National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Cancer (16)
- Cancer: Colorectal Cancer (2)
- Cancer: Lung Cancer (1)
- (-) Cancer: Prostate Cancer (23)
- Care Management (2)
- Colonoscopy (1)
- Comparative Effectiveness (3)
- Dementia (1)
- Diabetes (1)
- Diagnostic Safety and Quality (2)
- Disparities (2)
- Elderly (3)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (5)
- Guidelines (2)
- Healthcare Costs (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
- Imaging (3)
- Medication (2)
- Men's Health (7)
- Mortality (1)
- Outcomes (4)
- Patient-Centered Outcomes Research (6)
- Practice Patterns (2)
- Prevention (1)
- Quality Indicators (QIs) (1)
- Quality of Life (4)
- Racial and Ethnic Minorities (2)
- Registries (1)
- Research Methodologies (1)
- Risk (3)
- Screening (4)
- Sexual Health (2)
- Shared Decision Making (3)
- Surgery (3)
- Treatments (2)
- U.S. Preventive Services Task Force (USPSTF) (1)
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 23 of 23 Research Studies DisplayedChapman CH, Caram MEV, Radhakrishnan A
Association between PSA values and surveillance quality after prostate cancer surgery.
This study examined the association between PSA values and posttreatment surveillance after prostate cancer surgery. Normally the treatment cutoff rate is 0.2 ng/mL but 4.0 ng/mL may be more appropriate. Data from the US Veterans Health Administration was used to perform a retrospective longitudinal cohort study for men diagnosed with nonmetastatic prostate cancer from 2005 to 2008 who underwent radical prostatectomy. Guideline concordance was high at year 1 (95%) but decreased to 79% in year 7. After adjustment, guideline concordance was lowered for the youngest and oldest, Black, and unmarried men.
AHRQ-funded; HS018726.
Citation: Chapman CH, Caram MEV, Radhakrishnan A .
Association between PSA values and surveillance quality after prostate cancer surgery.
Cancer Med 2019 Dec;8(18):7903-12. doi: 10.1002/cam4.2663..
Keywords: Cancer: Prostate Cancer, Cancer, Surgery, Screening, Guidelines, Prevention, Evidence-Based Practice
Mullins BT, Basak R, Broughman JR
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
This study compares the effects of different types of radical prostatectomy and radiotherapy on sexual function. A population-based cohort of 835 men with newly diagnosed prostate cancer from 2011 through 2013 was recruited in collaboration with the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry. They were enrolled prior to treatment and followed retrospectively using the validated Prostate Cancer Symptom Indices (PCSI) instrument. The sexual function scores were compared among patients who received the following treatment types: external-beam RT (EBRT), EBRT with androgen deprivation therapy (ADT), brachytherapy, nerve-sparing radical prostatectomy (RP), and non-nerve-sparing RP. The cohort was surveyed at 24 months post-therapy, and RT alone was found to result in the best preservation of sexual function with brachytherapy, RT with ADT, and nerve-sparing RP yielding similar outcomes. Patients treated with non-nerve-sparing RP experienced the worst sexual function outcome.
AHRQ-funded.
Citation: Mullins BT, Basak R, Broughman JR .
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
Cancer 2019 Oct 15;125(20):3657-65. doi: 10.1002/cncr.32288..
Keywords: Quality of Life, Sexual Health, Surgery, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Cancer: Prostate Cancer, Cancer, Evidence-Based Practice
Modi PK, Kaufman SR, Herrel LA
Practice-level adoption of conservative management for prostate cancer.
In this study, the authors describe the longitudinal adoption of conservative management (ie, the absence of treatment) for prostate cancer among urology group practices in the United States and identify group practice features that influence this adoption. The investigators found that there was increasing variation among group practices in the use of conservative management for prostate cancer. They indicated that this underscores the need for a better understanding of practice-level factors that influence prostate cancer management.
AHRQ-funded; HS025707.
Citation: Modi PK, Kaufman SR, Herrel LA .
Practice-level adoption of conservative management for prostate cancer.
J Oncol Pract 2019 Oct;15(10):e863-e69. doi: 10.1200/jop.19.00088.
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Keywords: Cancer: Prostate Cancer, Cancer, Practice Patterns, Care Management
Caram MEV, Kaufman SR, Modi PK
Adoption of abiraterone and enzalutamide by urologists.
The purpose of this study was to investigate the adoption of abiraterone and enzalutamide by urologists. Abiraterone and enzalutamide are oral therapies approved for the treatment of metastatic castration-resistant prostate cancer, a disease most commonly treated by medical oncologists. The investigators found that urologists are increasingly prescribing oral therapies for metastatic castration-resistant prostate cancer. They suggest that understanding the distribution of urologists specializing in castration-resistant prostate cancer therapeutics will help guide future interventions to optimize the care for this important patient population.
AHRQ-funded; HS025707.
Citation: Caram MEV, Kaufman SR, Modi PK .
Adoption of abiraterone and enzalutamide by urologists.
Urology 2019 Sep;131:176-83. doi: 10.1016/j.urology.2019.05.012..
Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Medication, Men's Health
Cedars B, Lisker S, Borno HT
An electronic registry to improve adherence to active surveillance monitoring among men with prostate cancer at a safety-net hospital: protocol for a pilot study.
The goal of this study was to assess the efficacy and feasibility of a health information technology registry for men on active surveillance at a safety-net hospital to ensure patients receive guideline-recommended care. Use of a customized electronic approach for monitoring men on active surveillance could improve patient outcomes. It may help reduce the number of men lost to follow-up and improve adherence to timely follow-up testing.
AHRQ-funded; HS023558.
Citation: Cedars B, Lisker S, Borno HT .
An electronic registry to improve adherence to active surveillance monitoring among men with prostate cancer at a safety-net hospital: protocol for a pilot study.
Pilot Feasibility Stud 2019 Aug 14;5:101. doi: 10.1186/s40814-019-0482-x..
Keywords: Cancer, Cancer: Prostate Cancer, Health Information Technology (HIT), Men's Health, Registries
Ankerst DP, Goros M, Tomlins SA
Incorporation of urinary prostate cancer antigen 3 and TMPRSS2:ERG into Prostate Cancer Prevention Trial Risk Calculator.
The objective of this study was to determine whether the incorporation of two urinary markers, prostate cancer antigen 3 (PCA3) and TMPRSS2:ERG (T2:ERG), into the Prostate Cancer Prevention Trial Risk Calculator (PCPTRC) tool improves its discrimination, accuracy, and clinical net benefit. A Bayesian modeling approach was used to combine data where the markers were measured in a Michigan cohort with the PCPTRC as prior probabilities to create an updated PCPTRC; this update was compared to the existing PCPTRC in terms of discrimination, calibration, and decision curve analysis. Net benefit was improved for the updated PCPTRC, but calibration was not. The authors note that, the updated PCPTRC is limited since it was based on two separate cohorts, and further validation is required. The updated tool is available online.
AHRQ-funded; HS024810.
Citation: Ankerst DP, Goros M, Tomlins SA .
Incorporation of urinary prostate cancer antigen 3 and TMPRSS2:ERG into Prostate Cancer Prevention Trial Risk Calculator.
Eur Urol Focus 2019 Jan;5(1):54-61. doi: 10.1016/j.euf.2018.01.010..
Keywords: Cancer, Cancer: Prostate Cancer, Men's Health, Risk
Modi PK, Herrel LA, Kaufman SR
Urologist practice structure and spending for prostate cancer care.
This study examined the impact of urologist practice structure on health care spending for men being treated for prostate cancer. Their hypothesis that spending would be lower for urologists in multispecialty group practices and higher for practices with intensity-modulated radiation therapy (IMRT) ownership. A sample of 35.929 men with newly diagnosed prostate cancer being treated by 6381 urologists was identified. The sample came from fee-for-service Medicare beneficiaries between 2011 and 2014. Their hypothesis was proven true with the lowest costs for men going to MSGs and significantly higher among practices with IMRT ownership.
AHRQ-funded; HS025707.
Citation: Modi PK, Herrel LA, Kaufman SR .
Urologist practice structure and spending for prostate cancer care.
Urology 2019 Aug;130:65-71. doi: 10.1016/j.urology.2019.03.029.
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Keywords: Cancer: Prostate Cancer, Cancer, Healthcare Costs, Men's Health
Jayadevappa R, Chhatre S, Malkowicz SB
Association between androgen deprivation therapy use and diagnosis of dementia in men with prostate cancer.
The purpose of this study was to analyze the association between androgen deprivation therapy (ADT) exposure and diagnosis of Alzheimer disease or dementia among elderly men with prostate cancer. Results showed that, among elderly patients with prostate cancer, ADT exposure was associated with subsequent diagnosis of Alzheimer disease or dementia over a follow-up period of at least 10 years.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S, Malkowicz SB .
Association between androgen deprivation therapy use and diagnosis of dementia in men with prostate cancer.
JAMA Netw Open 2019 Jul 3;2(7):e196562. doi: 10.1001/jamanetworkopen.2019.6562..
Keywords: Cancer, Cancer: Prostate Cancer, Dementia, Elderly, Men's Health, Risk
Kirk PS, Borza T, Caram MEV
Characterising potential bone scan overuse amongst men treated with radical prostatectomy.
The authors characterized bone scan use after radical prostatectomy (RP) using data from a large, national integrated delivery system. They found a substantial rate of bone scan utilization after RP. The majority were performed for prostate-specific antigen levels in which the likelihood of a positive test was low. They recommended more judicious use of imaging in the post-RP setting.
AHRQ-funded; HS025707.
Citation: Kirk PS, Borza T, Caram MEV .
Characterising potential bone scan overuse amongst men treated with radical prostatectomy.
BJU Int 2019 Jul;124(1):55-61. doi: 10.1111/bju.14551..
Keywords: Cancer: Prostate Cancer, Cancer, Surgery, Imaging, Healthcare Utilization
Gordon BE, Basak R, Carpenter WR
Factors influencing prostate cancer treatment decisions for African American and white men.
This prospective, population-based cohort study examined some possible reasons for mortality outcome differences for prostate cancer between African American (AA) and white patients. A cohort of 1170 men with nonmetastatic prostate cancer were enrolled from 2011 to 2013 before treatment in North Carolina. Participants were asked to rate their aggressiveness of their cancer, and also the importance of 10 factors their treatment decision-making process. Among low-risk patients, there was no difference in perception of their cancer as “not very aggressive”. Among high-risk patients, 54% of AA patients considered their cancer to be “not very aggressive” while only 24% of white patients did. For AA patients, cost, treatment time, and recovery time were considered very important more than white patients.
AHRQ-funded.
Citation: Gordon BE, Basak R, Carpenter WR .
Factors influencing prostate cancer treatment decisions for African American and white men.
Cancer 2019 May 15;125(10):1693-700. doi: 10.1002/cncr.31932..
Keywords: Shared Decision Making, Cancer, Cancer: Prostate Cancer, Disparities, Men's Health, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Crawford ED, Koo PJ, Shore N
A clinician's guide to next generation imaging in patients with advanced prostate cancer (RADAR III).
This paper reports on the convening of the Radiographic Assessments for Detection of Advanced Recurrence (RADAR III) Group to offer guidance on the use of next generation imaging to stage prostate cancer based on available data and clinical experience. The RADAR III Group recommends next generation imaging techniques in select patients in whom disease progression is suspected based on biomarker values, comorbidities and symptoms.
AHRQ-funded.
Citation: Crawford ED, Koo PJ, Shore N .
A clinician's guide to next generation imaging in patients with advanced prostate cancer (RADAR III).
J Urol 2019 Apr;201(4):682-92. doi: 10.1016/j.juro.2018.05.164..
Keywords: Men's Health, Cancer: Prostate Cancer, Cancer, Diagnostic Safety and Quality, Imaging, Evidence-Based Practice, Guidelines
Schmidt B, Eapen RS, Cowan JE
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
This study investigated usage of external-beam radiation therapy (EBRT), with or without neoadjuvant androgen deprivation therapy (ADT), using data from a community-based prospective disease registry (CaPSURE). Data on 1337 men diagnosed between 1990 and 2014 with localized disease who received EBRT as primary treatment was compared. The authors conclude that use of ADT in conjunction with primary EBRT has increased in frequency and duration since 1990, and that men who received ADT have higher risk characteristics than those who receive EBRT alone.
AHRQ-funded; HS019356.
Citation: Schmidt B, Eapen RS, Cowan JE .
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
Prostate Cancer Prostatic Dis 2019 Mar;22(1):117-24. doi: 10.1038/s41391-018-0084-3..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Practice Patterns, Evidence-Based Practice, Comparative Effectiveness, Outcomes, Treatments
Risko R, Merdan S, Womble PR
Clinical predictors and recommendations for staging computed tomography scan among men with prostate cancer.
This study identified clinical variables associated with a positive computed tomography (CT) scan and estimated the performance of imaging recommendations in patients with newly diagnosed prostate cancer. It found that implementation of criterion for CT imaging that includes PSA levels greater than 20, a Gleason score of 8 or higher, or locally advanced disease (interpreted as cT3/4) would ensure that CT scans are performed for almost all men who would test positive for metastases.
AHRQ-funded; HS018346
Citation: Risko R, Merdan S, Womble PR .
Clinical predictors and recommendations for staging computed tomography scan among men with prostate cancer.
Urology. 2014 Dec;84(6):1329-34. doi: 10.1016/j.urology.2014.07.051..
Keywords: Cancer: Prostate Cancer, Imaging
Roth JA, Ramsey SD, Carlson JJ
Cost-effectiveness of a biopsy-based 8-protein prostate cancer prognostic assay to optimize treatment decision making in Gleason 3 + 3 and 3 + 4 early stage prostate cancer.
A novel 8-protein prognostic assay generates a risk score at time of biopsy that is predictive of prostate cancer aggressiveness and can inform treatment decisions. The objective of this study was to evaluate the cost-effectiveness of using the assay to inform treatment decisions compared with usual care. The 8-protein assay strategy resulted in 0.04 more quality-adjusted life years and $700 less in costs compared with usual care.
AHRQ-funded; HS022982.
Citation: Roth JA, Ramsey SD, Carlson JJ .
Cost-effectiveness of a biopsy-based 8-protein prostate cancer prognostic assay to optimize treatment decision making in Gleason 3 + 3 and 3 + 4 early stage prostate cancer.
Oncologist 2015 Dec;20(12):1355-64. doi: 10.1634/theoncologist.2015-0214.
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Keywords: Cancer, Cancer: Prostate Cancer, Patient-Centered Outcomes Research, Healthcare Costs, Shared Decision Making
Morgans AK, van Bommel AC, Stowell C
Development of a standardized set of patient-centered outcomes for advanced prostate cancer: an international effort for a unified approach.
The International Consortium for Health Outcomes Measurement assembled a multidisciplinary working group to develop a standard set of outcomes relevant to men with advanced prostate cancer to follow during routine clinical care. The international multidisciplinary group identified clinical data and patient-reported outcome measures that serve as a basis for international health outcome comparisons and quality-of-care assessments. The set will be revised annually.
AHRQ-funded; HS022990.
Citation: Morgans AK, van Bommel AC, Stowell C .
Development of a standardized set of patient-centered outcomes for advanced prostate cancer: an international effort for a unified approach.
Eur Urol 2015 Nov;68(5):891-8. doi: 10.1016/j.eururo.2015.06.007.
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Keywords: Cancer: Prostate Cancer, Patient-Centered Outcomes Research, Quality of Life, Adverse Events, Quality Indicators (QIs)
Murphy DR, Wu L, Thomas EJ
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
The researchers tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer. They found that electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up.
AHRQ-funded; HS017820.
Citation: Murphy DR, Wu L, Thomas EJ .
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
J Clin Oncol 2015 Nov 1;33(31):3560-7. doi: 10.1200/jco.2015.61.1301..
Keywords: Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Cantor SB, Deshmukh AA, Krahn MD
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
The researchers sought to determine whether the forecasted assessment of how someone would feel in a future health state can be predictive of utilities (e.g. as elicited by the time-trade-off method) and also predictive of optimal decisions as determined by a decision-analytic model. They concluded that anticipated difficulty adjusting to adverse health effects were highly related to preferences and could be used as a proxy measure of utility.
AHRQ-funded; HS08992.
Citation: Cantor SB, Deshmukh AA, Krahn MD .
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
Health Expect 2015 Oct;18(5):1610-20. doi: 10.1111/hex.12150.
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Keywords: Shared Decision Making, Cancer: Prostate Cancer, Elderly, Quality of Life, Screening
Chhatre S, Malkowicz SB, Schwartz JS
Understanding the racial and ethnic differences in cost and mortality among advanced stage prostate cancer patients (STROBE).
The aims of the study were to understand the racial/ethnic differences in cost of care and mortality in Medicare elderly with advanced stage prostate cancer. It found that relationship between race/ethnicity, cost of care, and mortality is intricate. For non-Hispanic black men, disparity in mortality can be attributed to treatment differences.
AHRQ-funded; HS024106.
Citation: Chhatre S, Malkowicz SB, Schwartz JS .
Understanding the racial and ethnic differences in cost and mortality among advanced stage prostate cancer patients (STROBE).
Med Health 2015 Aug;94(32):e1353. doi: 10.1097/md.0000000000001353..
Keywords: Cancer: Prostate Cancer, Mortality, Racial and Ethnic Minorities, Elderly, Disparities
Tsai HT, Keating NL, Van Den Eeden SK
Risk of diabetes among patients receiving primary androgen deprivation therapy for clinically localized prostate cancer.
The researchers sought to determine if primary androgen deprivation therapy increases the risk of diabetes and to determine the susceptibility factors. They found that primary androgen deprivation therapy may increase diabetes risk by 60% and recommended using caution when managing localized prostate cancer. They further recommended routine screening and lifestyle interventions to reduce the risk of diabetes in men receiving androgen deprivation therapy.
AHRQ-funded; HS022915.
Citation: Tsai HT, Keating NL, Van Den Eeden SK .
Risk of diabetes among patients receiving primary androgen deprivation therapy for clinically localized prostate cancer.
J Urol 2015 Jun;193(6):1956-62. doi: 10.1016/j.juro.2014.12.027.
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Keywords: Adverse Drug Events (ADE), Diabetes, Medication, Cancer: Prostate Cancer, Risk
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
Elstad EA, Sutkowi-Hemstreet A, Sheridan SL
Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.
The researchers sought to understand clinicians’ perceptions of the benefits and harms of two screening tests (colonoscopy and prostate-specific antigen (PSA) testing) that differ in their balance of potential benefits and harms. Clinicians perceived PSA testing to have a greater likelihood of harm as well as a lower likelihood of lengthening life relative to colonoscopy.
AHRQ-funded; HS000032; HS021133
Citation: Elstad EA, Sutkowi-Hemstreet A, Sheridan SL .
Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.
Med Decis Making. 2015 May;35(4):467-76. doi: 10.1177/0272989x15569780..
Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Cancer: Prostate Cancer, Screening
Gilbert SM, Dunn RL, Wittmann D
Quality of life and satisfaction among prostate cancer patients followed in a dedicated survivorship clinic.
The researchers integrated quality of lifer (QOL) assessments into a prostate cancer survivorship clinic and compared recovery and satisfaction among men managed in the survivorship clinic with those followed with more routine care. They concluded that patient QOL and satisfaction were higher among men managed in a survivorship program.
AHRQ-funded; HS020927.
Citation: Gilbert SM, Dunn RL, Wittmann D .
Quality of life and satisfaction among prostate cancer patients followed in a dedicated survivorship clinic.
Cancer 2015 May 1;121(9):1484-91. doi: 10.1002/cncr.29215..
Keywords: Cancer: Prostate Cancer, Quality of Life, Outcomes, Cancer
DeFrank JT, Barclay C, Sheridan S
The psychological harms of screening: the evidence we have versus the evidence we need.
The study’s purpose was to understand the extent of evidence on psychological harms. The researchers reviewed 68 studies and developed an evidence map that quantifies the distribution of evidence on psychological harms for five adult screening services. They found that the evidence for psychological harms of screening is inadequate in number of studies and in research design and measures.
AHRQ-funded; HS021133.
Citation: DeFrank JT, Barclay C, Sheridan S .
The psychological harms of screening: the evidence we have versus the evidence we need.
J Gen Intern Med 2015 Feb;30(2):242-8. doi: 10.1007/s11606-014-2996-5..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Cancer: Prostate Cancer, Evidence-Based Practice, Research Methodologies