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
776 to 796 of 796 Research Studies DisplayedLau BD, Haut ER
Practices to prevent venous thromboembolism: a brief review.
The purpose of this review is to provide an update on the most effective interventions aimed at improving adherence to guidelines on the use of venous thromboembolism (VTE) prevention strategies. After reviewing sixteen studies, the researchers concluded that the greatest and most sustained improvements were those that combined education with computerised tools.
AHRQ-funded; 290200710.
Citation: Lau BD, Haut ER .
Practices to prevent venous thromboembolism: a brief review.
BMJ Qual Saf 2014 Mar;23(3):187-95. doi: 10.1136/bmjqs-2012-001782..
Keywords: Comparative Effectiveness, Blood Clots, Prevention, Shared Decision Making, Guidelines
Nelson HD, Pappas M, Zakher B
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation.
This systematic review was done in support of the U.S. Preventive Services Task Force (USPSTF) updated recommendation on the benefit and harms of risk assessment, genetic testing, and genetic counseling for BRCA-related cancer in women. A systematic review was done on literature from 2004 to July 30, 2013 from MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Health Technology Assessment, Scopus, and reference lists. Data on the participants, study design, analysis, follow-up, and results was extracted and a second investigator confirmed key data. The studies were rated on study quality and applicability. The analysis found women with high-risk for breast cancer had decreased risk of breast cancer by 85% to 100% by having a mastectomy, and risk of mortality by 81% to 100% compared to women without surgery. There was also a lower risk of breast and ovarian cancer after having salpingo-oopherectomy surgery.
AHRQ-funded; 290200710057
Citation: Nelson HD, Pappas M, Zakher B .
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation.
Ann Intern Med 2014 Feb 18;160(4):255-66. doi: 10.7326/m13-1684..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer: Ovarian Cancer, Cancer, Genetics, Screening, Prevention, Guidelines, Evidence-Based Practice, Women, Risk, Family Health and History
Zai AH, Kim S, Kamis A
Applying operations research to optimize a novel population management system for cancer screening.
The objective of this paper is to optimize a new visit-independent, population-based cancer screening system (TopCare) by using operations research techniques to simulate changes in patient outreach staffing levels (delegates, navigators), modifications to user workflow within the information technology (IT) system, and changes in cancer screening recommendations. Results showed that simulating the impact of changes in staffing, system parameters, and clinical inputs on the effectiveness and efficiency of care can inform the allocation of limited resources in population management.
AHRQ-funded; HS018161.
Citation: Zai AH, Kim S, Kamis A .
Applying operations research to optimize a novel population management system for cancer screening.
J Am Med Inform Assoc 2014 Feb;21(e1):e129-35. doi: 10.1136/amiajnl-2013-001681.
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Keywords: Cancer, Health Information Technology (HIT), Prevention, Screening, Workflow
Battles JB, Farr SL, Weinberg DA
AHRQ Author: Battles JB
From research to nationwide implementation: the impact of AHRQ's HAI prevention program.
The authors sought to provide insight to AHRQ's healthcare-associated infection (HAI) prevention strategies by: first, discussing the context and structure of AHRQ's HAI research portfolio and funding decisions; secondly, describing the process of prevention practice implementation and lessons learned; and third, explaining the outcomes and national impact of the AHRQ program. Their paper described major contributions that have emerged from AHRQ-funded HAI projects.
AHRQ-authored.
Citation: Battles JB, Farr SL, Weinberg DA .
From research to nationwide implementation: the impact of AHRQ's HAI prevention program.
Med Care 2014 Feb;52(2 Suppl 1):S91-6. doi: 10.1097/mlr.0000000000000037.
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Keywords: Quality of Care, Healthcare-Associated Infections (HAIs), Quality Improvement, Patient Safety, Prevention
Earley A, Persson R, Garlitski AC
Effectiveness of implantable cardioverter defibrillators for primary prevention of sudden cardiac death in subgroups a systematic review.
The purpose of this review was to examine ICD effectiveness for primary prevention of SCD across subgroups by sex, age, QRS interval, time since myocardial infarction, blood urea nitrogen level, and diabetes. It concluded that there was weak evidence showing differences for all-cause mortality in subgroups of sex, age, and QRS interval. Also, evidence was indeterminate for all-cause mortality in the other subgroups and for SCD.
AHRQ-funded; 290200710055I.
Citation: Earley A, Persson R, Garlitski AC .
Effectiveness of implantable cardioverter defibrillators for primary prevention of sudden cardiac death in subgroups a systematic review.
Ann Intern Med 2014 Jan 21;160(2):111-21. doi: 10.7326/m13-1787..
Keywords: Medical Devices, Comparative Effectiveness, Prevention, Mortality
Nagykaldi ZJ, Yeaman B, Jones M
HIE-i-health information exchange with intelligence.
This article reports on the development and pilot testing of an innovative approach to implement health information exchange with intelligence (HIE-i) in primary care settings. Records of 346 patients were studied in 6 primary care practices. The results suggest that coupling a geographically inclusive set of clinical data with HIE-based clinical decision support for prevention can considerably improve prospective care delivery.
AHRQ-funded; 290200710009I.
Citation: Nagykaldi ZJ, Yeaman B, Jones M .
HIE-i-health information exchange with intelligence.
J Ambul Care Manage 2014 Jan-Mar;37(1):20-31. doi: 10.1097/jac.0000000000000002..
Keywords: Clinical Decision Support (CDS), Health Information Exchange (HIE), Health Information Technology (HIT), Prevention, Primary Care
Leeman J, Teal R, Jernigan J
What evidence and support do state-level public health practitioners need to address obesity prevention.
This study describes interview and survey findings that detail how public health practitioners characterize the obesity prevention task, the types of evidence and support they find most helpful, and their needs for additional evidence and support. The researchers conducted 10 in-depth interviews with public health practitioners and project officers followed by an online survey completed by 62 practitioners.
AHRQ-funded; HS019468.
Citation: Leeman J, Teal R, Jernigan J .
What evidence and support do state-level public health practitioners need to address obesity prevention.
Am J Health Promot 2014 Jan-Feb;28(3):189-96. doi: 10.4278/ajhp.120518-QUAL-266..
Keywords: Obesity, Prevention, Public Health
Hellinger FJ
AHRQ Author: Hellinger FJ
Assessing the cost effectiveness of pre-exposure prophylaxis for HIV prevention in the US.
In order to assess the cost-effectiveness of pre-exposure prophylaxis for HIV prevention in the U.S., the author evaluates various studies and finds that they yield widely varying estimates of the cost per quality-adjusted life year (QALY) gained, and that this variations reflects the substantial uncertainty surrounding the determinants of HIV transmission as well as different approaches to translating a reduction in HIV cases into an estimate of the increase in the number of QALYs.
AHRQ-authored.
Citation: Hellinger FJ .
Assessing the cost effectiveness of pre-exposure prophylaxis for HIV prevention in the US.
Pharmacoeconomics. 2013 Dec;31(12):1091-104. doi: 10.1007/s40273-013-0111-0..
Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Quality of Life, Healthcare Costs, Prevention
John DA, de Castro AB, Duran B
Nativity and occupational class disparities in uninsurance and routine preventive care use among Asian Americans.
The researchers examined how nativity and occupational class among Asian Americans may explain disparities in uninsurance and use of routine preventive healthcare services such as routine physical checkup and dental/eye exams. They found that 35 to 40 percent of workers in blue-collar and service occupations reported no physical checkup or dental/eye exams in the past year.
AHRQ-funded; HS013853
Citation: John DA, de Castro AB, Duran B .
Nativity and occupational class disparities in uninsurance and routine preventive care use among Asian Americans.
J Immigr Minor Health. 2013 Dec;15(6):1011-22. doi: 10.1007/s10903-013-9851-3..
Keywords: Disparities, Uninsured, Racial and Ethnic Minorities, Social Determinants of Health, Prevention
Zanocco K, Elaraj D, Sturgeon C
Routine prophylactic central neck dissection for low-risk papillary thyroid cancer: a cost-effectiveness analysis.
The researchers hypothesized that routine prophylactic central neck dissection (pCND) is not cost-effective in low-risk papillary thyroid cancer (PTC).Using a Markov transition-state model, they found that pCND cost $10,315 and produced an effectiveness of 23.785 quality-adjusted life years. They concluded that routine pCND for low-risk PTC is not cost-effective unless the recurrence rate is greater than 10.3 percent.
AHRQ-funded; HS000078.
Citation: Zanocco K, Elaraj D, Sturgeon C .
Routine prophylactic central neck dissection for low-risk papillary thyroid cancer: a cost-effectiveness analysis.
Surgery 2013 Dec;154(6):1148-55; discussion 54-5..
Keywords: Cancer, Surgery, Prevention, Healthcare Costs, Quality of Life
Abdus S, Selden TM
AHRQ Author: Abdus S, Selden TM
Preventive services for adults: how have differences across subgroups changed over the past decade?
This study uses MEPS data to track changes over time in the distribution of preventive services use across groups defined by poverty status, race/ethnicity, insurance coverage, Census region, and urbanicity. The analysis found that differences across subgroups tended to persist over time, with some of the largest gaps between adults with and without coverage. Regional differences persisted or widened over the study period.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Preventive services for adults: how have differences across subgroups changed over the past decade?
Med Care 2013 Nov;51(11):999-1007. doi: 10.1097/MLR.0b013e3182a97bc0.
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Keywords: Healthcare Utilization, Health Insurance, Medical Expenditure Panel Survey (MEPS), Prevention, Social Determinants of Health
Harris AD, Pineles L, Belton B
Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial.
Antibiotic-resistant bacteria are associated with increased patient morbidity and mortality. It is unknown whether wearing gloves and gowns for all patient contact in the intensive care unit (ICU) decreases acquisition of antibiotic-resistant bacteria. The purpose of this study was to assess whether wearing gloves and gowns for all patient contact in the ICU decreases acquisition of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) compared with usual care.
AHRQ-funded; HS018111; 290200600015.
Citation: Harris AD, Pineles L, Belton B .
Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial.
JAMA 2013 Oct 16;310(15):1571-80. doi: 10.1001/jama.2013.277815..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Infectious Diseases, Intensive Care Unit (ICU), Hospitals, Prevention, Critical Care
Steinberg JP, Denham ME, Zimring C
https://www.researchgate.net/publication/276382905/download
The role of the hospital environment in the prevention of healthcare-associated infections by contact transmission.
The authors describe the role of the hospital environment in the spread of pathogens by direct and indirect contact. In addition, the prevention of transmission through interventions involving the built environment is discussed. They conclude that enhanced environmental cleaning including touchless technologies and self-cleaning surfaces can reduce environmental contamination and may prevent infections.
AHRQ-funded; 290201000024I.
Citation: Steinberg JP, Denham ME, Zimring C .
The role of the hospital environment in the prevention of healthcare-associated infections by contact transmission.
HERD 2013 Oct;7(1 suppl):46-73..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Prevention, Patient Safety
Robin Yabroff K, Short PF, Machlin S
AHRQ Author: Machlin S
Access to preventive health care for cancer survivors.
The researchers evaluated the association between cancer survivorship and access to primary and preventive health care. They concluded that, although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18-64 years suggest that improvements in survivor care are needed.
AHRQ-authored.
Citation: Robin Yabroff K, Short PF, Machlin S .
Access to preventive health care for cancer survivors.
Am J Prev Med 2013 Sep;45(3):304-12. doi: 10.1016/j.amepre.2013.04.021.
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Keywords: Access to Care, Cancer, Medical Expenditure Panel Survey (MEPS), Prevention, Primary Care
Clancy CM
AHRQ Author: Clancy CM
Evidence-based toolkit helps organizations reduce patient falls.
This article describes an evidence-based hospital fall-prevention toolkit developed by AHRQ that helps clinicians negotiate the change process at their organization. It was created by a team with expertise both in fall prevention and in organizational change, including staff from the RAND Corporation, ECRI Institute, and Boston University.
AHRQ-authored.
Citation: Clancy CM .
Evidence-based toolkit helps organizations reduce patient falls.
J Nurs Care Qual 2013 Jul-Sep;28(3):195-7. doi: 10.1097/NCQ.0b013e318294a9d1.
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Keywords: Evidence-Based Practice, Falls, Tools & Toolkits, Patient Safety, Prevention
Huang SS, Septimus E, Kleinman K
Targeted versus universal decolonization to prevent ICU infection.
In this pragmatic, cluster-randomized trial the authors compared targeted versus universal decolonization of patients in intensive care units (ICUs) as strategies for preventing health care-associated infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA). They found that in routine ICU practice, universal decolonization was more effective than targeted decolonization or screening and isolation in reducing rates of MRSA clinical isolates and bloodstream infection from any pathogen.
AHRQ-funded; 290201000008I.
Citation: Huang SS, Septimus E, Kleinman K .
Targeted versus universal decolonization to prevent ICU infection.
N Engl J Med 2013 Jun 13;368(24):2255-65. doi: 10.1056/NEJMoa1207290..
Keywords: Comparative Effectiveness, Infectious Diseases, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Intensive Care Unit (ICU), Patient-Centered Healthcare, Patient Safety, Prevention
Percac-Lima S, Benner CS, Lui R
The impact of a culturally tailored patient navigator program on cervical cancer prevention in Latina women.
The authors evaluated the impact of patient navigation on cervical cancer prevention in Latinas. They found that patient navigation can prevent cervical cancer in Latina women by increasing colposcopy clinic attendance, shortening time to colposcopy, and decreasing severity of cervical abnormalities over time.
AHRQ-funded; HS019161.
Citation: Percac-Lima S, Benner CS, Lui R .
The impact of a culturally tailored patient navigator program on cervical cancer prevention in Latina women.
J Womens Health 2013 May;22(5):426-31. doi: 10.1089/jwh.2012.3900.
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Keywords: Cancer: Cervical Cancer, Cultural Competence, Prevention, Racial and Ethnic Minorities, Screening
Hempel S, Newberry S, Wang Z
AHRQ Author: Spector WD
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
The authors sought to document systematically the implementation, components, comparators, adherence, and effectiveness of published fall prevention approaches in U.S. acute care hospitals. They found that most interventions included multiple components, and the pooled postintervention incidence rate ratio (IRR) was 0.77. They found no systematic association between implementation intensity, intervention complexity, comparator information, or adherence levels and IRR. They concluded that promising approaches exist, but better reporting of outcomes, implementation, adherence, intervention components, and comparison group information is necessary to establish evidence on how hospitals can successfully prevent falls.
AHRQ-authored; AHRQ-funded; 290201000017I.
Citation: Hempel S, Newberry S, Wang Z .
Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness.
J Am Geriatr Soc 2013 Apr;61(4):483-94. doi: 10.1111/jgs.12169.
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Keywords: Adverse Events, Falls, Hospitals, Patient Safety, Prevention
Abdus S, Selden TM
AHRQ Author: Abdus S, Selden TM
Adherence with recommended well-child visits has grown, but large gaps persist among various socioeconomic groups.
Using MEPS data, the authors examined trends in well-child visit adherence and whether differences across population subgroups narrowed or widened over time. They found that the ratio of actual to recommended visits rose, with large differences in adherence at the start of the study period across income, race or ethnicity, parent education, region, insurance coverage, and having a usual source of care. None of these differences had narrowed significantly by the end of the study period, and differences widened across parent education, between those with and without insurance coverage, by usual source of care, and between the Northeast and the Midwest and West regions.
AHRQ-authored.
Citation: Abdus S, Selden TM .
Adherence with recommended well-child visits has grown, but large gaps persist among various socioeconomic groups.
Health Aff 2013 Mar;32(3):508-15. doi: 10.1377/hlthaff.2012.0691.
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Keywords: Children/Adolescents, Medical Expenditure Panel Survey (MEPS), Prevention, Social Determinants of Health
Sharkey S, Hudak S, Horn SD
AHRQ Author: Spector W
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
The researchers determined those factors that are associated with nursing homes' success in implementing the On-Time quality improvement (QI) for pressure ulcer prevention program and integrating health information technology (HIT) tools into practice at the unit level. They found that after at least 9 months of implementation effort, 36% of the nursing homes achieved level III of the On-Time QI-HIT program. They concluded that the learning from On-Time QI offers several lessons associated with facility factors that contribute to high level of implementation of a QI-HIT program in a nursing home.
AHRQ-authored; AHRQ-funded; 29020050020.
Citation: Sharkey S, Hudak S, Horn SD .
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
Adv Skin Wound Care 2013 Feb;26(2):83-92; quiz p.93-4. doi: 10.1097/01.ASW.0000426718.59326.bb.
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Keywords: Health Information Technology (HIT), Nursing Homes, Pressure Ulcers, Prevention, Quality Improvement
Mehrabi S, Schmidt CM, Waters JA
An efficient pancreatic cyst identification methodology using natural language processing.
Accurate identification, surveillance and treatment of pancreatic cysts represents an opportunity to prevent pancreatic cancer. Much information about pancreatic cysts can be found in free text format in various narrative medical reports. To capture this information, the researchers modified their cyst identification technique using the Unstructured Information Management Architecture (UIMA) pipeline.
AHRQ-funded; HS019818.
Citation: Mehrabi S, Schmidt CM, Waters JA .
An efficient pancreatic cyst identification methodology using natural language processing.
Stud Health Technol Inform 2013;192:822-6..
Keywords: Cancer, Electronic Health Records (EHRs), Data, Health Information Technology (HIT), Prevention