National Healthcare Quality and Disparities Report
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- Access to Care (1)
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- (-) Screening (52)
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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 52 Research Studies DisplayedBouchelle Z, Menko SG, Yazdani M
Parent perspectives on documentation and sharing of health-related social needs data.
This survey aimed to examine parents of pediatric patients’ preferences regarding how health-related social needs (HRSN) screening program data are documented and shared. The authors conducted semi-structured interviews with parents of hospitalized children participating in an HRSN screening program at a quaternary care children's hospital. Interviews were then coded to identify emergent themes. A total of 20 parents were interviewed with all being female, 55% identifying as Black or African American and 20% identifying as Hispanic or Latino. Parents expressed comfort with electronic health record documentation of HRSN data and the use of ICD-10 Revision Z codes as long as this information was used to provide families with meaningful support. Most parents viewed social workers and medical teams as being the most appropriate recipients of the data, with few parents feeling comfortable with HRSN data being shared with payors. Parents wanted transparency around HRSN data sharing, with many expressing concerns that documentation and sharing of HRSN data could lead to unwanted or unsafe disclosures or result in child welfare referrals.
AHRQ-funded; HS028555.
Citation: Bouchelle Z, Menko SG, Yazdani M .
Parent perspectives on documentation and sharing of health-related social needs data.
Hosp Pediatr 2024 Apr; 14(4):308-16. doi: 10.1542/hpeds.2023-007478..
Keywords: Children/Adolescents, Screening, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bradford W, Akselrod H, Bassler J
Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment.
This multisite, retrospective cohort study of hospitalized patients with opioid use disorder with infectious complications of injection drug use looked at rates of HIV screening, pre-exposure prophylaxis, and treatment among these patients. The authors included 322 patients, with most (300) now known to have HIV. Of those, only 2 had a documented discussion of PrEP, while only 1 was prescribed PrEP on discharge. Among the 22 people with HIV (PWH), only 13 had a viral load collected during admission of whom all were viremic and 10 were successfully linked to care post-discharge. Both groups had high rates of readmission, Medicaid or uninsured status, and unstable housing.
AHRQ-funded; HS013852.
Citation: Bradford W, Akselrod H, Bassler J .
Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment.
Addict Sci Clin Pract 2024 Mar 26; 19(1):22. doi: 10.1186/s13722-024-00451-z..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Prevention, Inpatient Care
Liu PH, Singal AG, Murphy CC
Colorectal cancer screening receipt does not differ by 10-year mortality risk among older adults.
This study examined receipt of past-year colorectal cancer (CRC screening) according to predicted 10-year mortality risk among 25,888 community-dwelling adults aged 65-84 years who were not up-to-date with screening in the nationwide National Health Interview Survey. Ten-year mortality risk was estimated using a validated index with the lowest to highest quintiles of the index ranging from 12%-79%. The authors also examined the proportion of screening performed among adults with life expectancy <10 years. They found that the prevalence of past-year CRC screening was 39.5%, 40.6%, 38.7%, 36.4%, and 35.4%, from the lowest to highest quintile of 10-year mortality risk, demonstrating that the odds of CRC screening did not differ in the lowest vs highest quintile. One-quarter of past-year CRC screening occurred in adults with life expectancy <10 years, and more than half (50.7%) of adults aged 75-84 years had 10-year mortality risk ≥50% at the time of screening. Invasive but not noninvasive screening increased as 10-year mortality risk increased among adults aged 70-79 years.
AHRQ-funded; HS022418.
Citation: Liu PH, Singal AG, Murphy CC .
Colorectal cancer screening receipt does not differ by 10-year mortality risk among older adults.
Am J Gastroenterol 2024 Feb; 119(2):353-63. doi: 10.14309/ajg.0000000000002536.
Keywords: Elderly, Cancer: Colorectal Cancer, Mortality, Screening, Colonoscopy
Miller AC, Koeneman SH, Suneja M
Diurnal temperature variation and the implications for diagnosis and infectious disease screening: a population-based study.
This study’s objective was to describe individual variation in diurnal temperature patterns during episodes of febrile activity using millions of recorded temperatures and evaluate the probability of recording a fever by sex and for different age groups. The authors used timestamped deidentified temperature readings from thermometers across the US to construct illness episodes where continuous periods of activity in a single user included a febrile reading. They modeled the mean temperature recorded and probability of registering a fever across the course of a day using sinusoidal regression models while accounting for user age and sex. They then estimated the probability of recording a fever by time of day for children, working-age adults, and older adults. They found wide variation in body temperatures over the course of a day and across individual characteristics, with temperature patterns differing between men and women, and average temperatures declining for older age groups. There was a wide variation of the likelihood of fever detection by the time of day and by an individual’s age or sex.
AHRQ-authored; HS027375.
Citation: Miller AC, Koeneman SH, Suneja M .
Diurnal temperature variation and the implications for diagnosis and infectious disease screening: a population-based study.
Diagnosis 2024 Feb 1; 11(1):54-62. doi: 10.1515/dx-2023-0074.
Keywords: Infectious Diseases, Screening
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
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
Balbin CA, Kawamoto K
The SIMPLE architectural pattern for integrating patient-facing apps into clinical workflows: desiderata and application for lung cancer screening.
To address the need for electronic health record (EHR) systems to accept the connection of any patient-facing digital health app using the SMART on FHIR standard, the authors proposed the Standards-based Implementation Maximizing Portability Leveraging the EHR (SIMPLE). SIMPLE’s architectural pattern was designed to meet several key requirements, such as not requiring patients to install new software; not retaining patient data outside of the EHR; leveraging existing personal health record (PHR) capabilities to optimize user experience; and maximizing portability.
AHRQ-funded; HS028791.
Citation: Balbin CA, Kawamoto K .
The SIMPLE architectural pattern for integrating patient-facing apps into clinical workflows: desiderata and application for lung cancer screening.
AMIA Annu Symp Proc 2024 Jan 11; 2023:844-53..
Keywords: Workflow, Health Information Technology (HIT), Cancer: Lung Cancer, Cancer, Screening
Fan T, Duffy M
Screening for osteoporosis to prevent fractures.
This case study provides case questions and answers related to the U.S. Preventive Services Task Force recommendations on screening for osteoporosis to prevent fractures. It is part of the “Putting Prevention into Practice” series.
AHRQ-authored.
Citation: Fan T, Duffy M .
Screening for osteoporosis to prevent fractures.
Am Fam Physician 2018 Nov 15;98(10):593-94..
Keywords: Case Study, Injuries and Wounds, Osteoporosis, Prevention, Screening
Magrath M, Yang E, Ahn C
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
The goal of this study was to characterize guideline adherence of surveillance recommendations after implementation of an electronic medical record (EMR)-based Colonoscopy Pathology Reporting and Clinical Decision Support System (CoRS). Results showed that an EMR-based CoRS was widely used and significantly improved guideline adherence of surveillance recommendations.
AHRQ-funded; HS022418.
Citation: Magrath M, Yang E, Ahn C .
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
J Natl Compr Canc Netw 2018 Nov;16(11):1321-28. doi: 10.6004/jnccn.2018.7050..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Colonoscopy, Cancer: Colorectal Cancer, Screening, Cancer, Guidelines, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention
Lee CI, Zhu W, Onega TL
The effect of digital breast tomosynthesis adoption on facility-level breast cancer screening volume.
This study examined whether adoption of digital breast tomosynthesis (DBT) was associated with a decrease in screening mammography capacity across Breast Cancer Screening Consortium facilities. Facility characteristics and examination volume data were collected from facilities that adopted DBT from 2011 and 2014. The majority of facilities had no academic affiliation (73%), were nonprofit (80%) and were general radiology practices (66.7%). Monthly screening volumes were slightly higher after the adoption period but otherwise remained relatively stable before and after adoption of DBT.
AHRQ-funded; HS018366.
Citation: Lee CI, Zhu W, Onega TL .
The effect of digital breast tomosynthesis adoption on facility-level breast cancer screening volume.
AJR Am J Roentgenol 2018 Nov;211(5):957-63. doi: 10.2214/ajr.17.19350..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women
Shaker M, Verma K, Greenhawt M
The health and economic outcomes of early egg introduction strategies.
This study compared the costs and benefits of early egg introduction (EEI) using simulation and Markov modeling over a 20-year horizon with data from the United States, Europe, and Canada. Per child it was more expensive to provide early screening for all children with early-onset eczema than to have a “wait and see” approach. While there would be more egg allergy diagnosis with early screening, the increased costs were too great compared to the no-screening approach.
Citation: Shaker M, Verma K, Greenhawt M .
The health and economic outcomes of early egg introduction strategies.
Allergy 2018 Nov;73(11):2214-23. doi: 10.1111/all.13565..
Keywords: Children/Adolescents, Screening, Healthcare Costs, Diagnostic Safety and Quality, Medication
Wolff T, Jadotte YJ
AHRQ Author: Wolff T
Screening for prostate cancer.
This case study describes a 57-year-old black man, non-smoker, who has a history of diabetes mellitus, currently well-controlled. He would like to discuss the prostate-specific antigen (PSA) test even though he has no family history of prostate cancer. The case study questions are based on USPSTF recommendations for prostate cancer screening.
AHRQ-authored.
Citation: Wolff T, Jadotte YJ .
Screening for prostate cancer.
Am Fam Physician 2018 Oct 15;98(8):537-38..
Keywords: Cancer: Prostate Cancer, Case Study, Guidelines, Prevention, Screening
Cartmell KB, Dismuke CE, Dooley M
Effect of an evidence-based inpatient tobacco dependence treatment service on 1-year postdischarge health care costs.
In 2014, the Medical University of South Carolina (MUSC) implemented a Tobacco Dependence Treatment Service (TDTS) consistent with the Joint Commission (JC) standards recommending that hospitals screen patients for smoking, provide cessation support, and follow-up contact for relapse prevention within 1 month of discharge. This paper examined whether exposure to the TDTS influenced downstream health care charges 12 months after patients were discharged from the hospital.
AHRQ-funded; HS023863.
Citation: Cartmell KB, Dismuke CE, Dooley M .
Effect of an evidence-based inpatient tobacco dependence treatment service on 1-year postdischarge health care costs.
Med Care 2018 Oct;56(10):883-89. doi: 10.1097/mlr.0000000000000979..
Keywords: Healthcare Costs, Inpatient Care, Screening, Substance Abuse, Tobacco Use: Smoking Cessation
Lee SC, Higashi RT, Sanders JM
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Effects of geographic program expansion to rural areas on mammogram screening program outcomes are understudied. The authors of this study sought to determine whether time-to-resolution (TTR) varied significantly by service delivery time period, location, and participant characteristics across 19 North Texas counties.
AHRQ-funded; HS022418.
Citation: Lee SC, Higashi RT, Sanders JM .
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Cancer Causes Control 2018 Oct;29(10):995-1005. doi: 10.1007/s10552-018-1074-4..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women, Rural Health, Access to Care, Prevention
Symer MM, Yeo HL
Recent advances in the management of anal cancer.
The incidence of anal cancer is gradually increasing. This article discusses the epidemiology and pathogenesis of anal cancer, and the prevention of human papilloma virus (HPV) infection as an important management principle. Screening recommendations from various sources are reviewed, and the authors note that screening for individuals at risk of anal cancer should include anal cytology and anoscopy. Current treatments and special cases are also reviewed; the authors conclude that treatments such biological therapies, therapeutic vaccination, and immunotherapy are likely to improve outcomes in patients with anal cancer.
AHRQ-funded; HS000066.
Citation: Symer MM, Yeo HL .
Recent advances in the management of anal cancer.
F1000Res 2018 Sep 28;7. doi: 10.12688/f1000research.14518.1..
Keywords: Cancer, Care Management, Diagnostic Safety and Quality, Screening
Tracer H, Jadotte YT
AHRQ Author: Tracer H
Screening for cardiovascular disease risk with electrocardiography.
This paper presents a case study, along with questions and answers, related to the U.S. Preventive Services Task Force (USPSTF) recommendations for screening for cardiovascular disease risk with electrocardiography.
AHRQ-authored.
Citation: Tracer H, Jadotte YT .
Screening for cardiovascular disease risk with electrocardiography.
Am Fam Physician 2018 Sep 15;98(6):375-76..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Screening, Risk, Prevention, Guidelines, Evidence-Based Practice, Case Study
Predmore Z, Pannikottu J, Sharma R
Factors associated with the overuse of colorectal cancer screening: a systematic review.
The purpose of this systematic review was to examine factors associated with overuse of colorectal cancer (CRC) screening, using studies that were in English, used a U.S. population, and contained original data. The review indicates that overuse of CRC screening was greater in the Northeast/Mid-Atlantic regions and in urban areas, but was lower in academically affiliated centers. The authors conclude that, although the literature supports important overuse of CRC screening, what drives these practices remains unclear and that future research should explore these factors thoroughly.
AHRQ-funded; HS000029.
Citation: Predmore Z, Pannikottu J, Sharma R .
Factors associated with the overuse of colorectal cancer screening: a systematic review.
Am J Med Qual 2018 Sep/Oct;33(5):472-80. doi: 10.1177/1062860618764302..
Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Prevention, Screening
Kim JJ, Burger EA, Regan C
Screening for cervical cancer in primary care: a decision analysis for the US Preventive Services Task Force.
The purpose of this study was to inform the US Preventive Services Task Force by modeling the benefits and harms of various cervical cancer screening strategies. In this microsimulation modeling study, it was estimated that primary hrHPV screening may represent a reasonable balance of harms and benefits when performed every 5 years. Switching from cytology to hrHPV testing at age 30 years yielded the most efficient harm to benefit ratio when using colposcopy as a proxy for harms.
AHRQ-funded; 290-2012-00015-I.
Citation: Kim JJ, Burger EA, Regan C .
Screening for cervical cancer in primary care: a decision analysis for the US Preventive Services Task Force.
JAMA 2018 Aug 21;320(7):706-14. doi: 10.1001/jama.2017.19872..
Keywords: Cancer: Cervical Cancer, Shared Decision Making, Primary Care, Screening, U.S. Preventive Services Task Force (USPSTF)
Melnikow J, Henderson JT, Burda BU J, Henderson JT, Burda BU
Screening for cervical cancer with high-risk human papillomavirus testing: updated evidence report and systematic review for the US Preventive Services Task Force.
Cervical cancer can be prevented with detection and treatment of precancerous cell changes caused primarily by high-risk types of human papillomavirus (hrHPV), the causative agents in more than 90% of cervical cancers. The objective of this study was to systematically review benefits and harms of cervical cancer screening for hrHPV to inform the US Preventive Services Task Force.
AHRQ-funded; 290201200015I.
Citation: Melnikow J, Henderson JT, Burda BU J, Henderson JT, Burda BU .
Screening for cervical cancer with high-risk human papillomavirus testing: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2018 Aug 21;320(7):687-705. doi: 10.1001/jama.2018.10400..
Keywords: Cancer: Cervical Cancer, Evidence-Based Practice, Infectious Diseases, Screening, U.S. Preventive Services Task Force (USPSTF)
Jonas DE, Kahwati LC, Yun JDY
Screening for atrial fibrillation with electrocardiography: evidence report and systematic review for the US Preventive Services Task Force.
The objective of this study was to review the evidence on screening for nonvalvular atrial fibrillation with electrocardiography (ECG) and stroke prevention treatment in asymptomatic adults 65 years or older to inform the US Preventive Services Task Force. The authors concluded that although screening with ECG can detect previously unknown cases of atrial fibrillation, it has not been shown to detect more cases than screening focused on pulse palpation.
AHRQ-funded; 290201500011I.
Citation: Jonas DE, Kahwati LC, Yun JDY .
Screening for atrial fibrillation with electrocardiography: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2018 Aug 7;320(5):485-98. doi: 10.1001/jama.2018.4190..
Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Screening, Evidence-Based Practice, Guidelines, Prevention
Shaker M, Stukus D, Chan ES
"To screen or not to screen": comparing the health and economic benefits of early peanut introduction strategies in five countries.
This study compared the costs and benefits of early peanut introduction (EPI) using data from five countries: US, Canada, Australia, New Zealand and United Kingdom. Per child it was more expensive to provide early screening for all children with early-onset eczema and/or egg allergy than to have a “wait and see” approach. While there would be more peanut allergy diagnosis with early screening, the increased costs were too great compared to the no-screening approach.
AHRQ-funded; HS024599.
Citation: Shaker M, Stukus D, Chan ES .
"To screen or not to screen": comparing the health and economic benefits of early peanut introduction strategies in five countries.
Allergy 2018 Aug;73(8):1707-14. doi: 10.1111/all.13446..
Keywords: Children/Adolescents, Screening, Diagnostic Safety and Quality, Healthcare Costs, Medication, Medication
Srivatsan S, Guduguntla V, Young KZ
Clinical versus patient-reported measures of depression in bariatric surgery.
This study examined the relationship between traditional clinical screening tools and a novel patient-reported depression screening survey, Patient Health Questionnaire 8 (PHQ-8), in the setting of the bariatric surgery preoperative assessment. The researchers found a higher rate of clinically diagnosed depression in their cohort compared to the general population. However, when using the validated PHQ-8 survey, the rate of depression more closely approximated the national incidence.
AHRQ-funded; HS023621; HS024403.
Citation: Srivatsan S, Guduguntla V, Young KZ .
Clinical versus patient-reported measures of depression in bariatric surgery.
Surg Endosc 2018 Aug;32(8):3683-90. doi: 10.1007/s00464-018-6101-8..
Keywords: Depression, Patient Safety, Screening, Surgery
Roth JA, Carter-Harris L, Brandzel S
A qualitative study exploring patient motivations for screening for lung cancer.
The purpose of this qualitative study was to explore the motivations for screening-eligible patients to screen for lung cancer. The investigators concluded that participants in their study were primarily motivated to screen for lung cancer based on perceived benefit of early-detection, absence of safety concerns, and personal relationships. They suggest that their findings can potentially be used to improve lung cancer screening uptake and shared decision-making processes.
AHRQ-funded; HS022982.
Citation: Roth JA, Carter-Harris L, Brandzel S .
A qualitative study exploring patient motivations for screening for lung cancer.
PLoS One 2018 Jul 5;13(7):e0196758. doi: 10.1371/journal.pone.0196758..
Keywords: Cancer: Lung Cancer, Shared Decision Making, Healthcare Utilization, Screening
Davies L, Petitti DB, Martin L
Defining, estimating, and communicating overdiagnosis in cancer screening.
Overdiagnosis represents one harm of too much medicine, but the concept can be confusing. Because the U.S. Preventive Services Task Force (USPSTF) issues screening recommendations aimed largely at healthy persons, it has a particular interest in understanding harms related to screening, especially but not limited to overdiagnosis. In support of the USPSTF, the authors summarize the knowledge and provide guidance on defining, estimating, and communicating overdiagnosis in cancer screening.
AHRQ-funded; 290201200015I; 290201600006C.
Citation: Davies L, Petitti DB, Martin L .
Defining, estimating, and communicating overdiagnosis in cancer screening.
Ann Intern Med 2018 Jul 3;169(1):36-43. doi: 10.7326/m18-0694..
Keywords: Cancer, Communication, Diagnostic Safety and Quality, Screening, U.S. Preventive Services Task Force (USPSTF)
Lewis CL, Kistler CE, Dalton AF
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
The purpose of this study was to test a patient decision aid (PtDA) to promote CRC screening in older adults. The PtDA was designed to facilitate individual decision-making to help patients understand the potential risks and benefit of CRC screening. 424 patients aged 70 – 84 who were not up to date with CRC screening participated in a double-blinded randomized controlled trial, using the PtDA or an attention control. Two outcomes - appropriate CRC screening behavior at 6 months following the initial visit or appropriate screening intent immediately after the visit - were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, or no screening or intent for patients in poor health. Appropriate screening behavior at 6 months was higher in the intervention group; appropriate screening intent following the provider visit was also higher. The authors conclude that the PtDA for older adults promoted appropriate CRC screening behavior.
AHRQ-funded; HS021133.
Citation: Lewis CL, Kistler CE, Dalton AF .
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
Med Decis Making 2018 Jul;38(5):614-24. doi: 10.1177/0272989x18773713..
Keywords: Cancer, Cancer: Colorectal Cancer, Shared Decision Making, Education: Patient and Caregiver, Elderly, Prevention, Screening