National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Arthritis (19)
- Children/Adolescents (1)
- Chronic Conditions (4)
- Comparative Effectiveness (6)
- Education (1)
- Elderly (1)
- Electronic Health Records (EHRs) (3)
- Evidence-Based Practice (4)
- Healthcare Costs (1)
- Health Information Technology (HIT) (3)
- Injuries and Wounds (2)
- Low-Income (1)
- Medication (7)
- Mortality (1)
- Opioids (1)
- Orthopedics (3)
- (-) Outcomes (19)
- Pain (5)
- Patient-Centered Outcomes Research (7)
- Quality Improvement (1)
- Quality Measures (3)
- Quality of Care (3)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Social Determinants of Health (2)
- Surgery (5)
- Telehealth (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 19 of 19 Research Studies DisplayedBingham CA, Harris JG, Qui T
Pediatric Rheumatology Care and Outcomes Improvement Network's quality measure set to improve care of children with juvenile idiopathic arthritis.
The objective of this study was to describe the selection, development, and implementation of quality measures for juvenile idiopathic arthritis (JIA) by the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN), a multihospital learning health network. Clinicians in PR-COIN and parents of children with JIA collaboratively selected outcome quality measures and a committee of rheumatologists and data analysts developed operational definitions. Initial measures were clinical inactive disease, low pain score, and optimal physical functioning; the revised set included additional measures of disease activity, data quality, and a balancing measure. The authors concluded that PR-COIN's set of JIA quality measures is the first comprehensive set used at the point-of-care for a large cohort of JIA patients in a variety of pediatric rheumatology practice settings.
AHRQ-funded; HS021114.
Citation: Bingham CA, Harris JG, Qui T .
Pediatric Rheumatology Care and Outcomes Improvement Network's quality measure set to improve care of children with juvenile idiopathic arthritis.
Arthritis Care Res 2023 Dec; 75(12):2442-52. doi: 10.1002/acr.25168.
Keywords: Children/Adolescents, Arthritis, Quality Measures, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Humbert-Droz M, Izadi Z, Schmajuk G
Development of a natural language processing system for extracting rheumatoid arthritis outcomes from clinical notes using the national rheumatology informatics system for effectiveness registry.
Researchers developed and evaluated a natural language processing pipeline for extracting outcome measures in rheumatology from free-text outpatient rheumatology notes within the ACR's Rheumatology Informatics System for Effectiveness (RISE) registry. All patients in RISE from 2015 to 2018 were included. The researchers found the pipeline to have good internal and external validity and they concluded that it could facilitate measurement of clinical and patient reported outcomes for use in both research and quality measurement.
AHRQ-funded; HS025638.
Citation: Humbert-Droz M, Izadi Z, Schmajuk G .
Development of a natural language processing system for extracting rheumatoid arthritis outcomes from clinical notes using the national rheumatology informatics system for effectiveness registry.
Arthritis Care Res 2023 Mar; 75(3):608-15. doi: 10.1002/acr.24869..
Keywords: Arthritis, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Ferucci ED, Day GM, Choromanski TL
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
This study’s objective was to evaluate outcomes and quality of care for rheumatoid arthritis (RA) in patients seen by video telemedicine compared to in-person only. Individuals in the Alaska Tribal Health System who were diagnosed with RA were recruited when seeing a rheumatologist either in person or by video telemedicine. Participants completed a Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire and a telephone medicine perception survey at the start of the survey. They also agreed to medical record review. The authors repeated the surveys by telephone and at 6 and 12 months, and medical record abstraction was performed at 12 months for quality measures. By the end of the 12-month period, about half of the 122 RA participants (52%) had ever used telemedicine for RA. Higher RAPID3 score and functional status were associated with the telemedicine group, with no statistically significant change over the 12-month period. The only quality measure that differed between the two groups at 12 months was the proportion of visits in which disease activity was documented, but it was not significantly after multivariate analysis.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Day GM, Choromanski TL .
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
Arthritis Care Res 2022 Mar;74(3):484-92. doi: 10.1002/acr.24485..
Keywords: Arthritis, Chronic Conditions, Telehealth, Health Information Technology (HIT), Quality of Care, Outcomes
Lange JK, DiSegna ST, Yang W
Using cluster analysis to identify patient factors linked to differential functional gains after total knee arthroplasty.
This study used cluster analysis to identify patient factors linked to different outcomes following total knee arthroplasty (TKA). The study analyzed Short Form 36 Physical Component Score (PCS) trajectories of 656 patients at 3 time points over a 1-year period. The MultiExperiment View (MeV) built-in bootstrapping method was used to assess statistical significance of the clusters. They found two distinct clusters: Cluster 1 included 550 patients (84%) who demonstrated persistent improvement at 6 and 12 months. The remainder of patients consisted of Cluster 2 who demonstrated decline in PCS at 6 months but improved by 12 months. Cluster 1 was found to have higher baseline mental health scores, lower baseline PCS, and a significantly higher proportion of non-Hispanic Whites compared to Cluster 2.
AHRQ-funded; HS018910.
Citation: Lange JK, DiSegna ST, Yang W .
Using cluster analysis to identify patient factors linked to differential functional gains after total knee arthroplasty.
J Arthroplasty 2020 Jan;35(1):121-26.e6. doi: 10.1016/j.arth.2019.08.039..
Keywords: Orthopedics, Surgery, Arthritis, Outcomes, Chronic Conditions
Kim SC, Jin Y, Lee YC
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
The purpose of this study was to determine the association of preoperative opioid use among patients 65 years and older with mortality and other complications at 30 days post-total knee replacement (TKR). Findings show that continuous opioid users had a higher risk of revision operations, vertebral fractures, and opioid overdose at 30 days post-TKR but not of in-hospital or 30-day mortality, compared with opioid-naive patients. Highlights include the need for better understanding of patient characteristics associated with chronic opioid use to optimize preoperative assessment of overall risk after TKR.
AHRQ-funded; HS018910.
Citation: Kim SC, Jin Y, Lee YC .
Association of preoperative opioid use with mortality and short-term safety outcomes after total knee replacement.
JAMA Netw Open 2019 Jul 3;2(7):e198061. doi: 10.1001/jamanetworkopen.2019.8061..
Keywords: Opioids, Medication, Surgery, Orthopedics, Elderly, Patient-Centered Outcomes Research, Mortality, Outcomes, Arthritis, Evidence-Based Practice
Gandek B, Roos EM, Franklin PD
A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness.
The purpose of this study was to evaluate reliability, validity and responsiveness of KOOS-12, a 12-item short form of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) that provides Pain, Function and Quality of Life (QOL) scale scores and a summary knee impact score. Results showed that KOOS-12 was a reliable and valid alternative to KOOS in total knee replacement patients with moderate to severe knee osteoarthritis and provided three domain-specific and summary knee impact scores with substantially reduced respondent burden.
AHRQ-funded; HS024632; HS018910.
Citation: Gandek B, Roos EM, Franklin PD .
A 12-item short form of the Knee injury and Osteoarthritis Outcome Score (KOOS-12): tests of reliability, validity and responsiveness.
Osteoarthritis Cartilage 2019 May;27(5):762-70. doi: 10.1016/j.joca.2019.01.011..
Keywords: Arthritis, Evidence-Based Practice, Injuries and Wounds, Outcomes, Pain, Patient-Centered Outcomes Research, Quality of Life
Norgeot B, Glicksberg BS, Trupin L
Assessment of a deep learning model based on electronic health record data to forecast clinical outcomes in patients with rheumatoid arthritis.
This study researched the use of artificial intelligence learning models to predict clinical outcomes in patients with rheumatoid arthritis (RA). Patients from a university hospital (UH) and a public safety-net hospital (SNH). The populations were quite different from each other. A total of 578 UH patients and 242 SNH patients were included in the study. Patients at the UH were seen more frequently than the SNH patients and were often prescribed high-class medications (63% vs. 28.9%). The model that was used showed a statistically random performance based on each patients’ most recent disease activity score.
AHRQ-funded; HS024412.
Citation: Norgeot B, Glicksberg BS, Trupin L .
Assessment of a deep learning model based on electronic health record data to forecast clinical outcomes in patients with rheumatoid arthritis.
JAMA Netw Open 2019 Mar;2(3):e190606. doi: 10.1001/jamanetworkopen.2019.0606..
Keywords: Arthritis, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes
Mehta B, Szymonifka J, Dey S
Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
The objective of this study was to assess the relationship of neighborhood immigrant proportion (IP) to preoperative and 2-year postoperative pain and function after elective total knee arthroplasty (TKA) using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patients in a high-volume institutional TKA registry were analyzed retrospectively, and demographics, pre-op and 2-year post-op WOMAC pain and function scores, and addresses obtained. Patient-level variables were linked to Census Bureau tract data. Researchers conclude that patients living in high IP neighborhoods do not have worse pre-op or 2-year post-op pain and function outcomes after TKA compared to those living in lower IP neighborhoods.
AHRQ-funded; HS016075.
Citation: Mehta B, Szymonifka J, Dey S .
Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.
BMC Musculoskelet Disord 2019 Feb 9;20(1):67. doi: 10.1186/s12891-019-2446-y..
Keywords: Arthritis, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Social Determinants of Health, Surgery
Goodman SM, Mandi LA, Mehta B
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
The authors assessed the interaction between education and poverty on 2-year Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function. They found that having no college was associated with worse pain and function at baseline and 2 years and that living in a poor neighborhood was associated with worse 2-year pain and function. There was a strong interaction between individual education and community poverty with WOMAC scores at 2 years. Patients without college living in poor communities had pain scores that were ~10 points worse than those with some college; in wealthy communities, college was associated with a 1-point difference in pain. Function was similar. The authors recommended further study on how education protects those in impoverished communities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandi LA, Mehta B .
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
Arthritis Care Res 2018 Jun;70(6):884-91. doi: 10.1002/acr.23442..
Keywords: Arthritis, Education, Low-Income, Orthopedics, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Bove AM, Smith KJ, Bise CG
Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial.
The study objective was to compare the cost-effectiveness of 4 different combinations of exercise, manual therapy, and booster sessions for individuals with knee osteoarthritis (OA). The authors found that spacing exercise-based physical therapy sessions over 12 months using periodic booster sessions was less costly and more effective over 2 years than strategies not containing booster sessions for individuals with knee OA.
AHRQ-funded; HS019642.
Citation: Bove AM, Smith KJ, Bise CG .
Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial.
Phys Ther 2018 Jan;98(1):16-27. doi: 10.1093/ptj/pzx104..
Keywords: Arthritis, Comparative Effectiveness, Healthcare Costs, Outcomes
Gandek B, Ware JE, Jr.
Validity and responsiveness of the knee injury and osteoarthritis outcome score: a comparative study among total knee replacement patients.
The researchers evaluated validity and responsiveness of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in relation to other patient-reported outcome measures before and after total knee replacement (TKR). They concluded that KOOS scales were valid and responsive in a cohort of 1,143 US TKR patients. KOOS QOL performed particularly well in capturing aggregate knee-specific outcomes.
AHRQ-funded; HS018910; HS024632.
Citation: Gandek B, Ware JE, Jr. .
Validity and responsiveness of the knee injury and osteoarthritis outcome score: a comparative study among total knee replacement patients.
Arthritis Care Res 2017 Jun;69(6):817-25. doi: 10.1002/acr.23193.
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Keywords: Arthritis, Surgery, Patient-Centered Outcomes Research, Outcomes, Injuries and Wounds
Herrinton LJ, Harrold L, Salman C
Population variations in rheumatoid arthritis treatment and outcomes, Northern California, 1998-2009.
This study assessed variations in rheumatoid arthritis treatment and outcomes at the community level from 1998 through 2009. It found that disease-modifying anti-rheumatic drug use increased in the typical patient from 38 to 63 percent of the time, and oral prednisone use declined from 23 to 15 percent of the time, whereas opioid use initially rose but then fell to 23 percent of the time.
AHRQ-funded; HS019912; HS010391; HS021590; HS018517; HS017919.
Citation: Herrinton LJ, Harrold L, Salman C .
Population variations in rheumatoid arthritis treatment and outcomes, Northern California, 1998-2009.
Perm J 2016 Winter;20(1):4-12. doi: 10.7812/tpp/15-028.
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Keywords: Arthritis, Medication, Comparative Effectiveness, Outcomes
Yazdany J, Robbins M, Schmajuk G
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
The researchers sought to develop and test electronic clinical quality measures for rheumatoid arthritis. Disease activity assessment, functional status assessment, disease-modifying antirheumatic durg use, and tuberculosis screening measures have achieved national endorsement and are recommended for use in federal quality reporting programs.
AHRQ-funded; HS024412.
Citation: Yazdany J, Robbins M, Schmajuk G .
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
Arthritis Care Res 2016 Nov;68(11):1579-90. doi: 10.1002/acr.22984.
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Keywords: Electronic Health Records (EHRs), Medication, Quality Measures, Arthritis, Outcomes
Suter LG, Barber CE, Herrin J
American College of Rheumatology white paper on performance outcome measures in rheumatology.
The objective of this study was to highlight the opportunities and challenges of developing and implementing performance outcome measures in rheumatology for accountability purposes. The authors' hypothetical outcome measure was a measure of rheumatoid arthritis disease activity intended for evaluating Accountable Care Organization performance. They provided a summary table of key take-home points for clinicians and policymakers. The authors concluded that the most effective and meaningful measures can only be created through the close collaboration of patients, providers, measure developers, and policymakers.
AHRQ-funded; HS024412.
Citation: Suter LG, Barber CE, Herrin J .
American College of Rheumatology white paper on performance outcome measures in rheumatology.
Arthritis Care Res 2016 Oct;68(10):1390-401. doi: 10.1002/acr.22936.
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Keywords: Quality of Care, Quality Measures, Outcomes, Arthritis
Wasserstein D, Huston LJ, Nwosu S
KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.
The researchers applied three different models of Knee injury and Osteoarthritis Outcome Score (KOOS) thresholds for significant knee pain to an anterior cruciate ligament reconstruction (ACLR) cohort to identify prevalence and risk factors. They concluded that significant knee pain is prevalent after ACLR; with those who undergo subsequent ipsilateral surgery at greatest risk.
AHRQ-funded; HS016075.
Citation: Wasserstein D, Huston LJ, Nwosu S .
KOOS pain as a marker for significant knee pain two and six years after primary ACL reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort study.
Osteoarthritis Cartilage 2015 Oct;23(10):1674-84. doi: 10.1016/j.joca.2015.05.025..
Keywords: Arthritis, Surgery, Pain, Chronic Conditions, Outcomes
Bannuru RR, McAlindon TE, Sullivan MC
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
The researchers evaluated the effects of alternative placebo types on pain outcomes in knee osteoarthritis. Their review concluded that all placebos are not equal, and some can trigger clinically relevant responses. Differential placebo effects can substantially alter estimates of the relative efficacies of active treatments.
AHRQ-funded; HS021396.
Citation: Bannuru RR, McAlindon TE, Sullivan MC .
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
Ann Intern Med 2015 Sep 1;163(5):365-72. doi: 10.7326/m15-0623..
Keywords: Comparative Effectiveness, Arthritis, Medication, Pain, Outcomes
Bannuru RR, McAlindon TE, Sullivan MC
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
The researchers evaluated the effects of alternative placebo types on pain outcomes in knee osteoarthritis. Their review concluded that all placebos are not equal, and some can trigger clinically relevant responses. Differential placebo effects can substantially alter estimates of the relative efficacies of active treatments.
AHRQ-funded; HS021396.
Citation: Bannuru RR, McAlindon TE, Sullivan MC .
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
Ann Intern Med 2015 Sep 1;163(5):365-72. doi: 10.7326/m15-0623..
Keywords: Comparative Effectiveness, Arthritis, Medication, Pain, Outcomes
Bannuru RR, Schmid CH, Kent DM
Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis.
To determine the relative efficacy of the primary knee osteoarthritis (OA) treatments, the researchers performed a comprehensive review of the literature, using a network meta-analysis design. Their comparison of seven different medications found that intra-articular (IA) treatments (IA corticosteroids, IA hyaluronic acid) were superior to non-steroidal anti-inflammatory drugs.
AHRQ-funded; HS021396; HS018574
Citation: Bannuru RR, Schmid CH, Kent DM .
Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis.
Ann Intern Med. 2015 Jan 6;162(1):46-54. doi: 10.7326/M14-1231..
Keywords: Comparative Effectiveness, Medication, Arthritis, Outcomes, Pain
Navarro-Millán I, Sattui SE, Curtis JR
Systematic review of tumor necrosis factor inhibitor discontinuation studies in rheumatoid arthritis.
The objective of this article is to conduct a systematic review of the available literature on discontinuation of anti-tumor necrosis factor (anti-TNF) agents in rheumatoid arthritis (RA) patients and the associated features of study designs, including eligibility criteria, outcome definitions, and outcomes of discontinuation. The authors concluded that discontinuation of anti-TNF therapy is achievable for many RA patients who start in clinical remission or low disease activity.
AHRQ-funded; HS018517
Citation: Navarro-Millán I, Sattui SE, Curtis JR .
Systematic review of tumor necrosis factor inhibitor discontinuation studies in rheumatoid arthritis.
Clin Ther. 2013 Nov;35(11):1850-61.e1. doi: 10.1016/j.clinthera.2013.09.015..
Keywords: Comparative Effectiveness, Outcomes, Arthritis, Medication, Chronic Conditions