STI) caused by herpes simplex virus (HSV) subtypes HSV-1 or HSV-2, is a prevalent STI in the US. Early identification of unrecognized HSV-2 infection could reduce transmission and morbidity. In 2016, the US Preventive Services Task Force (USPSTF) recommended against routine serologic screening for genital herpes in asymptomatic individuals. This updated evidence report aimed to identify studies published since the previous 2016 evidence review. A literature search was conducted from September 30, 2015, through January 16, 2022, with ongoing surveillance through July 22, 2022. The review identified no new eligible studies, leading to unchanged overall conclusions from the 2016 recommendation against screening. The prior recommendation was based on psychosocial harms from false-positive test results due to poor screening test accuracy and uncertain benefit of preventive viral medications for reducing viral shedding or improving health outcomes. The review focused on the general population of asymptomatic adolescents and adults and may not be applicable to populations at higher risk for infection, such as those with HIV or other immunosuppressive conditions.
AHRQ-funded; 75Q80120D00007.
Citation: Asher GN, Feltner C, Harrison WN .
Serologic screening for genital herpes: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Feb 14; 329(6):510-12. doi: 10.1001/jama.2022.20356..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Screening, Guidelines, Evidence-Based Practice, Prevention
Morgan DJ, Dubberke ER, Hink T
The impact of universal glove and gown use on Clostridioides difficile acquisition: a cluster-randomized trial.
This article described a secondary analysis of a cluster-randomized trial in medical and surgical intensive care units (ICUs) in 20 US hospitals to assess whether universal gown and glove use decreases Clostridioides difficile infection. ICUs were randomized to standard practice for glove and gown use versus all healthcare workers required to wear gloves and gowns for all patient contact or when entering a patient room. The results showed no significant difference in the rate of toxigenic C. difficile with universal gown and glove use.
AHRQ-funded; HS025456.
Citation: Morgan DJ, Dubberke ER, Hink T .
The impact of universal glove and gown use on Clostridioides difficile acquisition: a cluster-randomized trial.
Clin Infect Dis 2023 Feb 8; 76(3):e1202-e07. doi: 10.1093/cid/ciac519..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Prevention
Gregory ME, MacEwan SR, Sova LN
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
The objective of this study was to investigate the role of interprofessional teamwork in the prevention of health care-associated infections (HAIs), focusing on central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) prevention. The authors interviewed participating physicians, nurses, and other staff from 18 hospitals about interprofessional collaboration, and proposed an Input-Mediator-Output-Input (IMOI) model as well as strategies to support teamwork for the prevention of HAIs.
AHRQ-funded; HS024958.
Citation: Gregory ME, MacEwan SR, Sova LN .
A qualitative examination of interprofessional teamwork for infection prevention: development of a model and solutions.
Med Care Res Rev 2023 Feb;80(1):30-42. doi: 10.1177/10775587221103973..
Keywords: Teams, Prevention, Healthcare-Associated Infections (HAIs)
Tracer H, Barnhart H
AHRQ Author: Tracer H
Statin use for the primary prevention of cardiovascular disease in adults.
In this Putting Prevention into Practice case study to increase understanding of the USPSTF final recommendation on statin use for the primary prevention of cardiovascular disease (CVD) in adults, a 66-year-old woman presents for a wellness visit. The patient’s smoking history, blood pressure, VMI, and cholesterol levels are described. Three multiple-choice questions are presented regarding when to initiate statin use, and other information provided in the final recommendation.
AHRQ-authored.
Citation: Tracer H, Barnhart H .
Statin use for the primary prevention of cardiovascular disease in adults.
Am Fam Physician 2023 Feb; 107(2):185-86..
Keywords: U.S. Preventive Services Task Force (USPSTF), Medication, Prevention
Herman WH, Bullock A, Boltri JM
AHRQ Author: Tracer H
The National Clinical Care Commission report to Congress: background, methods, and foundational recommendations.
This AHRQ-authored paper describes the background, methods, and recommendations of the National Clinical Care Commission (NCCC) focused on factors likely to improve the delivery of high-quality care to all people with diabetes. It is the first in a series of five articles describing the recommendations. The Commission made recommendations at all levels: patient, practice, health system, and health policy. This is the first paper in a series of five articles about the NCCC recommendations. The five articles include recommendations to 1) reduce diabetes-related risks, prevent type 2 diabetes, and avert diabetes complications through changes in federal policies and programs affecting the general population; 2) prevent type 2 diabetes in at-risk individuals through targeted lifestyle and medication interventions; and 3) improve the treatment of diabetes and its complications to improve the health outcomes of people with diabetes. This first article reviews the successes and limitations of previous federal efforts to combat diabetes, describes the establishment of and charge to the NCCC, and discusses the development of a hybrid conceptual model that guided the NCCC’s novel all-of-government approach to address diabetes as a societal and medical problem. The authors then review the procedures used by the NCCC to gather information from federal agencies, stakeholders, key informants, and the public and to conduct literature reviews. Finally, they review the NCCC's three foundational recommendations: 1) improve the coordination of non-health-related and health-related federal agencies to address the social and environmental conditions that are accelerating the diabetes epidemic; 2) ensure that all Americans at risk for and with diabetes have health insurance and access to health care; and 3) ensure that all federal policies and programs promote health equity in diabetes.
AHRQ-authored; AHRQ-funded.
Citation: Herman WH, Bullock A, Boltri JM .
The National Clinical Care Commission report to Congress: background, methods, and foundational recommendations.
Diabetes Care 2023 Feb; 46(2):e14-e23. doi: 10.2337/dc22-0611..
Keywords: Diabetes, Chronic Conditions, Prevention, Research Methodologies
Schillinger D, Bullock A, Powell C
The National Clinical Care Commission report to Congress: leveraging federal policies and programs for population-level diabetes prevention and control: recommendations from the National Clinical Care Commission.
The purpose of this article was to explore and consider the National Clinical Care Commission’s (NCCC) population-wide recommendations focusing on food systems; consumption of water over beverages sweetened with sugar; labeling of food and beverages; marketing and advertising; workplace, ambient, and built environments; and research to address the myriad of complex factors contributing to Type 1 and 2 diabetes. The authors’ recommendations are directed toward federal policies, agencies, departments and programs, including the Environmental Protection Agency, the Food and Drug Administration, the Department of Housing and Urban Development, and others.
AHRQ-funded.
Citation: Schillinger D, Bullock A, Powell C .
The National Clinical Care Commission report to Congress: leveraging federal policies and programs for population-level diabetes prevention and control: recommendations from the National Clinical Care Commission.
Diabetes Care 2023 Feb; 46(2):e24-e38. doi: 10.2337/dc22-0619..
Keywords: Diabetes, Chronic Conditions, Policy, Prevention
Greenlee MC, Bolen S, Chong W
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to improve diabetes treatment and reduce complications.
This paper is the fourth in a series of five articles describing the recommendations of the National Clinician Care Commission (NCCC) on diabetes care. This paper focused on the recommendations of the Treatment and Complications subcommittee of the National Clinical Care Commission. The Commission made recommendations at all levels: patient, practice, health system, and health policy. They also identified several areas that need additional research, such as studying the barriers to uptake of diabetes self-management education and support, exploring methods to implement team-based care, and evaluating the importance of digital connectivity as a social determinant of health.
AHRQ-funded.
Citation: Greenlee MC, Bolen S, Chong W .
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to improve diabetes treatment and reduce complications.
Diabetes Care 2023 Feb; 46(2):e51-e59. doi: 10.2337/dc22-0621..
Keywords: Diabetes, Chronic Conditions, Policy, Prevention, Quality of Life
Boltri JM, Tracer H, Strogatz D
AHRQ Author: Tracer H
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to prevent diabetes in people with prediabetes.
This article described the recommendations of a National Clinical Care Commission subcommittee focused primarily on the prevention of type 2 diabetes in people with prediabetes. The goal of these recommendations is to improve current Federal diabetes prevention activities by increasing awareness of and diagnosis of prediabetes on a population basis, facilitating FDA review and approval of metformin for diabetes prevention, and supporting research to enhance the effectiveness of diabetes prevention. The recommendations also highlight the importance of research to advance understanding of the etiology of and opportunities for prevention of type 1 diabetes.
AHRQ-authored; AHRQ-funded.
Citation: Boltri JM, Tracer H, Strogatz D .
The National Clinical Care Commission report to Congress: leveraging federal policies and programs to prevent diabetes in people with prediabetes.
Diabetes Care 2023 Feb; 46(2):e39-e50. doi: 10.2337/dc22-0620..
Keywords: Diabetes, Prevention, Chronic Conditions
Herman WH, Schillinger D, Bolen S
AHRQ Author: Tracer H
The National Clinical Care Commission report to Congress: recommendations to better leverage federal policies and programs to prevent and control diabetes.
This AHRQ-authored article is an overview paper of the recommendations of the National Clinical Care Commission (NCCC) Report to Congress to better leverage federal policies and programs to prevent and control diabetes. The NCCC surveyed federal agencies and conducted follow-up meetings with representatives from 10 health-related and 11 non-health-related federal agencies. They held 12 public meetings, solicited comments, met with numerous interested parties and key informants, and performed comprehensive literature reviews. The final report was transmitted to Congress in January 2022 and contained 39 specific recommendations, including 3 foundational recommendations that addressed the necessity of an all-of-government approach to diabetes, health equity, and access to health care. Recommendations were made at the general population level and the individual level to strengthen federal policies and programs to increase awareness of prediabetes and remove barriers to proven effective treatments for diabetes and its complications.
AHRQ-authored; AHRQ-funded.
Citation: Herman WH, Schillinger D, Bolen S .
The National Clinical Care Commission report to Congress: recommendations to better leverage federal policies and programs to prevent and control diabetes.
Diabetes Care 2023 Feb; 46(2):255-61. doi: 10.2337/dc22-1587..
Keywords: Diabetes, Chronic Conditions, Policy, Prevention
Conlin PR, Boltri JM, Bullock A
The National Clinical Care Commission report to Congress: summary and next steps.
This article summarized recommendations of the National Clinical Care Commission (NCCC) to prevent and control diabetes and its complications more effectively. The NCCC has determined that diabetes should not be considered solely as a medical problem but must also as a societal problem. Its recommendations cover policies and programs of both non-health-related and health-related federal agencies, including three recommendations that: non-health-related and health-related federal agencies coordinate their activities to better address diabetes; all federal agencies and departments ensure health equity as a guiding principle for their policies and programs that impact diabetes; all Americans have access to comprehensive and affordable health care. The NCCC also recommends that a coordinating Office of National Diabetes Policy be established.
AHRQ-authored; AHRQ-funded.
Citation: Conlin PR, Boltri JM, Bullock A .
The National Clinical Care Commission report to Congress: summary and next steps.
Diabetes Care 2023 Feb; 46(2):e60-e63. doi: 10.2337/dc22-0622..
Keywords: Diabetes, Chronic Conditions, Policy, Prevention