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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
101 to 125 of 163 Research Studies DisplayedFrasier LL, Leverson G, Gosain A
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
This study was designed to investigate outcomes for adults undergoing laparoscopic surgery vs. open Ladd’s repair for malrotation. It found no significant differences in complication rates, need for re-operation, or symptom resolution. There was a statistically significant decrease in length of stay following laparoscopy compared to open surgery.
AHRQ-funded; HS022403.
Citation: Frasier LL, Leverson G, Gosain A .
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
Surg Endosc 2015 Jun;29(6):1598-604. doi: 10.1007/s00464-014-3849-3..
Keywords: Surgery, Outcomes, Patient-Centered Outcomes Research, Adverse Events, Comparative Effectiveness
Schmittdiel JA, Desai J, Schroeder EB
Methods for engaging stakeholders in comparative effectiveness research: a patient-centered approach to improving diabetes care.
This article presents ways to engage stakeholders in comparative effectiveness research, including patient community surveys, stakeholder meetings with substantial patient representation, and patient stakeholder deciding votes in selecting pilot research topics. Researchers and health care leaders should continue to develop best-practices and strategies for increasing patient involvement in comparative effectiveness and delivery science research.
AHRQ-funded; HS022963; HS019859.
Citation: Schmittdiel JA, Desai J, Schroeder EB .
Methods for engaging stakeholders in comparative effectiveness research: a patient-centered approach to improving diabetes care.
Healthc (Amst) 2015 Jun;3(2):80-8. doi: 10.1016/j.hjdsi.2015.02.005.
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Keywords: Comparative Effectiveness, Diabetes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement
Pruitt SL, Lee SJ, Tiro JA
Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009.
The authors investigated whether residential segregation was associated with mortality among urban women with breast cancer. They found that greater black segregation and Hispanic segregation were adversely associated with cause-specific mortality and all-cause mortality.
AHRQ-funded; HS022418.
Citation: Pruitt SL, Lee SJ, Tiro JA .
Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009.
Cancer 2015 Jun 1;121(11):1845-55. doi: 10.1002/cncr.29282..
Keywords: Cancer: Breast Cancer, Mortality, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Urban Health
Yun H, Xie F, Delzell E
Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy.
The researchers compare the subsequent risk of hospitalized infections associated with specific biologic agents among RA patients previously hospitalized for infection while receiving anti-tumor necrosis factor (anti-TNF) therapy. They found that among rheumatoid arthritis patients who experienced a hospitalized infection while on anti-TNF therapy, abatacept and etanercept were associated with the lowest risk of a subsequent infection compared to other biologic therapies.
AHRQ-funded; HS021694; HS023009; HS018517.
Citation: Yun H, Xie F, Delzell E .
Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy.
Ann Rheum Dis 2015 Jun;74(6):1065-71. doi: 10.1136/annrheumdis-2013-204011..
Keywords: Arthritis, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Patient Safety
Whicher D, Kass N, Faden R
Stakeholders' views of alternatives to prospective informed consent for minimal-risk pragmatic comparative effectiveness trials.
This paper reports on interviews with Institutional Review Board members and researchers and on focus groups with patients from Geisinger and Johns Hopkins health systems, with the objective of eliciting participants' views of the acceptability of four different disclosure and authorization models for low-risk pragmatic comparative effectiveness trials of widely-used therapies. Results suggested that many participants believed that it was acceptable to streamline information disclosure and to use an opt-out process for eligible individuals who would prefer not to participate.
AHRQ-funded; HS021064.
Citation: Whicher D, Kass N, Faden R .
Stakeholders' views of alternatives to prospective informed consent for minimal-risk pragmatic comparative effectiveness trials.
J Law Med Ethics 2015 Summer;43(2):397-409. doi: 10.1111/jlme.12256.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Resnick MJ, Barocas DA, Morgans AK
The evolution of self-reported urinary and sexual dysfunction over the last two decades: implications for comparative effectiveness research.
This study evaluated differences in pretreatment urinary and sexual function in two population-based cohorts of men with prostate cancer enrolled nearly 20 yrs. apart. It concluded that reporting of pretreatment urinary incontinence and erectile dysfunction has increased over the past two decades. These findings may reflect sociological changes including heightened media attention and direct-to-consumer marketing, among other potential explanations.
AHRQ-funded; HS019356; HS022640; HS022990.
Citation: Resnick MJ, Barocas DA, Morgans AK .
The evolution of self-reported urinary and sexual dysfunction over the last two decades: implications for comparative effectiveness research.
Eur Urol 2015 Jun;67(6):1019-25. doi: 10.1016/j.eururo.2014.08.035..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer, Cancer: Prostate Cancer, Sexual Health
Gibbons MB, Thompson SM, Mack RA
The relation of baseline skills to psychotherapy outcome across diverse psychotherapies.
The researchers explored the role of baseline skills deficits in compensatory skills and self-understanding across both cognitive and dynamic treatment modalities. Their results support a capitalization model for cognitive therapy but failed to support either a compensation model or a capitalization model for the short-term dynamic model.
AHRQ-funded; HS022124.
Citation: Gibbons MB, Thompson SM, Mack RA .
The relation of baseline skills to psychotherapy outcome across diverse psychotherapies.
J Clin Psychol 2015 Jun;71(6):491-9. doi: 10.1002/jclp.22165..
Keywords: Comparative Effectiveness, Depression, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Huo J, Du XL, Lairson DR
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
The authors examined the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end-of-life care for patients diagnosed with metastatic melanoma. They found that surgery and hospice care use increased over the 8 years of this study, whereas the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.
AHRQ-funded; HS018956.
Citation: Huo J, Du XL, Lairson DR .
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
Am J Clin Oncol 2015 Jun;38(3):235-41. doi: 10.1097/COC.0b013e31829378f9.
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Keywords: Cancer, Cancer: Skin Cancer, Treatments, Elderly, Healthcare Utilization, Palliative Care, Patient-Centered Outcomes Research, Surgery
Khalil D, Boktor M, Mortensen EM
Comparison of frequency of inflammatory bowel disease and noninfectious gastroenteritis among statin users versus nonusers.
The objective of this study was to examine the association of statin use on the prevalence of IBD and noninfectious gastroenteritis (NI-GE) in a cohort of patients who were followed longitudinally in a military health care system, where patients had similar access and availability of health care. It found that statin use was not associated with either an increased or decreased risk of IBD or NI-GE diagnoses.
AHRQ-funded; HS022418.
Citation: Khalil D, Boktor M, Mortensen EM .
Comparison of frequency of inflammatory bowel disease and noninfectious gastroenteritis among statin users versus nonusers.
Am J Cardiol 2015 May 15;115(10):1396-401. doi: 10.1016/j.amjcard.2015.02.035..
Keywords: Digestive Disease and Health, Patient-Centered Outcomes Research, Risk, Medication, Cardiovascular Conditions
Singh JA, Akhras KS, Shiozawa A
Comparative effectiveness of urate lowering with febuxostat versus allopurinol in gout: analyses from large U.S. managed care cohort.
The researchers sought to assess the comparative effectiveness of febuxostat and allopurinol in reducing serum urate (sUA) levels in a real-world U.S. managed care setting. It concluded that febuxostat was more effective than allopurinol at the currently used doses in lowering sUA in gout patients as demonstrated by post-index mean sUA level, the likelihood of and the time to achieving sUA goals.
AHRQ-funded; HS021110.
Citation: Singh JA, Akhras KS, Shiozawa A .
Comparative effectiveness of urate lowering with febuxostat versus allopurinol in gout: analyses from large U.S. managed care cohort.
Arthritis Res Ther 2015 May 12;17(1):120. doi: 10.1186/s13075-015-0624-3..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Medication, Treatments
Rao SS, Benninga MA, Bharucha AE
ANMS-ESNM position paper and consensus guidelines on biofeedback therapy for anorectal disorders.
This society position paper examined the study performance characteristics and efficacy of biofeedback therapy for anorectal disorders, and provided evidence based recommendations including: (1) Biofeedback therapy is recommended for the short-term and long-term treatment of constipation with dyssynergic defecation (DD). Level I, Grade A. (2)Biofeedback therapy is recommended for the short-term and long-term treatment of Fecal Incontinence (FI). Level II, Grade B.
AHRQ-funded; HS018695.
Citation: Rao SS, Benninga MA, Bharucha AE .
ANMS-ESNM position paper and consensus guidelines on biofeedback therapy for anorectal disorders.
Neurogastroenterol Motil 2015 May;27(5):594-609. doi: 10.1111/nmo.12520..
Keywords: Elderly, Comparative Effectiveness, Patient-Centered Outcomes Research
Rothberg MB, Zilberberg MD, Pekow PS
Association of guideline-based antimicrobial therapy and outcomes in healthcare-associated pneumonia.
The study objective was to examine the association between guideline-based therapy (GBT) and outcomes for patients with healthcare associated pneumonia (HCAP). It found that among patients who met HCAP criteria, GBT was not associated with lower adjusted mortality, length of stay or costs in any analyses.
AHRQ-funded; HS018723.
Citation: Rothberg MB, Zilberberg MD, Pekow PS .
Association of guideline-based antimicrobial therapy and outcomes in healthcare-associated pneumonia.
J Antimicrob Chemother 2015 May;70(5):1573-9. doi: 10.1093/jac/dku533..
Keywords: Patient-Centered Outcomes Research, Healthcare-Associated Infections (HAIs), Antimicrobial Stewardship, Comparative Effectiveness
Holmqvist F, Simon D, Steinberg BA
Catheter ablation of atrial fibrillation in U.S. community practice--results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF).
The objective of the study was to describe the utilization of catheter ablation in a contemporary U.S. clinical practice and describe the characteristics and subsequent outcomes in patients undergoing AF ablation in community practice. It found that there were no clinically relevant differences in oral anticoagulation post-AF ablation or differences in outcomes in patients with or without previous AF catheter ablation.
AHRQ-funded; HS021092.
Citation: Holmqvist F, Simon D, Steinberg BA .
Catheter ablation of atrial fibrillation in U.S. community practice--results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF).
J Am Heart Assoc 2015 May;4(5):e001901. doi: 10.1161/jaha.115.001901..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Registries, Evidence-Based Practice
Singh JA, Ramachandran R
Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US?
The researchers assessed the association of hospital procedure volume for total shoulder arthroplasty (TSA) with patient outcomes and complications. They found that, compared to low volume hospitals (<5, 5–9, or 10–14 procedures annually), patients receiving TSA at higher volume hospitals (15–24 or ‡25 procedures annually) had significantly lower likelihood of being discharged to an inpatient medical facility.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandran R .
Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US?
Arthritis Care Res 2015 May;67(6):885-90. doi: 10.1002/acr.22507..
Keywords: Patient-Centered Outcomes Research, Adverse Events, Patient Safety, Quality of Care, Healthcare Cost and Utilization Project (HCUP)
O'Brien EC, Kim S, Hess PL
Effect of the 2014 atrial fibrillation guideline revisions on the proportion of patients recommended for oral anticoagulation.
Researchers assessed the potential effect of a new guideline for atrial fibrillation (AF) by comparing the proportion of patients with AF recommended for oral anticoagulation (OAC) under the 2011 and 2014 guidelines. They found that two-thirds of patients with AF who were previously not recommended for OAC are newly recommended under the 2014 guideline. They advised future studies evaluating longitudinal changes in anticoagulation treatment patterns and outcomes among patients reclassified by the new guidelines.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Kim S, Hess PL .
Effect of the 2014 atrial fibrillation guideline revisions on the proportion of patients recommended for oral anticoagulation.
JAMA Intern Med 2015 May;175(5):848-50. doi: 10.1001/jamainternmed.2015.13.
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Keywords: Heart Disease and Health, Blood Thinners, Guidelines, Medication, Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research
Westover AN, Nakonezny PA, Barlow CE
Exercise outcomes in prevalent users of stimulant medications.
This study compared prevalent stimulant medication users to matched nonusers undergoing a maximal treadmill test for differences in peak systolic blood pressure, average rise in SBP during exercise, peak heart rate (HR), and aerobic exercise capacity. It found that stimulant use was associated with a decreased peak HR as well as an increased risk of chronotropic incompetence.
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Barlow CE .
Exercise outcomes in prevalent users of stimulant medications.
J Psychiatr Res 2015 May;64:32-9. doi: 10.1016/j.jpsychires.2015.03.011.
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Keywords: Medication, Substance Abuse, Patient-Centered Outcomes Research
Yun H, Delzell E, Saag KG
Fractures and mortality in relation to different osteoporosis treatments.
The researchers aimed to determine if fracture and mortality rates vary among patients initiating different osteoporosis medications. They found that IV ibandronate and calcitonin were associated with higher rates of some types of fracture when compared to IV zolendronic acid. The relatively high mortality associated with use of calcitonin may reflect the poorer health of users of this agent.
AHRQ-funded; HS018517.
Citation: Yun H, Delzell E, Saag KG .
Fractures and mortality in relation to different osteoporosis treatments.
Clin Exp Rheumatol 2015 May-Jun;33(3):302-9..
Keywords: Osteoporosis, Medication, Comparative Effectiveness, Patient-Centered Outcomes Research
Zhang J, Xie F, Delzell E
Impact of biologic agents with and without concomitant methotrexate and at reduced doses in older rheumatoid arthritis patients.
The purpose of this study was to examine whether concomitant methotrexate (MTX) use is associated with better biologic persistence and whether self-administered anti–tumor necrosis factor (anti-TNF) therapies are used at reduced doses in real world clinical care settings, not just clinical trials. It found that use of concomitant MTX is associated with greater persistence to biologic therapy.
AHRQ-funded; HS018517.
Citation: Zhang J, Xie F, Delzell E .
Impact of biologic agents with and without concomitant methotrexate and at reduced doses in older rheumatoid arthritis patients.
Arthritis Care Res 2015 May;67(5):624-32. doi: 10.1002/acr.22510..
Keywords: Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research, Treatments
Goldberger ZD, Nallamothu BK, Nichol G
Policies allowing family presence during resuscitation and patterns of care during in-hospital cardiac arrest.
A growing number of hospitals have begun to implement policies allowing for family presence during resuscitation (FPDR). However, the overall safety of these policies and their effect on resuscitation care is unknown. This study suggests that hospitals with an FPDR policy generally have no statistically significant differences in outcomes and processes of care as hospitals without this policy.
AHRQ-funded; HS020672.
Citation: Goldberger ZD, Nallamothu BK, Nichol G .
Policies allowing family presence during resuscitation and patterns of care during in-hospital cardiac arrest.
Circ Cardiovasc Qual Outcomes 2015 May;8(3):226-34. doi: 10.1161/circoutcomes.114.001272..
Keywords: Cardiovascular Conditions, Patient Safety, Patient-Centered Outcomes Research, Inpatient Care
Vazquez-Benitez G, Desai JR, Xu S
Preventable major cardiovascular events associated with uncontrolled glucose, blood pressure, and lipids and active smoking in adults with diabetes with and without cardiovascular disease: a contemporary analysis.
The objective of this study was to assess the incidence of major cardiovascular (CV) hospitalization events and all-cause deaths among adults with diabetes with or without CV disease (CVD) associated with inadequately controlled glycated hemoglobin, high LDL cholesterol, high blood pressure, and current smoking. It found that the percentages of CV events associated with inadequate risk factor control were 11 percent for those with CVD and 34 percent for those without CVD.
AHRQ-funded; HS019859.
Citation: Vazquez-Benitez G, Desai JR, Xu S .
Preventable major cardiovascular events associated with uncontrolled glucose, blood pressure, and lipids and active smoking in adults with diabetes with and without cardiovascular disease: a contemporary analysis.
Diabetes Care 2015 May;38(5):905-12. doi: 10.2337/dc14-1877..
Keywords: Diabetes, Cardiovascular Conditions, Risk, Patient-Centered Outcomes Research
Scheck McAlearney A, Hefner J, Robbins J
AHRQ Author: Harrison MI
Preventing central line-associated bloodstream infections: a qualitative study of management practices.
This study identified factors that may explain hospital-level differences in outcomes of programs to prevent central line–associated bloodstream infections. A main theme that differentiated higher- from lower-performing hospitals was a distinctive framing of the goal of “getting to zero” infections. Five additional management practices were nearly exclusively present in the higher-performing hospitals: (1) top-level commitment, (2) physician-nurse alignment, (3) systematic education, (4) meaningful use of data, and (5) rewards and recognition.
AHRQ-authored; AHRQ-funded; 290200600022.
Citation: Scheck McAlearney A, Hefner J, Robbins J .
Preventing central line-associated bloodstream infections: a qualitative study of management practices.
Infect Control Hosp Epidemiol 2015 May;36(5):557-63. doi: 10.1017/ice.2015.27..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Prevention
Yun H, Xie F, Delzell E
Risks of herpes zoster in patients with rheumatoid arthritis according to biologic disease-modifying therapy.
This study evaluated whether the risks of herpes zoster (HZ) differed by biologic agents with different mechanisms of action (MOAs) in older rheumatoid arthritis (RA) patients. Using Medicare data from 2006–2011, the researchers found that among RA patients, the rate and adjusted hazard ratios of HZ were similar among biologic agents, including those with non–tumor necrosis factor mechanisms of action.
AHRQ-funded; HS021694; HS018517.
Citation: Yun H, Xie F, Delzell E .
Risks of herpes zoster in patients with rheumatoid arthritis according to biologic disease-modifying therapy.
Arthritis Care Res 2015 May;67(5):731-6. doi: 10.1002/acr.22470..
Keywords: Arthritis, Risk, Patient Safety, Patient-Centered Outcomes Research
Wang X, Du XL
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
The researchers assessed socio-demographic, geographic, and other variations in the receipt of hormone therapy among patients with hormone receptor-positive breast cancer as well as adherence to hormone therapy within 1-year follow-up. They found that found that increasing age was significantly associated with a decreased receipt of hormone therapy and aromatase inhibitors in all hormone receptor-positive breast cancer patients after adjusting for other factors regardless of whether chemotherapy was received.
AHRQ-funded; HS018956.
Citation: Wang X, Du XL .
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
Med Oncol 2015 May;32(5):154. doi: 10.1007/s12032-015-0599-6..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Determinants of Health
Kumamaru H, Jalbert JJ, Nguyen LL
Surgeon case volume and 30-day mortality after carotid endarterectomy among contemporary medicare beneficiaries: before and after national coverage determination for carotid artery stenting.
The objective of this study is to examine the decline in past-year case-volumes of surgeons performing carotid endarterectomy (CEA) before and after the National Coverage Determination (NCD) for carotid artery stenting (CAS) and to assess its effect on 30-day post-CEA mortality. It found that the rate of CEA procedures decreased substantially during 2001 to 2008. The postprocedural mortality in Medicare beneficiaries was high compared with trial patients.
AHRQ-funded; 29020050016I.
Citation: Kumamaru H, Jalbert JJ, Nguyen LL .
Surgeon case volume and 30-day mortality after carotid endarterectomy among contemporary medicare beneficiaries: before and after national coverage determination for carotid artery stenting.
Stroke 2015 May;46(5):1288-94. doi: 10.1161/strokeaha.114.006276..
Keywords: Surgery, Mortality, Patient-Centered Outcomes Research, Outcomes, Elderly
Cross RK, Jambaulikar G, Langenberg P
TELEmedicine for Patients with Inflammatory Bowel Disease (TELE-IBD): design and implementation of randomized clinical trial.
This study compares disease activity and quality of life over 1 year in a randomized trial of IBD patients receiving standard care versus telemedicine. If effective, telemedicine should decrease symptoms, improve quality of life, and decrease health care utilization. The burden associated with use of telemedicine for patients and providers needs to be assessed. This trial is ongoing and will be completed in July 2016.
AHRQ-funded; HS018975.
Citation: Cross RK, Jambaulikar G, Langenberg P .
TELEmedicine for Patients with Inflammatory Bowel Disease (TELE-IBD): design and implementation of randomized clinical trial.
Contemp Clin Trials 2015 May;42:132-44. doi: 10.1016/j.cct.2015.03.006..
Keywords: Comparative Effectiveness, Digestive Disease and Health, Health Information Technology (HIT), Patient-Centered Outcomes Research, Telehealth